The following is based on state and federal health department information. ANMF has written to all private, not-for-profit, local government and stand-alone community health centre employers urging them to follow the DHHS advice in the Coronavirus Guidance Note on Employment-Related Matters.
Advice for pregnant members
The Royal Australian and New Zealand College of Obstetricians and Gynaecologists recommends that where possible pregnant health care workers be allocated to patients, and duties, that have reduced exposure to patients with, or suspected to have, COVID-19 infection.
If you are at higher risk if you contract coronavirus, you need to inform your employer, so they can take steps to minimise your risk.
A pregnant employee has an entitlement to request a transfer to a safe job without loss of any employment conditions in circumstances where it is inadvisable for the employee to continue in their present position. Members are advised to initiate a discussion with their manager/employer and request a transfer to a safe job for the duration of your pregnancy.
Members who are unable to secure an acceptable offer of a safe job from their employer should submit a Member Assistance online inquiry.
The DHHS COVID-19 guidance note on employment-related matters (bit.ly/2UhDSU2) says employers should offer at risk nurses and midwives the opportunity to temporarily transfer to other duties, flexible work arrangements, or work from an alternative location – including working from home – to reduce your risk of infection with the coronavirus. The department says employers should try to accommodate employees’ requests for these arrangements.
In some cases, employers and employees might reach agreement on taking paid leave.
ANMF has asked all health and aged care service employers to follow the DHHS employment guidance.
Members who are at greater risk if they contract coronavirus and have not been able to reach a satisfactory arrangement with their employer to eliminate or minimise their risk, should contact ANMF via Member Assistance online inquiry form.
Personal protective equipment
The COVID-19 pandemic is unprecedented and so is the international demand for personal protective equipment.
Given the circumstances, what is considered reasonable PPE measures may change.
ANMF understands that the state and federal governments have ordered more PPE and that there are regular deliveries. On 19 March Premier Daniel Andrews announced an extra $22 million of PPE – including 275 million pairs of gloves, 8.6 million face masks, and 1.7 million gowns to keep workers safe while they help others. This is in addition to the $10 million for PPE previously announced.
DHHS is advising employers that part of their responsibility in minimising risk to employees is providing personal protective equipment such as gloves, gowns, masks, eye protection and respirators commensurate with the level of risk faced by an employee in the duties they perform and the direct environment in which those duties are performed.
Employers have an obligation to provide you with adequate PPE. If PPE is unavailable, and as a result your health and safety is at imminent risk, raise your concerns immediately with your management, and Job Rep and Health and Safety Rep. In the event your issues are not resolved please contact ANMF via Member Assistance online inquiry form.
DHHS is updating information on its website. Members are encouraged to read the latest Healthcare worker PPE guidance – update 26 March.
Victoria’s Chief Health Officer has advised public health sector employers to follow the WHO guidance (updated 19 March) on who does and does not need to wear PPE.
The WHO is urging interventions that minimise the need for PPE to optimise its availability. These are:
- using telemedicine to evaluate suspected cases of COVID-19 where possible
- using physical barriers to reduce exposure to the virus, such as glass or plastic windows at triage areas and reception/registration desks
- restricting healthcare workers from entering rooms of COVID-19 patients if they are not involved in direct care
- restricting the number of visitors in areas where COVID-19 patients are being isolated.
WHO advises use of PPE as follows:
- Healthcare workers involved in the direct care of coronavirus patients should use the following PPE: gowns, gloves, medical mask and eye protection (goggles or face shield).
- Specifically, for aerosol-generating procedures (e.g. tracheal intubation, non-invasive ventilation, tracheostomy, cardiopulmonary resuscitation, manual ventilation before intubation, bronchoscopy) healthcare workers should use respirators, eye protection, gloves and gowns; aprons should also be used if gowns are not fluid resistant.
WHO has issued clear guidance on appropriate clinical practices, including guidance on who does NOT need to wear PPE if proper protocols are in place and followed. WHO recommends that healthcare workers do not wear a mask when caring for patients or clients who do not have coronavirus symptoms.
Where members have raised PPE supply concerns with ANMF we are raising these issues with the DHHS to find a solution. Our Branch officials are also working with the DHHS on nursing, midwifery and workplace health and safety issues impacting across the state.
Expansion of COVID-19 testing eligibility criteria
On 25 March the national cabinet expanded the COVID-19 testing criteria to include testing health workers and aged care workers who have fever or acute respiratory infection.
The expanded testing criteria also includes people with fever or acute respiratory infection in:
- geographically localised areas where there is elevated risk of community transmission as defined by the local public health unit
- high risk settings where there are two or more plausibly-linked cases, for example:
- aged and residential care
- rural and remote Aboriginal and Torres Strait Islander communities
- detention centres/correctional facilities
- boarding schools
- military bases (including Navy ships) that have live-in accommodation.
National cabinet also agreed that testing will be expanded to include hospitalised patients with fever and acute respiratory symptoms of unknown cause, at the discretion of the treating clinician.
Safe Patient Care Act and staffing levels
How do the provisions of the Safe Patient Care Act apply if the number of people requiring health care vastly outstrips the capacity of the system?
Victorian Premier Daniel Andrews’ declaration of a State of Emergency on 16 March does not suspend or override other legislative requirements.
It gives the government the power to enforce mandatory self-quarantine for people returning from international travel as well as the power to enforce social gathering restrictions.
If demand is so overwhelming that maintaining ratios becomes challenging, the DHHS, health services and the ANMF will work together to find a solution that protects patients, nurses and midwives.
Elective surgery wind back and redeployment
On 25 March the national cabinet suspended all non-urgent elective surgery from midnight, 25 March. On 26 March, Prime Minister Scott Morrison extended the deadline for the suspension of some Category 2 and 3 elective surgery at private hospitals to 11.59pm on 1 April.
This decision will have a significant impact on all public and private acute workplaces that undertake elective surgery.
ANMF is liaising directly with all employers to mitigate the impact of this decision.
We anticipate that the public sector and larger private acute employers will have greater capacity to redeploy theatre staff to other areas within their hospitals. This will be subject to nurses being clinically safe, and provided with support where it is needed, to work in other areas.
We also expect the impact of this announcement at smaller private acute hospitals, particularly those that are stand alone, may be more significant.
ANMF will be undertaking urgent discussions with those employers to ensure, as far as practicable, that members’ employment interests are protected. By necessity this is likely to include negotiations relating to ensuring all accrued annual and long service leave entitlements, special paid leave and an agreed process to deal with members who may be ‘stood down’ temporarily or discussions concerning redundancy payments.
ANMF will also undertake discussions with the DHHS to attempt to secure alternative employment (either temporarily or permanently) with public sector health facilities.
Workplace-specific newsflashes are being issued.
Dual employment more than one employer? More than one site?
A number of members, who undertake dual employment, have contacted the ANMF.
These members may typically perform work at more than one site but with the same employer or they are employed in two or more jobs with two or more employers.
Some members have reported that one employer is requiring them to cease employment with their other employer due to concerns relating to cross infection between the two sites or between the two employers.
There are a number of scenarios where this situation may occur. For example:
- a member is employed at large employer and works at two different sites from time to time
- members who may work for two different employers, such as 0.4 EFT with one aged care facility and 0.6 EFT at a different aged care facility
- maternal and child health nurses and immunisation nurses working for more than one local government organisation
- agency nurses and midwives.
All members need to be mindful of workplace health and safety guidelines and good nursing and midwifery infection control principles and practices.
Regarding residential aged care facilities, the Australian Health Protection Principal Committee has not taken a stand on this issue. Its latest statement on 17 March says:
The following visitors and staff (including visiting workers) should not be permitted to enter the facility:
- those who have returned from overseas in the last 14 days
- those who have been in contact with a confirmed case of COVID-19 in the last 14 days
- a contact is defined as anyone who has been in contact with a known case, including the 24 hours before the case became symptomatic
- those with fever or symptoms of acute respiratory infection (e.g. cough, sore throat, runny nose, shortness of breath) symptoms
- those who have not been vaccinated against influenza (after 1 May 2020).
DHHS states in its actions for residential aged care facilities that they should:
- Not permit visitors or staff to enter the facility who:
- have returned from overseas in the last 14 days
- have been in contact with a confirmed case of coronavirus (COVID-19) in the last 14 days
- have fever or symptoms of acute respiratory infection
- from 1 May 2020, have not been vaccinated against influenza.
- Require visitors and staff to provide details of symptoms consistent with coronavirus (COVID-19).
There is currently no restriction on members undertaking dual employment unless any of the above scenarios apply.
Members who have matters arise concerning dual employment should submit via the Member Assistance online inquiry form.
Social media – the good and the bad
Supportive online communities for nurses, midwives and carers have popped up all over social media.
The COVID-19 pandemic has created a new normal, but some things stay the same.
Nurses, midwives and carers must still follow their employer’s social media policy and the NMBA’s social media guidelines. ANMF strongly recommends your online activity is also guided by our ANMF social media policy.
Members are urged to be cautious with their private information on social media.
Members are also strongly advised not to discuss, or vent about, what their employer is doing or not doing in relation to COVID-19 on any social media platform or online forum.
Instead please raise your concerns with your immediate manager at work. If your issues are not satisfactorily addressed submit an online inquiry via Member Assistance for advice, guidance and/or representation.
ANMF acute care re-orientation education updates
The first ‘Re-orientation to acute care setting’ workshops start next week at the ANMF Education Centre.
The two-day workshops, in our nursing simulation labs, are limited to eight per workshop to ensure COVID-19 physical distancing rules are maintained.
We received an overwhelming response from nurses so we have opened a ‘register your interest form’ so we can understand the demand for this education and plan more workshops.
If you would like to refresh your acute practice skills register your interest.
The course, sponsored by ANMF (Vic Branch), First State Super and HESTA, is provided at no cost.
To register for the course, nurses are required to nominate three hospitals you are prepared to work at in the event an increase in COVID-19 patients means an additional workforce is needed.
Emergency nurse COVID-19 patient webinar
The College of Emergency Nursing Australasia has opened up 100 free places for emergency nurses to participate in a live webinar titled ‘Caring for the critical and ventilated COVID-19 patient in the ED’.
Register for the 31 March webinar.