After a recent stay at Wollongong Hospital’s maternity unit, Greens Councillor Cath Blakey knows all too well the pressures placed on staff.
That’s why she’s added her support to a NSW Nurses and Midwives Association (NSWNMA) campaign to highlight “dangerous” staff shortages within the state’s maternity wards.
Staff from 10 NSW public hospitals – including Wollongong – have backed an open letter to Health Minister Brad Hazzard, urging the NSW Government to implement mandated staff-to-patient ratios in maternity services in all hospitals.
They claim that the current staffing system allows ongoing unfilled vacancies, which places mothers and their babies at risk and puts additional strain on staff and hospital resources.
For Ms Blakey – who brought her one-month-old daughter Jedda to her first rally outside the hospital on Wednesday – the evidence was plain to see.
“Adequate ratios are essential for patient care and for decent working conditions for staff,” she said.
“I had complications with pre-eclampsia so had to spend two weeks in the maternity ward prior to the birth. I had my baby by emergency ceasarean and when we were moved back to the ward, we were counted as one patient even though I’d had major abdominal surgery.
“It’s a sneaky way to understaff hospitals – by not counting babies as patients. And while the care I received from the nurses and midwives at Wollongong was fantastic, they were restrained by lack of staff.”
The union is asking for ratios of at least one midwife to three mothers in postnatal wards, and claim that to date the NSW Government has refused to commit to a more transparent ratios system.
NSWNMA Wollongong branch president Sarah Morton said Wednesday was a case in point.
“This afternoon there’s one midwife and one nurse to look after around 11 babies and their mothers,” she said. “The women that stay on the ward have either just given birth, are not well or are needing breastfeeding assistance, and they need a lot of support and advice.
“Staff are demoralised because they’re not able to give the care they want – we’re doing our best but we need the state government to legislate for ratios so these vital positions can be funded.
“Staffing at Wollongong’s maternity unit has been an issue for some years – it got better for a short period but now we’re back at having around 18 full-time-equivalent staff vacancies.”
Miss Morton said as a result, breastfeeding rates on discharge dropped seven per cent at the hospital in the last year. Meantime many women who’d had caesareans had been denied adequate skin-to-skin contact and breastfeeding in recovery as there wasn’t the staff to supervise.
Ms Blakey said additional staff would enable the expansion of the hospital’s midwifery group practice program, which is currently only available to around eight per cent of pregnant women.
“It’s great we have seen investments in infrastructure in our hospitals, but unless we staff them properly we won’t see improvements.”
Recruitment is ongoing: health district
The Illawarra Shoalhaven Local Health District is working hard to replace the vacancies within Wollongong Hospital’s midwifery service according to Executive Director Nursing and Midwifery Deborah Cameron.
“We value our nurses and midwives and acknowledge the vital and challenging work nurses and midwives do to support our community,” she said. “The skill, professionalism and extraordinary effort shown to patients each and every day is recognised and appreciated.”
Ms Cameron said there were more midwives than ever working across the district with 171 part-time and full-time midwives as at June 30, 2018.
However, she said, as at 12 December 2018 there were around 13 full-time equivalent vacancies within Wollongong Hospital’s midwifery service.
“Whilst active recruitment to these positions is ongoing, the service is using casual and agency midwives and overtime. Staff and patient safety is of paramount importance to us.”
Ms Cameron said NSW Health determined the staffing requirements in maternity services based on the needs of women for midwifery care throughout pregnancy, labour and the postnatal period.
“Our workforce planning model reflects changes in the number and type of births, evolving models of care and the impacts of changing clinical policy,” she said. “This means that, rather than just birth numbers, other important factors that affect staffing are also considered.
“It also accounts for the postnatal care of the mother-baby unit including babies with higher than average needs who stay with their mother in the maternity ward.
“It provides the minimum staffing required and additional staff are added when needed to manage unexpected activity and acuity. This means mothers and babies who need a higher level of postnatal care are able to have the care when they need it.”