I’ve worked in ICUs and ED for over 40 years.
From 2000 to 2017, I worked at one of Sydney’s biggest and busiest hospitals. In ED, I would get a four to five patient load, but at times would look after eight beds. As long as you didn’t go on a break, you had a chance with the turnover. Take a break, and you had six new patients and were “behind the 8-ball”. If you were quick, you had a chance to welcome them to the unit, ask their symptoms, get them comfortable while doing their obs, cannulate if needed, start IV fluids, take bloods, and then get a doctor to prescribe pain relief immediately (never let the system tell you the patient “hasn’t been taken up by a doctor yet”). That said, back then, you could offer the patient a pillow and a blanket, and ask the family if they wanted a cuppa.
I still work those areas. However, we now have less staffing, a greater workload and less time. On nights, no one has a break through a 10-hour shift. I frequently come on to find sick patients who haven’t had obs done for six to eight hours. Frequent clinical review calls and rapid response calls are becoming almost a daily event. Not having safe ratios is killing people, and this means that the NSW government is killing people through incompetence, apathy and inaction. But don’t worry – “it’s only one in 350,000 who are dying” – seems to be the common phrase these days, and no longer “sadly, a 45-year-old woman (with small children, a husband, a family, a job) has died tragically”!
Safe staffing ratios are essential in ED, as they are everywhere.
Bernhard Racz, RN