Not skewed at all Robin. This is exactly what I'm talking about. This is the situation we need to be fighting about and not simply accepting the management determination of what our job is and how long it takes. 15 minutes would be just for the paperwork, then there are physical checks of mother and baby, assistance, demonstration, discussion of breastfeeding, infant behaviour and other parenting education, to say nothing of the emotional psychological assessment, support and reassurance. We do need to make a habit of articulating what we do - for ourselves and others to understand the value of what we do. Midwives and nurses need to stop:- 1) doing antenatal classes and the preparation for them in their own time (as is I was told last week at the local ACMI subbranch meeting is happening in a neighbouring hospital in this region and many others I suspect) 2) skipping meal breaks to fit the jobs in 3) doing unpaid overtime as they catch up on that paperwork that didn't get done because they were debriefing someone who had been through a traumatic event 4) accepting the unacceptable
We need to argue with "superiors" and managers who consistently underestimate our workloads and undervalue us. We need to be assertive and less accepting of the restrictions placed on us. Nothing less than a revolution will do. I'm starting to foam at the mouth now so I'll stop...for a while anyway. Sandra ----- Original Message ----- From: "Robin Moon" <[EMAIL PROTECTED]> To: <[EMAIL PROTECTED]> Sent: Monday, April 07, 2003 12:27 PM Subject: Re: [ozmidwifery] Workloads - doing something about it > a slight skewed observation to the conversation, but I once knew a num who > told her staff on the early discharge program that they only needed 15 > minutes per woman per visit. Therefore they could come back and take a > patient load in the unit as well. > > Impossible to measure how much time is needed when being with women. In > fact, I often find the mistakes i make with documentation or time management > occur when I have spent much time talking, listening, debriefing and just > being with them. I've literally forgotten the paperwork in lieu of what I > believe is a higher priority. Unfortunately the hospital system does not > recognise this input in their DRG's, and does not value this input enough to > support midwives who do this. > > Robin. > > ----- Original Message ----- > From: "Sandra J. Eales" <[EMAIL PROTECTED]> > To: <[EMAIL PROTECTED]> > Sent: Monday, April 07, 2003 11:12 AM > Subject: [ozmidwifery] Workloads - doing something about it > > > > Nurses and their unions have been struggling with tools for workload > > management for a long time. The ratios in Victoria look promising as you > > say but I imagine there will still be inherent problems as Marilyn > mentioned > > the complexity needs to be taken into account. but more than the medical > > complexity. Two women with the same DRG may require quite different > levels > > of midwifery time. Medically they may be judged uncomplicated because they > > had a spontaneous vaginal birth but one will breeze through it and the > next > > will be very traumatised and need much more support to recover emotionally > > and physically to be able make the transition to motherhood, > breastfeeding, > > parentcraft. > > > > The problem comes down to articulating and measuring the value of nursing > or > > midwifery work > > The most valuable part of caring for a woman is the "being with" her - > > talking her thru the hard parts and coaching her to relax, rubbing her > back > > or showing the partner what to do in, supporting her physically and > > emotionally. This isn't properly measured though - For most tools that > try > > to measure workloads, jobs are broken down to tasks - doing observations, > > giving medications. The value of the time that is used by a midwife in > > "being with" a labouring woman or a vulnerable postnatal mum trying to > > breastfeed, or the nurse who stops running for a moment to comfort the > sick > > or dying by just being with them. > > Nurses and midwives don't articulate the value of this part of our job and > > are as likely to criticise those who do. > > The clients appreciate it and know that this is one of the most important > > elements of our job but where is it expressed in terms of workload > > justification. > > Deep within us when know we have done a good job and have job satisfaction > > only when we have this time to be with our clients. Too often nurses and > > midwives spend their whole work day racing frantically from one task to > the > > next without making the deeper connection required for caring and healing. > > We are the only ones who can make this time available. We need to > recognise > > the value of caring and demand the time to do it properly. > > > > > > Sandra > > > > > > ----- Original Message ----- > > From: "Heartlogic" <[EMAIL PROTECTED]> > > To: <[EMAIL PROTECTED]> > > Sent: Sunday, April 06, 2003 3:49 PM > > Subject: RE: [ozmidwifery] Bullying - doing something about it > > > > > > > Hmmm, you Barb and Sandra are amazing. Both being active in the union > and > > > doing what needs to be done! How sensible. I had drifted away from the > > > union idea and hadn't been a member for ages, thinking that the union > > didn't > > > have midwifery issues at heart and so was no longer relevant to me. It > > > never occurred to me to become more active in the union, which would > have > > > been a far better plan I realise now. A position I now realise was the > > > result of my version of learned helplessness, didn't think I could make > a > > > difference through that pathway. > > > > > > It has only been since coming in out of the wilderness (homebirth > > practice) > > > and seeing how it is for my colleagues and students, not to mention the > > > director of nursing who had been sidelined so much from the role of > > managing > > > nursing (and midwifery)and who has been subjected to corporate > bullying... > > > grrrr... that I felt moved to do something strategically intelligent > > instead > > > of whinging and/or feeling aggrieved (which was VERY tempting and which > I > > am > > > still seeking to avoid doing :-) > > > > > > The position of the Realnurses team on the many complex issues facing > our > > > twin professions also gives me real hope. We can make a difference. > > > Interesting looking at Victorian facts and stats about ratios for > > example - > > > read on if you are interested... > > > > > > in solidarity ;-) > > > > > > Carolyn Hastie > > > Council candidate, Realnurses and Midwives team (NSWNA Election June 03) > > > www.realnurses.net > > > > > > I thought you would be interested in what is happening about ratios, so > > have > > > included the following information: > > > > > > The Realnurses team are committed to delivering mandatory, enforceable > > nurse > > > to patient ratios encompassing acuity and safe skill mix. > > > > > > This will be done in every sector - not just the public sector > > > > > > And this is only the start of our campaign to make nurses work easer, > > safer > > > and more enjoyable. > > > > > > The Real FACTS about ratios > > > > > > Fact: Ratios have seen 2650 nurses return to the public sector in > > Victoria > > > > > > Fact: Victorian universities have seen a 26.5% increase in nursing > > > enrolments since ratios were introduced > > > > > > Fact: Victorian employers argued that they would need between 800 and > 1200 > > > extra nurses, which they claimed would be impossible to get. In fact > 2650 > > > nurses returned > > > > > > Fact: In the Victorian ratios case the employer argued that they would > > > need to close up to 1200 beds. They got the extra nurses despite the > > global > > > nursing shortage and the mass bed closures did not eventuate > > > > > > Fact: The majority of wards and units in Victoria have now met the > ratio > > > requirements while NSW struggles with a nursing shortage > > > > > > Fact: Ratios are now in use in City, Regional and Rural areas of > > Victoria > > > > > > Fact: Ratios are being used successfully in a wide variety of clinical > > > settings including medical, surgical, ED, midwifery, OT, ICUs, > > > Rehabilitation, CCUs, Palliative Care and Special Care Nurseries > > > > > > Fact: Ratios in Victoria are minimum staffing levels. They also take > > into > > > account skill mix and acuity of patients. Agreements have been signed in > > > some areas to give specific wards higher ratios > > > > > > Fact: As part of the ratios case in Victoria, nurses were awarded 3 > days > > > paid professional leave > > > > > > Fact: The Judges in the ratios case stated that ratios had to be met > > > through the employment of permanent nursing staff > > > > > > Fact: The Judges ordered the employer to employ an additional 50 FTE > > CNEs > > > and an additional 50 FTE CNCs > > > > > > Fact: In Victoria ratios have improved roster planning > > > > > > Fact: Ratios are enforceable and guarantee nurses appropriate and safe > > > staffing levels > > > > > > Fact: In Victoria, 'Patient Dependency Systems' were tried and > discarded > > > because they were not enforceable and management did not follow them > > > > > > Fact: Management in Victoria can no longer keep beds open on a promise > > that > > > they will find more nurses later in the shift > > > > > > Fact: The Victorian model of ratios has been such a huge success that > > > models are being introduced in Queensland, Tasmania, Western Australia, > > > California USA, Massachusetts USA, Maine USA and are being looked at in > > New > > > Zealand. > > > > > > > > > ANF Victoria research is showing that ratios are responsible for: > > > > > > > > > 1. Reduction in staff turnover > > > > > > 2. Reduction in sick leave > > > > > > 3. Improved morale > > > > > > 4. Increased graduate confidence because of suitably resourced > > preceptors > > > > > > 5. A decline in workplace injuries > > > > > > These facts are from the ANF Victoria website www.anfvic.asn.au and from > > the > > > AIRC Victorian ratios decision. Please take the time to check the > website > > > and see for yourself. > > > > > > What About NSW > > > > > > Professor John Dwyer, Professor of Medicine, University of New South > Wales > > > and Clinical Director of programs for Medicine and Oncology, Prince of > > Wales > > > Hospital, said as part of his evidence in the 'Whats a Nurse Worth' > case: > > > > > > 'Now I know the argument is if we specify the ratio, given the number > of > > > nurses we don't have, we would have to close a lot of beds but the > > argument > > > can be put the other way, until tested no one can give the answer'. > > > > > > The Realnurses Team say it is time to test the argument. > > > > > > He went on to say: > > > > > > 'We have heard in Victoria where ratios were introduced the (sic) > prophets > > > of doom who said that would mean a decrease in the number of beds you > will > > > be able to run have been found wanting. Nurses are voting with their > feet > > > and coming back into the system because of ratios. I believe for my sort > > of > > > hospital this would be a very important issue.' > > > > > > Why has NSW waited for so long for workload management? > > > > > > . The Realnurses team are committed to the introduction of nurse > to > > > patient ratios encompassing skill mix and acuity in all sectors > > > > > > . The Realnurses team are committed to ratios because they give > > nurses > > > mandatory enforceable staffing levels not just a daily dispute system > > > > > > . The Realnurses Team are committed to nurse to patient ratios > > because > > > dependency systems alone are not working > > > > > > > > > > > > -- > > > This mailing list is sponsored by ACE Graphics. > > > Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe. > > > > -- > > This mailing list is sponsored by ACE Graphics. > > Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe. > > > -- > This mailing list is sponsored by ACE Graphics. > Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe.
