Nurses are warning the public to avoid hospitals if they can next Wednesday during industrial action that follows a breakdown in negotiations with the government over pay and conditions.
Nurses will walk off the job between 11am and 2:30pm for a stop-work meeting to protest the government's refusal to implement nurse-to-patient ratios.
"We're advising the public if you can, avoid hospitals on the 12th of October for the couple of hours between midday and 2pm," Australian Nursing Federation (ANF) WA secretary Janet Reah said.
"Give the nurses a chance to come and talk and discuss action and get what they deserve."
The ANF has warned the meeting will be just the start of industrial action which will escalate further if the government does not come to the table.
The state government is currently negotiating deals with a range of public sector unions, and last month was forced to put forward its third wages offer in less than a year.
That offer would see workers who earn less than $104,000 paid an extra $60 a week, while workers over that threshold will be paid an extra 3 per cent a year.
Both will also get a one-off $3,000 sign-on bonus.
But the ANF, which represents 39,000 of the state's nurses, midwives and carers, wants the government to also agree to a range of conditions.
In addition to nurse-to-patient ratios, the union has asked for midwife-to-patient ratios which count babies as patients in the equation.
WA hospitals currently use a Nurse Hours per Patient Day (NHPPD) system which the union has said does not work.
"This government has missed another opportunity to have our mass meeting next week postponed by not meeting our requests," Ms Reah said.
"The only reason I can see for this delay is that the government does not want to talk about ratios because it will expose the lack of staff, and it's black or white, if you have ratios you either have enough staff or you do not.
"Whereas at the moment they are fudging the figures with the NHPPD, they've been lying for two years about the scope of our nursing and midwifery shortages."
Nurses want Victoria's 4:1 model
Several other states in Australia have adopted nurse-to-patient ratios including Victoria, which legislated for one nurse to four patients during the day and one to eight at night.
Ms Reah has said the government should start by committing to ratios and begin trying to implement the Victorian model.
She said the nurses' enterprise bargaining agreement (EBA) expires on October 11 and the government has had a long time to meet their requests.
"They've had our log of claims since July and that has been detailed in that log of claims, the pay rise we wanted and the ratios," she said.
"They need to commit now and then we can get a working party together to sort out what ratios would look like in the various wards and areas around the state."
Ms Reah acknowledged the ratios may not be achievable right away, but she was confident they could be met within a few months.
The ANF would like the ratios encoded in the EBA initially and legislated in the future.
Bed closures, overtime bans could follow
The ANF stop work meeting next Wednesday will be held at Perth Convention Centre and could see more than 2,000 members in attendance.
In a letter last month the union asked Health Minister Amber-Jade Sanderson to ensure hospitals were prepared to safely accommodate the disruption.
The ANF suggested elective surgeries be rescheduled and agency staff rostered on.
At the meeting nurses and midwives will vote on what further industrial action to take, which could begin that same afternoon.
The list of actions up for debate read as follows:
- Bans on overtime
- Bans on double shifts
- Rolling hospital based rallies
- Closing beds
- Rolling stoppages
- Flash mob stoppages
Asked whether such action could put patients at risk Ms Reah said they were already in danger.
"Patients are already at risk, we're running below minimum safe standards now from day to day," she said.
"That's why nurses are so frightened and angry, because it's not just risk to themselves and their patients, it's a risk to their reputation and career.
"They can lose everything if a patient dies on their watch because they can't get to them because their workloads are impossible."
The ANF indicated they had little hope the government would come to the table with an "acceptable offer" before Wednesday's meeting.
"We would rather not have to force their hand but we're running out of options, we've been quite open to postponing the meeting," Ms Reah said.
"They literally said they had no offer for us this morning, which is very disappointing.
"So, it's up to the government again, the ball is in their court."
Earlier in the day, the health minister said negotiations were ongoing with the union but did not comment directly on nurse-to-patient ratios.
Government leaves open threat of IR Commission
Ms Sanderson also would not rule out going to the Industrial Relations Commission to try and stop proposed action.
"I would expect the ANF to minimise disruptions to patients, as every other union in the health sector has done when they've taken industrial action," she said.
"I would always prefer not to have to go to the Commission, and expect the union to do the right thing and minimise the impact on patients."
Ms Sanderson said a decision to go to the Commission to halt any industrial action would ultimately be made by the Health Department.
"They'll keep a close eye on patient safety and certainly impacts on hospitals," she said.
In 2013 the ANF ignored advice from the Commission to halt industrial action.
At the time union members closed one-in-five beds for a number of days as part of their push for an up to 20 per cent pay rise over three years.
WA's Health Department accused the union of putting patients' lives at risk and asked the Industrial Relations Commission to intervene.
Further strike action was averted shortly before it was due to begin when then-Premier Colin Barnett offered a 14 per cent increase.
As the then-opposition leader, Mark McGowan sided with the nurses and said he believed they had a good case.
This time around, Ms Reah has questioned what the government would present to the Industrial Relations Commission.
"Well, they can go to the Commission but they haven't got an offer to bring to the Commission to say that we've refused or we're ignoring," she said.
"So, it's going to look pretty silly for them going to Commission lodging a complaint and they say 'Well, what have you offered the ANF?' and they say, 'Well, nothing',"
"They would look pretty foolish if they did that."
The ANF has also asked the government to provide nurses with the offered $3,000 cost of living bonus now as a show of good faith as negotiations continue.
The union said WA nurses are the second-lowest paid in the country.