By BELINDA SCOTT

NURSING difficulties emerged as a focus at yesterday's Commission of Inquiry hearing at Coffs Harbour Health Campus.

In an intense six hours of hearings, the Special Commission of Inquiry into Acute Care Services in NSW heard from Coffs Coast doctors, patients, nurses, administrators and lobby groups.

Senior Coffs Harbour health campus registered nurses Amanda Short, Liz Allen and Susan French all expressed their concern at the pressures on nurses as did specialist anaesthetist Dr Paul Moran and director of nursing and manager of inpatient services Steve Rodwell.

Mr Rodwell said while nursing ratios varied depending on the ward or unit, to meet their concerns the ratio of nurses to patients needed to be one to four instead of one to five, a 20 per cent increase.

The three RNs painted a picture of wards where nurses are being faced with patients requiring more and more complex and technical nursing during increasingly-short stays. In this pressure-cooker atmosphere, where nurses say their basic role in patient care is being lost in the middle of the technology, dwindling numbers of experienced nurses are struggling to support increasing numbers of young and inexperienced staff.

Nurses enticed back to the profession through the Reconnect program are not staying, saying nursing has become too hard and experienced nurses are being enticed away to better-paid academic jobs with more sociable hours. Most seriously they say the steadily increasing complexity is not being recognised in staffing ratios and the formula used for staffing does not recognise different level of experience, so that a trainee enrolled nurse with four weeks training is 'weighted' the same as a registered nurse educator with many years of clinical experience.

As well, the nurses say centralising functions like ordering and payroll away from the hospital to a distant centre has left them with an administrative burden that can take up 20 per cent of their day.

Coffs Harbour Health Campus general manager Margaret Bennett said they appreciated Commissioner Garling's professionalism and she wanted to thank everone who had given evidence.

"They showed great honesty in speaking about their health experiences or workplace concerns," she said.

The Commissioner, Peter Garling and his team will move on to Port Macquarie this morning, where they are likely to hear very similar stories.

The Commission is nearing the end of its state-wide program of hearings, which will end next week at Royal North Shore Hospital.

The inquiry was announced by the NSW Minister for Health, Reba Meagher following problems at RNS and the Commissioner will report to the Health Minister by July 31.