Newcastle University nursing school facing budget shortfall and staff unrest

A series of disputes have come to a head at the one time at the School of Nursing and Midwifery, which trains hundreds of nurses and midwives every year from the Newcastle campus and at Ourimbah and Port Macquarie.

Documents obtained by the Newcastle Herald show:

The nursing school is grappling with a $5.4 million funding shortfall after the Federal Government axed its Health Workforce Australia clinical training fund;

Hunter New England Health has baulked at a plan to put all students from first, second and third years on placement at John Hunter Hospital at the same time, with issues of “patient safety” raised in negotiations involving University Vice-Chancellor Caroline McMillen, and;

The nursing school has come to blows with the main academic union after highly-trained staff were told to accept drastic cuts to their pay.

An overhaul of the executive management team has seen all three deputy heads of the nursing school replaced in recent months.

The university has embarked upon a program of cost-cutting after the Federal Government announced the immediate withdrawal of an $84 million fund –  designed to assist Australian universities with the costs of clinical training – in its mid-year fiscal and economic outlook in December.

A spokesperson for the University of Newcastle said the measures had impacted on "many" Australian universities and developing new, "financially sustainable arrangements" for 2017 was a priority.

Despite the budgetary concerns, the university’s latest annual report shows after-tax income for the 2015 calendar year of more than $60 million on turnover of $718 million.

One of the most controversial changes proposed under the leadership of the Dean of the School of Nursing and Midwifery, Professor Sally Chan, has been to way students are "placed" in various workplaces as part of their practical training.

Because of the sheer size of the school – with around 1750 students across three campuses – nursing placements have traditionally been "staggered" throughout the year.

But a plan for all the students to go on placement at the one time has brought the university into conflict with organisations such as as Hunter New England Health, that have happily accepted students since nursing became a tertiary degree. The nursing school celebrated its 25th anniversary last year.

Director of Nurses at John Hunter Hospital, Sally Milson-Hawke, admitted that under the new model, the hospital was no longer willing to take the same numbers of junior students.

"John Hunter Hospital is a tertiary hospital and as a result, many of our placements are in critical care," Ms Milson-Hawke said. 

"The critical care environment can be challenging, especially for new students. We have proposed that students that have progressed further through their degree, eg second and third year students, are placed at John Hunter Hospital as a priority.

"We will of course continue to accept first year students, however feel that they would benefit more from placement in a smaller hospital or aged care facility in the first instance."

Documents obtained by the Herald show the dispute has reached the highest levels of management, with a meeting held in order for "difficulties to be sorted out" between Professor McMillen and the chief executive of Hunter New England Health, Michael DiRienzo.

The university spokesperson said the school was also looking at an extension of the use of "simulated environments" as an alternative to practical training in hospitals.

Simulation is already widely used in nursing training, with students using mannequins to practise or hone nursing techniques.

The spokesperson defended a turnover in the ranks of executive management, with the three deputy heads of the nursing school – Professor Tracy Levett-Jones, Associate Professor Pamela van der Riet and Associate Professor Ashley Kable – replaced in recent months.

"The School has established a new generation of nursing leaders who are taking senior positions as deputy heads with extensive experience, which bodes well for the future of the school," the university spokesperson said. 

The university has also backed down on a move to cut pay rates for clinical assessors and clinical liaison nurses.

Clinical liaison nurses, who provide guidance to students on placement, were told in late June that an expressions of interest process had begun for their jobs. 

If they wished to reapply, they would have to accept a reclassified role and a new rate of pay – $22 an hour less than what they had been receiving. They were also asked to do their assessments in 4.5 hours instead of five.

The assessors act as the last line of quality control before the students enter the workforce as registered nurses. When many of the staff refused to reapply for their positions, the university began recruiting agency nurses to replace them.

With staff concerned about the quality of outsourced assessments, the National Tertiary Education Union intervened, arguing staff had not been given proper notice of the changes.

Newcastle branch president Tom Griffiths said the union was "pleased" the nursing school had reversed its decision, despite suggestions the plan could be revived next year.

"[The university] has demonstrated a willingness to work with staff and the union in the future before any further changes, if and when any further changes are made," Mr Griffiths said.

The head of the faculty, Pro Vice-Chancellor John Aitken, has become involved in the dispute, writing to academic staff in the first week of July to say he was aware of concerns "around clinical placements" and the workload of academics.

"I share your concerns and would like to provide some context around why these matters are becoming increasingly difficult to manage," Professor Aitken said.

"The expectation by us (along with many others) was that these ($5.4 million in) funds would be maintained in 2016 and any removal would include a transition period.

"Secondly, our budget for 2016 was cut whilst our student numbers increased. This, of course, adds further pressure to our already hard-working academic and professional staff."

Professor Chan told staff in an email this month: “I understand that many of you have concerns with workloads and clinical placement issues.

“The school is trying hard to resolve these challenges that are imposed on us.”

Commonwealth-supported students make a contribution of $6256 each year, over the three years of an undergraduate degree. 

The Herald asked how much of the money raised by the nursing school was spent in the school, and the university responded, saying: “The university's funding model passes the full funding from student revenues to faculties to meet their direct costs of teaching, administration and clinical supervision, with faculties then contributing on an agreed basis to meeting the costs of running the university and contributing to renewal of the university’s physical infrastructure and other strategic initiatives.”

Mr Griffiths acknowledged the federal funding cuts but said the university had intensified its cost-cutting with the arrival of the NeW Space Hunter Street campus.

"There’s constant restructuring and the university is trying to accumulate larger surpluses,” Mr Griffiths said.

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