Will Australia's healthcare workforce measures work?

After returning to work as a nurse following a 12-month maternity break, Andrea Simmons* had hoped to cut down her shifts and spend more time with her son. Her employer, however, had other ideas and wouldn’t budge on the two-day week she’d been contracted to prior to having the baby. After much back and forth, Andrea conceded and began her reluctant search for a day care placement.

“I tried everything I could to cut my shifts down to just two per fortnight, but my boss was desperate, and he knew I couldn’t afford to walk away from the job,” she told Hospital + Healthcare.

Andrea’s situation is one of many symptoms plaguing Australia’s overburdened health workforce. After being dealt a double blow of surging illness and a migration freeze, the already understaffed sector has been in crisis for much of the pandemic.

Add to that the impending challenges around chronic disease and an aging population, and there are few signs of abatement. In fact, Health Workforce Australia (HWA) has estimated that there will be a shortage of more than 100,000 nurses nationally by 2025.

Andrea has noticed the rise in pressure since returning to work and believes it is both a consequence and cause of the workforce crisis.

In the last few months, 15 of her senior colleagues on the emergency department have vacated their roles — some after decades of service.

“Things feel different now than they did 12 months ago. Sure, we were in the thick of the pandemic then. But now we are even deeper into it and people haven’t had a break. People are just too stressed and are looking for work elsewhere.”

To combat the staffing crisis in health care, Australia is introducing a range of measures. Soon, aspiring nurses and midwives in Victoria will benefit from complimentary education as part of a $270 million state government initiative; and there are hopes that overseas talent will soon flood in with the lifting of migration caps.

Andrea believes neither of these approaches are sustainable without serious reform.

“Put it this way, I studied for four years to get where I am today in my career and I seriously toy with the idea of jacking it in on a daily basis. I know many other nurses that do too,” she said.

“Some of the staff that recently left the emergency department had taken 20-plus years to get to where they were, and they are now finding jobs in other sectors.

“In other words, free education may entice workers into health care but it won’t guarantee they stay there for more than a few years — and almost certainly not for a lifetime.”

Changes to migration policy may also fail to move the dial, with nurse understaffing a global problem. The World Health Organization has warned that there will be a deficit of 13 million nurses around the world by 2030. While Australia is an attractive destination for immigrants, the global healthcare talent pool may be too shallow to draw from.

Andrea believes overwork and underpay are the main barriers to recruitment and retention in health care. She believes higher nurse ratios and a liveable salary would have kept most of her departing colleagues in their jobs.

In the absence of an adequate funding avenue for a pay rise, factors like workplace flexibility and employee entitlements could make a meaningful difference, she says.

“When I was negotiating a shift reduction with my employer, I also proposed working solely on weekends [instead of reducing shifts]. That way my husband could take care of our son whilst I work and we could have avoided costly day care fees. However, my boss refused and scheduled my shifts for midweek [when my partner is working],” she said.

“I get that it might not be reasonable to get the pay we want, but having to fork out unnecessarily for day care has been like having a pay cut — and with the conditions we are in now, it sometimes doesn’t feel worthwhile.

“Besides, my boss has shot himself in the foot because my son is bringing home sickness constantly from day care and I’ve had lots of time off as a result.”

Meaningful gestures of gratitude can also make a difference to quality of life as a nurse, Andrea said — scoffing at some of the tokens of appreciation she had received to date.

“This year we were gifted a badge to say we had worked with COVID patients, along with a drink bottle and a towel.

“It was a nice sentiment, but the gifts were pretty laughable, especially in light of what we had been through. I know nurses who are currently seeking mental health support from having over-extended themselves these last few years — I’m not sure a drink bottle is adequate,” she concluded.

*name changed for privacy

Image credit: iStockphoto.com/JohnnyGreig