The World Socialist Web Site asked three nurses to comment on the exodus of nurses from Australian hospitals. Jean is an enrolled nurse who left the public hospital system 15 months ago, after nursing for 20 years. Vivian, also an enrolled nurse, recently quit after working in the system for five years. Sophie, who has been nursing for seven years, is currently working in a psychiatric hospital and studying at university to become a registered nurse.
WSWS began by asking the three nurses why they thought their colleagues were leaving the hospitals.
Jean: The main reasons are shift work and staff shortages. There are also not enough registered senior nurses to help and assist junior nurses. This sometimes leads to junior nurses being thrown onto the wards and left to their own devices. The increased workloads give rise to other problems, which mainly relate to patient care. Modern hospital systems have shifted the focus of care onto the management of illnesses, diseases and injuries, instead of nursing patients in a holistic way.
You are only able to carry out basic nursing care. You don’t have time to sit with patients, to discuss their diagnoses or any concerns they may have. In the case of a dying patient, you don’t have time to sit with them and hold their hand and just be there for them, because you have so much of a workload to complete before you finish your shift.
Vivian: My reasons for leaving were numerous. It got to the point where I was working outside my job description, and playing a leadership role. The ward was short-staffed and there were more enrolled nurses than registered nurses. There were more part-time staff than full-time and no backup for new junior staff.
Patients were not being looked after, because of the time factor. You didn’t have time to be with the patient. Hospitals are run down because there is no money. There is no staff, and no money to bring staff in. New nurses are leaving because they’ve seen better horizons: getting more money overseas or doing agency work.
Sophie: I would never go and work in a general hospital as a registered nurse because you have too much responsibility. And you don’t have time to nurse the patient in a holistic way, to provide the care they need. That makes nursing unattractive, because you don’t have time to care for patients properly.
Nurses are leaving because of the way managers deal with the problems. Instead of management targeting what the problems are and having an in-service and further education, they just target a few people and blame them. This in turn travels around the hospital and damages their reputation and credibility.
WSWS asked how these conditions had impacted on nurses.
Jean: You used to have six or seven staff on a morning shift in a 30-bed ward. That changed to a maximum of four, which could be one registered nurse to three enrolled nurses, or two registered nurses to two enrolled nurses. Sometimes the registered nurses might be junior nurses, with little knowledge of how the ward was run and this could create further difficulties.
The hospital where I worked for 13 years had permanent night staff. Gradually, over a number of years, the night staff started to leave or resign, and their positions were not filled. This meant that morning and afternoon staff had to cover the night shift, and you would end up working morning, afternoon and night shift, all in one week. This would happen week after week, and it became unbearable. This in turn created problems in staffing levels. So, overall there were less staff. This really took its toll on me.
Vivian: Basically, nurses are being told by the administration to cope with what they have. There is only so much you can cope with before you reach breaking point. If all the nurses go in the hospital, what happens to the hospital? I think nurses are looking for jobs that are less stressful, less physical and not so harsh on their bodies. I’m only 28 years old and I’ve had three injuries to my back.
Sophie: As a student, I am petrified of getting into nursing in the general hospitals, because there isn’t enough support around, or people are too busy to approach. They are too busy because there are not enough nurses. Also there is far too much paper work, which is taking time away from patients.
We asked about the NSW Nurses Federation’s campaign for better pay and conditions.
Jean: Basically any industrial campaign by the union has been just a lot of hot air. At the end of the day, they might say they are generally fighting for better pay, etc., but they don’t fight to change the existing conditions. You are basically being told to work within the existing structure and cope the best way you can.
I think nurses have lost faith in the unions. I don’t think it makes a difference whether you have a Labor or Liberal government when it comes down to handing down the budget. I’ve been nursing for a long time when both parties have been in power, and health and education have always come under attack. They have less and less funds directed towards them.
Vivian: If nurses went on strike for better pay, everyone would agree that nurses don’t get paid enough, but I don’t think that more money would correct the problem. I don’t think the union has helped us as nurses to look at how we can better everything, or what suggestions we can put to the government. Nurses could get paid more money, but you would still have the increased patient load and all the stress that goes with it.
I don’t believe you can put a price on health. I think, blow the budget and save as many lives as you can. Health should be seen as a necessity, like education.
Sophie: Well, the union had the “what’s a nurse worth?” campaign last year, and there hasn’t been anything develop from that. They were pushing for more money, which is OK, but I don’t think that will keep nurses at work. It won’t relieve the stress or overload of work.