Complicated feelings are emerging as WA reopens its borders. While families continue to reunite, two Western Australian emergency department nurses have spoken up about “unsafe staffing levels” and “burnout” as the state readies itself for what could be the most challenging stage of the pandemic yet.
WA announced a new daily record number of 2,420 new COVID cases and one death at the end of last week, while the state began to receive outside visitors for the first time in close to 700 days.
In a move that shocked many, the initial February 5 reopening was delayed so as to bump vaccination levels and mitigate hospital admissions.
Mark McGowan, WA Premier, has repeatedly stated the border had served its purpose and the state’s hospital system was prepared and operating well.
However, health workers have commented to the ABC that they are suffering from burnout already, while looking ahead to the state’s potentially most arduous stage of the pandemic.
Staffing level concerns outlined in email
An emergency nurse at Sir Charles Gairdner Hospital (SCGH) wrote an email to the WA nurses union, outlining a “staffing crisis that could not be worse”.
Asking to remain anonymous, the nurse spoke to 7.30 saying the hospital ED was working with terrible “staff morale, job satisfaction and safe staffing”.
They noted, “Since before the end of 2021 we have been experiencing a staffing crisis, even though a number of recruitment drives have occurred with applicants being successful, and frequently we have new staff commencing in the department.”
Continuing, “We still remain in a staffing crisis – often short-staffed and with skill mix being very tight and not always ideal.”
The nurse also relayed that they had received numerous staff daily emails requesting they pick up additional shifts.
A screenshot shared with the ABC showed one of the emails displaying the number of nurses on various shifts would be anywhere between five-to-nine nurses below quota.
The trend of understaffing continued on the roster for the remainder of the week.
“Our department is at times very junior staff-heavy, which has its challenges and can at times make the department unsafe because of inadequate skill mix.”
Mark Olsen, the Australian Nursing Federation (ANF) WA state secretary, relayed that he has been sent numerous emails like this in the last few months.
He noted, “We effectively had no pandemic in this state for two years and yet we still have a burnt-out, tired, dispirited workforce.”
Responding to the rising concerns, a spokesperson for the North Metropolitan Health Service stated the SCGH Emergency Department had 97 additional nurses since October 2021, highlighting a “hugely successful recruitment campaign and focus on ensuring enough skilled staff are available to meet the needs of our patients”.
Continuing they stated, “Staffing levels in emergency departments do fluctuate on a day-to-day, shift-by-shift basis, and projected shortages a week out do not reflect actual numbers on the day.
“With a worldwide and local shortage of clinical professionals, staffing is challenging; however we are continuing to plan and allocate our workforce to meet any future COVID-19 demand.”
December 2021 saw the state government broadcast its intention to fund a further 270 hospital beds, 410 nursing staff and over 180 additional doctors.
A WA Health spokeswoman stated there were 1,018 additional full-time equivalent (FTE) nursing and midwifery personnel in January 2022 in relation to the levels 12 months ago.
However, the SCGH nurse conveyed they remained fearful of the mounting pressure COVID-19 would demand.
Openly concerned they shared, “I am at a loss of how … the department and hospital will be able to provide safe and optimum patient care without causing all their nursing staff to have further stress, burnout, and compassion fatigue from such heightened expectations, and the increased responsibility expected of us.”
While graduates enter the system, veteran nurses still suffering burn out
Mr Olsen argues that the state government had decided on the right course of action delaying the border reopening from February 5, so as to facilitate hundreds of additional nursing graduates to be ready for work.
He stated, “I am hoping that with the high vaccination rates and the public health measures that have now been adopted by the government, and the fact that we have given our graduates an extra four weeks to get ready for the surge, that we are in the best possible place that we could be.”
Staffing shortages and fatigue are not limited to just the metropolitan area. In the state’s Pilbara region, another nurse conveyed to the ABC, on assurance of anonymity, that the Hedland Health campus, too, was struggling.
They stressed, “We’re so understaffed, our high dependency unit is shut because we can’t staff that.
“We also have our children’s ward shut because we’ve got no nurses to man that either.”
Continuing, “On top of that, we have got all this COVID stuff happening.
“We have had so many staff leave. Everyone is over it. Because we have been asking for staff for so long, and everyone is just getting burnt out.
“I have honestly been thinking about leaving nursing.”
The nurse confessed they were significantly concerned patients would not be receiving the care they required.
“I don’t know what is going to happen with COVID, how the hospitals will be,” they commented.
“It is dangerous.”
WA Country Health Service Pilbara Regional Director, Margi Faulkner, put out a statement highlighting the “robust safety and quality indicators make it clear care at the facility continues to be of a high quality”.
“We have reconfigured some of our services to reduce instances of staff overtime where we can – and while still maintaining high standards of care,” Ms Faulkner noted.
“As part of this, we have been accommodating pediatric patients on our general ward.”
“This isn’t an abnormal change – in general hospitals, for example, patients are not always separated out into specialist areas – and we closely consulted with our staff on it.”
“As an organisation, WA Country Health Service is actively working on attraction and retention strategies – including things like increasing financial incentives.”
The WA health system is ‘as ready as it can be’
Mark Duncan-Smith, President of the Australian Medical Association (AMA) of WA, believes that due to WA’s elevated vaccination levels, the hospital system is very likely set to cope well with the oncoming COVID-19 peak.
He stated, “It is as ready as it can be with the resources we’ve got available.
“We are very lucky that we have had the isolation and a zero COVID environment for so long. It has allowed incredibly high vaccination rates.
“We are seeing very low hospitalisation rates, and hopefully that will continue.”