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Tasmanian health care hit by cuts

Snap poll of 300 public sector nurses paints a picture of declining standards of care and poor staff morale. By Linda Belardi.

Ninety per cent of Tasmanian public sector nurses believe that patient care is being compromised due to the state’s health budget cuts, according to a union survey.

Australian Nursing Federation (Tasmanian branch) secretary Neroli Ellis said one third of nurses had raised examples of serious or adverse incidents, including patients being sent home too early, cancelled surgeries and several suicide attempts that could have been prevented had clients had access to a mental health case manager.

Nurses reported that mental health patients were now presenting to hospital emergency departments because of the reduced case management in the community.

Ellis told Nursing Review she was gravely concerned by the results and had sought an urgent meeting with the Minster for Health, Michelle O’Byrne. Nurses said these incidents were directly attributable to the budget cuts.

Other incidents included patients being sent to wards due to no access to intensive care beds, constant readmissions of patients and an inability of staff to “recognise a deteriorating patient due to casualisation and skill mix issues”. One nurse described a situation where a patient who had suffered a heart attack was left on a trolley for three days due to an unavailability of beds.

Examples of self-discharge and medication errors were also identified.

Service delays, bed closures and reduced staffing numbers were cited as reasons for the increased risks to patient safety.

The snap poll was completed by more than 300 public sector nurses over three days from all clinical specialities and resulted in 219 pages of written comments, said Ellis.

Three-quarters of surveyed nurses said patients were not being admitted into hospital due to a lack of beds and over 50 per cent of nurses had witnessed a weekly “ramping” of an ambulance since the budget cuts were introduced last year.

Ellis said nursing staff were now doing the jobs usually done by cleaners or assistants in nursing because these roles were not being filled after hours. One nurse said: “There is the expectation that we are able to do more treatments with less staffing and resources – impossible and unsafe.”

Ellis said all clinical specialty areas were reporting direct effects on patient care. “Nurses from emergency departments, theatres, mental health and education have outlined the crisis in the lack of access to beds, due to the closure of over 100 acute inpatient beds in Tasmania.”

She said elective surgeries were being cancelled on a daily basis and diagnostic endoscopies were not being performed in reasonable timeframes.

Ellis also said some patients were resorting to selling their homes to access the private health system.

The survey, which is aimed to put pressure on the government ahead of the May 17 state budget, also painted a grim picture of a broadly disillusioned and overworked workforce, reporting poor morale and high stress. “It is frightening to see over 45 per cent of nurses have indicated that they have considered leaving Tasmania as a result of the budget cuts,” said Ellis.

The survey found 95 per cent of nurses felt that previous budget cuts have had an effect on staff morale and about 60 per cent did not feel secure in their employment with the Department of Health and Human Services.

Michelle O’Byrne said that while she recognised the measures put in place were having an impact, she said if left unchecked health costs could eventually bankrupt the state. “I have made my decisions fully aware of the clinical, community and political consequences.”

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