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Nurses get advice on patient ratios

Australian union won battle over staffing policy IAN FAIRCLOUGH Staff Reporter Published February 4, 2014 - 7:40pm  

With contract talks for 2,600 nurses in the Capital district health authority breaking down last week, their union has brought in someone with experience in one of the key issues in dispute.

The three main issues causing the impasse are mandated nurse-to-patient ratios, schedules and the length of the contract, according to Local 97 of the Nova Scotia Government & General Employees Union.

This week, the union is hosting a member of the organization that represents nurses and midwives in New South Wales, Australia, that successfully fought for nurse-to-patient ratios in 2010.

Judith Kiejda, assistant general secretary of the NSW Nurses and Midwives’ Association, is talking to union members about the ratios and what has happened since they were implemented.

There are only three jurisdictions with nurse-to-patient ratios — California, New South Wales and another Australian state, Victoria — Kiejda said in an interview Tuesday.

“For our members, the workload was the top issue because they wanted to know when they got on shift that the roster was going to have the right number of people with the right qualifications to deliver the care that was required of that unit.”

She said budget pressures over the years had put unit managers in the position of not calling in people to fill a shift when someone was sick. That continued until members successfully campaigned and negotiated for the ratios with a campaign similar to what the Nova Scotia union is doing with ads and social media.

“It’s the one campaign that has galvanized our numbers,” Kiejda said. “There is no nurse out there that has not experienced what it’s like to not have the resources to do the job they want to do.”

She said the overtime nurses are being asked to work affects their family lives because of the time away from home and exhaustion, and professionally it prevents them from being able to spend enough time with patients to notice subtle improvements or deterioration in their condition.

Kiejda said the ratios meant hiring the equivalent of 1,700 full-time nurses in New South Wales, and while she has no information yet to quantify the cost savings in overtime and sick leave, “I don’t believe in the long term it’s an expense that can be avoided.”

The Local 97 nurses’ contract expired in October 2012. Last Wednesday, the union broke off talks because it said Capital Health wasn’t moving on the three key areas.

A conciliator has been appointed to help with contract talks, but no date for conciliation has been set.

A mail-in strike vote is underway and closes Feb. 21. The votes will be counted Feb. 24, but nothing will happen until after conciliation ends and the conciliator’s report is filed. Two weeks after that, the union would be in a legal strike position.

Union president Joan Jessome said she has no doubt the strike vote will come in overwhelmingly in favour. She said health authority costs for overtime and sick time could be reduced with proper ratios.

The health authority has said there is little desire to negotiate on the ratios issue. Kathy MacNeil, its vice-president responsible for people services, said last week that it “doesn’t address the fact that we work in a multi-disciplinary environment, that patient needs change over time (and) we weren’t convinced that we saw the evidence where these ratios were coming from.”

She said concerns about patient care and staff workload could be dealt with by changes to scheduling and care teams.

Most of Local 97’s members work at the Queen Elizabeth II Health Sciences Centre in Halifax. Nurses at the Dartmouth General Hospital, the Cobequid Community Health Centre in Lower Sackville and the IWK Health Centre in Halifax are represented by a different union.