Neil Richardson

6/15/2017 Two hands and a heartbeat – Creating, Kippers Creating, Kippers  UNI Two hands and a heartbeat She had only left the room for five minutes but when she returned something had changed. The partner had a desperate look of panic on his face and the labouring woman no longer smiled. She listened to the fetal heartbeat to ensure that it was coping with the sudden change in the nature of the contractions. That is when she noted that it was slower. It was beating at about 80-90 beats per minute instead of the 120-140 that was the norm. She kept listening, intent, blocking out the questions and groans around her, trying desperately to decipher the pattern — a fast beat, then a contraction and the heart rate slowed, then fast after the contraction then another and slow. She told the labouring woman to push with all the energy she could muster without betraying the fear in her voice. The partner took a step back and stared, horrified and hopeless, at what was happening in front of him. She knew on her car journey to work that night that it would be busy. It was a full moon, and every experienced midwife knows that means busloads of labouring women. So she wasn’t disappointed to find every birth suite full and her first two cases handed to her before she even took off her coat. The baby had become tangled up in its umbilical cord; it was looped around its neck twice and once around its body. She carefully unravelled the baby from its cord and detached it from its mother — not as ceremonially as she would have liked — without even a hint of panic, but the child was pale and limp and needed resuscitation. It was yet to take its first breath. She quickly placed it on the resuscitation trolley she had set up earlier, and with a little stimulation and some oxygen it soon became pink and gave a heart-wrenching cry. The room relaxed, and there were sighs of relief and smiles. She left the room and went next door to her other labouring woman. It would be a long night. June Smith* is a midwife at John Hunter Hospital in Newcastle, NSW with over 17 years experience. She is one of a growing number of discontented nurses that are threatening to resign if the Hunter New England Area Health Service (HNEAHS) brings in its proposed responsive rostering system. Currently, the hospital’s rostering system is completed per request. The nurses can request particular shifts or roster patterns before the roster is drawn up. The result is greater job satisfaction as the nurses get the shifts that best suit them. https://awkcmedia.wordpress.com/2017/06/13/two-hands-and-a-heartbeat/ 1/4 6/15/2017 Two hands and a heartbeat – Creating, Kippers For the past 18 months speculation has been rife in the nursing industry about the implementation of responsive rostering and in October a report set up by the Health Service with the assistance of NSW Nurses’ Association will announce its findings. The reason HNEAHS wishes to proceed with the responsive system is that they believe the process does not formally match shift allocations to patients needs. Responsive rostering makes the patient’s care its primary focus and reduces the day and a half it takes a Nurse Unit Manager to complete the request roster. A responsive roster provides the right number of staff of each skill level to provide quality care for the patient. “I will miss these experiences,” Jane says “if I have to leave this job due to inflexible working hours. But more importantly, the women will miss my experience and my confidence in handling situations such as these.” A recent NSW Nurses Association (NSWNA) survey on responsive rostering saw 85 percent of the posted forms returned with 75 per cent of nurses saying they would leave the profession if the new rostering system were implemented. It also confirmed that 92 percent of the nursing profession are females and many are the primary carers for their children. “It is a rostering system that is based on what works best in a male dominated workforce . . . the mining industry . . . and I know this is a generalisation but the female population also have to work, cook dinner, run the kids around and get them ready for school . . . so it just doesn’t work in a female dominated industry, which is what nursing is,” Jane says. A recent meeting at West Leagues Club in Newcastle saw over 600 nurses turn up to fight their case. General secretary of the NSWNA Brett Holmes speaking on the union website about the meeting says, “a failure by the Hunter New England Area Health Service to acknowledge and take into account this concern would be both foolish and arrogant in the extreme.” The project sponsor and Director of Clinical Operations for Hunter New England Health Tracey McCosker recently wrote in the Newcastle Herald that “patient care is our highest priority. This new roster is a strategy to help us achieve that. We know there are concerns about this new rostering method and we totally understand this. Change can be distressing.” Recently several departments trialled the responsive roster system. Felicity Rush* is a Registered Nurse (RN) with two years experience who currently works in postnatal care. She says, “I don’t have any sort of pattern. If my mum and dad come up from Victoria and I can’t get someone to swap my shift with, then it’s tough. I have to work it. That’s when I use sick leave. Sick leave will increase with this roster.” She says that when the trial occurred stress levels rose as people frantically scrambled to swap shifts. “Moral is crap. Every time you sit down someone is trying to swap shifts with you. We were happy with what we had,” Felicity says. Acting Director of Clinical Operations Michael DiRienzo in a letter to the NSWNA in 2008 says, “the current rosters on many units and wards are not fair and equitable leaving some staff frustrated . . . it can be difficult for staff to arrange swaps and there can be a level of uncertainty and a lack of consistency in rosters. There have also been concerns . . . of preferential treatment or ‘roster bullying’.” https://awkcmedia.wordpress.com/2017/06/13/two-hands-and-a-heartbeat/ 2/4 6/15/2017 Two hands and a heartbeat – Creating, Kippers With 75 percent stating that they would resign if the roster were implemented, years of experience have already been lost as staff walk away from the job they love. Ashlee Cameron is an RN with several years experience in Neo-Natal Intensive Care where she looked after premature babies. “I preferred to work night shifts which aligned me closely with my husbands work hours. Responsive rostering would remove this opportunity, treating me as a number and not a person. “The idea of leaving a speciality area I adored was stressful . . . ultimately the idea of pursuing a career away from the constraints of responsive rostering won through, and I resigned. I now work in private practice where I have the flexibility to choose the shift I want,” Ashlee says. A report set up by both the HNEAHS and NSWNA concluded that experience of previous significant changes that were introduced by HNEAHS did not see the resignations that were claimed to occur eventuate. “I couldn’t have left,” Felicity says, “I love my job. I told them that.” Holmes states on the NSWNA website that while nurses and midwives support the ideals of better workload and skill-mix management they do not believe the proposed system will help. “Having a rigid pattern, which does not adequately take into account people’s family, study and other legitimate commitments will force many out of a career that is run in such an onerous way. That is the last thing we need at the moment as we struggle to overcome nurse shortages,” he says. Kristie Ballico is an RN with three years experience. She believes that management does not want the new system but are too afraid to speak out. “They can’t say anything; they have all these nurses that are unhappy, that want to leave. All those years of experience, of care, lost. What can they say?” Jane believes there is a big “don’t care” attitude from management because they can find someone else with “two hands and a heartbeat” to fill the roles. The magazine for the NSW Nurses Association, The Lamp, believes the rostering process should change to better balance the needs of patients, nurses and ward operations. It believes that HNEAHS and NSWNA need to work closer together to implement a more flexible rostering system. Mandy an ex-RN with over 20 years experience is sympathetic to the cause of her ex-colleagues. When she was nursing in the late 1970s all nurses worked full time and did whatever shift they were told to do. Then management changed it to a week of nights and a week of days. Being a newlywed she left the service, as she never saw her husband Laurie. It was only when her ex-supervisor walked into the jeans shop that she was running and asked her what she was doing did she return after being told that things had changed. “If I were working now, at my position in life, I would leave,” she says. “It’s poor money and lots of responsibility as it is. Why, then, should the nurses be burdened with this roster?” “I wonder how responsive rostering might achieve a better skill mix when it potentially may create a bigger nurse shortage through its implementation alone?” As Jane ponders her future as a midwife who has personally delivered over 1000 babies, she believes this could almost be a crisis for the nursing service and future parents too. https://awkcmedia.wordpress.com/2017/06/13/two-hands-and-a-heartbeat/ 3/4 6/15/2017 Two hands and a heartbeat – Creating, Kippers “We are losing so much working knowledge it’s scary,” she says. *Name has been changed by request AWKCMEDIA  Blog at WordPress.com. https://awkcmedia.wordpress.com/2017/06/13/two-hands-and-a-heartbeat/ 4/4