There is nothing as taxing as working night shift. Not because the work itself is any harder than during the day, but because sleep deprivation tests your endurance. Any shift worker will tell you that, yet management of public pathology services seem to think night shift is a bludge.
A while ago where I work they decided that it would make great sense for the overnight scientist to be responsible for the monthly maintenance of our main analyser machine. When it was pointed out that this would entail a sleep-deprived individual handling dangerous chemicals while entirely on their own – a clear occupational health and safety issue – their retort was that they expect us to be well rested when we turn up to night shift.
Anyone who has worked in the sector for any length of time knows too well that increasing workloads and understaffing are a systemic problem in allied health. In pathology there are two main causes for this. Firstly, the increased reliance of medical staff on pathology testing for diagnosis and patient monitoring. Secondly, the systemic underfunding of our public hospital system that leads management to try to “do more with less” – read squeeze more and more out of an exhausted workforce.
In the 10 years that I have been the union delegate at my current workplace, not one extra scientist has been hired. This is despite the fact that, as management constantly tell us, the quantity of work coming in keeps going up and up.
What’s more, in those 10 years there has not been a single day in which we’ve been fully staffed. Whenever a position becomes vacant, management always drag their feet filling it. It’s standard for there to be a gap of a month or more between someone finishing and their replacement being hired. The longer they delay, the more money they save.
Management even do this when it comes to backfilling maternity and long service leave, which is particularly egregious considering how much forewarning they have for this type of leave.
In my department (of 20 people), we are currently down three full-timers. One was promoted into a management position three months ago. Another went on maternity leave a month and a half ago. We’ve been told that they are just about ready to appoint, but there is no set date for the new people to start. When they do start, it will take at least three months for them to be trained, and in the meantime the rest of us will be expected to pick up the slack.
Unfortunately, this sort of chronic understaffing is the norm across the sector. Ridiculously heavy workloads, massive amounts of overtime (mostly unpaid), and sped-up roster rotations are the result. Management relies on the fact that our concern for patient wellbeing is so high that we’ll compromise our health and safety to ensure the work gets done.
Our union, the Medical Scientists Association of Victoria, recently commissioned an independent investigation of rostering and staffing in public pathology services. Researchers at RMIT were asked to undertake a study of rostering practices in four public sector pathology services: Melbourne Health, Alfred Health, Monash Health and the Royal Children’s Hospital. Their focus was on the impact of current rostering practices on fatigue and absenteeism. The study was conducted in the second half of 2018 by analysing rosters, interviewing pathology services senior managers and conducting focus groups of scientists.
The researchers found the services to be chronically understaffed. Each department, according to the report, was found to be “understaffed by four to five full-time Medical Scientists”. This shortfall was found to be compromising the health and safety of workers, to the point where there is significant risk of injury. It was also found to have a detrimental impact on patient safety and make it difficult for management to comply with enterprise bargain provisions concerning rostering, leave relief and workload. Medical scientists reported feeling under pressure to work night shift and meet the demands of unrealistically high workloads.
In recent years medical scientists, in conjunction with the union, have made a concerted effort to address this issue by enforcing clauses in our agreement that require staffing shortages due to annual leave to be filled. This has had reasonable success, but it has been a frustrating process, with hospital management doing everything in their power to avoid having to hire more scientists.
Ultimately, staffing and all the other issues that impact negatively on the pathology workforce and the quality of patient service (outsourcing of public hospital pathology services and down-skilling of the workforce, among others) will not be dealt with until state and federal governments start properly funding our public health system.