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Check this out! http://www.health.nsw.gov.au/careers/conditions/Awards/nurses.pdf
It may explain why you are busy at your hospital!
NSW PUBLIC HEALTH SYSTEM NURSES' AND MIDWIVES' (STATE) AWARD 2015
Section II: Nursing Hours Wards and Units
(a) Nursing hours wards and units comprise general inpatient wards, dedicated palliative care
wards/units, dedicated rehabilitation wards/units and inpatient adult acute mental health
wards/units.
(b) General inpatient wards do not include:
1. All Types of Critical Care Units:
- Intensive Care Units
- High Dependency Units
- Coronary Care Units
- Burns Units
- Neo-natal Intensive Care Units
2. Day Only Wards
3. Day of Surgery Wards
4. Procedural Units (Haemodialysis, Endoscopy, Cardiac Catheter, etc)
5. Paediatrics
6. Drug & Alcohol
7. All Midwifery Services:
- Antenatal
- Post Natal, Nurseries
- Delivery & Birthing Suites
8. 23 Hour Wards
9. Fast track wards
10. Transition Wards (slow stream)
11. Medical Assessment Units
12. Medical/Surgical Acute Care Units (MACU & SACU)
13. Wards/Units attached to Emergency Departments:
- Psychiatric Emergency Care Centres (PECC)
- Observation wards
- Emergency Medical Units (EMUs)
(c) The Association and the Ministry have agreed that staffing will be determined by the Nursing
Hours Per Patient Day ('NHPPD') specified below, provided over a week, to determine the
number of nurses required to provide direct clinical care. The number of nursing hours per
patient day may also be expressed as an equivalent ratio.
(d) 6.0 NHPPD will apply to general inpatient wards in Peer Group A facilities, being Principal
Referral Hospitals, accounted for over the period of a week
(e) 5.5 NHPPD will apply to general inpatient wards in Peer Group B facilities, being Major
Metropolitan and Major Non – Metropolitan Hospitals, accounted for over the period of a week
(f) 5.0 NHPPD will apply to general inpatient wards in Peer Group C facilities, being District Group
Hospitals, accounted for over the period of a week.
(g) 6.0 NHPPD will apply to dedicated palliative care wards, accounted for over the period of a
week.
(h) 5.0 NHPPD will apply to dedicated general rehabilitation wards and units, and 6.0 NHPPD will
apply to dedicated rehabilitation specialist brain and spinal injury units, accounted for over the
period of a week. For these wards and units only, NHPPD includes the hours usually worked by
nursing and other categories of staff, however titled, agreed with the Association.
(i) 6.0 NHPPD will apply to inpatient adult acute mental health wards in general hospitals which
are not specialist mental health facilities, accounted for over the period of a week.
(j) 5.5 NHPPD will apply to inpatient adult acute mental health wards in specialised mental health
facilities, accounted for over the period of a week.
(k) The specified staffing set out above shall be implemented progressively in accordance with a
timetable agreed between the Ministry and the Association, with full effect from 1 July 2013.
(l) At the time the new staffing levels referred to in Section II subclauses d) to j) above are
introduced on a ward or unit for the first time, staffing levels in wards and units with higher than
the specified staffing will either continue to apply or be reviewed. A reduction in staffing will not
occur without a review taking place. If there is disagreement between the Employer and
Association about the outcome of the review the provisions of subclause (vii) Grievances in
relation to workload will apply.
(m) The number of nursing hours per patient day may also be expressed as an equivalent ratio
which provides the same nursing hours over a week. For example:
1. a NHPPD of 6.0 can provide sufficient nursing hours to provide am/pm/night equivalent
ratios of 1:4/1:4/1:7 across seven days, as well as the option of some shifts with a nurse
in charge who does not also have an allocated patient workload.
2. a NHPPD of 5.5 can provide sufficient nursing hours to provide am/pm/night equivalent
ratios of 1:4/1:5/1:7 across seven days, as well as the option of some shifts with a nurse
in charge who does not also have an allocated patient workload.
3. a NHPPD of 5.0 can provide sufficient nursing hours to provide am/pm/night equivalent
ratios of 1:5/1:5/1:7 across seven days, as well as the option of some shifts with a nurse
in charge who does not also have an allocated patient workload.
(n) Only nurses providing direct clinical care are included in the NHPPD. This does not include
positions such as Nursing Unit Managers, Nurse Managers, Clinical Nurse Educators, Clinical
Nurse Consultants, dedicated administrative support staff and wardspersons.
(o) In implementing Nursing Hours in Nursing Hours Wards the daily bed census data averaged
over a specified preceding period of up to 52 weeks (in whole weeks) will be used to determine
the ‘number of patients’. In determining the specified period due regard should be given to
reduced activity periods, seasonality and other local factors. Where seasonality is a significant
factor, the specified period can be the equivalent period in the preceding year.
(p) The NUM will distribute the hours/shifts across the day and week in a rostering pattern with due
regard to the workload pattern of their ward, provided the applicable NHPPD is achieved over
the week.
(q) The NUM may distribute the NHPPD to include a nurse in charge who does not also have an
allocated patient workload, provided the applicable NHPPD are achieved over the week
(r) When, on a shift, the NUM considers that patient care needs cannot be sufficiently met from the
nurses immediately available and the NUM (or nurse delegated with responsibility for patient
care within the ward/unit) considers additional nursing hours should be provided in order to
meet clinical needs, the NUM will inform the appropriate Nurse Manager who, together with the
NUM, will consider a solution including, but not limited to, the following options:
1. deployment of nurses from other wards/units;
2. additional hours for part time staff;
3. engagement of casual/agency nursing staff;
4. overtime;
5. prioritisation of nursing activities on the ward/unit;
6. reallocation of patients.
When these options have been exhausted and only with approval from the Director of Nursing
and Midwifery and the concurrence of the General Manager, the decision may be made to limit
admissions when discharges occur from the ward/unit. This decision is to be made as soon as
practicable after commencement of the shift.
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