A view from close-up of a dysfunctional government health system

In Queensland, Australia

For many years I have been working as an emergency nurse at a busy Brisbane hospital. My first few years in emergency nursing were so rewarding. Every day I felt like the team I worked with was not only saving lives but also changing lives for the better. But soon the excitement wore off and the reality hit me of what was happening to the Queensland Health system. For years I have watched staff struggle to even keep their practice safe due to the conditions that we are enduring day in and day out. I have seen first-hand what it's like in the public health system. Let me tell you it's not pretty.

It is a harsh truth that there is a growing demand on the system and the money injected into it is not sufficient. Those who pay the price are not the politicians who decide how much money to allocate to health, but rather the likes of your loved ones and friends. There is increasing pressure on emergency departments due to many reasons:

* People are presenting with ailments that GPs could fix, but there are not enough bulk-billing services or after-hours clinics.

* Increasing lack of skilled staff in areas such as emergency due to high numbers of trained staff who are leaving the field.

* An increasing population, therefore an increasing number of people presenting to emergency departments, which means an increase in the patient-to-staff ratio.

* Not enough operational hospital beds. Hospitals throughout Brisbane have wards that are fully stocked but are empty of patients because there is no funding for staff.

Patients are waiting in emergency departments for up to 24 hours to get a hospital bed. Do you understand the implications of this? I am often forced to choose which patient should come off a trolley so that a more critically ill patient can have a bed. Sometimes I cannot take anyone off a trolley. Sick patients are put in chairs because there are simply not enough resources. I have watched patients have cardiac arrests on ambulance trolleys in the corridor while waiting for a bed in the emergency department. Ambulance officers can wait more than two hours to offload a patient at times.

I have seen nurses conduct cardiac tests on patients lying on the floor because there was absolutely no place to put this patient having a heart attack. Every day, patients wait far beyond their allocated triage time to receive medical treatment. As a triage nurse, it is terrifying to see someone with a potentially life-threatening condition wait up to three hours when they should be seen within 30 minutes.

The patients and their families become really angry about this and I don't blame them. Daily now I am verbally abused and so are my colleagues. It has become a frequent occurrence for an angry patient to threaten my life. I have seen the stress of working in this environment take its toll on many doctors and nurses, including me. Lots of excellent staff have left or are in the process of leaving because it seems the situation is only going to get worse.

Once we just had to deal and cope with the reality of what our jobs involved. Now we are not only trying to save lives, but also trying to do this within a system that is potentially killing our patients. I suggest to the state and federal governments that they send a representative to work a full 10 days straight with an emergency nurse - not just walk through an emergency department when you are campaigning. What true reality will that give you? It is obvious that you are not aware of the extremely dangerous conditions patients are being put in or I simply would not be writing this.

To the public I say, next time you feel like threatening a health professional, maybe instead you should consider voicing your anger in a letter to The Sunday Mail. It is time for you to speak up for your rights before someone you love is hurt by the public health system this State Government has created. I write this anonymously because I am bound to a contract with Queensland Health. A condition of my employment is that I don't disclose any information to the media or public regarding what happens within the hospital I work. So the sad truth is the public really have no idea what is happening behind closed doors - until it's happening to them.



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