With healthcare workers and services under extreme stress, more effort must be put into reducing COVID-19 transmission as well as wider reform efforts, writes a senior health system leader, whose identity is not disclosed due to their employment conditions.
As winter officially commences and with significant numbers of people hospitalised with COVID-19 or influenza, as a healthcare worker it is hard to see the light at the end of the tunnel.
We seem to be stuck in this endless cycle of wave after wave of COVID-19 surges with no end in sight. Add to that a particularly dangerous flu season and we are bracing ourselves for another difficult winter.
We haven’t even hit the peak of the flu season, yet the admissions of patients with influenza are rising rapidly. Hospitals are also “flipping” wards back to COVID wards, which reduces the hospital beds available to patients with other illnesses and patients who are waiting for elective surgery.
As healthcare workers we don’t have magical powers that grant us a higher level of immunity than anyone else, so as long as we have COVID-19 and the flu circulating we will continue to have significant numbers of staff off sick which further impacts on our ability to provide services.
This means we struggle to provide the full amount of elective surgery, open all our ICU beds or provide rehabilitation services. It is important for the public to understand this. While it is fantastic that some jurisdictions are providing extra funding to the health system, we can’t provide the services if our staff are off sick.
At the start of the pandemic there seemed to be a collective goodwill to do what was necessary to try and protect the health system from being completely overwhelmed. We need to go back to working together to protect our health system.
I am not the first person, nor will I be the last, to write about the demand pressures on our health system. Even before COVID-19 hit, we were struggling to meet the demand. We were already grappling with an ageing population, long waiting lists for elective surgery, increasing rates of chronic disease and workforce challenges, to name just a few of the pressures. It was a system that was already stressed and stretched.
Each major hospital in the state that I work in has a plan for how they will respond to increasing hospital admissions due to COVID-19 and staff shortages. And we also have an overarching state plan.
But what we don’t have is a plan to reduce the number of COVID-19 cases. Where is the public health campaign regarding mask use and the importance of ventilation?
Yes, we are all well and truly sick of COVID-19 – but that is not going to make it go away. We can’t keep having these numbers of patients hospitalised; the system is not coping.
On the day that I am writing this, we have had 60 deaths from COVID-19 in Australia, yet it doesn’t even make the news. We know that COVID-19 is more dangerous for those who are elderly, have underlying co-morbidities and are generally more vulnerable but we seem to have stopped trying to protect these people.
We can do better
Are we really that uncaring as a society? Surely we can do better to protect those who are most at risk.
It baffles me that the use of more effective masks such as N95 masks is not being recommended by federal and state governments.
Even within hospitals there is variation in the type of masks that are given to visitors. The hospital that I work in is providing N95 masks for visitors but I know of other hospitals that are only providing surgical masks. Surely we can start by being consistent in providing more effective masks to hospital visitors so that we can ensure that we are protecting our hospital patients.
Since the start of the COVID-19 pandemic, I’ve witnessed a distressing shift in behaviour towards healthcare workers by some hospital patients and visitors. The increased occupational violence and aggression my colleagues are experiencing is disturbing.
We don’t come to work each day to be physically or verbally abused. It is not uncommon for our staff on the screening desk, where they screen outpatients and visitors on arrival to the hospital, to have to call for assistance in response to patient or visitor aggression. These staff do not deserve to be abused or threatened merely because they have asked someone to wear a mask whilst they are in the hospital.
It truly feels as if there is less respect for healthcare workers than there was before the pandemic – and I do emphasise that this is only some patients and visitors but it does have a lasting impact and it makes our jobs harder.
Which brings me to our future workforce. We need to grow our healthcare workforce and that includes tackling the difficult topic of workforce reform. We can’t keep doing things the way we’ve always done them. This was evident before COVID-19 and it is even more evident now.
We need to look at moving beyond our traditional workforce models and this will require courage, collaboration and innovation. And we need to make sure that the health system is seen as an attractive career option and that we are able to retain our workforce.
As well as workforce reform, we also need to reform the health system to reduce the demand. When I first started working in public hospitals in the early 1990’s the system was stretched at times but there were also lulls where you could catch your breath. There are no lulls now and there haven’t been for many, many years.
We have needed to do things differently for a long time but for various reasons we haven’t been able to effect meaningful change. I am hopeful that with a change of Federal Government we will be able to tackle this reform and in doing so, protect our health system for the next pandemic to that will invariably arrive.
I am also hopeful that the new Federal Government will take some meaningful action on COVID-19 and help reduce the pressure on the health system that we continue to experience.
I started this article by referring to the light at the end of the tunnel. Healthcare workers desperately need to know there is a light at the end of the tunnel – and that it’s not an oncoming freight train.
• This article is by a senior health leader, who cannot be publicly identified
See Croakey’s extensive archive of stories on health reform
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