Local nurses are exhausted and frightened for their patients, they said as they walked off the job on Thursday.
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About 150 nurses and midwives at raillies in Armidale and Moree chanted for improved staff ratios and brandished placards that read - we deserve more than thanks, we deserve staffing - during community rallies outside the two hospitals.
NSW Nurses and Midwives Association, Moree hospital branch secretary, Mellisa Counsell said emergency departments were over-capacity and patients who were critically unwell were waiting hours to be seen.
Michelle Chappell who works as a theatre nurse at Armidale hospital, said they're "surging" with patients, and hospital wards were "overflowing".
"If a nurse has seven patients to one, then they are having to do the bare minimum for those seven patients. There's no way they can care for seven patients," Ms Chappell said.
Dire situation
Ms Chappell said the situation at Armidale hospital was so dire that untrained Assistant in Nursing (AIN) staff were replacing highly-qualified Registered Nurses (RNs) for basic duties in some areas.
And in the Emergency Department, Registered Nurses were having to step up to fill in for doctors.
"If there's no doctor in ED, those nurses on their registrations are constantly at risk of working outside their scope of practice," Ms Chappell said.
"So what do we do?
"Because if someone comes into ED and there is something wrong with them... we've got to help these patients. It's pretty disastrous.
"And people who have been waiting for operations for a long time, or elective cases, are having to be cancelled because we have no beds to put them in after we've operated.
"And then we're desperately trying to juggle when we have emergencies come in."
Overworked and underappreciated
The association is calling for ratios of one nurse for every four patients.
Ms Counsell said excessive overtime due to rampant under-staffing was wearing down the already exhausted workforce.
"NSW nurses are the lowest paid nurses in the country. The pandemic has seen a mass exodus of nurses from NSW Health to other states," Ms Counsell said.
"States like QLD and Victoria that offer nurse to patient ratios like 1:3 in ED and 1:4 on the ward. Ratios that have been proven to save lives," she said.
Nurses and midwives with families said they were often having to choose between working another double shift or seeing their children.
They talked about how passionate they were about caring for people but that the circumstances under which they were having to work was making it nearly impossible.
Local midwife, Helen Grzazk, said her colleagues were stressed because they were not recognised for their double workload due to babies not being counted as patients in the hospital system.
"If you have a baby, you're the only one that's counted, not the baby," Ms Grzazk said.
Education is key
Registered Nurse Emma Ratajczyk stopped working at Armidale hospital four years ago due to the crisis and now works in community health and as an educator.
"We're flooded with first year nurses," Ms Ratajczk said. "And the education requirements of those staff are still very huge during that first year," she said.
"We've still got a huge need for postgraduate education."
Support from the local MP
Member for Northern Tablelands, Adam Marshall, was also at the strike in Armidale to lend his strength, stating that a lot needed to change to better support existing nurses and to encourage more into the system.
"But also to increase staffing levels so they don't have that burnout," Mr Marshall said.
The MP said low staffing levels were at the "crux" of the petition throughout the electorate to get the split of the Hunter New England Health district debated in NSW parliament.
"We've got nearly 9000 signatures on that petition," Mr Marshall said. "So I'm very confident we will get over the 10,000 that we require by the end of this month."
A bigger picture
Thursday's strike action was part of a larger effort across NSW by the nurses and midwives union, with health staff rallying in more than 70 locations including Tamworth, Randwick, Broken Hill and Albury.
Armidale nurses and midwives coordinated their walk-off after their morning shift, so patients already feeling the brunt of the staff shortage wouldn't be impacted by their strike.
The Moree branch decided to strike for only half an hour due to the "extreme staffing shortages" the hospital was facing, already running on minimal staffing levels.
"Nurses are so concerned about these issues, they are prepared to go without meal breaks, go without pay," Ms Counsell said.
"And for the most part, the staff involved in the strike action came in on their own time. They were on a very rare day off, on holidays, or had finished their shifts," she said.
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"We do not want to strike. This is not an action that we take lightly. But it is the only way to send a strong message to this government that enough is enough.
"We just don't understand why NSW Health has their head in the sand. Chronic staffing shortages have hit nurses and midwives across the state; they are burnt out and planning exit strategies. And yet the NSW government has done little to rectify this critical issue.
"Nowhere is it more evident than in rural hospitals. Who is going to be held responsible for the wellbeing of our nurses? The wellbeing of our patients?"
