Australian doctors, nurses and aged care workers tell us how they’re dealing with COVID-19
Half an hour into a 12-hour shift, elastic starts to cut into the skin behind Jack’s* ears.
The mask straps have to be tight, but he wears glasses too, so it doesn’t take long for the pressure to become pain.
His glasses sit on top of the mask straps. Then a face shield sits on top of that. He’s also wearing a hat, a plastic gown and gloves.
“Your whole body is sweating and wet. Your facial bones all hurt,” Jack says.
“After half an hour, you feel so tired.”
But there are 11.5 hours to go and this is the intensive care unit (ICU), so every minute matters. Jack will spend them struggling to breathe under the personal protective equipment (PPE) and with his own temperature rising.
Jack works as a nurse at a Melbourne hospital. His wife is a nurse too — so are a lot of their friends.
They told us their story when the ABC asked healthcare workers worried about the COVID-19 crisis to get in touch.
Over the past six weeks, we received nearly 200 responses from nurses, doctors, aged care workers, allied health professionals, radiographers — the list goes on.
Here’s a snapshot of some of the comments:
“It was scary. I’ve never said that about work before.”
“It was horrific. Students should not have been there.”
“If infection control was taken seriously, we wouldn’t be in this position.”
“The general feeling is a sense of guilt that we contracted it.”
“Exhaustion beyond what is normal.”
“There is more confusion. There is more pain.”
The most talked-about topic was PPE, its availability, and whether or not it was sufficient to protect the workforce.
Respondents were also notably concerned about infection control and contact tracing efforts in hospitals and aged care homes.
Among the responses, healthcare workers told us that contracting COVID-19 itself was scary, but worse was the guilt that came from being forced to isolate when they just wanted to go to work and do their job.
They also wrote to us about the details.
One aged care worker talked about a small space near the door to a resident’s room that was available for donning PPE. It was stressful because it was also the place designated for taking the gear off, raising concerns about contamination.
Nurses talked about not having a space to take a break. The tea rooms they once rested in had been closed to reduce gathering — for some, that meant breaks were spent sitting on the floor.
There were some positive stories about PPE being sufficient and new systems working, but there were many more from people who were scared to go to work.
Among healthcare workers and nurses, there was a lot of sadness about what was happening to the people they cared for and worked beside. There was anger too.
This is an industry that attracts people who care, but throughout the COVID-19 pandemic, particularly the outbreak in Victoria, there are healthcare workers left wondering who is looking after them.
COVID-19 made hospitals and aged care homes places where workers were no longer safe, but as Jack says, unlike other high-risk industries “there’s no danger money”.
“You’re just expected to do everything you’d normally do,” he said.
“There’s no understanding from the organisation. They just think it’s a normal day.
“There’s no extra financial incentive or even extra staff.”
‘Surge staff’ also Uber drivers
In Victoria, as the COVID-19 curve climbed during the second wave, so too did that of the healthcare workers’ infections.
In total, more than 3,500 healthcare workers have contracted COVID-19 in Victoria and as of Tuesday, 2,602 had caught the disease at work.
As the Victorian outbreak was peaking, Jane* was one of the few nurses left working in a Melbourne aged care home when it was taken over by health officials.
The vast majority of the staff were either infected or in isolation. She said it was “emotionally traumatic” seeing so many of the residents die after caring for them for many years.
“Those residents are like family to us,” she said. “It’s very hard for us to see them suffer without any family around.”
She said COVID-19 infection at the facility started in one wing but, because they did not have enough staff to isolate that part of the home, they moved around, spreading the disease.
“If we’d had a proper plan, training on full PPE, about donning and doffing, it would have been different,” she said.
“Lots of lives have been lost that shouldn’t have because it wasn’t managed well.”
Kelly* had been working at another aged care home for five years when COVID-19 hit.
Surge staff were sent in at her workplace — extra workers trained at short notice and brought in when nursing homes have an outbreak.
She described some of the situations involving the new surge staff as “gobsmacking”.
“They were doing multiple jobs, and they were Uber drivers and it was just terrifying,” she said.
“We couldn’t wait for the surge staff to leave.”
Like many of the healthcare workers who spoke to us, Kelly believes the amount of pain and anguish being felt by the people she looks after could have been avoided.
“They’ve done nothing wrong, but get old.”
The residents don’t know when they’ll be able to see family or “what the future holds”.
“Sometimes we quickly pull our masks down to sneak a smile,” Kelly said.
Consequences of the outbreak
Associate Professor Alicia Dennis, an internationally recognised anaesthetist and lecturer at the University of Melbourne, said it was more difficult to provide patient-centred and personalised care during a pandemic.
“Something as simple as holding a person’s hand when they are suffering, that in many cases can not be done,” she said.
“Necessary barriers like a face mask, a face shield, full-body personal protective equipment, hat and gloves — that does reduce the personalised care.”
Over the course of the outbreak in Victoria, several groups called on governments to do more to protect healthcare workers.
There were calls to mandate the fit-testing of masks as is required on construction sites.
In response to calls from healthcare workers and the various representative bodies, the Victorian Government introduced a broad “respiratory protection program”, which it said included training on how to use masks, fit testing and how to assess risk in the workplace.
Safer Care Victoria Chief Medical Officer Andrew Wilson said the program was “underway and moving ahead”.
Professor Wilson said a drop in COVID-19 infections in healthcare settings in Victoria showed infection control had improved.
“The last couple of days have been zero healthcare workers diagnosed, which we are watching very carefully,” he told ABC Melbourne on Tuesday.
“We are looking all the time at the risk [but] it’s very challenging.”
The impact of the COVID-19 pandemic cannot be calculated, but some nurses who spoke to us warned one consequence of the outbreak in the Victorian healthcare system and the way it was handled may be that some caregivers walk away.
A system built on care starts to crack
Andrew* is a nurse in a Victorian hospital.
He thinks our health system usually works effectively, but the pressure put on it by the pandemic has exposed failings — and shown it was ill-prepared.
“We thought what we were doing was good enough, so I guess we were all wrong.”
He has worked with drug addicts, in mental health facilities and in ICU wards for many years and said this was the first time he felt fearful being at work.
“The random nature of it made me fearful. It was really quite an unpleasant environment to work in,” he said.
Andrew’s view is that ICU was well-resourced with plenty of staff, but on the wards, where caring for patients can require more work, staff were forgotten.
“Nurses and doctors are very dedicated. And if it means putting your life at risk, we will do that. That’s part of the job,” he said.
“But there’s quite a few of my colleagues who’ve said this is the end of it.
“I’m not going to pull out now, but after this is over, I think I’m done.”
Sense of ‘disillusionment’
Professor Dennis said it was crucial to support healthcare workers who had worked so hard during the pandemic.
“The last thing we want to do is to lose these health professionals who provide care at our most distressing times when we are sick, who are so highly skilled and committed to what they do,” she said.
“There is a sense of disillusionment with the system, making many people think about whether they want to continue on.”
She said while there had been some improvements, like introducing fit-testing of personal protective equipment and increased awareness of how the virus was spread, more needed to be done to protect healthcare workers, particularly once lockdown restrictions were lifted.
As one nurse who spoke to us said:
“When you’re broken and can’t do it anymore, you’re just replaced.”
*Not their real names. Identities have been hidden to protect workers currently employed in Australian hospitals and aged care homes.