Industry & reform the reason I am championing this as loud as I can in my role .
As a predominately female workforce 3 ( 90 per cent ), the issues of sexual assault against women echoes loudly through our profession , as society grapples with the impacts of the Me Too movement , the Brittany Higgins case , and even the Women ’ s Safety Summit hosted by the Federal Government . For nurses , the topic of domestic and family violence as well as occupational violence is front of mind .
From a professional perspective , the high rates of abuse sustained by the nursing profession has deep , lasting impacts and many members of the Australian College of Nursing report symptoms of trauma , posttraumatic stress syndrome and vicarious trauma . In January 2021 , the World Health Organization confirmed the ‘ mass trauma ’ of healthcare workers , which was highlighted by the International College of Nursing ( ICN ) 4 . This needs to change . Today . The pressure on the nursing profession is mounting on a day-to-day level , when nurses are required to isolate from their family and friends after being exposed to COVID-19 at work .
Nurses have informed me , in some sectors , they get paid for the first three days of that isolation in the public health system . However , if they acquire the virus , they are expected to take sick leave for the remainder of their recovery .
Many nurses are not permanent or full-time staff , rather casual , part-time or working as agency nurses , which are often not entitled to sick leave . This vulnerable group of workers – most often women – are left without a means to earn an income after virus exposure .
The regular absences of clinical staff in client-facing health environments means teams are short-staffed , or managers , clinical nurse consultants and nurse educators – all vital for the coordination , oversight and safety of health systems – are pulled off their work and asked to be clinically facing . This leaves these nursing experts to work extensive hours each day , as there is no back-fill for their roles .
Nurses are turning away from the profession as a result .
In March 2021 , the ICN conducted global research in nurse shortages one year on from the WHO declaring COVID-19 a pandemic . They reported that nearly one in five of the National Nursing Associations surveyed reported an increase in the number of nurses leaving the profession , and 90 per cent of them are “ somewhat or extremely concerned ” that heavy workloads , insufficient resources , burn-out and stress are the factors that are driving that exodus . 5
The 2020 Aged Care Workforce Census reported that 29 per cent of their direct care workforce had left their employment over the 12 months from November 2019 to November 2020 6 and there were almost 10,000 vacant roles in aged care alone . That was before the current extended lockdowns both Victoria and New South Wales are experiencing .
ICN reports the world entered the pandemic with a shortfall of up to six million nurses and an additional four million expected to retire by 2030 , which puts the global nursing workforce under an intolerable strain . ICN says large numbers of experienced nurses are leaving the profession or considering calling time after the pandemic , which should be a wake-up call for governments to invest in nursing jobs , education and leadership before it is too late 7 .
Whilst the issues are challenging , there are strategies that can be put into place to ease the pressure , to support nurses , and nursing care in Australia .
Firstly , we need to immediately support the graduating class of 2021 . Right now , thousands of third-year nursing students are at risk of being ineligible to graduate this year as they are struggling to obtain clinical placement hours required of their three-year tertiary degrees due to disruptions to the health care system . It is estimated almost 20,000 nurses across Australia are due to graduate in their final semester . This workforce will make a tremendous contribution , with adequate support , to all health care sectors . Governments and employers should be working to secure employment for all graduating nurses to provide a pipeline for workforce planning for 2022 and beyond .
We need additional funding for refresher courses for retired registered nurses and enrolled nurses , as well as non-clinical active registered nurses , so they can supplement the workforce across Australia . This needs to be coupled with job certainty and tangible benefits to them for coming back into the workforce 8 .
The Australian College of Nursing has always championed overseas trained eligible registered nurses provided with right to work visas in Australia . Skilled nursing migration enhances opportunity , diversity and care delivery to those living in Australia , and nursing has long been considered a profession that can take you around the world .
Support and relief must be given to the executive directors , directors of nursing , and other senior workforce executives who are dealing with tired , burnt out and exhausted staff – they must be given the support and resources they need to manage their teams , and patients . The complete transformation of health systems to deal with the impacts of COVID-19 have largely landed on their shoulders , and they need practical support , people funds and the go-ahead to overcome policies and procedures not suited to the current challenges .
Funding models are outdated and exclude mental health nurses , nurse practitioners and registered nurses from accessing Medicare numbers in order to be paid for the work they do . This is having the greatest impact in rural and remote Australia , where community health care systems are often staffed by nurses who cover enormous areas . Your postcode should not determine your health outcomes in the 21st Century , but in Australia it does .
We recommend a national summit to be sponsored by the federal government in collaboration with the Australian College of Nursing which is representative of all the health care systems – including aged care and disability – so a national action plan for a sustainable and supported nursing workforce can be established , prioritised and actioned in light of the pending crisis .
And finally , and most urgently , we ask all Australians to please consider the way fear , frustration and stress is expressed in clinical , aged care and community settings , for this is having a major and lasting impact on the emotional and mental health of Australian nurses .
We thank and acknowledge those of you who are patient , express kindness and gratitude , it means so much . We are , and have always been , the caring profession so we appreciate what toll COVID-19 is taking on people , but harassment , violence and intimidation of nurses and women in our society and workplaces will never be okay . ■
For references go to www . nursingreview . com . au . Adjunct Professor Kylie Ward is the chief executive of the Australian College of Nursing . nursingreview . com . au | 13