The union has demanded NSW Health provide more information on its contingency plans for the mass resignation of psychiatrists and how it will impact nurses.
NSW nurses, already in the thick of their own pay dispute with the state government, have slammed its handling of the public psychiatry crisis which has seen more than 200 psychiatrists hand in their resignations.
And a Sydney mental health care nurse has warned patients’ lives will be put at risk unless something is urgently done to address the massive shortfalls in the public mental health care system.
One of the biggest fears is that nurses will be pressured to work outside their scope of practice to help plug the gaps left by the decimated psychiatry workforce.
Even before the mass resignation, the system had been operating on a shortfall of about 140 psychiatrists. The mass resignation effectively leaves around 90 psychiatrists left across the state system.
NSW Health is trying to secure locum services as part of its contingency plan, but this will cost millions of dollars, as Health Services Daily analysis reveals.
NSW Nurses and Midwives’ Association general secretary Shaye Candish said the state government claimed it had contingency plans to manage the psychiatrist shortfall, but it remains unclear how these contingencies will unfold.
The lack of communication with nurses on what this means for them has sent the NSWNMA to the Industrial Relations Commission of NSW to force NSW Health to get clarification.
“We are currently in dispute with NSW Health in the Industrial Relations Commission where we are seeking the full disclosure of relevant information to help provide further advice to our members,” she said.
Ms Candish said the industrial dispute was expected to have implications for both mental health nurses and nurses who working in emergency departments.
“No one has bothered to properly consult with our members, yet the premier has stated publicly that they are expected to fill in the shortfalls. It’s not acceptable.”
Ms Candish said the association had been raising the alarm for more than 12 months “about what happens when you underfund your health system, when you underfund the workforce, and when you see nurses and midwives leave to go and work in other states”.
“We cannot have a labour market where nurses and midwives in other states are being paid so significantly differently to our health workforce,” she said.
“You cannot keep people in jobs in NSW when they can go and work somewhere else and earn so much more. That is just a baseline reality that we must wrestle with.
“The government may not have caused the problems that we’re facing in the health system, but they must now step up and solve them. Our residents, our patients and the people who live in this state, deserve nothing less.”
Skye Romer is a mental health care nurse and secretary of the NSWNMA Prince of Wales Mental Health Branch. She told Health Services Daily the mental health system was already buckling before this crisis.
“I’ve worked in mental health in the public health system for over a decade now,” she said.
“I think one of the things that you know needs to be communicated to the government, and quite clearly hasn’t been understood, is that our level of acuity, that is, people that are coming into hospital are more unwell, and we’re seeing a larger amount of people presenting to our emergency departments in mental health crisis.
“That already puts a strain on a health system that doesn’t have the full capacity of psychiatrists that they should, but it’s felt across the hospital. We’re all holding our breaths to see what happens next.
“We 100% understand why the psychiatrists are doing this. We’ve been trying to communicate to the government for over 12 months what happens when a health system is underfunded and under-resourced.
“And it appears this is the moment when we work out what our government’s priorities are.”
Ms Romer said many mental health care nurses were concerned they would be pressured to work outside their scope of practice to plug the gaping holes left by the resigned and resigning psychiatrists.
“Our public mental health system is quite reliant on psychiatrists, but we also work within the parameters of the Mental Health Act, and we take those very seriously, and part of that is working within our scope of practice,” she told HSD.
“There are senior psychiatrists who are required for different steps when somebody is entering a mental health unit in our public hospitals and that can’t be taken away from a doctor doing that. That’s quite clear.”
Ms Romer’s distress about the situation is clearly evident as she talks to HSD.
“One of the things that I fear is that these contingency plans that the government keep referring to, I don’t think have necessarily been that greatly thought through,” she said.
“I think that there could be some more consultation. I’m quite concerned that that mental health beds may be closed, that community mental health services will have to be reduced, and that’s including child and adolescent services.
“And when you look at the government’s mental health strategy and what previous governments have talked about mental health strategy, those are services that we just can’t afford to lose.”
Nurses didn’t go into mental health nursing because they “just want another job”, she said.
“We truly care about our consumers and we definitely see them in the most vulnerable places in their life,” she said.
“I’m terrified that people won’t get the care that they need when they’re in that crisis, and then the flow on effect from that.
“We don’t want to lose more people to suicide. We don’t want environments in mental health wards to be more unsafe. We want consumers and the staff to feel safe, whether they are so that, you know, it’s a therapeutic environment, and consumers can go home healthy, and staff can go home at the end of the night healthy.
“It’s actually quite terrifying.”
HSD has been told there are chats in private nurses’ social media groups in which some have said it would not take much to push them to follow psychiatrists down the mass resignation path.
And while Ms Romer has not seen or heard this firsthand, she said it was a worry.
“I don’t think anything’s out of the realm of possibilities,” she said.
“At this stage, the government has not sat at the table with us and engaged in negotiations [for their own current pay dispute which is ongoing].
“They may make out that they do and publicly state that they do, but there has been no good faith bargaining. We are really trying to hold on to nurses and hoping that things will improve. At this stage, I think we’re going to have to wait and see what occurs.”