Sun Herald, April 10 2022

From the moment the Ruby Princess docked in 2020 to the current wave of Omicron disrupting the community, healthcare workers have been on the front line of the COVID-19 pandemic.

And while many Australians are trying to move on from two years of illness and lockdowns, for these workers it is not over yet.

The Sun-Herald has spoken to three essential workers in Sydney’s busy public hospitals and one in the ambulance service about the struggle of the past two years and their ongoing conditions.

Long hours, intensified work, concerns about patient care, and even the demands of constantly wearing personal protective equipment, have all taken their toll.

This is the backdrop for the NSW government’s separate enterprise bargaining negotiations with the Health Services Union and NSW Nurses & Midwives Union, who between them cover nearly all hospital employees besides doctors, as well as employees of NSW Ambulance and disability and aged care workers. Both unions have gone on strike recently, the Health Services Union as recently as Thursday.

They’ve been called “healthcare heroes”, but Health Services Union secretary Gerard Hayes said they “just wanted to be treated reasonably”.

He said the strike on Thursday achieved its aim of educating the public about why health workers need a pay rise, and there was no further industrial action planned at this stage. The next step would be a conference in May with more than 1000 members, a few weeks before the state budget is due to be handed down.

Health Minister Brad Hazzard said the government was meeting with the unions to address their substantive concerns, while also considering the state budget needs.

“I believe the community would want all of our incredible health workers to be treated respectfully and reasonably,” Mr Hazzard said. “The extraordinary job they do and particularly during COVID emphasises the need to achieve fair and balanced outcomes on wages and conditions.”

The COVID nurse

After two years of the COVID-19 pandemic, infectious diseases nurse Regina Spadavecchia feels “drained and fatigued”, and is considering leaving nursing altogether.

Ms Spadavecchia, the Westmead Hospital branch delegate for the NSW Nurses & Midwives Union, said her ward was devoted entirely to COVID-19 during the Delta and Omicron waves, until recently.

This meant a lot more work for the nurses because it shut out most of the HealthShare jobs.
 
“We had to empty bins, do the menus for the patient, bring their meals in and out, bring the laundry skips in and out, and get our own PPE because they wouldn’t deliver PPE to the ward,” she said. “We had to do everything.”

Ms Spadavecchia said the hardest thing was looking after people who needed more care than she could give them.

“We’d have to escalate them to ICU because they started requiring extra oxygen and having trouble breathing, but ICU got so full that we couldn’t actually send the patients up - some of them were waiting nine hours before they got to ICU,” she said.

The paramedic

For Kieran Egan, Sydney’s Delta wave in 2021 was the “hardest time of his life”.

Mr Egan, a delegate with the Health Services Union and paramedic with NSW Ambulance in south-west Sydney, saw first-hand the effects of COVID-19 on his community.

“It was incredibly demoralising to be seeing people in the same condition over and over again; people who are incredibly unwell and struggling to breathe, but are young and otherwise fit and healthy,” Mr Egan said.

“It was incredibly, emotionally hard; I’ve never broken down in my job apart from working during that time, and everyone else was struggling with it too.”

From the very beginning of the pandemic, paramedics had extra work in decontaminating the ambulance between every patient, as well as heightened anxiety. But that was nothing compared with when Delta hit in 2021.

“We could end up stuck with a person with COVID during Delta when the hospitals had all their surgical wards converted to COVID wards, and they were absolutely full,” Mr Egan said.

In one case, he worked five or six hours’ overtime after taking care of one COVID patient for seven or eight hours. The crew was directed away from Liverpool Hospital, which was 10 minutes away, to Westmead Hospital, where they waited for five hours and had an X-ray, before finally being sent to North Shore Hospital.

Mr Egan said the main problem this year had been staff shortages, as other paramedics either contract COVID-19 or are furloughed due to close contacts.

“We feel the community has moved on from COVID, but we’re still dealing with it as a healthcare sector,” he said.

“The other day we had a lot of COVID jobs and one of them was a six-year-old girl who had a febrile convulsion [a seizure induced by fever], so it’s still out there and still dangerous, it just feels like no one wants to talk about it.”

The radiographer

When asked to sum up the past two years as a radiographer at Royal Prince Alfred Hospital, Trisha Hann has one word: “hectic”.

Ms Hann, a Health Services Union delegate, said radiographers were understaffed even before the pandemic because of a rising demand for imaging such as X-rays and ultrasounds.

The impact of the pandemic was immediate.

“Basically we had to treat pretty much every patient that comes through the emergency department as potentially having COVID,” Ms Hann said.

“What meant for us was, instead of bringing patients to our department and performing procedures like we normally do, we were going to them in the emergency department with our mobile equipment, which just completely changed our workflow and made everything take twice or three times as long.”

“Basically we had to treat pretty much every patient that comes through the emergency department as potentially having COVID,” Ms Hann said.

“What meant for us was, instead of bringing patients to our department and performing procedures like we normally do, we were going to them in the emergency department with our mobile equipment, which just completely changed our workflow and made everything take twice or three times as long.”

Ms Hann said double shifts became common, or someone on an 8am to 4pm shift might be rostered on to also work midnight to 8am.

“If you say ‘no’, the problem is you’re not just saying no to your manager, you’re also saying no to the people who’ll be working and struggling without you,” she said. “We all feel that we owe it to our colleagues and the patients.”

Earlier in the pandemic, staff shortages arose because of strict rules about close contacts. Now it was because the virus was so widespread.

The mental health nurse

While the wider community had people stockpiling food and panic-buying toilet paper, the equivalent in hospitals was for PPE.

Nicholas Howson, a mental health nurse and the Cumberland Hospital branch delegate for the NSW Nurses & Midwives Union, said at the beginning of the pandemic there was a shortage and that led to “panic usage or rainy-day stockpiling”.

“There was a time when people were literally given two masks a day and told you have to make these last because they’re too expensive,” he said.
 
Mr Howson said the mental health hospital was operating at full capacity, and he knew from the hospitals in his network there was unmet demand, with many emergency departments facing a surge in self-harm and mental health presentations.

The biggest problem was patients who would normally come in for a two-week stay would end up staying six or eight weeks because it was so difficult to organise accommodation and Centrelink payments, and patients with COVID-19 could not be released into the community if they had nowhere to isolate.

He said staff also found it disheartening that management would “chastise” staff for raising safety concerns, saying they had filled out the wrong form and leaving an overall impression they were “trying to stop a record of events that endanger patients”.

“You manage, and you manage, and it’s fine until it’s not,” Mr Howson said. “But when it’s not fine in a healthcare setting, something generally goes very terribly wrong. Someone gets hurt. Someone dies.”