The Victoria branch of the Australian Nursing and Midwifery Federation (ANMF) says the historic hospital staffing laws in a bill being introduced to Victoria’s state parliament this week will make the state the “envy of the world”. If passed, the bill will be phased in over five years, starting in March next year, leading to the expected employment of 600 extra nurses and midwives to meet the new ratios.

Nurse-to-patient and midwife-to-patient ratios were first introduced in Victoria in 2000 as part of the public sector nurses’ collective agreement but were not enshrined in state law until 2015.  The new amendment follows a taskforce acknowledging ratios needed to be updated to reflect “increasing patient complexity, changing models of care and the growing demand for health services”.

Current ratios for a general medical or surgical ward on a morning shift in a large Victorian public hospital is one nurse for every four patients and one nurse in charge. The ratio for general medical/surgical wards will not change under the bill but will require management to “round-up” nursing numbers for example rostering eight nurses for a 30 bed ward rather than seven.  But the bill does introduce new ratios for

acute stroke wards, haematology wards and acute inpatient oncology wards and increased ratios for palliative care, birthing suites and special care nurseries, and during peak times in emergency department resuscitation cubicles

‘These changes are part of the Andrews Government’s promise that nurses and midwives will rightly never again have to bargain for safe patient care,” said ANMF branch secretary Lisa Fitzpatrick.

‘Victoria is still one of the few places in the world to have mandated ratios ward-by-ward and shift-by-shift. These improvements will make us the envy of many nurses and midwives across the world trying to care for patients with unpredictable staffing levels,’ she said.

The New Zealand Nurses Organisation was set to follow Victoria in seeking nurse-to-patient ratios during the ‘fair pay’ negotiations of 2003-4 but opted to follow an alternative safe staffing path which lead to the development of the patient acuity-based Care Capacity Demand Management System.

The slow implementation of the CCDM system – which requires accurate patient acuity data to calculate what staffing a ward or unit requires based on patient need (not the number of beds in a ward) – was a major issue in the recent DHB NZNO negotiations that saw DHBs agreeing to step up the implementation of CCDM and the signing of a safe staffing Accord  and a government commitment to monitor implementation.

The new NZNO DHB collective agreement also includes funding for the immediate employment of the equivalent of 500 extra nurses to reduce workload pressures in the 20 DHBs’ most stretched wards and units.



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