Frantic ED Night Shift 'Satisfying' Says Health Dept

Type: Union News Subject: Workloads
29 April 2009

Grant Isedale

In its case against the NSWNA's claim for increased night shift penalty rates, NSW Health has said increased penalties would be too expensive and change is unnecessary because everything is working okay.

NSW Health has submitted its arguments against the NSWNA’s claim for an in-crease in night shift penalty rates, which begins its hearing in the NSW Industrial Relations Commission on 4 May.

While the NSWNA’s case is based on current scientific evidence showing the deleterious affects of working night shifts, with submissions from top experts in the fields of sleep medicine and circadian research, the Department’s case is based on the standard positions that a penalty increase would be too expensive and that change is unnecessary because everything is working okay.

One of the Department’s key witnesses, an Area Health Service Director of Nursing and Midwifery, has made a submission stating that night shifts in Emergency Departments are satisfying because nurses have a heavy workload, while night shifts in medical wards are ‘likely to involve little more than doing basic observations on a regular basis’.

The argument is that ED nurses are ‘satisfied’ because their work is hard, and that, because their work is ‘light’, other nurses only complain about working night shifts because of a lack of job satisfaction.

The witness believes night shifts are so easy that nurses often choose to work nights because it allows ‘those who are studying to attend lectures during the day and to do some study during quiet periods’.

The NSWNA has presented medical evidence showing it can be hard to maintain a healthy diet when working night shifts. However, the Department’s witness said: ‘In my opinion, there is nothing inherent about working night shift that is more likely to lead to nurses eating lollies or other unhealthy food during the shift.’

In his submission on behalf of the NSWNA, Dr Ron Grunstein, who is a global expert in sleep medicine, said working nights radically displaces the body’s natural circadian rhythm, thus disrupting natural eating patterns. A nurse working nights is likely to ask herself if a meal at 8am is dinner or breakfast. Should she eat steak and vegies or a bowl of cereal with yoghurt? And at what time should she eat ‘lunch’, assuming she can find a place to buy a decent meal in the sleepy hours of the night?

Because many nurses care for their families during the day, it can be hard to find time to prepare meals before going to work.

Eating disruptions was a minor detail of Dr Grunstein’s medical evidence in relation to the disruption to circadian rhythms, which also increases the risk of developing breast cancer, cardiovascular disease, gastro-intestinal disorders and reproductive health problems. However, the Department has not responded to any of this evidence.

Instead, the Department and its witnesses have focused on relatively minor issues, such as arguing there is no evidence that increasing night shift penalty rates would help retain older nursing staff, and that working four night shifts in a roster is less detrimental than working seven.

‘If a nurse is required to work a large number of nights in a 28-hour period, for example seven or more, this is likely to have more negative consequences than a nurse working four [nights] or less,’ said a witness for the Department.

What nurses say

NSWNA members Karen Featon, Donna Garland, Dianne McCarthy and Grant Isedale have responded to the Department’s evidence as part of the Association’s claim before the NSW Industrial Relations Commission. Here is some of what they had to say:

Night shifts on medical wards are ‘easy’

Donna Garland: ‘Medical Wards are some of the heaviest wards in the hospital with some of the poorest staff mixes. These units have an increased number of older patients, often with complex co-morbidities, and there is great pressure to discharge patients as quickly as possible. The current patients in medical wards are not light work for night shift workers in any respect.’

Working four night shifts in a roster is less detrimental than working seven or more

Karen Featon: ‘In my time working as a nurse, only on the very odd occasion have I known nurses to work seven nights in 28 days. I usually work nights night shifts per 28 day cycle and the disruption caused is very detrimental.’

Night shifts allow time for study

Donna Garland: ‘I have never heard these sentiments expressed by nurses or midwives. On the contrary, they express the opposite view that night shift impacts upon their ability to focus during lectures, to do assignments and to study in their own time.’

Grant Isedale: ‘I do not know of any department or unit in which nursing staff would have downtime on a night shift to study.’

There is nothing inherent about night shifts that cause unhealthy eating

Karen Featon: ‘Working night shifts means that eating patterns are in turmoil, exercise routines are more frequently put on hold, and normal family and social life is disrupted.’

Dianne McCarthy: ‘If nurses are not well prepared in terms of bringing
their own food then the choice in our facility is the vending machine food. When you are tired, often take away, while not the healthy option, is the easy option.’

There is no evidence that increased penalty rates will help retain nurses

Grant Isedale: ‘I believe younger nurses would be more willing to do night shift, and weekend nights in particular if there was higher remuneration available. Most of these nurses have family expenses, mortgages and child care to pay for so any extra money would be beneficial. Older nurses would be more inclined to remain in the workforce if there was a reduced requirement for them to work nightshifts.’

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