Nurses in NSW have been campaigning for nurse to patient ratios for over 10 years. This week marks the beginning, but local nurses won’t see the impact just yet. 

The first step of implementing ratios for nurses was secured on 22 February 2024, when it was announced that NSW will have minimum and enforceable shift-by-shift nurse-to-patient ratios implemented in specific clinical areas of public hospitals. 

While NSW Nurses and Midwives Association (NSWNMA) General Secretary Shaye Candish said the announcement is a major milestone in the fight for ratios, it will begin small before seeing reforms roll out elsewhere. 

“Several EDs will see a substantial boost to their staffing numbers as these reforms are phased in…In Emergency Departments, there will be one nurse allocated to every three treatment spaces,” Ms Candish said. 

To begin with the reforms will be implemented at Liverpool and Royal North Shore Hospitals’ emergency departments during March. 

While other wards are expected to follow, there is no confirmation about when local Multi-Purpose Health Services (the model used for smaller rural hospital services) will see the same reforms. 

Nyngan is one local MPS where the need for better staffing has become critical.

Despite mystery around what reforms could look like, nurses are hopeful the changes will be soon to follow on a local level. 

“Nurses and midwives must not be forced to choose between safe workloads and fair pay for the work they do. This is a great first step, but there is more to do,” Ms Candish said. 

The NSWNMA Safe staffing for Country NSW campaign is fighting for a minimum of three nurses on all shifts, including two registered nurses, as well as ‘staffing enhancements’ available when there are no visiting medical officers and where hospitals are reliant on virtual medical officer coverage. 

The reforms came from negotiations with the government-appointed Safe Staffing Levels Taskforce, which was formed in April, 2023. 

NSWNMA members were encouraged to vote in favour of the reform, despite not being as extensive as the ideal outcome, to prove that ratios are a ‘worthwhile ongoing investment’, and to deliver workload relief for some.

According to NSWNMA, the Ministry of Health has also undertaken work to reform undergraduate Assistants in Nursing (AiN) roles to ensure job-readiness is maximised, in order to prevent ‘repeated shifts of poor skill mix being the status quo’.