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We are globally in mourning

Unexpectedly, adjusting to the “New Normal” now includes the reign of King Charles the third. What a sudden turn events, that we all knew was inevitable but not imminent. Somehow, we never allowed ourselves to think about ‘The changing of the guards’ to apply to the monarchy; our Queen was such a constant in all our lives, that thinking she would one day not be, was” a bridge too far”, what with all the issues that this year has brought.

It has been such a shock for everyone, as the previous day we had seen her invite Liz Truss to be Prime Minister and to form the new government. She had been standing and smiling through the formalities, although the photographs portrayed a frail figure with bruising apparent on her hands.

The news of the Queens deterioration escalated here, in Australia, as the evening went on, and it felt like we were all globally and collectively holding our breath for the inevitable. The public announcement that the Royal family had been called to the bedside, left us in no doubt that it was just a matter of time before we heard the news and, like a well-oiled machine, the transition to Charles becoming King began as soon as the Queen died, the process following protocol that has been well rehearsed for years.

If only the health service was running like a well-oiled machine, instead of feeling like the wheels are falling off. In my last article I mentioned that in caring for families, daily focus has shifted from proactively moving forward, to defending the progress that has been made and voicing our concerns about retrogressive consequences that are emerging;, either because of the policies introduced urgently during the early pandemic, or because of acute absenteeism from the next reoccurring wave of sickness, caused by whichever variant is in the limelight. Sars- cov-2, that we are “learning to live with”, is delivering a version of reality that we didn’t expect “learning to live with it” would bring. The Ba5 Omicron variant is proving to be an adversary worthy of a fourth vaccination, now being hastily rolled out to those over thirty years old. A necessity in the light of another surging wave of Covid cases, combined with the worst flu season for a few years in Australia, resulting in a significant increase in loss of life, hospitalisations, and unprecedented absenteeism across the whole employment spectrum, but particularly felt in the health service.

From the discussions and threads followed on Twitter and social media, it is a shared experience globally; our health services are under the greatest pressures and stories of burn-out and nursing shortages are hot topics and well documented on the COINN blog page.

The issues were apparent well before the Pandemic caused the cracks to further damage the health service infrastructure. After an earthquake, buildings are deemed unsafe when the structural integrity has been significantly damaged, but on we all go in the health service, band aiding the problems and papering over the cracks, shifts covered more by good will than good insight into planning and prioritising; although to be fair, the current wave of absenteeism is so high that “providing the best care with the staff that we have got” is a reality and a headache for all bed managers There remains risk of cross infection; the irony being that many of the newly diagnosed are in-patients who have been close contacts through sharing the same room.

The plan to address the labour shortages by opening up the borders and recruiting health workers (and all sectors) from overseas, is concerning. The answer is not as easy as the politicians think, as every western country is facing the same issues and looking to solve them with instant overseas experienced workers, thereby destabilizing their own countries skilled labour markets. It will be a question of who can deliver the largest financial carrot to incoming workers and how will that impact on permanent staff who have been holding the health system together with double shifts throughout the crisis?? Wouldn’t it be better to increase the pay to incentivize staff and stop the exodus? I am not alone with being in despair at the current situation, I am listening to young new grads not wanting to stay in the health service, even students just filling in their time to get their degree before leaving.

In Australia, there is even a bold new decision to waiver student loan fees to encourage becoming a nurse. Currently It is only in Victoria but it will mean every state has to do the same, otherwise their potential student nurses will flock to Victoria. And who can blame them, who wants a mega student debt with the future looking financially challenging? It’s a national crisis, it should be a national solution; offering financial carrots is destabilizing the work force even more.

There are “surge “recruitment agencies providing mega financial incentives, where nurses are recruited to literally be a pool nurse and deployed to wherever there is a shortfall, even supplied a car to be prepared to go to plug the gap.

The disparities are obvious: those nurses trying to get experience in a specialty and those following the money. Many are earning eye watering high hourly rates. How will this be evaluated in the all- important “professional portfolio”? So many specialties need to work as a team to nurture new nurses and to have experience to draw upon. Currently, patient assessments dependent on tick box early warning scores and interventions must be based on technology to confirm diagnosis. The move towards greater reliance on digital technology and Automated Intelligence(AI) has accelerated, proving to be the silver bullet of the Pandemic, achieving a pace of change that may have taken years without the instant need for health service delivery adaptation during isolation and lockdown, proving unequivocally that “Necessity is the mother of all invention”. That pace of change will continue as the current service delivery evolves and adapts to meet the increasing challenges that

the health service faces.

International Council of Nurses CEO, Howard Catton has expressed his concern, at the International Metropolis Conference in Berlin 2022, that as staff shortages grow, regulatory bodies are likely to come under increasing pressure from governments to streamline and minimise checks for migrating healthcare professionals, which could increase patient safety risks.(Twitter: @Howard Catton,@ICNurses)

Increasing migration could prove to be a counter intuitive move potentially causing more problems than it solves, a silver-plated bullet that tarnishes easily.

As we adapt to the new normal and a new era in the monarchy; governments and health service managers responsible for the solutions to our complex problems, must look at the long-term consequences of the situation and adopt smarter management to provide timely, cost-effective care, but also appreciate the intrinsic value that nurses have in meeting these aspirations.

With the ALIGNN conference in HAWAII happening in mid October and World Prematurity day on 17 November, the year is racing towards the holidays and thoughts turning towards the New Year, lets hope that the closing of 2022 brings the end of the pandemic era and more optimism for nursing in the health sector in 2023


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