Public meeting, leaked staff survey expose staff concerns and plummeting morale at Albany Health Campus

Staff shortages, workplace bullying and under-resourcing were in the spotlight at a public meeting about Albany Health Campus last week as an internal staff survey exposed plummeting staff morale. About 100 people gathered at Retravision Stadium on Thursday night for a meeting hosted by shadow health minister Libby Mettam and South West MLC James Hayward. The meeting came after Mr Hayward wrote to WorkSafe and Health Minister Roger Cook in October, calling for a review into an “unsafe working environment” at AHC. Mr Hayward said he had received “regular messages” from past and present hospital staff citing bullying, failure to resolve ongoing human resources issues, and high staff turnover because of poor workplace culture. In a show of hands during the meeting, the majority of attendees said they were former or current WACHS staff, but only health workers who had left the service spoke out. WA Health employees are barred from providing comment or information to the media without authorisation. An internal staff survey from earlier this year — leaked to the Advertiser ahead of the meeting — showed the dissatisfaction voiced at the meeting was reflected behind closed doors. Just 19 per cent of the 227 AHC staff who took part in the 2021 Your Voice in Health survey agreed their “organisation is making the necessary improvements to meet our future challenges”, compared to a WACHS average of 45 per cent. That marked an 11 per cent drop from last year’s survey. A quarter of staff said they “believe my organisation cares about my health and wellbeing”, compared to a 49 per cent WACHS average. Only 38 per cent said they were “proud to tell others I work for my organisation”, compared to 65 per cent overall for WACHS. Attendees at Thursday’s community meeting were quick to praise AHC workers for their dedication, thanking those in the room for the care they and their loved ones had received. The community raised concerns about the need for more hospital beds to relieve ambulance ramping and bottle-necking in the emergency department, as well as improved aged care and NDIS service delivery to keep people out of the hospital. A retired AHC nurse of more than 25 years said she was speaking out on behalf of her peers. “I am appalled that we are struggling with staffing levels right now when we haven’t even got COVID,” she said. “When COVID arrives, and it is going to arrive, how are they going to cope? “We don’t have many ventilators here, we don’t even have an ICU in Albany, we only have a high dependency unit, so how are we going to cope when COVID happens? “And I am really tired of politicians saying well we will give you new facilities. We don’t need new facilities. We need plenty of staff on the ground.” Former WACHS registered nurse of eight years, Greg Pead, spoke out about what he described as bullying in the workplace. “What I saw there and what my impression was, was this culture of bullying, and nastiness and unfair treatment is endemic in WACHS Great Southern — not just in Albany Health Campus,” he said. “They could start by acting with a little kindness to their staff, and a little positivity and support. “I just think the management are standing by while there is a slow haemorrhage of staff. “I call for an independent review into this place and I think WACHS needs to stand up and accept that they have got a problem and that they are going to address it.” Albany Mayor Dennis Wellington told the crowd that as the City moved towards an expected population of 50,000 by 2030, the 131-bed hospital needed to grow. “If you think it is bad now, come back in two or three years time because it is going to become considerably worse,” he said. “Everybody accepts that the care and the attention we get at the hospital is absolutely fantastic. “It is a pretty simple situation to my mind — that we just need more than what we’ve got.” In an interview with the Advertiser on Monday, WA Country Health Service Great Southern regional director Geraldine Ennis — who attended the meeting — said staffing pressures had been exacerbated by the COVID-19 pandemic, with the State’s health system facing unprecedented demand. Before COVID-19, about 20 per cent of WACHS Great Southern staff came from interstate or overseas, Ms Ennis said. “As an organisation, recruitment has been quite a challenge,” she said. “We remain totally committed to providing exceptional care for our country communities and I am really proud of the hard work, resilience and dedication that staff have shown everyday.” Ms Ennis said these were “unprecedented times”. “There is a huge amount of uncertainty for people not only in their communities, but in their families and their work lives,” she said. “People are, I think, fatigued and probably stressed like I have never seen it before. “I think what is really important is that we support our staff and we are supporting our staff with additional education.” She said WACHS had “good, robust systems” to handle complaints of bullying. “If you look at the region, we employ close to 1500 people and from time to time there will always be issues with staff,” she said. “We have got human resource processes that they can speak to if there is bullying. “They can talk to their line manager, they can talk to their management team at Albany hospital or they can approach me, the regional director, if they have a concern. And people actually do do this. “It is quite disappointing to talk about an endemic culture of bullying. “But I think for us is making sure we listen, that we are open and that we are willing to change and challenge poor behaviours.” An Australian Nursing Federation survey of its members at AHC this month gave insight into “chronic staff shortages” and nurses “feeling unsafe and constantly compromised”. According to the survey, day procedure units and short-stay units are being used for ED overflow, and registered nurses are being asked to work night shift caring for 8-12 patients per nurse with only an assistant-in-nursing for support. “I am concerned there’s been no upskilling or education provided to nurses in the event of a local COVID surge”, one AHC nurse said in the ANF survey. “We’ve had 18 months to get a plan to be created and rolled out — yet nothing.” The nursing workforce was also recording increasing absenteeism due to stress and increased workloads, according to the survey. “We are experiencing dramatically increased activity, ambulance ramping and access block just as our colleagues in the city are, but without the same ability to provide quick fixes,” another ANF survey respondent said. “The government and WACHS are telling us we can have more staff but are doing nothing practical to help us achieve this”. Former WACHS director of nursing Sam Barron said housing was a key barrier to AHC recruiting and retaining nursing staff. He called for more transparency around patient to staff ratios at WA hospitals. Ms Ennis said the AHC nurses were allocated on a “nursing hours per patient days” basis depending on the acuity of the patient. “During this COVID period of the last 21 months, actually getting staff — be that nurses, doctors, allied health staff and support staff — has been quite challenging,” she said. “There are times that I think the staff are fatigued and I think they are doing a great job but what we are looking at is ways that we can improve the conditions for nursing. “But I would have to say the nursing staff are under pressure, as are the medical staff, as are the allied health staff. “But we are still committed to providing exceptional care to our communities, and I think hopefully with the borders opening we will be able to recruit more staff from interstate and overseas.” The day before last week’s public meeting, Health Minister Roger Cook slammed the Opposition in State Parliament for “undermining community confidence” in the AHC by hosting the public meeting. “It is disappointing to say the least to hear that the Opposition, which as we know is constantly trying to undermine our hospital system and confidence in it in these unprecedented times, will tomorrow be holding an event to try to derive more division in the community and more anxiety, undermining community confidence in our great hospital system,” Mr Cook said. “The shadow minister for health is not going down there to hear people’s concerns. She is going down there with preconceived and preloaded false assertions about how that hospital is failing the community, and it is not. “We are also future-planning for the hospital, with a master plan currently under way to determine the future needs of AHC and the community it services. “It is time that everyone in this place got behind the doctors, nurses, allied health staff and leaders at that hospital and we should be thankful for the great work that they do every day on behalf of the people of WA.” However after the meeting, Ms Mettam said the Opposition would continue to push for a WorkSafe investigation. “Tonight has certainly endorsed the fact that we are on the right track with this in supporting calls for better investment in our health system and better investment at AHC,” she said. “We know that tragedy can occur when a health workforce is overworked and understaffed and also when the morale is so low.” LETTER FROM A STAFF MEMBER To all our patients, Thank you for your beautiful cards that thanked us for our care and told us you couldn’t have done it without us. Thank you for the hugs as you left as you told us we’d helped you at your most vulnerable time in your life. Thank you for the choccies that keep us going at work when we don’t have time to stop for our breaks. Thank you for understanding when you had to navigate something hard on your own because we were too busy to sit with you and allow you the time that you so desperately needed and wanted. Thank you for advocating for us in the community and telling your friends and family that you think the staff are doing the best they can in a failing system. Thank you for showing up and trusting us, we do our jobs because of you! To our management, I’m so sorry you feel we are constantly letting you down. I’m sorry for the ward meetings you hold, emails you send, meetings you all have and audits that you do that are telling us we are failing. I’m sorry we’re not completing our forms the way you would like ... there’s just so many and sometimes we just don’t have the time. I’m sorry you had to constantly watch over us in handover, washing our hands, giving medications etc to make sure we were getting it right ... it must feel embarrassing for you to have to babysit adult professionals too. I’m sorry that our overtime is blowing your budgets on so many days when we’re busy and at capacity and short-staffed. I’m sorry when our beds aren’t full and your nurse-to-patient ratios look bad that we didn’t take that on-call shift you offered us instead so you didn’t have to pay us our full shift allowance. I’m sorry you have to constantly chase us up about our on-line learning that’s falling behind ... there’s just so much of that now too. I’m sorry you spend so much of your day looking for staff when your burnt-out staff call in sick. I’m sorry you’re constantly trying to employ staff and sitting in interviews because you’ve lost so many wonderfully experienced team members who were fed up with “the way things are going”. I’m sorry those staff leaving left you with an inadequate staff mix on the ward of junior staff. I’m sorry those junior staff left because they felt unsupported, unsafe and found nursing “wasn’t what they thought it would be”. My advice to you management so we don’t have to keep apologising to you ... be kind to your staff, we’re doing the best we can. And every year, I challenge you to “walk a mile in our shoes” ... literally! Work a week on the wards or ED or theatre, and get a feel for what we’re up against. I’m sure that alone would evoke change in the way we work together to provide a safe health care system for patients and staff. Kind regards, Your healthcare professional * This letter was submitted to the Advertiser for publishing by a healthcare worker at Albany Health Campus.