Nursing shortages in Australia

Thanks to Jeff from TravelNursingBlogs for posing the following questions:

“Is there a nursing shortage in Australia? What is the industry like there? Has the global recession hit it?”

credit: TheAlieness GiselaGiardino²³

The short answer to your questions is yes – Australia is suffering with quite a severe shortage of nursing staff, and yes the recession has changed things around a little.

It gets a little complicated when examining data though, particularly as census figures only are made available every few years.

On a personal note, I’ve worked in both the private and public sectors in Australia over the last ten years, and I’ve always felt as if my job was very secure. The nursing profession in general never downsizes – it simply can’t afford to. There are always jobs available in some area or other, and while specialty areas fluctuate at times with job availability, there always seems to be nursing jobs available for those who are looking for work.

In fact, for the last few years there have been incentive and bonus programs in place to try and lure retired or non-working nurses back to the profession.

Regarding staffing – most hospitals frequently use casual staff to back fill sick leave and roster shortages, and use agency staff when desperate. I have noticed however that agency staff are being used less in the hospital where I work. Possibly this is due to the costs involved – agency staff are traditionally always paid higher than regular staff or casuals. Cutting back (unless really desperate) & employing more casual staff is therefore a likely implementation of some cost cutting measures.

But getting back to your questions – let me quote a few paragraphs from a recent QNU Federal Budget submission from January 2009, it might just give you a glimpse into nursing conditions in Queensland:

“In Queensland, there remains a critical shortage of nurses across public and private hospitals and aged care facilities (conservative estimates put this at around 1400 nurses) resulting from years of neglect of recruitment and retention strategies.
 
Currently in Queensland there are shortages in most areas of nursing including accident and emergency, critical/intensive care, midwifery, mental health, community care, aged care and indigenous health (Department of Education, Employment and Workplace Relations, 2008). The significant migration to this state and its consequent demand on health services, especially in the south east corner, has exacerbated these shortages.
 
ABS 2006 Census figures on the rate of nurses per 100,000 population by state or territory reveal Queensland is well below the Australian average of 1107 nurses per 100,000 population with just 1025.3 nurses per 100,000 population. As the population continues to rise in Queensland, the QNU’s data modelling indicates we can expect a shortfall of 14,000 nurses by 2014 across the public, private and aged-care sectors.
 
In the public sector, Queensland Health’s conservative shortage estimates are based only on maintaining the current service status and fail to take into account significant predicted retirements from the profession, backfill requirements for leave and training, as well as increases in services—such as new beds coming online—which all have a direct impact on the number of additional nurses required.
 
Aged care figures are difficult to determine without reliable information on staffing shortages. However, the QNU estimates shortages are even more acute in this sector due to the poor wages and conditions on offer and the lack of incentives. According to the Australian Institute for Health and Welfare (AHWI) (2005), based on a predicted retirement age of 65, over the next 20 years Australia will lose 60% of the existing employed registered and enrolled nurse labour force through retirement.
 
Nearly 15 per cent of nurses are retiring every five years—creating a projected cumulative exodus of 90,000 nurses by 2026 (Australian Health Workforce Institute, 2008). Unfortunately, new graduates from existing educational programs are not adequately replacing these nurses and it seems future planning for the huge exodus of nurses from the health system is severely lacking. To keep experienced nurses in the health system, employers and government should provide transition to retirement programs to retain nurses and knowledge for longer.”

So there’s a glimpse of the general conditions surrounding the Nursing Profession in Queensland, and I believe the figures are similar in the rest of the states and territories in Australia.

It’s difficult for me to say how this differs from the rest of the world as I have only nursed in Australia before. Additionally, the article above paints a bleak picture that is correct in terms of data and numbers, however the day to day conditions (in terms of staffing and patient loads etc) in the hospitals I have worked at, are not quite as dire as they sound.

In critical care areas and particularly emergency nursing where I work, staffing is critical & receives a fairly high priority in order to maintain a safe level of care. Because of this, my personal experiences probably don’t reflect the greater picture of nursing shortages in Australia. Occasionally in the department where I work there are days where too many are off sick, or for some reason we have a higher than usual casual-to-regulars ratio making skill mix a bit of an issue, but again this is not the norm. What is the norm though, is difficult, busy shifts made more difficult by overcrowding, ramping of ambulances, and bed block issues.

Unfortunately, as the quote from the article above suggests, this is not always the case in every hospital, and certainly not always the case when it comes to ward nursing or other specialty areas. For example, my sister who works as a Registered Nurse recently joined a casual pool at a hospital she had never worked at before (pool nurses work anywhere in the hospital, rather than staying permanently in one ward).

On her second shift she was sent to a ward (orthopaedics, I believe) to discover that not only was she supposed to be in charge as the most senior person on, the only other Registered Nurse present was a casual who had never worked there before! Needless to say she was not too thrilled….

What are your experiences with nursing shortages & the effect it has on staff or patients?