24/09/2021
SHARE THIS and TAG A NURSE A letter to Australia from a nurse in an overwhelmed system.
https://thenursebreak.org/covid-ed-nurse-letter/
My name is Katie, and I am a Registered Nurse working in an extremely overwhelmed and exhausted Emergency Department in a Melbourne public hospital.
I have spent the last ten years at university; completing a three-year Bachelor Degree in Nursing, an Honours degree in Nursing Research, a Postgraduate Specialist Certification in Critical Care, graduate coursework in Applied Pathophysiology, and I am currently undertaking my Masters in Emergency Nursing.
I have worked as an ED nurse for just short of five years, and what should be the beginning of my career, feels like the end, and my passion is has been short-lived.
I look around at our Emergency Department every day, myself and my colleagues are burnt out and at breaking point.
Our job is stressful, to say the least. We see people on the worst days of their lives, and we do as much as we can to help, leaving no concern overlooked. But as of late, our Emergency Departments, our hospitals, our healthcare services, and our facilities are inundated, and progressively worsening as each day passes.
We are doing the most, but we are exhausted, and I fear for the healthcare of our communities, our families and our children, and for the physical and mental well-being of our care providers, and for our patients.
As a nurse working in ED, I’ve already seen it all. We deal daily with cardiac arrests, strokes, trauma, broken bones, chronic and acute diseases. We treat mental illness. We treat all ages, races, genders. We consider your treatment preferences, decisions and choices, and we never discriminate.
We will see you on your worst day, seeking our help. You ask us for our suggestions, and for our recommendations, for we are the professionals, and this is what we do.
We keep up to date with the best evidence-based practice, and provide the highest quality of timely care we can, to ensure you have the best outcome, and the greatest quality of life.
But now we are fearful.
We fear for those who need our services desperately, but cannot or will not have access to them due to our current surge in demand.
I’ll try to explain this as simply as I can:
When our hospitals are at capacity, and no beds are left, how will we treat you? How will you have access to our services, our specialities, and our skills, when you need it the most?
Our hospitals are at capacity. We have no beds left. We are understaffed. And our healthcare facilities across Melbourne are doing the most to try to keep up with demand.
With the projected numbers of emergency presentations over the next few weeks, I am almost certain we cannot AND will not cope, because our limits are already stretched.
The increase in COVID-19 presentations has forced the closure of wards, the delay in surgeries, and the restructuring of hospitals, so that we may treat COVID-19 and non-COVID-19 presentations simultaneously. Important resources like ventilators, protective equipment and healthcare staff are scarce.
And I fear we will be struck with the dilemma like many other countries have already faced: to make a choice of who we prioritise care for. Why are we even faced with such immoral decision making when one persons’ life costs no more than the next?
As I said before, we do not discriminate. We treat everyone equally, and we will do the most to provide you with the best quality healthcare to keep you alive.
So when the rates of patients presenting to hospitals with COVID-19 increase drastically, overruling current demands, what happens to those people who are in dire need of urgent care?
How are we meant to prioritise care when there are physically no beds left in our hospitals, In our Intensive Care Units, and in our Emergency Departments?
For many months now, our waiting rooms have been at capacity, ambulances fill our emergency bays, often spilling onto surrounding streets, waiting – like the rest of our patients, for a free bed to receive urgent treatment. Like us, our paramedics are under immense pressure to provide emergency care to those who urgently need it, yet they are forced to wait in our hallways and deliver care to patients on their ambulance stretchers, whilst our hospitals do their best to find more beds.
We are trying our hardest to keep our heads above water, but it the struggle to stay afloat gets harder each day.
Treating patients with COVID-19 in the hospital is not a rare phenomenon. It is a daily task in our ED. However, the constant change and evolving nature of the issue, coupled with the precautionary measures we put in place to keep our patients, our communities and our staff safe are immense, and it puts a massive burden on us, and the delivery of healthcare.
We ‘don’ our tier 3 PPE, applying our N95 masks, our hairnets, our water-resistant long-sleeved isolation gowns, our face shields and gloves, we scan each-others PPE for potential flaws or mistakes, before heading out the department to treat everyone as we have normally done. We ‘doff’ multiple times a day, after exposure with someone who has respiratory symptoms, after we perform tasks that may lead to contamination, after contact with each patient needing individual isolation. What is a rare phenomenon, however, is the bathroom breaks, the water breaks, the lunch or dinner breaks and the constant callout for more staff due to overwhelming and intense pressure. We are burnt out and are physically and mentally exhausted.
Our hands are red raw from the copious amounts of sanitiser and alcohol rub we use between every patient encounter, and our faces are bruised, with injuries forming from the prolonged pressures of our masks. We suffer migraines and headaches from our goggles and face shields, but our resilience is growing thin.
We carry unspoken fears: a breach in our PPE, unknown exposure to COVID-19 in the community or our workplace, and an unknowing transmission to vulnerable patients or our families. But we will treat as we do every other patient, with kindness and compassion, and with the best care, we can provide.
As of 19th September, there is currently 204 patients in our hospitals receiving treatment for COVID-19. The majority of which are unvaccinated. Fifty-five of those 204 patients are in our ICU’s, with 40 ICU patients requiring mechanical ventilation. All of these patients are unvaccinated.
This number may not seem significant to the general public, but based on these statistics, we can assume for every patient admitted to hospital requiring treatment for COVID-19, at least 25% of those will require an Intensive Care Unit admission, and 20% will require mechanical ventilation. This is alarming.
Elective surgeries have been suspended to try and keep up with demand. To free up beds. But that comes at a cost. Patients’ requiring surgery for debilitating illnesses, for treatment of cancers, tumours, injuries, broken bones, are left waiting.
We understand the burden lockdowns create on businesses, on families, on children and on loved ones, for we are human too. However, the burden we would face if we were unable to deliver treatment and life-saving care to anyone who presents to hospitals, regardless of COVID-19 status, is much greater.
I fear that we cannot care for you as we once would when our hospitals could once cope with demand.
I fear our most vulnerable populations, who cannot get vaccinated due to medical reasons, are exposed and succumbed to an illness that could’ve potentially been prevented, or minimised through vaccinations. But how can that be achieved when fear spreads faster than facts.
I fear that even those who’ve received vaccinations, simply do not have the capability to fight and surpass the effects of COVID-19.
I fear for the long term health repercussions to those affected directly and indirectly by the disease.
And I fear for our future, as the eradication of preventable illnesses is no longer about the safety of one another and the reliance and trust on our experts, but is about the disinformation and distortion of knowledge to comply with ones’ own immoral views. We are privileged as a nation, but false news prevails, and will always spread 10x faster than facts.
It is clear vaccinations work, we’ve eradicated diseases time and time again. Without them, we’d be lucky if our lives surpassed the age of 30. I understand your fears, concerns and worries about vaccines. I am not anti-vax, and I will not treat you any differently than the next. But please listen to us, for this is our field, and we simply are the experts.
This is not about freedom of choice. This is not a conspiracy theory. This is not a hoax. It is real. And like our duty to keep you safe, as is yours to keep each other safe. I would love to see my family again, as I’m sure you would too, and I’d love to be able to treat my patients without the fear and the worry we face today.
Thank you for taking the time to read this, and on behalf of my colleagues and I, we wish you the best of health. Please stay safe, please prioritise the safety of your families, friends and loved ones, and please consider getting vaccinated.
Katie, a concerned, and heartbroken Emergency Department nurse.
