Running for a whole shift to ensure someone doesn’t die
As an RN prior to COVID, I had to care for six to eight patients per shift on an acute medical ward, where I should have had no more than four. I have worked in emergency and been deployed to midwifery, where staffing has often been so much worse.
And since March 2020, this situation has only escalated. Not just because we’ve been caring for patients with COVID, but also because our workforce has been stretched to provide the frontline pandemic response, taking nurses away from the hospital wards.
During the Delta wave, nurses from across the health system were redeployed to staff hotel quarantine, airport screening, vaccination hubs and COVID clinics. Despite this, there was more expected of a finite and dwindling pool of staff. As a result, colleagues of mine have moved interstate for better conditions and better pay, or have left the profession entirely.
While it feels like the COVID-19 pandemic is in the past, it’s not like that for healthcare workers. Since we took the “living with COVID” approach, we’ve had a constant rotation of staff off sick due to COVID infections, while still caring for patients continuing to present to our hospitals. You only need to consider the number of ambulances sitting outside a hospital emergency department to imagine what the demand may be like.
Nursing hours per patient day is failing us. It is a budgetary calculation that does not provide the nursing and midwifery staffing levels we need, and does not account for ward surging – which is when more beds need to be opened so patients can be moved from ED or ICU to make more space to meet demand on those areas.
Imagine running your entire shift, skipping breaks and ignoring a full bladder or your need for hydration, just to ensure that someone doesn’t die. Let alone attempting to meet the basic care needs of your patients, like someone to help them eat, drink or go to the toilet. We have to navigate complex family dynamics, socio-economic situations, consider whether our patients have an appropriate place to go after discharge, and connect them with services to keep them well in the community and address any further psychosocial needs.
Inadequate staffing each shift puts an immense amount of pressure on nurses, leading to burnout, and colleagues reducing their hours, or leaving the profession outright. Nurses have been experiencing a higher rate of adverse mental health issues, and we’ve lost many caring and compassionate colleagues due to the increased stress of our roles. Some of those colleagues are no longer with us. Inadequate ratios are dangerous. It puts our registrations, and our patients’ lives on the line, and significantly reduces the quality of care we are able to deliver. As a nurse, I find this incredibly distressing.
Julia Farley, RN