Nurses’ And Patient Safety Should Not Be Placed In Competition

28 June 2019

Opinion piece published in today’s edition of The Advertiser

Gayle’s Law, which is aimed at keeping nurses, midwives and other health professionals safe from harm when providing care in remote towns and settlements, has been back in the news lately. The State Government says they have “got the balance right” when setting down the new regulations that will finally see the laws take force.
But the proposed regulations require remote area nurses, midwives and other health professionals to make an on-the-spot choice between their safety or a patient’s wellbeing. It is clear this ‘balance’ is completely out of focus. We need regulations that, as intended by the legislation, make sure that nurses are accompanied when making out-of-hours and unplanned trips to provide care to people in isolated and remote settings.

The balance that needs to be struck is not between nurses/midwives and their patients but in forcing funders—mainly governments along with the local health services—to act in ways that will ensure the safety, health and wellbeing of all.

Gayle’s Law makes it abundantly clear: no health care professional working in remote areas should be forced to attend after-hours emergency callouts alone. Health service providers in these areas need to have processes in place where a second responder is recruited, trained and ready to go. This need not be another health care worker, but a teacher, police officer, Aboriginal elder or Aboriginal health worker to provide additional protection.

There may be times when a trained second responder is not able to attend, and we would expect health care providers to have planned for this type of scenario. Like any other employer they must meet their obligation to their employees which is to provide a safe work environment and safe systems of work. These health services cannot duck their responsibilities to manage risk and meet their duty of care,  both to their staff and to the communities to whom they provide care.

Abrogating this responsibility to the individual nurse, midwife or other health professional in leaving them to assess whether an after-hours emergency warrants one or two responders is potentially asking them to make a choice between their safety and their patient’s welfare.

Deciding it is safe to attend alone may place them in unforeseen danger but deciding to wait for a second responder may take critical time a patient might not have. And, under the proposed regulations, liability for an adverse outcome in the latter scenario rests with the health care professional who could face professional sanctions.

Only when we have regulations that remain faithful to the intent of a law enacted to ensure the safety of remote area health care professionals and their patients will we truly have the balance right.

Adj Assoc Professor Elizabeth Dabars AM