A seasoned Wollongong emergency department nurse has spoken out about the stress of working in an understaffed "pressure-cooker" environment.
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"A lot of the time it's just daunting, you have to have an eye on everything and really trust your colleagues are on their game because things can escalate out of control in an instant," the nurse, who asked not to be identified, said yesterday.
She spoke out about what goes on behind the emergency doors to shed light on the nurses' union campaign for better conditions.
"The dynamics of keeping an eye on everything happening all at once can be really intense," the nurse of more than 30 years said.
"Some nights we think 'How did we even get to this?' We have to really rely on each other, [we] have to trust that each other is doing what we assume they're doing. We have to have faith in that.
"A patient sitting quietly in the corner, a junior nurse might have checked all their vitals, done their job but then things can change in an instant and go downhill really fast," she said.
Five nurses are rostered each night to the emergency department.
"That's a one-to-four ratio as far as beds go. One person does triage but that's where it falls in a hole.
"We have three nurses just on the 11 beds, then we have two paediatric beds, mental health ... so the patient capacity on any one night could be 20."
The nurse concedes there is no quick fix in such an unpredictable workplace, but believes increasing staff will relieve pressure.
"Ideally we'd like at least another two staff on night shift," she said.
"We are on the coalface, we've got to always be on the ball and alert doctors who themselves have five or six patients on the go."
The South Coast Labour Council has added weight to the NSW Nurses and Midwives' Association's call for increased nurse-to-patient ratios.
"The demand is for a minimum ratio of one nurse for every three patients in emergency departments and one nurse for every four patients in the wards, nothing less," labour council secretary Arthur Rorris said yesterday.
"Does anyone really want to be the unlucky patient that slips through the cracks?"
Nurses' association secretary Brett Holmes said emergency departments did not have guaranteed minimum staffing levels.
"Things usually work OK because hard-working and responsible clinicians ensure they do," he said.
"But to continue leaving it to chance is not acceptable."
The NSW Ministry of Health said discussions about the union's current wages claim were "ongoing".
"The number of nurses in both regional and metropolitan hospitals is guided by a staffing method called 'nursing hours per patient day'," a spokesman said.
"Specific levels of staffing for particular types of wards and units were agreed between NSW Health and the NSW Nurses and Midwives' Association in 2011.
"Within this framework nursing management makes an assessment of staffing requirements based on a range of factors including previous experience, clinical needs, professional judgment, safe systems of work and patient safety."
