Volunteers move to more hands-on roles

Hospitals and healthcare services are becoming more appreciative of the work done by unpaid workers and find it is rewarding for all involved, writes Mardi Chapman.

A nationwide army of hospital volunteers has chosen to step out of the kitchen, ignoring traditional auxiliary roles in the hospital kiosk or behind a cafe trolley to take on more direct, patient support roles.

Whether it’s reassuring patients and families in the emergency department, providing social or peer support in a cancer ward, feeding the elderly or cuddling infants in a nursery, volunteers are adding some comfort and care to daunting hospital environments.

When Robyn Jewell heard a volunteer program was being trialled in Canberra Hospital’s emergency department last year, she was happy to put up her hand. “The concept of providing support, information, a willing ear or a cup of coffee in the emergency department was a good one,” she says.

The former radiation therapist has also worked in roles such as palliative care and as a volunteer counsellor and trainer for Lifeline.

“I have 38 hours a week that I used to fill with paid work. I’m happy to do 15-20 hours of volunteer work and feel very useful. I have the satisfaction of knowing that I’m filling a gap and using my skills and experience so that others feel more cared for as a result.”

The Canberra Hospital is just one of many hospitals who have adopted such a program.

Michele Evans, an ED nurse and acting project officer for the program, says it developed from a summit involving both clinical and administrative staff to identify ways to improve their service.

A working group was set up in 2010 to develop the pilot project and staff have been heavily involved through all stages of its development.

She credits Victoria for leading the way with such programs and their comprehensive Volunteers in Victorian Emergency Departments program manual is available online for others to learn from. “It’s a wonderful resource with good guidelines around the numbers of volunteers for the size of the ED, policies, documentation, etc,” Evans says.

“Initially our volunteers were only in the waiting room, which we saw as the area of real need. Given there were no concerns there, we have expanded the role so volunteers can also be with families in the acute areas of the ED.

Two volunteers, wearing bright orange tabards with their volunteer role clearly displayed, are rostered on for three-hour shifts during the afternoons and evenings.

“Volunteers seem to bring a calming influence to the ED. During the 12-week pilot, we gave our patients evaluation forms and all the feedback was that volunteers were a wonderful asset for the ED. Staff were also supportive of the program and comfortable with volunteers coming to them with any questions.”

Dr Christine Stirling, senior lecturer in the School of Nursing and Midwifery at the University of Tasmania, says there is huge potential for volunteer programs that are well thought through and adequately resourced.

“Volunteer programs can be rewarding for the organisation, the volunteers and the clients. Increasingly, with time pressured staff and absent families, volunteers in hospitals can be doing the things that a family would have done in the past – sitting with and reassuring the patient.”

However, volunteer programs are far from “free”, Stirling says. Organisations need to invest resources in the recruitment process, training, orientation, rostering, responding to the needs of volunteers, and recognition programs. “Hospitals are quite a formal setting compared to others and you need a recruiting and vetting process, for volunteers to participate in training such as infection control, and have their police checks.”

Stirling says it’s a worthwhile investment as organisations typically enjoy about $6 to $8 value for every $1 invested in a volunteer program. Volunteering Australia says about 6.1 million people volunteer their time in some way. While some donate just one hour per week, the value of this unpaid labour was estimated at $14.6 billion in 2006-07.

Organisations who are interested in retaining their volunteers will also ensure they are compensated for out of pocket expenses. “Volunteers say they don’t want to be paid for their time but they also don’t want to be out of pocket,” Stirling says.

A 2006 study of the costs of volunteering in emergency management settings by charity Anglicare, found volunteers were often absorbing direct costs such as fuel to the value of $544 per year. Contributions in kind, especially for those still in the paid workforce, could almost double that figure.

“People volunteer if it has meaning for them – often if they have had a personal experience and have seen something that could have made a difference for them or a relative,” Stirling says.

Her research shows that volunteers will walk away, however, if they face too much red tape or bureaucracy, or if they feel their efforts are not recognised. “It’s an interesting tension. Volunteers are coming into environments that need supervision, that need to meet legislative and safety requirements, but they don’t want to be using their time doing paperwork.”

Gold Coast Health Service District has about 300 volunteers across their two hospitals and community health centres working in a variety of positions including dialysis and cancer services day units, palliative care and the emergency department.

Volunteers are mostly women who range in age from 18 to 84 years.

Volunteer co-ordinator Dale Tatterson says many of the volunteers are active retirees who want to maintain a meaningful role in the community. Another group are unemployed 55- to 65-year-olds on Newstart allowances who can meet their activity requirements for Centrelink by volunteering for at least 15 hours per week.

Tatterson finds university students are often more interested in meeting their own needs for work experience rather than meeting the organisation’s needs for volunteers.

“We have a lot of retired nurses who volunteer in the hospital and we targeted them first for the ED program. We knew they could cope with trauma, they understood boundaries and they also knew when to ask for help.”

She says ED staff were initially ambivalent about the idea of a volunteer program but the trial program proved its value to all. “It’s all about making people comfortable. Our volunteers are not there to replace AINs or RNs and we are very mindful of that. When there are no volunteers, the work still gets done.”

The Australian Nursing Federation’s position statement on volunteers in health and aged care acknowledges their important role in delivering support to patients, with provisos such as they don’t displace staff, their tasks are well described and they don’t encroach on nursing care.

Dr Peter O’Meara, professor of rural and regional paramedicine at La Trobe University, says there is always some debate about the crossover between volunteers and paid staff working together. “In the ambulance services, volunteers are actually providing clinical care so it’s a bit different to the ED situation but the key is effective and dedicated management.

“Volunteers are motivated by a ‘sense of belonging’ – they like to be involved and they are entitled to the same quality of management as salaried staff. It’s not about replacing people but enhancing what you’ve got by the effective use of volunteers.”

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