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Report From a National Survey Of Health Service Facilities for the National Review of Nursing Education 20013. Staff DemographicsSeveral questions relating to staff demographics were asked, particularly with respect to qualifications and experience, in order to establish a profile of respondents. Establishing such a profile was undertaken as an alternative to organisational size (see Table 4). In addition, these data were sought to determine whether decisions about providing clinical experience to students or taking new graduates related to staffing variables such as skillmix (the use of unskilled workers and clinical nurse specialists) or staff experience (in years). Institutions were asked to indicate for the previous 12 months the average number of full-time equivalent staff (FTE) employed in several classifications. These included registered nurses, midwives, enrolled nurses and unskilled workers such as assistants in nursing (AINs) and patient care assistants (PCAs). Respondents were also asked to indicate the years of experience for each staff classification (less than one year, 1-4 years experience, 5-8 years experience and 8+ years of experience). In Table 7 the overall numbers are expressed as the sum of all responses for that category. For example, for responses from the public category, there was a total of 337FTE RNs of less than one year's experience employed across the 51 responding institutions. Only single facilities have been included in this analysis as the intention of the question was to determine staffing at the institutional level in order to evaluate the impact on staffing and workload of having student supervision added. Table - 7 Overall staff numbers by category of institution by years of experience at single facilities (n indicates number of responses)
Registered nurses - Table 7 indicates that in the not-for-profit category, the number of FTE registered nurses increases with each experiential group from 173.5 FTE with less than one year experience to 1 125.2FTE with 8+ years experience. A similar trend is found in the private for-profit category which increases in each band of experience from 177.9 FTE registered nurses with less than one year's experience to 2 196.3 FTE with 8+ years. The charitable category has a similar pattern but there is a substantial increase in the number of registered nurses with more than eight years experience. In the public institution category there is a fairly substantial increase in the number of staff with 8+ years of experience. Midwives - For all categories of institution the sum number of FTE rises for each band of experience (Table 7). Of note, there is a sizeable increase in the number of midwives with 8+ years of experience in the public institution category and an even more marked increase in 5-8 and 8+ years of experience for midwives in the private not-for-profit category. Enrolled nurses - There is an increase in the sum number over the experiential bands in the public category. In the private for-profit category the sum number of enrolled nurses increases from 52.9 FTE with less than one year experience to 294.2 FTE with 8+ years of experience. There is a similar trend in the private not-for-profit category as well (34.5 to 163.44 FTE). In the charitable category there is a slight drop in the 1-4 range of years experience. Assistants in nursing (AINs) or patient care assistants (PCAs) - Across all categories of institutions there is a decrease in the sum number with 5-8 years' experience, but the sum increases at 8+ years. In terms of skillmix, institutions were also asked to indicate the number of paid/salaried clinical nurse specialists (CNS or Level 2 RN), student midwives and enrolled nurses who were employed at the time of the survey (Figure 2). Figure 2 - Mean number of staff (CNS, student midwives and enrolled nurses) employed at single facilities by category of institution
Figure 2 indicates that there are more clinical nurse specialists (CNSs) and enrolled nurses (ENs) employed in the public institution category than the others. The large number of CNSs in the public institution category is important when the number of undergraduate bachelor of nursing students provided clinical experience is considered (see Tables 8, 12 and 13). The charitable category has the least number of CNSs and enrolled nurses. There is little difference across all categories in terms of the small numbers of student midwives. The number of years of experience is one measure of skillmix as is the number of specialist clinicians such as clinical nurse specialists. Another is the number of staff holding or undertaking postgraduate study (see Figure 3). The mean number of nursing staff holding postgraduate qualifications below appear as 'Postgrad qual' on the X axis while those currently studying appear as 'Univ course'. Results are again presented by category of institution and only data for single institutions have been included. One institution in Tasmania indicating it had 1 911 CNSs was also excluded. Figure 3 - Mean number of staff (A) holding university postgraduate qualifications or (B) undertaking university courses in single facilities, by category of institution
There are many more nursing staff who hold postgraduate qualifications in the public category institutions. There are also more in the public institutions who are undertaking a university course (type not specified). [Note differences in the Y axis]. Overall, the charitable category of institutions has far fewer nursing staff with or undertaking postgraduate qualifications. 3.1 SummaryIn summary, the employment of 337 registered nurses with less than one year experience in the public category indicates that they are a major employer of new graduates. However, it is impossible to determine from the data what proportion of the staffing profile this represents in each individual institution. Further work should be undertaken to determine whether institutions have large numbers of less experienced staff relative to numbers of more senior and experienced staff. In the private (for-profit and not-for-profit) categories the numbers of registered nurses in both the 5-8 and 8+ years of experience represents a significant resource that may support more involvement in nurse education. Public health facilities are more likely to employ expert clinicians (CNSs) and enrolled nurses. The number of registered nurses employed who have less than one year experience (new graduates) is low for a national figure and it reflects the level of under representation of metropolitan-based public category institutions, particularly in NSW and Queensland. More registered nurses in the public institutions have or are undertaking postgraduate qualifications. This may reflect the greater number of agreements and collaborative links between the public category of institutions and universities (see Tables 31 and 39). |
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