I work as a Manager at a Residential Aged Care Facility of 56 residents. I am new to the position and have worked tirelessly at advancing my career over 11 long years. I was so excited to reach this position, with all my hard work and dedication to people that I care for being finally recognised.

But now I just feel shattered; broken into pieces following a COVID outbreak within my facility. I have had to take time off as my mental health had severely deteriorated and stress levels were over the top. All I did was think about work, blocking out family and developing unhealthy habits such as drinking too much and smoking like a chimney, just to get by.

COVID entered our facility in very early January. A resident had gone out for Christmas lunch with family from Sydney and she carried that bug into our facility. We were quick to recognise the symptoms of her illness and she was quickly isolated. The resident suffered, not being able to see her family had repercussions on her mental health, and we seen a lady that was in the early stages of Dementia and able to self care, become very fragile, her memory slipping. When I seen her after recovery, all she could do was sigh sadly. She became angry and forever changed.

Then shortly after her isolation, one of our beautiful elderly gents had a fall. As he was on blood thinners and had a head injury, he was sent to hospital for further assessment. He came home with a few stitches and COVID. Before COVID his dementia ebbed and flowed, however he was going well with strategies in place. On day 3 of his COVID illness he began to wander from his room. We could not stop him and were directing him back to his room at every opportunity. We started to see our staff coming down with COVID although they were highly trained in the use of PPE. With the staffing levels dropped, the resident would be frequently found out in the dining area and at one stage walked out into a common area that I had to quickly evacuate other resident away from and shut all available doors. We just could not stop him, and so our cases spread.

All residents were put on room lockdown following the next case to emerge.

I think the third case for me was the saddest and I feel guilt in her death.  I watched her struggle to breath as her COPD flared and COVID took its toll. I toileted her and cleaned her. I offered her food and ensured she was aware that she was seriously unwell. The Doctors at the hospital would not accept her and kept asking “so what is her ceiling of care”; she was NFR so they would not take her. However, she was also adamant that she did not want to go to hospital, but I ask myself – did she know she was going to die? Could have I pushed her a little harder to go to hospital? Could have I just done something. I was called in at 2230hrs to verify her death as there were no available RNs on duty – I had just thought she may make it….I was devastated.

I think this is the biggest fear for when COVID strikes a Residential Aged Care Facility – how many will die? And now I have also learnt – how many will deteriorate and never be the same again.

I had staff yelling at me, telling me they would not work under these circumstances. At times there was only the RN in charge and one care worker available for 56. What could I do to rectify this problem – nothing – all other staff members either had COVID or were exhausted from double shifts. So I worked back. I worked many double shifts and literally felt like I was going to die. I sobbed on the phone to a roster clerk – “I just cannot do this anymore – I am an unsafe worker” and all she could say was that she was very sorry – there is nothing she could do. And there was nothing that could be done, but to work another shift, in a daze, body aching and limping around the facility as my hip had finally called its last hooragh. Eyes leaking with tears. No breaks. Dehydrated and hungry.

I just do not know if I can do this all again. COVID will get back in to the facility – there is nothing that can be done about this as the symptoms come after the spread is already happening. I just cannot feel the guilt of letting people down in their care, missing wound care, having to tell people to wait for care, being late with pain relief and watching people you have grown to care for – die.

There is something very, very wrong with our Aged Care System, and it is coming to a head now. Something has to be done. We cannot keep up with the demand to have a high level of care with all the documentation for our Residents when there is literally no one to care for them in the workplace.

Something will give, and it will be the workers. There will be losses of long term workers: workers with years of knowledge and skills- RN’s, EN’s, Managers and Care Staff – because it is just too much. Then what?