Many people think they know what nurses do, but there’s more than the task you see us perform; what you can’t see is the clinical judgement, the assessments, the constant re-prioritising of needs, so that what can seem really straightforward from the bed is more complicated on the floor. Some of that is inevitable, but some of it is made harder by a system under stress.
I’ve been a registered nurse in Melbourne’s public health system for over twenty years – it’s a job that I love, because I get to make a positive difference to people’s lives every day, often at a time when they’re afraid, in pain, or vulnerable.
Delivering health care has never been easy, but under the Baillieu/Naphine government my job has been more difficult than it needs to be. Every month our hospitals are put under more pressure to increase how quickly we process patients – to get them up to the wards from Emergency within four hours, even if that means they haven’t been adequately assessed, or may not even need admission; and to send patients home as quickly as physically possible, to community health support services that are increasingly stretched.
Those people who need treatment like intravenous antibiotics can, in some cases, now have them at home. Health Minister Davis has counted these patients towards the 800 new hospital beds that his government promised at the last election. But they’re not new beds.
Despite this increasingly demanding, difficult nature of our work, Victoria’s health care system is still productive and efficient, treating more patients without increased resources.
Instead of recognising that more acutely ill, complex patients need more nurses to care for them, the Napthine Government tried to reduce the number and experience of staff caring for the public.
In 2011/12, nurses had to fight harder than we’ve ever needed to before, to ensure our patients only get acute public health care from qualified nurses, not minimally-trained aides nominally under our supervision, and to keep nurse: patient ratios. Before nurse:patient ratios, I would try to care for eight or more complex patients on my own.
We asked for more nurses in emergency departments, to manage the increasing number of patients who need treating every day; we were told that would shorten ambulance turnaround times, and count as a paramedic efficiency gain, but a nursing cost, as though the aim isn’t to have a health care system functioning as a coordinated, effective whole.
And at a time when we need to be investing in aged care services, the Napthine Government has privatised 588 aged care beds, including a specialist facility that had a waiting list for vulnerable aged people with significant mental health concerns.
And there are another 243 aged care beds slated for sale, to private companies whose goal is profit, not people’s health and wellbeing. The burden of their care will fall increasingly on already struggling families, and on to the acute public sector.
Our nursing workforce is now middle aged, and getting older. We have new nurses keen to enter the profession, but funding for graduate year placements has been slashed by the Napthine Government – ending their careers before they’d begun. In one year alone, some 800 Victorian graduates were left with debt, and no options.
Premier Napthine and Health Minister Davis are making a lot of promises about their commitment to health. They’ve had four years to demonstrate that they value health, and the professionals who provide it. In that time Victoria has seen unprecedented elective surgery waiting times, fewer acute care hospital beds, privatised aged care beds, emergency departments struggling to cope, a jump in violence against health providers, and too few new graduates entering the nursing profession to keep it sustainable, let alone attract prospective nurses.
I worry about the kind of health care my colleagues and I will be able to provide under a second term of this government, and I worry about the care my loved ones will receive. Because that’s the thing about the public health sector – if you’re really sick, it’s the only place you can be cared for. And, as so many of my patients have discovered, the next person needing emergency care could be any one of us.