NURSING shifts at John Hunter Hospital's emergency department are to be cut despite a state government pledge not to axe frontline services under health budget cuts, unions have said.
The Health Services Union has learnt department staffing is to be cut by one nurse every morning and one after midnight about four days a week.
Paramedics are concerned it will mean the number of ambulance off-loading beds will drop from five to three and extend the backlog of waiting ambulances.
Hunter New England Health said yesterday the roster had not changed but it regularly reviewed rostering to match emergency department activity.
It comes after a contingent of NSW Nurses and Midwives Association delegates joined 200 of their colleagues from around the state outside NSW Parliament yesterday for the launch of their nurse-to-patient ratio campaign.
Nurses want the state government to extend nurse-to-patient ratios to emergency departments, intensive care, children's wards, neonatal intensive care, high-dependency wards and community nursing.
Ratios exist in medical and surgical wards, palliative care and adult mental health.
NSW Nurses Association secretary Brett Holmes said it was particularly important in district hospitals such as Maitland, Muswellbrook, Kurri Kurri and Singleton where there were fewer allied health professionals to support staff.
At Singleton Hospital there was one nurse in the emergency department who frequently needed help from ward nurses.
Mr Holmes said at district hospitals nurse-to-patient ratios in emergency departments could be one nurse to six or 10 patients. Nurses want one to three.
"It's not unusual at Maitland to have to look after six or more patients," he said. "This is a great opportunity for the O'Farrell government to prove that it cares for country patients."
Health Services Union Hunter ambulance sub-branch president Peter Rumball said the John Hunter cuts were "absolutely ludicrous". "It's going to be chaos," he said. "We're going to have to sit there and nurse-maid patients in hallways."
John Hunter Hospital general manager Michael Symonds said there would be no change to nursing rosters until it had examined staffing levels and emergency department activity.
"The right level of nursing staff to match emergency department activity is our priority," he said.
Mr Symonds said John Hunter treated 89 per cent of patients coming off an ambulance within 30 minutes. The state target was 90 per cent.
"We are committed to ensuring that the care of patients arriving by ambulance is transferred to the treating team as soon as possible," Mr Symonds said. "Hunter New England Health works in line with state government directives in relation to frontline nurse employment."
NSW Health Minister Jillian Skinner said the government would negotiate with the union on ratios but would remain within the state government's wages policy of 2.5 per cent.
She said that under the current award they had recruited more than 3000 nurses, including 1300 in rural and regional NSW.