During the peak of the COVID-19 pandemic, nurses – who make up the largest clinical workforce in Australia – were commonly heralded as superheroes. At the same time, nurses were also experiencing increased levels of anxiety and depression, driving many to the brink of burnout. While far from over, the pandemic has since eased off – but the challenges continue. Nurses across the country are now racing to meet pent-up demand for care, while our healthcare systems are struggling to navigate challenges in funding and spiraling inflation. All of these factors are contributing to an unprecedented nursing shortage.
While understaffing has been an issue since long before the pandemic, the situation is set to further deteriorate in the coming years. According to estimates by Health Workforce Australia, Australia is projected to have a shortfall of 85,000 nurses by 2025. By 2030, the shortage is predicted to be 123,000.
Patient and employee safety is at stake
Nurses in understaffed emergency rooms and hospital wards are constantly having to work with insufficient resources while being chronically pressed for time. This despite studies showing a clear link between low nurse staffing levels and adverse health outcomes. Conversely, shifts where more nurses are on duty are associated with fewer adverse events, shorter hospital stays, and fewer missed observations in acute patients.
Besides jeopardising patient care, understaffing also puts nurses themselves at risk. Understaffed shifts create an unsafe work environment where nurses are forced to tackle high-risk situations alone and treat potentially aggressive patients on their own. This high-stress environment can contribute to burnout or even result in lasting physical injuries. Our healthcare systems cannot afford to inflict either on our nursing staff.
Besides putting people in acute danger, understaffing has an eroding effect on employee morale. Most of us want to go to work and do our job well. For nurses, understaffing is making this more and more difficult to do. Not being able to provide your patients with the best level of care while also having to work in unsafe conditions creates a demoralising work environment that benefits no one.
The crisis has become a hot political topic
The nursing crisis has been widely discussed in the media. It was hardly surprising then it also became one of the hot topics of the 2022 federal election. One of the most highly debated issues has been the Aged Care Amendment (Implementing Care Reform) Bill 2022. The bill makes it mandatory for aged care facilities to have a registered nurse on duty at all times. The goal of the bill is to ensure that elderly residents have immediate access to clinical care when needed, thus cutting back on unnecessary hospital visits and improving residents’ health outcomes.
These are admirable goals. However, it is hard to see how having a registered nurse on site 24 hours a day can be achieved under the current conditions. The situation is particularly challenging in rural areas. For a small rural nursing home with only a handful of beds, achieving the mandatory minimums is virtually impossible. The only option will be for these providers to close their doors. This will leave vulnerable communities without access to care and further deepen the divide between rural and urban areas.
Have we reached a breaking point?
After gathering steam for several years, the nursing crisis seems to be reaching a breaking point. From New South Wales to Western Australia, we are already seeing large-scale strikes, with nurses demanding for the nurse to patient ratios, better working conditions, and more pay to fend off the impacts of raging inflation.
On the other side, the state is placing the blame on the unions, calming that the strikes are putting patient safety at risk. Meanwhile, nurses are drawing attention to the fact that patient safety has already been at risk due to chronic understaffing. The situation has evolved into gridlock with no real solution in sight. One thing has become painfully clear: something needs to change.
Where do we go from here?
While there are no easy fixes, a myriad of solutions have been brought forward to try and solve the nursing shortage. A lot of emphasis has been placed on recruiting new entrants to the field, be that domestic or from overseas. But while the government can encourage new entrants by guaranteeing wages or offering increased fee-free placements, there is no escaping the fact that it takes, on average, three years to train as a nurse. This means it will take a decade for recruiting new talent to have any meaningful impact. That’s why it’s imperative that we now focus on retention.
The way things stand, we are seeing far too many nurses experience burnout. An alarming number of senior nursing staff are deciding to leave the field altogether. This is something we simply cannot afford. That’s why it’s so critical that we focus on retention above all else. To do that, we need to do everything we can to make sure our nurses are happy and healthy in the work that they do. This will help retain current staff as well as attract new applicants to the field. This will benefit all of us now – and well into the future.