As a nurse in Alice Springs, Erin McKenzie often feels the weight of the world on her shoulders.
"The calls go out constantly — 'need staff, need staff, need staff'," she said.
"Around town, clinics are shut because they don't have the workers."
In her six years in the Red Centre, she has never seen the local healthcare system running on such skeleton crews.
Clinics are haemorrhaging nurses — and pressure is mounting on those left behind.
"Staff are burning out, people are leaving town," Ms McKenzie said.
"They're just sick of the same things over and over.
"These problems have been bubbling for a while, and we need to have them addressed."
A healthcare crisis
In the wake of the Alice Springs crime wave, there are concerns another crisis is looming.
In recent weeks, two Aboriginal health clinics have had to shut their doors due to staff shortages.
Practices are riddled with empty consulting rooms, as peak bodies claim the town is down to just a third of GP numbers required.
And according to Sam Heard, chair of the Royal Australian College of General Practitioners in the NT, it's getting harder to attract new staff.
"If you go back a decade, we were taking maybe 50 to 55 junior doctors into GP training in the Territory," Dr Heard said.
"This year, it's seven — and they're all in Darwin."
Crime sparks shortage
Advocates say alcohol-fuelled crime is a major culprit, burning out staff in town, and driving away a fresh workforce.
The nurses' union says the hospital is running on only 50 per cent of its usual nursing numbers.
And there's little relief in sight.
"Approximately 22 new graduates were supposed to start in January," said Cath Hatcher, NT branch secretary of the Australian Nursing and Midwifery Federation.
"Half of them have pulled out because they're frightened of the level of violence they have seen on the media."
Emergency department struggles
It's a similar picture in the local emergency department, according to Australian Medical Association NT president Robert Parker.
Dr Parker said emergency staff had been exposed to high rates of trauma since NT liquor bans lapsed in July last year.
These included a surge in domestic violence incidents, including a recent attempted beheading.
Dr Parker said it was taking a toll on staff.
"It's quite emotionally draining for them to see," he said.
"And then there's also assaults on staff from inebriated individuals turning up at ED."
'We're all burnt out'
Brent Pannell has been a GP in Alice Springs for 37 years.
He only planned to move here for a short stint, but swiftly fell in love with the place.
Dr Pannell acknowledged crime in Alice Springs was "problematic" at the moment.
"We've had medical students being attacked, we've had doctors being attacked, we've had places ransacked," he said.
But he said crime was a reality in any town, and he wouldn't want to work anywhere else.
"The work is, I think, better than big cities, you get to do a lot more, you see a lot more," he said.
However, he's starting to reconsider his future.
"I think we're all burnt out," Dr Pannell said.
"It's just that we realise we have to continue on, because the catch in not continuing on is that I've got to close my shop and say, 'I can't do this any more.'
"I don't want to do that, and all my GPs don't want to do that. But we have discussed, 'If you go, I'm going,'"
Locum and agency staff fill gaps
It's a crisis that stretches beyond the borders of Alice Springs.
According to the nurses' union, remote public and Aboriginal-controlled health clinics are seeing vacancy rates of more than 60 per cent.
Ms Hatcher said the government has been paying agency nurses $1,500 a day since late December to fill a swathe of positions.
"A lot of staff are saying, 'Why should I continue to work as permanent? Why don't I resign and come back as agency and I'll get paid triple what I am now?" she said.
Ms Hatcher worried what would happen when this "ridiculous" pay rate ended at the end of this month, with many agency nurses indicating they wouldn't stay.
"They may need to look at closing maybe two or even three clinics in the Central Australian area," Ms Hatcher said.
Dr Parker said they were seeing similarly exorbitant pay rates for locum doctors in the hospital.
"It just blows the budget out, because the hospital has to spend a lot of money on locum fees, rather than regular staff wages," he said.
Corrosion of primary care
While this staff shortage is biting across the board, primary care is feeling it particularly keenly.
Dr Heard said this was partially due to the public health sector providing highly competitive salaries.
For instance, he claimed the NT government was offering remote nurses up to $200,000 more to work in public health than at his clinic.
This had caused many doctors and nurses to flee private general practices and Aboriginal-controlled health services.
He said the Medicare freeze, a decline in medical students choosing general practice, and lower pay compared to other specialties were also to blame.
Calls for urgent action
NT Health said a domestic and international recruitment drive was underway to attract clinical staff to the Territory.
A spokesperson added it was "standard practice" to fill workforce gaps with agency and casual health staff over holiday periods in the region.
NT Health refused to confirm how much they were paying agency staff.
The federal government, which largely funds primary care, was also contacted for comment.
Some hope once the national furore over Alice Springs crime dies down, the workforce shortage will turn around.
Many also hope the reinstatement of alcohol bans across the NT will relieve pressures on burnt-out staff.
But others say this crisis has been brewing for years, and won't improve without serious systemic change.
"These are certainly not new problems we're dealing with," Ms McKenzie said.
"This has been happening for a long time."
