Three months ago, I was running on empty.
Dealing with the Covid pandemic on multiple fronts for more than two years had taken their toll, and I was suffering from burnout. I had to get away from my clinical work to take the necessary steps to rest, reflect and recover.
It was a difficult decision at the time, but with the benefit of hindsight, I am convinced that it was the right thing to do.
What I was not prepared for was the number of colleagues across Australia who confided that they also felt overwhelmed and traumatised by the pressures and demands they faced day after day.
It is no secret or surprise that Australia’s health system has been battered over the course of the pandemic, and hundreds of thousands of healthcare workers have had to confront extraordinary levels of fatigue, rapidly growing workloads with inadequate resources, and no way of knowing when this ordeal will end. The diabolical combination of surging numbers of patients, finite numbers of beds and an understaffed workforce has led to more and more delays to care.
Delays to medical care inevitably lead to avoidable deaths, and an exhausted workforce is going to make more mistakes.
Australia is currently in the grip of another wave of Covid-19, this time due to variants which are many times more infectious than their predecessors. We have more than 5,000 Australians in hospital because of Covid, and more than 9,000 have died in this year alone – many times more than in 2020 and 2021.
Our system’s lack of surge capacity has been exposed, and while it has taken longer than we expected, our health system is now at the point where it is struggling to deliver the care we expect and deserve. Calls to 000 don’t guarantee an urgent ambulance will arrive when needed, and the arrival of critically unwell people at hospital by private car or taxi is happening more than ever before. Waiting times to see a GP or undergo urgent surgery are deteriorating.
We have N95 masks which reduce virus transmission – but we’re not using them when we should. We see many people out and about with viral symptoms, who should be staying home from work and school. We have vaccinations which still confer significant protection against severe and fatal Covid – but uptake rates of the important booster have been stagnant. We have effective antiviral treatments if used in high-risk groups early in their illness – but they’re only reaching a proportion of those who would benefit. Our attention to air quality measures – even in warmer parts of the country – has declined.
After two years of severe restrictions, fear, uncertainty and trauma, many Australians desperately want to believe that the pandemic is over. Having been away from the hospitals since May, I can see how seductive it is to adopt an “out of sight, out of mind” approach to the Covid nightmare.
But wishing the pandemic to be over does not make it so, and while we observe the intersection of community fatigue and political hesitation to act on some aspects of the medical advice, we are now facing the consequences of a Covid wave that is the most severe in Australia to date.
As I resume my clinical work, I would like to think that I return with changes in my approach to providing medical care.
My determination to see changes in the way we deliver healthcare has only been strengthened.
New models of care, better use of health information and technology, better community supports and cooperation across tiers of government are the tip of an iceberg of measures that would make a difference.
But right now, support and protection of a depleted, exhausted healthcare workforce – in order to preserve their ability to provide the best care they can – is the highest on my list of priorities.
As one doctor, I might not be able to change the health system. But from now on, I intend to practice better self-care, so that I will be able to deliver better care to my patients, and my colleagues.
• Dr Stephen Parnis is a Melbourne emergency physician, and a former vice-president of the Australian Medical Association
