Fatigued. Worn out. Exhausted. Burnt out.
It was one of the many signs held up by Liverpool Hospital nurses and midwives during a rally on Thursday morning seeking a commitment from the NSW government to urgently address the long-standing staffing crisis being further exposed by the current COVID-19 outbreak.
The action from more than 50 nurses and midwives in their own time follows a statewide meeting of nurses and midwives last week where NSW Nurses and Midwives' Association (NSWNMA) delegates voted to condemn the state government's handling of the pandemic.
NSWNMA acting general secretary Shaye Candish said they have written to Premier Dominic Perrottet calling on some immediate steps to alleviate the "unsustainable pressure" on hospitals, including the payment of a COVID-19 allowance for healthcare workers, allowing nurses and midwives to access special leave when COVID-19 positive and committing to implement shift-by-shift ratios to ensure staffing levels.
"Well before the pandemic, nurses and midwives in NSW have been working understaffed and unsupported. This peak has relied on our members working excessive overtime to keep hospitals running and staff are burning out," Ms Candish said.
"This isn't confined to one or two hospitals. We're seeing nurses and midwives right across the state calling for urgent action from this government because the staffing situation is so dire.
"Nurses and midwives are well past breaking point, the current crisis of constant overtime and huge workloads will see many burnout and leave, meaning we will be in an even weaker position when the next wave hits.
"It should never have come to this. For years, nurses and midwives have been calling on the NSW government to increase staffing to address systemic problems.
"The Premier must urgently step in and commit to staffing improvements through safer nurse-to-patient ratios to ensure we have more resilience in our healthcare system into the future."
A spokesperson for South Western Sydney Local Health District said the district is "deeply thankful" for the "outstanding commitment" of nurses and midwives throughout the past two years of the COVID-19 pandemic.
"We acknowledge the ongoing impact the challenges presented by the pandemic have had on our staff working across our hospitals and services to care for our community. The District offers a range of services and wellbeing initiatives, including counselling and an online wellbeing program, to support our nurses and midwives during the pandemic," the spokesperson said.
"We are also continuing to work with our clinicians to ensure our hospitals have the capacity to care for COVID-19 patients who need to be hospitalised. We have well-developed workforce surge and demand management plans in place to respond to COVID-19, and our networked hospital system ensures patients can be transferred or redirected to other hospitals where necessary, including private hospitals."
The spokesperson said as part of their pandemic planning, the District has "upskilled nurses" from a range of different clinical specialities to provide care to COVID-19 patients where necessary.
"NSW Health has also implemented a workforce strategy which permits previously registered health professionals, including nurses, who retired or whose registration lapsed between three and 10 years ago, to return to the health system as vaccination workers to assist in our vaccination hubs," said the spokesperson, who also added the state government is investing in a further 5000 nurses and midwives over four years under a record $2.8 billion boost to frontline staff.
"These former health professionals, as well as students from a range of health disciplines, allow us to ensure we use our most experienced clinical workforce in our hospitals. There are more nurses and midwives in NSW public hospitals than at any other time in history. Between 2012 and 2021, the nursing workforce and midwifery workforce in NSW increased by 9599 full-time equivalent (FTE) staff, or 23 per cent, to 51,794 FTE.
"The NSW Government has also committed more than $4 billion to manage the impacts of the COVID-19 pandemic since March 2020, including $340 million for personal protective equipment (PPE) to keep our frontline workers safe."
The NSWNMA says there is a feeling of "despair" among ICU nurses in a recent survey they conducted.
"There are members who are telling us that they will get through this crisis, and then that's it," acting assistant general secretary Michael Whaites said.
He said calculating ratios shift by shift instead could help address understaffing in the hospitals.