The foundations of our healthcare system have been washed away
“Our healthcare system remains strong,” says our premier. It’s hard to explain that to the 91-year-old woman who slept in a chair last night in the emergency department I work at. Or the patient with cancer, receiving chemo, stuck at the cancer treatment centre for more than 24 hours, her journey delayed because she had became a close contact while waiting for a bed.
Or the patient with suicidal ideation, who has been scheduled under the Mental Health Act, was told they have Covid-19, and is being forced to wait indefinitely for days as there are no beds at the specialised mental health facility.
Or the ever-growing number of Covid-positive and suspected Covid-positive patients we are treating in a makeshift tent – literally a tent that has been set up outside the front of the department, as there is no room inside.
No, Mr Premier. As a nurse working in an New South Wales emergency department, I can tell you our healthcare system no longer remains strong. After two years of fighting the pandemic, the foundations of our healthcare system have been washed away.
We do not have the capacity to treat the influx of Covid-positive patients. In addition to the Covid patients who require hospitalisation due to the virus, the usual presentations to ED haven’t stopped – there are still all the patients suffering strokes, heart attacks, lacerated hands from broken beer bottles, broken legs from motor vehicle accidents, pregnant women with abdominal pain, children with burns from scalding water – and they all happen to have Covid-19.
These patients require treatment in a separated area from the rest of the ED patients to avoid a situation where patients come to hospital and catch Covid-19. This area is over capacity. At times, we have to add additional chairs in the corridor to keep up with the demand. Ambulances have had to wait over an hour to offload their Covidpositive patients as there is simply no room.
Despite the influx of patients the nursing ratio does not change, creating an unsafe working environment. We are working with skeleton staff as so many senior colleagues have called it quits after having been worked into the ground over the past 24 months.
It has become the norm for us to be asked every shift to do overtime or to come in on our days off. We do it, not for the extra money, but out of guilt and solidarity for our colleagues so they are not left to work a shift with deadly nurse-to-patient ratios.
It is not uncommon for shifts to be so short-staffed that they have only one third of the nurses required rostered on. It is not a sustainable work model. Compounding the issue now is the growing number of staff members who themselves are testing positive.
Adding to the situation is the issue of the staffing skill mix, which has become dangerous. To scrape through each shift, we are reliant on agency staff or staff being sent from other areas of the hospital to work in areas where they lack the specialised training.
It is just not safe.
The working conditions in hospitals has deteriorated throughout the pandemic. Beds replaced with chairs to make way for the growing number of patients. Tents erected outside, exposed to the elements, to make additional space to treat the ever-growing number of Covid-confirmed and suspected patients.
Nurses having to work outdoors, in over 30-degree heat, in direct sunlight, in blue plastic gowns, gloves, goggles, N95 masks and a face shield. Simple procedures take twice as long and are twice as difficult to complete due to infection control procedures.
We feel defeated: we are not able to provide the level of care we could prepandemic.
What is most wearing, though, is the lack of recognition from our leaders about how hard this pandemic is for the nursing workforce.
Every day of this pandemic, we have been expected to come to work without any additional hazard pay for putting ourselves on the front line of this deadly virus. With this latest wave, we have been begged to cancel our leave and extorted to dig deeper as our “community has needed us now more than ever”. Now we are told that we are exempt from isolating when we become a close contact.
Yet when will our politicians care for us? When will our politicians stop calling us “healthcare heroes”, as if we are superheroes able to work through any catastrophe, and stop ignoring our pleas for mandated nurse-to-patient ratios to ensure patient safety, and listen to our request for a fair pay rise following the wage freeze imposed on us in 2020?
I worry for my colleagues and the profession that I have grown to love.
We have already lost so many of our best senior nurses and paramedics over the past few months due to the fatigue of this pandemic. I just know that with this fourth wave of infections, we are going to lose many, many more.
My colleagues and I are beyond fatigued.
We feel hopeless, we feel scared. There is nothing left for us to give. The author is a nurse in an emergency department in Sydney