Right Nurse, Right Place, Right NOW!

13
100

The Right Nurse Campaign is about protecting patient safety from budget cuts that undermine the proper nursing skill mix in healthcare settings. There is no doubt cutting Registered Nurse numbers poses a serious risk to patient well-being in our hospitals, Mr Holmes.

nswna nurse rally

The Glueing It together Report conducted by UTS and funded by NSW Health in 2007 states that:

Managing today’s clinical environments requires skilled nurse leaders who understand but can also manage this complexity to ensure a safe and work environment for staff and positive outcomes for patients.

Despite the findings in this report, NSW health has proposed the introduction of untrained nursing assistants or health care assistants. I am worried that the employment of these workers will not assist registered nurses but substitute us.

The Garling Report released this year stated that nurses were carrying out too many duties that did not require the expertise and skills of a registered nurse. Although this would suggest that more assistance is needed, this does not mean that we should relinquish nursing duties and cares.

Assistants In Nursing are valuable to our nursing teams but cannot and should not replace the jobs of trained and educated registered and enrolled nurses. Yesterday the Health Minister for NSW, John Della-Bosca, addressed the NSW Nurses’ Association’s Annual Conference. He claimed that he had heard of no plan to replace registered nurses with these new health care workers.

Unfortunately, as an association and as a professional body we cannot blindly believe this statement. My skepticism is based on information provided by members of the NSWNA who claimed that the NSW Department of Health already planed to replace 200 registered nurses.

On Thursday, hundreds of nurses who are members of the NSWNA took to the streets of Sydney in their lunch break to rally against the introduction of these health care assistance chanting “right nurse, right place, right time.” I attended this rally as I believe we need to protect our skill mix for the safety of a our patients and the nursing profession.

What do you think?

Note: Photo above is from a NSWNA rally in April 2009. Photos from the ‘Righ Nurse Campaign’ rally will be uploaded in our image gallery soon!

13 COMMENTS

  1. ASSISTANT IN NURSING I am an ASSISTANT IN NURSING working in a HIGH CARE facility.I am also a DELEGATE for NSWNA for our branch.I was involved in the RALLY and PROUD to be there.Assistants in NURSING are a VALUABLE part of the TEAM .The TEAM being made up of R.N ,EEN and A.I.N.
    Let us all remember that we do WANT THE RIGHT NURSE DOING THE RIGHT JOB RIGHT NOW!!!!!!!!!!Let us all continue to SUPPORT EACH OTHER remember STRONGER TOGETHER BECAUSE WE CARE !!!!!!

  2. AINs as part of the nurses team I went to the Delegates conference and firmly believe like all other delegates and registered nurses , that AINs have a place as part of a nursing team as an extra nurse not in replacement of an EEN, EN or RN.In the acute facility I personally have witnessed when patients are admitted to hospital from a nursing home or from home where the patient has usually a history of CCF (congestive heart failure) and the condition has been exacerbated because the AIN/Carer at the facility or at community level, doesn’t recognise the early symptoms or signs that could prevent a hospital admission if the client’s doctor had been alerted to the early signs. AIN’s are not educated to understand the medications they are giving their clients out of the Webster packs and if the patient is on Digoxin and the heart rate is as low as 45 that the dose should be witheld and the registered nurse or the doctor notified, half of AINs could not tell you what a Digoxin/lanoxin looks like in most cases. Their employers are placing these health workers at risk because they are not employing enough RN’s do do the work they are educated to do, all becuse of supposedly saving a few dollars. My colleagues at work were absolutely flabbergasted to find out what the State government is doing to the public health system in relation to introduction of AINS to replace RNs. The question I was asked are RNs in the private sectors in danger as well?

    • What really upsets me is the slackness of some of these nursing homes. RNs are employed, some really good ones, and management (following the instructions of directors) sets to work bullying these RNs and systematically deskilling them. I have had an RN lean over to me, whilst orientating into a new facility, telling me that they dont send anyone to hospital from here unless there is an obvious broken limb. I made sure I didnt do as she said. Whilst busily deskilling RNs they are upskilling EENs. These EENs, some good. get a false impression of themselves and their responsibilities to the point where they will dominate new RNs and tell them what the score is, as opposed to following nursing council guidelines for their scope of practice. Those of us RNs who keep working in acute care and aged care have the experience of seeing our colleagues come in on a visiting basis to give a blood transfusion, and intravenous antibiotice whilst management continues the game of deskilling. I was interested to see the behavious of buddies and aged care RN and her EEN deal with a teal blue coloured pill found beside a resident;s bed. The aged care RN (worked in aged care only) asked the EEN if she though the pill was one of those warfarin type pills. Between them they decided it was and straightway asked the resident to swallow it. We have a collection of good RNs and EENs, and rogues. The rogues will take extended morning tea breaks, flatly refuse to assist with ACFI assessments, refuse to do dressings, are insulted if an RN is required to sign their progress note entries, withold information about the existence of new pressure sores to the detriment of the resident. Will follow a directive if it suits them, and are handled with kidgloves by management who lets them go with a soft reprimand, and God help the person who exposed them because the manager will not support them. All gloom and doom. But, these are common in the aged care sector. Accreditation spot checks are definitely needed.

  3. Assistants in nursing As a RN who works in disabilities (where RNs have been replaced by AiNs), I want to warn my colleges in the general hospital setting about allowing the numbers of AiNs employed to expand un checked.
    This should best be achieved by utilising every avenue legally available.
    The continued reduction of RN positions in DADHC facilities has allowed a dangerous and tenuos position to emerge for people with disabilities with complex health care needs. Current swine flu pandemic has put further strain on these already over burdened services that now further threaten the health and wellfare of these very vulnrable poeple. Liasion with NSWNA branches who represent nurses working in disabilities is welcome. We can share our insights and experiences on how this deplorable state of affairs came about, which may assist in preventing this on going attack on the provision of quality nursing services in NSW.

  4. Assistant In Nursing numbers We read about the 200 AiNs that Mr Della Bosca wants to put into the Health system statewide. Everyone is up in arms at that number , “Stop Right Now”,I was at the demonstration. I work in what is now called a “Large Residential Centre” the “Hospital ” title has been removed. Up until the last couple of years it was staffed by approximately 80% RN & 20% ENs, there were around 450 nurses. Aproximately 6 years ago Mr Della Boscas name was linked with the idea of shoring up the deficit in the General Hospital system by getting the RNs to leave disabilities and go to that system. The idea was sidelined with the proviso of an Memorandum of understanding that we would allow AiNs to work there.
    Now in 2009 it is common for a shift with 5 nurses to be made up of 1 RN with 4 AiNs. 200 state wide seems drastic, we have somewhere around 150 AiNs on one site. Beware Public Health System Nurses and Midwives it will happen to you. The quality of your service delivery is in jeopardy now.Ours has become a dog’s breakfast of skills mix.
    I am the first to agree that there are many excellent and committed AiNs. However the financial bonanza to health budgets of low rates of pay fuels the urge to employ ever increasing numbers of AiNs. The short order 6 week course means people can be taken off long term unemployment numbers and suddenly become a “nurse”.
    The influx of high numbers of unlicensed, inexperienced staff and the fear of being held responsible for this inexperience is one of the reasons some RNs have given as they run out of the gate. We no longer have enough RNs to cover all shifts. We do have some very frail vulnerable people with complex health care needs.
    For more information pleas feel free to contact the Stockton Hospital Branch of the NSWNA. They have’nt been able to take the ‘Hospital” out of our branch!!

  5. Response to RIght Nurse, Right Place, Right Now Good Morning All,
    After many years as a “Nurse” (since 1992 an RN with a Bachelor of Nursing and since 1975 a Hospital trained Enrolled Nurse) how wonderful it is to finally witness this great Quality Improvement opportunity for all levels of Nurses, their higly valued colleagues and members of the Community to comment without fear of ridicule or retribution. My background is varied and in fact hail from the remote sector of South Aust just over 2 years ago. May I say that NSW is quite a beautiful place indeed and that the journey to this point has been more than interesting to say the least.

    As indicated, my background is varied and I prefer “community” Nursing in the forms of Communit, Policy and Business Development and Research. For many years people could not understand how a “Nurse”could do these things:- that I wasn’t wearing a white uniform and carrying a bed pan….. Ahh the perceptions. In whatever setting I was/am in, the Nursing Process was/is always used to assist “communityand business” to the trajectory of “wellness” . How many times has one heard the term a “healthy business”? In fact I refer to myself as a Registered Nurse Entrepreneur and may I take this opportunity to humbly say that at one time had a model of Best Practice in community development used by the Dept. of Veterans’ Affairs as Benchmark Indicators for grant applications in community development.

    What has this to do with RIght Nurse, Right Place, Right Now??? Well, currently I am priviledged to be working on a contract basis with a marvellous and highly innovative Nursing organisation who for quite some time has identified the skill gaps that are espoused here and in the Garling Report. Through researching these recent and not so recent documents coupled with my journey of working as a Manager in a Registered Training Organisation (RTO) dealing with the Aged Care sector, I believe we have found a “key” to help unlock the mysteries that perpetuate misunderstandings surrounding the delivery of quality “Nursing” and “Care” in all sectors of the Health System. I personally beleive we have been able to clearly articulate some of the missing links, one is as follows:-

    With respect, Aged Care Workers / AIN’s are not Nurses. It is recognised that they carry out care duties which relate to the practice of Nursing. Upon graduation these students become unlicensed workers without any mechanisms of accountability to an auspicing Registration Board that qualified Nurses have in the form of the NSW Nurses & Midwives Board.

    A major role of this board is to establish and maintain standards of Nursing Practice as criteria for Nursing care and skills. Hence the standards of Carer’s are reliant on the standards of the RTO providing the training, not the Nursing Professions’ Governance Board/s sanctioned by legislative Acts of Parliament.

    Training and education are b

  6. Where will it stop?!? It seems that in my experience there has been and continues to be a gradual errosion of the responsibilities of the diminishing number of nurses that remain at the bedside to provide first line care.

    I wonder if my personal prediction of the Govt introducing a “weekend course” to become an “Assistant, Assistant in Nursing” will become a reality any time soon? Maybe the Govt will start to put the patient’s relatives through a course like this so they can be paid peanuts to provide the care that they obviously want to stop paying us to provide.

    Will it become a reality?
    Rich

  7. Right Nurse I think that all Nurse do a great job. I was in bospital about a month ago. All the nurses there were great an they couldnt do enough me.
    I also have a mother who is a nurse and also is a delegate for the NSWNA.She does a wonderful job and i knoww she had a great tme last week.
    But i agreee with eeverything she and everyone else says

    RIGHT NURSE RIGHT PLACE RIGHT NOW

  8. right nurse right job right now Let us all continue to lobby Mr Della Bosca.Staff eg Assistant s in Nursing are as concerned about the issues surrounding the Public System because if these things occur in NSW HEALTH then we in the AGED CARE SECTOR should be very afraid.Let us continue to support each other and respect each others role.

  9. Absolutely illawarrior! we must not let them get away with this! we, as nurses, must define the roles we all can undertake as we want to do what is best for the patients, not the budget!

  10. AIN’s are not the Issue A while back Nursing moved into the Universities, we wanted Nursing to be seen as a PROFESSION. But listening to the Minister for Health (Della Bosca) he referred to our PROFESSION as a VOCATION. My problem with that is, Nurses have been around for some time as have Doctors. No way does a doctor refer to his PROFESSION as a VOCATION!!
    The issue with the AIN’s, whether we like it or not they are here, reading other blogs, listening to people talk, saying things like “we must not allow it”, no one asked us in the beginning (or did I miss the part where we were asked??) Our greatest problem is not bureaucracy, but middle management in our employment areas. The Department of Health give us a budget, we must work within it (we are in a financial crisis out of our hands/control), middle management decides who is employed and where. I find it funny that in many institutions the only thing that qualifies Nurses going into management roles and positions is longevity at that institution, not a Management in Health Administration or any kind of Management qualification. That is where most of the mistakes are created, while they are told to cost cut it is not always done in the safest way. What do staff levels have to do with Della Bosca?? nothing but the ADON who does not put the staff on and sends people home because they are saving money are putting ALL of US at RISK!!!
    It is not the fault of any AIN EN or RN our roles need to be distinguished, and it is not always up to the Della Bosca’s of the world to do so. People who put their registration on the line and do things beyond their legal duties
    need to wake up and realise that is dangerous practice.
    Are there Assistants in Doctor?NO their profession has clearly distinguished itself, they care about their job and what they do, and when they are not happy about things they mount a factual argument not an emotional one. The whole right nurse right job etc… has everything to do with nurses at a local level not government level. We must specify which nurse does which job and how. We must take control of these issues, not expect someone else to do it for us! Forget the old “Oh your a Nurse you must be a special person!!” thing, if you do not pay you electricity bill on time they never say “Oh don’t worry your a special person your a nurse this one’s on us!!” Forget the emotional argument and give FACTS, Financially we went into University, our wages don’t reflect this. I am an ED Specialist and do a lot of what the medical staff do, well they don’t do it WE the Nurses do it for $30 +/- few $$ and they get $ 150/hr + Do we care so much that we undervalue ourselves, on call we are paid $20 not per hour but the entire day if not called in. The Doctors get hundreds of $$ per hour and they may not even get called in. I find this disturbing.
    There may be a spillage on the floor, it is not the cleaners job to clean, they have a degree in ‘MOP’ and therfore we

  11. Right Nurse Right job Right Now As an ASSSISTANT IN NURSING and the Delegate for our Branch of the NSWNA I returned to work today knowing that there would lots of questions about this issue.I explained to those who were interested what the issues are mainly that NSW Health wants to replace R.Ns with A.I.NS.
    As A.I.N s who work in the AGED CARE sector we are very concerned about this issue and will be watching closely .Again we all have a role to play and wish to work within our scope of practice.Remember STRONGER TOGETHER because we care.

  12. Well said Susan! Doctors have tradition and power behind them. They own the health system – just look at medicare. all other health workers have to fight to get a piece of that and who gets it first? Not nurses! The only way a nurse can earn money more is by going into management. Excellent clinical practice and years of teriary education – often as much as a doctor – goes unrecognised and monetarily unrewarded. Nurse must raise their profile and display their qualifications. That’s why I put all those letters after my name in my first blog – it’s almost as if we’re afraid to say “look at all the letters I have”! But that’s what impresses the world as dumb as that may seem. You never see a doctor without their letters and affliations. Nurses committment to caring is taken advantage of by government and the community. It as ever remains a gender-based debate the de-valuing of caring work which has always been perceived to be a “woman’s role” and therefore “natural”. AND I’m not talking male-female – I’m talking in the purist sense of perceived gender roles no matter who does them. Men and women nurses are disenfranchised because they choose a career that is perceived as either madonna or whore you only have to google nurse to see that! So lets get professional and factual and not emotional because that’s such a gender-based notion as well!

LEAVE A REPLY

Please enter your comment!
Please enter your name here