Case Study and Nurses

Restructuring Victorian Public Hospitals

The case study narrates the impact of policy changes in the Victorian public health system on nurses. When the Kennett Liberal-National Coalition government came to power in 1992, a number of changes were undertaken in an attempt to reduce the health care budget. These included reducing staff numbers, restructuring hospital management, shifting to outsourcing of services such as pathology and radiology, privatising some public hospitals, and introducing throughput-based performance measures (Teicher, Holland and Gough, 2013). Though the changes were aimed at ensuring a more cost-effective public health system, there were negative impacts on the health care workforce, particularly nurses. The changes resulted in understaffing, undesirable nurse-to-patient ratios, increased workloads, poor pay, as well as turnover. Bracks' Labour government, which succeeded Kennett's government, focused on addressing these issues. The new government abandoned the privatisation of public hospitals and funded the establishment of new hospitals. This led to improved working conditions and more employment opportunities for nurses. Nonetheless, nurse shortage remained a major problem. The gains of improved nurse staffing were offset by the increased demand for health care services, owing to factors such as population ageing and technological advancement (Teicher, Holland and Gough, 2013).

One employment relations issue that is evident in the case study is staffing. To effectively achieve its overall goals and objectives, an organisation must have a sufficient number of personnel (Gennard and Judge, 2005). This is crucial for ensuring optimal workload, tolerable work pressure, as well as satisfaction with work. Adequate staffing is also important for retaining employees. As seen in the case study, the government in an effort to cut the health care budget introduced a set of measures that led to nurse understaffing (Teicher, Holland and Gough, 2013). This meant increased workload and work pressure on nurses. The problem of understaffing was further compounded by the burgeoning demand for health care services. This is likely to have undermined the delivery of quality, safe, effective, and timely care. In the health care context, understaffing can result in negative patient outcomes such as increased waiting times, greater incidence of medical errors, and elevated patient dissatisfaction, which can eventually injure the reputation of a health care organisation. Understaffing affects not only patients and the organisation, but also employees. As seen in the case study, work intensification caused most nurses to either shift to the private sector or leave the profession altogether (Teicher, Holland and Gough, 2013). Indeed, understaffing can have dire consequences on employees. It can be a source of physical and emotional exhaustion. Organisations must, therefore, ensure they have the right staffing levels.