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Blood donors will be increasingly cared for by assistants without nursing qualifications under controversial changes being carried out by the Australian Red Cross Blood Service that have sparked concerns about quality of care.
Nursing assistants who receive significantly less training and payment than university-trained registered nurses have this year started putting needles into donors, administering intravenous drugs and monitoring people for adverse reactions at Victorian, Tasmanian and Queensland collection centers.
Secretary of the Victorian branch of the Australian Nursing and Midwifery Federation, Lisa Fitzpatrick, said she was concerned about how this would impact on the safety of donors and the mix of nurses and assistants caring for them.
While the Blood Service insists that registered nurses will still be caring for donors and overseeing their treatment, Ms Fitzpatrick said the service’s management had been “dismissive” of the qualifications of registered nurses and enrolled nurses who generally receive three years and 18 months’ training respectively.
“We view the blood service as a vital part of the health care services. Unfortunately, the Blood Service has described itself to us as more akin to a manufacturing plant. We consider this to be alarming,” she said.
University-trained “registered nurses” and TAFE-trained “enrolled nurses” have traditionally been the main carers of blood donors in Australia, but in 2010 the blood service started employing “nursing assistants” to take needles out of donors and monitor them.
Since 2013, these assistants who earn a maximum of $45,000 after completing about six months of part time study, have been progressively allowed to complete extra training in blood collection and first aid to take on more tasks.
The 2012 Enterprise Bargaining Agreement shows enrolled nurses earn a maximum annual salary of $54,000 and registered nurses $71,000.
Executive Director of Donor Services Janine Wilson said the service was changing its workforce because of forecast nursing shortages and to improve waiting times for donors. She said it was not an “economical decision”.
“The Blood Service, along with other health organizations, is acting now to ensure we have a sustainable workforce in our donor collection centers so we can continue collecting blood without interruption,” she said.
One nurse who works for the service said she was concerned the move was a cost cutting exercise that could undermine the high quality of care that keeps unpaid donors coming back. She said some nursing assistants lacked the experience to comfortably insert needles and pick up on signs that suggest a donor is unwell.
“There will always be at least one nurse on the donation floor while people are donating, but there are two main issues with this; the nurse is usually busy, and the DSNA (nursing assistant) often doesn’t recognize that they need help until they’re a long way out of their depth. You don’t know what you don’t know,” said the nurse, who did not want to be named.
But Ms Wilson said data from states where nursing assistants had been taking blood showed no impact on donor safety.
“In fact, anecdotal feedback from staff in those states is that having more skilled people on the donor centre floor results in reduced waiting times for donors,” she said.
Ms Wilson said the service currently employed 449 registered nurses, 397 enrolled nurses and 204 nursing assistants.
Original article published 4/1/15 by The Age.