PCH Rally

HISTORIC RALLY:

NURSES AND DOCTORS UNITE TO FIGHT PCH INJUSTICE

The tragic death of Aishwarya Aswath exposed the plight of hard-working nurses and doctors across a WA Health system in crisis, and how the Department and State Government ignored their desperate cries for help for more than six months, until now … Nurses from across Perth rallied on Tuesday 25 May to support their colleagues at Perth Children’s Hospital (PCH) after three junior colleagues were reported to the Australian Health Practitioner Regulation Agency (AHPRA) over the tragic death of a seven year-old girl. On Easter Saturday 2021, Aishwarya Aswath was presented at the PCH Emergency Department (ED) by her terrified parents, and waited almost two hours to be seen, before she died of sepsis after being admitted.

NO TRIAGE POLICY IN PLACE AT PCH

On that night, one nurse was covering eight ED cubicles, another called to help administer life support to a critical patient, leaving a junior colleague alone at the busy triage desk with no triage policy in place at Perth’s largest children’s hospital. Despite acknowledging the risk of a death or disaster in the PCH ED was formally and specifically communicated by frontline nursing staff to the Child and Adolescent Health Service (CAHS) executive 12 times since October 2020, after Aishwarya’s tragic death, CAHS and WA Health prematurely reported the two junior nurses, and one junior doctor, who briefly saw the seven-year old in the waiting room, to AHPRA, the most powerful professional watchdog which deals with serious misconduct and malpractice, and before a proper internal and coronial inquiry was undertaken. The move has been widely acknowledged as akin to “pushing” junior staff “under the bus”, particularly after their concerns about significant risks were ignored more than 12 times over six months in the lead up to the death. The ANF WA supports these and the other PCH nurses.

WHAT THE EXECUTIVE AND THE HEALTH MINISTER KNEW

CAHS and WA Health have admitted that workforce shortages, acuity and increasing patient presentation numbers at PCH had been formally and specifically communicated to the medical and nursing stream leadership group, and members of the executive team, on a number of occasions from October 2020 – way before Aishwarya’s tragic death in April 2021. Meetings had occurred between the ED staff and the executive, and data was presented to illustrate the concerns, specifically concerns around the safety of children in the waiting room.

Minister for Health Roger Cook addresses the angry crowd

WA Health admitted that during the transition from Princess Margaret Hospital to PCH in 2018, a “triage support nurse” was supposed to be added to conduct vital signs, complete an initial assessment, and initiate care at the commencement of the patient’s journey, but, due to the establishment numbers, this was not progressed. There had been ongoing and well-known concerns about the design of the PCH waiting room, resource capacity, about education and clinical supervision of nursing staff – and let’s not forget – not even a triage policy at Perth’s premier children’s hospital.

IN DENIAL

But WA Health Director General, David Russell-Weisz, denied any knowledge of the issues in the PCH ED until after the tragic death, as did Health Minister and Deputy Premier, Roger Cook, who was directly contacted by ANF WA State Secretary, Mark Olson, about the issues in October 2020 – again - way before Aishwarya’s tragic death in April 2021. The chair of the hospital board, Debbie Karasinski, stepped down after an initial report on Aishwarya’s death was handed down, however Dr Russell-Weisz refused to accept the resignation of PCH Chief Executive, Aresh Anwar, who admitted he knew about the ongoing and serious concerns of frontline workers over many, many months.

ANF ACTION

With no action resulting from the ANF concerns raised with the Health Minister in October 2020 days after Aishwarya’s tragic death, the ANF acted swiftly to ensure staff in the PCH ED were adequately supported, and their concerns acknowledged, by successfully lobbying the Health Minister, Roger Cook, to implement a life-saving 10-point plan. Among the changes requested was a minimum of one nurse for every three patients, specifically trained paediatric security staff, and, on top of normal staffing levels, a dedicated resuscitation team. He also promised the Paediatric Critical Care Unit would be opened to its full capabilities, and nurse applications would be fast-tracked to four weeks.

ANF State Secretary talks to members at the PCH rally

NURSES THROWN UNDER THE BUS

Then came the shocking news about the premature, and arguably unnecessary reporting of junior nursing staff, and a junior doctor, to AHPRA – which WA Health claims was merely a notification. The ANF acted swiftly to understand members’ concerns that those in power were unfairly putting the blame for Aishwarya’s tragic death on the junior staff, and held a survey with 96 per cent in favour of taking industrial action and rallying outside PCH to: • Show support for the nurses under fire from the PCH Hospital Executive • Have the WA Health Minister acknowledge serious systemic problems in the public health system that require everyone working together to fix them – that includes the ANF and the AMA. • Have the WA Health Minister listen to concerns being raised by Members • Have role of the PCH Executive Nursing Team also looked at by AHPRA. • Request the WA Health Minister to drop his other portfolios and become a full-time health Minister for the next 12 months so that he can focus solely on fixing the problems. THE LARGEST DEMONSTRATION OF ITS KIND

On 25 May 2021, more than 1,000 nurses and other hospital workers rallied outside PCH.

They cried, they raged, they wrapped their arms around each other for support, and they demanded the Health Minister, Roger Cook, act immediately to address the critical issues they had been facing for months, and reported, months before Aishwarya’s tragic death. They waved placards and demanded justice, and acknowledgement of their concerns about the crumbling WA Health system, the risks posed to their patients, their own careers, morale and mental health, and the lives of everyday West Australians – namely WA’s children. For the first time in WA history, the Australian Medical Association, and its members, joined nurses in protest, along with sick patients and members of the public. News of the huge rally led every nightly news bulletin in Western Australia, and was broadcast across the nation, and around the world, with a large number of nurses standing up strongly to speak to the media, even on camera, about the critical issues. The rally was described as the largest demonstration of its kind in WA in a decade.

ANF WA State Secretary Mark Olson refused to go on camera after the rally to allow brave nurses to speak out. He had announced to nurses at the rally: • The ANF would refer the PCH Executive Nursing Team to AHPRA • The Health Minister would be notified of issues where members were advising they were chronically under-resourced or where member concerns were being ignored by the relevant Executive • The ANF would develop 10-Point Plans for other wards, units and areas – in consultation with its members in those areas

• There would be more rallies where requested by members including rallies in regional areas • To continue to contact him directly about issues that needed to be addressed, so that workplace meeting could be organised at times that suited staff and their colleagues

HISTORIC REPORT

On Friday 28 May 2021, the ANF WA reported three members of the CAHS executive to AHPRA after an overwhelming demand by ANF members at the PCH rally. Those reported make up the nursing contingent of the CAHS executive whose professional conduct is regulated by the Nursing and Midwifery Board of Australia.

ANF WA State Secretary, Mark Olson, said members called for the registered nurses on the CAHS executive to also be looked at after the publicly released SAC 1 report identified that workforce shortages, acuity, and increasing patient presentation numbers at PCH, had been formally and specifically communicated by frontline nursing staff to the executive team, on a number of occasions since October 2020.

“It is the first time in ANF history that we have reported executive nurses to the regulatory authority,” Mr Olson said. “Frontline nurses directed the ANF to do this. It is not personal. It is simply untenable that AHPRA only look into the practice of frontline staff, and not those who are responsible for the system in which those frontline staff work, and in circumstances where nurses have identified their specific concerns to management over and over again, including no less than 12 times since October last year.”

WHAT NOW?

The ANF is surprised and deeply concerned by the State Government’s approach in investigating the tragic death of Aishwarya Aswath. On 25 May 2021, the day of the rally, Health Minister, Roger Cook, outlined Terms of Reference for an Independent Inquiry into the PCH Emergency Department following the death, which was due to hand down its findings in August but has been significantly delayed and is now expected to be completed at the end of September 2021.

Patients from PCH joined the rally

THE ANF’S TEN POINT PLAN FOR PCH ED

1. Implement a staff allocation of one nurse for every three patients 2. Shift coordinators and triage nurses not included in floor numbers of dot point one – which means they don’t take a patient load 3. Supernumerary resuscitation team – minimum of 4 nurses for the resuscitation team would also be available to assist the floor staff with category 2 patients and patients with behavioural problems 4. Engagement from the PCH Executive team on a PCH Emergency

Department Taskforce that includes nursing representation. This will be a Staff Led Taskforce with key performance indicators to manage the transition and oversee the implementation of the above dot points aswell as looking at ways to recruit additional staff to the department in a timely manner 5. Double the number of Staff Development Nurses in the Emergency

Department 6. Open the Paediatric Critical Care Unit to its full capabilities to that it can function as an Intensive Care Unit and High Dependency Unit 7. A clearly articulated Winter/Surge Bed Management Strategy that is published and available to all staff and the community. 8. Fast track recruitment with a maximum turnaround time of 4 weeks.

That is no more than 4 weeks from application to working the first shift.

9. 3C (the short stay surgical unit) that currently closes at 3.30pm on

Saturday needs to be kept open 24/7 on the weekend and staffed appropriately as this will reduce access block. 10. Additional numbers of specifically trained paediatric security staff for the Perth Children’s hospital.

WHAT ABOUT US?

The ANF acknowledges that systemic issues are occurring right across the WA health system, and we are here for you. If you do have issues that need to be addressed, contact us immediately so we can organise a workplace meeting at a time that suits you and your colleagues. If you are not a member, now more than ever, it is time to join the ANF and unite with your colleagues to ensure the future is brighter and lives are saved. Let us know how you feel and we will support you individually, or as a group, including demanding a 10-Point Plan for your wards and rallies at your hospitals.

Brave nurses stood up at the rally and spoke to the Western Australian media about their concerns. Here’s a snapshot of what they said: “They’re always telling us how are we going to pay for more nurses? But, that’s what we need. Healthcare should not be run like a business. This is about people, and we can’t take care of people if you keep cutting the rug out from under us financially.” “We’ve been chronically understaffed and not enough’s really been done, even though we’ve been begging for help.” “I’ll come onto a shift as a coordinator I’ll be told that we’re down eight staff and they’re not replacing them and we somehow have to run a department without staff. It’s scary. It’s scary for the patients, it’s scary for the staff, it’s just not fair.”

THE SIGNS

Nurses at the rally were angry, they were furious, they cried and shouted and heckled the Health Minister, some threw their arms around each other for support. They remain devastated by Aishwarya’s death and its aftermath. They waved placards with their messages, and featuring the faces of those they feel are responsible for WA’s hospital crisis, PCH CEO Aresh Anwar, Health Minister Roger Cook, and WA Premier Mark McGowan.

“The nurses are struggling, everything is being micro-managed now, everything is being looked at, the nurses are being blamed. It’s just not the same anymore, it’s just not the ‘family’ we used to have. We used to be a happy team and now everyone is just going home upset and they’re afraid to come to work.” “We feel threatened. I’ve been in nursing for 50 years and Florence Nightingale — where I trained — would be ashamed. Those two nurses did nothing wrong. Am I going to be next?” “Withdraw the report.” “I don’t want to do it any longer. So the nurses in the ED are the first. Am I going to be the third? I’m angry.” “I’ve been here 35 years, and when I came here I wanted to come to work, and these days all I hear is my staff and other staff say I don’t want to come to work.” “Not only is there a problem here, but there is a problem through all of WA Health.” “Give us our nurses back.”

“Our base level of staffing was never enough to begin with, let alone being short-staffed.” “I feel threatened. A mistake might be made and I’m going to be the next.” “Do something.” “I want our emergency department to be united again, working together again, to support each other again.” “I’ve been in nursing 50 years, and I feel betrayed by the executives.”

Here’s a snapshot of their signs:

Anwar were you? | We told you 12 times | Please don’t throw me under a bus | Nurses save lives – the system kills | We care about Aishwarya | Listen to frontline staff | Doctors and Midwives Together | Let nurses care | Let doctors care | Where’s the 10-point plan for Graylands | Fiona Stanley has a staffing crisis too | KEMH has a staffing crisis too! | Stop the spin | We had your back, do you have ours? | Country Hospitals need help too | Are you listening now? | Report the executive – not us | I don’t feel supported by my hospital executive | Doctors and nurses together | Stop ramping | I stand with PCH nurses | Hospital Executive – you are the weakest link - goodbye | Our emergency departments are sick | I know my hospital executive will throw me: to the dogs, to the wolves, under the bus | Fix the system Roger | PCH Executive – stop shifting the blame – you were told 12 times | No more than four | Are you listening Roger?

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