Aged Care Insite Issue 119 Jun-Jul 2020 | Page 29

workforce No show What would happen if nurses stopped showing up for work? By Conor Burke What happens if this pandemic gets worse? What if it got so bad that healthcare workers, doctors and nurses all walked off the job? While the Australian healthcare system has been stretched by the COVID-19 crisis, it has yet to feel its full force when compared to its US or European counterparts. We have seen coronavirus cases explode in the US, and a number of doctors and nurses have criticised the lack of essential PPE available to protect themselves, resulting in a number of health workers falling ill and dying. In early March when the first Australian aged care home experienced an outbreak of COVID-19, aged care workers refused to come to work the following day. After news of the outbreak was confirmed by BaptistCare, The Australian reported that aged care staff collectively called in sick, forcing the NSW Health Department to step in. “NSW Health has had to agree to fund NSW Health staff into a nursing home that has had some coronavirus issues and its staff have become, for whatever reason, unavailable,” said NSW Health Minister Brad Hazzard at the time. Staff who did go to work at the facility said they were not given any information about what was happening. If PPE becomes scarce and the rates of infection go up, would nurses be forced to choose between the safety of patients and the safety of their family and themselves? Erin Smith, associate professor in disaster and emergency response within the School of Medical Sciences at Edith Cowan University, says that previous research indicated that a pandemic was one of the situations that would likely result in a decreased willingness to work among paramedics. “We have known for some time that essential frontline workers would have difficulty weighing up professional obligation with personal risk when it came to a situation like a pandemic,” she says. “However, despite this obvious ethical dilemma, clarification of an acceptable level of personal risk for many healthcare workers and essential frontline personnel – like police officers – is still lacking.” The Guardian has reported that doctors and nurses in the UK are being “bullied and shamed” into treating patients with COVID-19 despite not having the masks, gowns and eyewear they need to protect themselves from the virus. They are also being advised to hold their breath when treating patients due to PPE shortages. A perfect storm of a lack of communication from management, a lack of PPE, panic and low pay could come together and cause an issue among the nursing workforce, Smith says. “I think we’re coming off the back of an unprecedented bushfire season, so psychologically we’ve already been stretched to our limits. In terms of PPE, we’ve used up a huge amount of our existing stockpile, particularly in terms of the face masks that we need. “Here comes this pandemic of a brand new virus and we’re being asked to get back up off the ground and start again. It’s difficult because we know first-hand from a lot of the people that I’m speaking to that their hospitals are essentially gagging their staff and saying, ‘You cannot speak to the media. You cannot tell people what’s happening’,” she says. Smith adds that you only have to walk down the corridors of Australian hospitals now and you can see all the hand sanitiser stations are empty, and nurses and doctors are being told to use their PPE masks for well beyond what the standard protocol would usually be. “That’s not out of a malicious kind of direction from the hospital, it’s simply because they are trying to ration what they have,” Smith says. “It’s a bit of a perfect storm because we’ve run out of the stockpile. The government are working as hard as they possibly can to replenish those stockpiles, but it takes time. “We need to remember that a lot of those are coming in from overseas, ships are being quarantined. There’s not as many flights coming in. When they do arrive, a lot of these have been waiting for at least 14 days in isolation before they can be a distributed. Then it’s that interesting process of how we actually divvy these up. “The government announced [recently] that 30 million masks arrived in the country. But it would be very interesting to see how long it takes before they are actually on the faces of our frontline healthcare workers, because there will be that complex decisionmaking process now of who actually gets them.” In addition, Smith says that if health workers attempt to speak out about PPE shortages, they are threatened with losing their job. “What’s the priority matrix here, and who makes those decisions? Because I’m talking to nurses and I’m talking to GPs, and they’re down to, if not weeks, days’ worth of supply left. “They will be making very real decisions very soon about, ‘My life and my health is not worth my job. My job is not worth it’.” Adding to this bubbling issue is the accumulative psychological scarring the nation has incurred after a long, hard bushfire season, which captured the nation’s attention for months. 26 agedcareinsite.com.au