RN/M Kathryn Fifield is the facility manager of the multipurpose service in the southwestern NSW town of Henty. Her witness statement described the impact of increasing patient acuity on the MPS, which has 12 aged care beds, three acute beds and two ED beds.

In her witness statement, Kathryn outlined:

Five years ago I saw that the patients in the acute beds were sub-acute. These patients were likely a step up in assistance from home care, were waiting for an aged care bed or had a disease such as gastroenteritis.

Today I see that we are holding higher acuity patients including those with mild sepsis, congestive heart failure or renal failure. This has meant the workload at Henty MPS has also increased. Patients in the aged beds are people that can’t live at home and who need increased assistance.

Five years ago, I observed that we used to have low and high-acuity patients in the aged care beds. Today I observe that they are all high-acuity patients as chronic and complex conditions have increased across the board tenfold due to new medical interventions and people staying alive longer.

I have experienced that there is a higher level of medical intervention and we nurses are expected to care for these patients. This means nurses need to be upskilled and there is a requirement for further education for more complex interventions.

This has increased the knowledgebase people need as there are many more procedures and things people have now that nurses have had to learn to do.

I have seen a 50 per cent increase in the number of bariatric patients which are obese patients with a body mass index greater than 40… If you put two or three bariatric patients in a ward this is a lot of additional work.

An increase in bariatric patients increases safety fatigue and manual handling risks for staff. When I did a medication round in Deniliquin in the early 2000s I gave out half the medication I see that is given now… nurses now need to know a wide variety of medications [and] understand those and their interactions.

*This is an excerpt from witness statements of one of our members who participated in the Special Case.