Healthcare workers are desperate for the public to know what's been happening in our hospitals. As the Omicron wave peaked in Sydney last month, Background Briefing was following them. These are their stories* — in their words — about what they saw in January.
Amelia, senior emergency department nurse
We have a resuscitation bay at the hospital that is staffed for six nurses and six beds. And we've been getting 19 patients in that space. When these people are deteriorating, we've got nowhere else to put them. Things are missed and mistakes are made, and we have had so many experiences where there'll be two nurses in an area that's supposed to have six that will have, you know, like 10, 16, 18 patients. And you'll have to make the decision: Am I going to go to that patient that's bleeding out or am I going to go to that patient who's just had a massive stroke?
I have been having continuous tsunami dreams. I'm standing outside the hospital and waves are coming in. I'm watching the building collapse. An alarm goes and you're already on the shore, but you're not far enough inland. There's nothing you can do, but plant your feet and brace yourself and take a breath. And that's it.
On Christmas Day, I was working in triage and this unit manager came up to me and handed me a document that had over 80 nursing homes where there was a COVID outbreak. I needed to screen which nursing home a person was coming from at triage so they could be isolated into a separate place in the department.
Eighty nursing homes with roughly 100 residents each. Eight hundred people susceptible to getting COVID, unable to see their family or their grandchildren on Christmas Day, give their gifts and, quite possibly for a lot of them — because they're the most vulnerable — their last Christmas or last summer. And they're going to be completely alone from that day. Because then the whole nursing home is shut down for 28 days. And if they are to contract COVID during that time when you're already elderly, vulnerable — that's it.
Everyone wants to go and have a glass of wine at a wine bar, and small businesses do need to open and these things are important. But there's so much more that's being lost because of what has been determined we need to get back.
My mum and I didn't attend our family Christmas because the numbers going were far too high, so we did our own little Christmas together. But I knew that while we were sitting there eating a socially distanced Christmas dinner, across the entire country that was not happening. I knew that this night was going to be a super spreader event in households across the state, across this city. I know that Christmas Day probably killed a lot of people.
I just did two 18-hour shifts in a row. Eighteen hours and eight hours sleep and then back for another 18 hours. I'm in survival mode. You know, work, shower, eat, sleep.
We were talking on night shift and someone said, 'I guarantee you if we were to do a poll, 90 per cent of us here are either looking at other jobs or have applied for other jobs.' And then we went around the room and every single person said they were looking at jobs or that they had new jobs already lined up. There were about 16 of us. And that was just the people who were on that shift.
I actually resigned, but I was contacted by our nursing manager — and then again in a personal email and then again in a personal text message — asking me to come back and work overtime shifts because they were so desperate for staff. And that's what I'm doing now.
Marcus, senior emergency department doctor
I've had staff shortages before, but not so critical. And not so dangerous. I'm telling you because this needs to be told: Our health system is not coping. What that means is that if it's time-critical care that you need, then you will not get it.
Do people know that when their mother goes to hospital, they have one doctor looking after four wards? If I knew that there was one registrar running the whole acute area and my mother was brought in by ambulance, I would have to go with her. I wouldn't let her be there by herself. Sorry. Yeah, it's bad.
People say the most dramatic ethical dilemma is that your hospital is so overwhelmed that you might have to decide who gets the ventilator. But that's not the ceiling of care. The ceiling of care is to be able to see a patient with a heart attack within the time limit that helps save their heart so they don't live the rest of their lives a cardiac cripple because they can't breathe. So time is muscle. They say time is brain as well, so you have to see a stroke patient very quickly in order to save their brain.
Our health system was overwhelmed. Let's get that on the record. We did not cope. When you have people being treated out in corridors and people waiting for 24 to 48 hours for a bed in the hospital, we were overwhelmed. When we have resuscitation rooms full and we don't have the staff to actually look after those people, something has to give.
We had so many meetings talking about workforce. We had a framework. We had everything, but when we needed the staff, initially it didn't materialise. And then it took a week. If there is political will, it can happen the next day.
It's a bit like you're drowning in water and your practice drills say that if someone drowns you throw them a life jacket. Then when someone is actually calling for help and you don't have a life jacket to throw them, but you're telling them, it's coming, it's coming, it's coming until the person drowns.
Australia has always had the good fortune of having time to prepare its system because we see it in our northern hemisphere neighbours. And Omicron could have been our way out of this pandemic, if it was managed well, but we opened up to uncontrolled crowds meeting up in the two busiest periods in a year.
I went to the CBD to get some Christmas presents on December 22, and no-one was wearing a mask inside. And I thought, OK, this is not good. And I made a mental note that in two weeks' time, I'm going to feel this, and I have.
But we can't address a problem unless we face it. I would like these lessons to be recorded. And I would like them to be shown when we are again told that we didn't expect this. We completely expected this.
I laugh because otherwise I'll cry. When you try to speak the truth instead of getting solutions and help, you are at risk of losing your job. When did we become like this? People who are not knowledgeable, not experienced can say whatever they want and have no consequences. And when you try to highlight a problem from the perspective of someone experienced and knowledgeable, you get shot down. We live in a very strange society and a very strange time.
Bianca, emergency department nurse
I've been in the COVID unit in emergency today. And it was the worst shift in my entire life. I cried and broke down in the tearoom. Even the night shift nurse that was handing over to us told us she cried in the bathroom during her shift. Because they made her work two nurses to 11 patients. We're meant to have three patients to one nurse.
I started in the morning with 11 COVID patients with only two nurses as well. And these patients were really sick.
We weren't able to cope with just two nurses and we escalated multiple times that we needed a resuscitation bed. Resus is like an ICU bed in ED. They said, 'We don't have any more resus beds, you just have to cope.'
Because we're in a locked area, if something's happening, others can't really see. A patient ran away and got herself all tangled up with all the drips and everything. A new grad nurse was trying to hold her down. She was screaming and she pressed the button for help, and no-one came.
I ran to help her, and while I was trying to help, I was screamed at by an unvaccinated patient. He was telling me COVID was fake and he wanted to go home. I'm trying to explain to him that he came in very sick. We had to give him adrenaline to help him breathe. The next day, he felt better and it didn't click in his mind that we actually prevented him from dying.
I said, 'Can't you see I am trying to help this critically ill patient?' He told me, 'Well, you're coping.'
That's how frustrating it is. I just feel like for two years, we've been sacrificing so much already, like our family, our own safety. The first year, everyone was like, thank you so much, nurses, you're amazing, you're heroes. And now we're just getting verbally abused all the time. It's really shit. That's what we call it now. It's a shit show.
In the first week of January, I asked all the patients, 'Do you know where you got COVID from?' More than half of my patients said, 'I had a Christmas party,' or 'We had Christmas at home,' 'I went to Melbourne for Christmas,' … It's all during that period. That's how they got it. And then they went home and brought it back to their own family.
There's no more room in Emergency. The other day, I had to put four COVID patients in a room that's meant for one person. We just have to make them sit down rather than lying down. And then here comes a negative person, and we have to put them next to a COVID patient. So if they were negative when they came in the door, they're going to be positive when they go out.
Every day, I'm paranoid that I will be positive today because I'm a close contact. If I get COVID, I'll be f***ed because I'm not healthy at the moment. Definitely not.
On the other hand, to be honest with you, I'd rather just be positive now, because I don't want to go to work anymore. Everyone now is just trying to find a way not to go to work.
It's affecting my relationship with my husband because I don't have much energy for him. He feels sorry for me and whenever I tell him the stories, he's just shocked. The other day he asked me, 'Can you find a different job?'
Simon, paramedic
I've been a paramedic since I was 21 and I've never seen anything like this. We had the increase with Delta, but this is a lot worse. Our dispatch screen shows huge call numbers every day, equal to, if not exceeding New Year's Eve.
Patients can't regularly get to their GPs anymore. They ring up and the GPs say it could be seven days to two weeks before we can get you in. And for some of our more vulnerable members of the community, two weeks is too long to wait and that workload for the GPs is then backing up to us.
Recently, I heard on the radio crews that are already on scene with other patients and the dispatchers realise that their job is probably not as critical, saying, 'Can you reassure your patient that you're treating at the moment and just leave them there and depart from your scene to go to a more critical job around the corner?'
The whole health system is just absolutely broken.
We are only seeing four patients per shift, and we've been out all day past our knock off time. That's the regular occurrence now. And unfortunately, a lot of it is the bed block delay — getting seen and offloaded into the hospital. Almost half of the ED was not functioning because they don't have the staff to man those brand new shiny beds which have just been put in there, which is pretty upsetting for us. If we have quick turnarounds, we'd see easily eight to nine, maybe 10 patients a day.
You do sign up to serve your community, and it's an honour to do that and be trusted to go into strangers' houses that call you for help. We love that stuff. But you'd expect that the government would support you as a workforce to give you enough staff members to perform your job effectively and efficiently as well. You wouldn't let someone work 14, 15, 16 hours without a break, but that's just common practice in the ambulance service — safety goes out the window.
Doing four shifts of multiple overruns and no breaks, and then your first day off you just can't get out of bed, you're grumpy. You want to have some time away from your family, but they haven't seen you in the last four days, so they're desperate to see you. And yeah, it's really tough. I find at home that's where a lot of us feel it the worst, the family life.
I just had a chat with a nurse an hour ago and I said, 'When is this going to stop?' And she goes, 'I know when it's going to stop, I'm quitting next week'. She goes, 'I can't do it anymore.' And that's a similar sentiment I've heard with other paramedics as well.
Olivia, senior ICU nurse
I cannot get the images of what I saw during the Delta wave out of my head. I would never have gone into nursing if I knew that this was what I was going to be getting myself into. You walk into the unit and the first thing you see is pretty much everyone is paralysed, sedated and lying face down, prone on their stomachs. It's surreal because I'd never had to prone a patient until COVID hit. The amount of paralysis and sedation that we had to give patients to keep them under and asleep so that we could mechanically ventilate them — I've never seen that before either.
And to watch our patients struggle to breathe and gasp for air while you stand behind a glass door and watch them and hope that they pick themselves up. You feel so terrible because you're encouraged not to enter the rooms unless you have to. But these patients, they're scared and they're alone. They can see your eyes and you're just staring at them through glass. It's awful.
When you hold their hands as they're passing away and you've got their family on the video call and they're crying for their family members and you're holding their hands in lieu of their family members and you just watch the screen as they pass away …
A lot of these patients, we put them under, we put them on a ventilator, and a lot of them don't wake up from that. They don't even get woken up enough for us to say, 'We're so sorry, you're too sick, we can't save you.' It goes from them watching us prep for an intubation, then watching us set up to sedate them, and put them under so we can ventilate them. And they're scared. They go from us reassuring them that we're going to do our best. And that's it. That's the last conscious image that they're going to have.
By mid-January, the simplest way to describe it is absolute chaos. We are seeing ICU filled back up with COVID patients, and a lot of nurses are now close contacts or isolating and unable to come to work.
It's pretty much back to where we were with the Delta wave. We are getting more people who need ventilation now, but not as much as before. They're not as sick as last time. And there's a lot of patients who are in our ICU now who are being treated for something else, and they incidentally also have COVID.
A lot of patients need one-to-one care because they need a ventilator. There are times when a patient's blood pressure has climbed up to 180 or 192, and it's not being picked up because the nurse has been busy watching another patient. Our managers try their best. But at the end of the day, we're just so short. In the last six months, at least 20 staff members have left out of a group of 200-plus nurses in ICU. Management is constantly sending out text messages asking people to do overtime. You've got the managers approaching staff members while they're on shift, asking you if you'd like to stay back and things like that. It's constant. There's always a deficit and they need to fill it up.
There have been times where I've been so exhausted that, after a drive home, I sit in the car for half an hour because I don't have the energy to get out of my car and walk inside the house. When I get inside, I don't want to talk to my friends, I don't want to talk to my family, I don't want to talk to my partner. I just keep to myself because I have nothing left to give.
I think as healthcare workers, you can definitely see through the politicians in press conferences saying we are in a strong position, that we are well prepared for outbreaks and we have staff for it. It's all a lie.
I've heard stories of nurses having to leave their patients in a pool of faeces and urine for a few hours because they're so busy keeping patients alive and there was no back up. If I had to do that on a daily basis that would emotionally wreck me.
I think a lot of us are at this point now where we are starting to realise that this employer-employee relationship between us and the government has become quite toxic and very abusive. And we have to draw a line somewhere. I don't know how much more we can call out for help before they understand how serious this issue is.
*All healthcare worker names have been changed to protect their identity, because they said they feared repercussions from their employer if they spoke to the media.
A NSW health spokesperson said that they acknowledge the health workforce has worked tirelessly during the two years of this pandemic.
They also said that since the start of the pandemic, NSW Health has engaged in forward planning with clinicians to ensure hospitals have capacity to care for all COVID-19 patients who need to be hospitalised.
They said that during January and February, the NSW Health system engaged new medical interns, and allied health and nursing graduates to replenish their workforce. They said that in 2021, NSW Health employed more than 2,900 graduate nurses and midwives, and more than 1,000 medical interns.
Read their full statement.
Background Briefing also sent questions to the offices of the Health Minister, Brad Hazzard and the Premier Dominic Perrottet about what the health workers had told us. Minister Hazzard's office referred us to recent public statements, but neither office responded to our specific questions.
Credits
Words: Mayeta Clark
Illustration: Safdar Ahmed
