Victoria's emergency nurses are tired, stressed and burned out.
Almost 20 months after COVID-19 was first detected, many working in hospitals are feeling pressure to do double shifts due to a shortfall of skilled and qualified critical care staff.
Some haven't taken annual leave since the pandemic began.
And now, the state is facing its biggest outbreak since August 2020.
Amanda worked as a critical care nurse at a hospital in Melbourne's west throughout last year's deadly outbreak.
She was pregnant while nursing COVID patients as the case numbers peaked but back then, there was little research into the virus' impact on expecting mums.
"I felt scared a lot of the time. I had passing thoughts about how I was upset that I was placed at this increased risk," Amanda told AAP.
"But I also knew that my managers didn't have a choice other than to place me in the respiratory-side because there were not enough nurses; there was a huge shortage of the skills that I had."
Now on maternity leave, Amanda has recently seen several nursing colleagues leave emergency due to burnout.
Some have opted to work at vaccination hubs while others have transferred to different hospital wards.
She says there's "definitely a pressure" to work double shifts of up to 18 hours in emergency, which can lead to mistakes and patients not receiving the same level of care.
"Every nurse I know has done doubles. They do them regularly because you don't want to leave your team short and that leads to burnout, which means there's always a shortage," she said.
"Nurses are fatigued and worn out by the monotony of repeated lockdowns."
The Australian Nursing and Midwifery Union has heard similar stories but Victorian Secretary Lisa Fitzpatrick says the pressures now faced are "quite different than last year".
"We weren't manning vaccination hubs and of course we've got this incredible catch up and demand, particularly in relation to emergency departments," she told AAP.
"The number of double shifts that are being worked across the state in the public sector is quite frightening."
One of the biggest gaps in staff is for critical care nurses like Amanda but the cost to qualify can outweigh the benefits.
A Graduate Certificate in Critical Care Nursing at the University of Melbourne costs about $11,000 and will rise by $336 next year yet those nurses are only paid an extra $56 a week.
With universities already under stress, Ms Fitzpatrick says the Commonwealth needs to step in and offer more funded places for those wanting to upskill.
"Ultimately, if the course cost less it would be far more easy for people to be able to find the time and the money to commit," she said.
"Given that we desperately need for nurses to be undertaking these courses, recognising that added stress, time, effort and funding, we should be doing more to support them."
Victoria has recorded four consecutive days with case numbers above 50, which makes Amanda "shudder".
She pleas for people to get vaccinated, saying last year is still fresh in the minds of healthcare workers.
Yet she's also unsure if she will go back to critical care once her maternity leave ends.
"You're asking people to go into a workplace that is no longer safe for them; that's scary and now I have a child, it's no longer an abstract thought that I'm placing the baby at risk," she said.
A Federal Department of Education and Skills spokesman said funding of the commonwealth grant scheme for nursing courses had increased seven per cent, with some students paying 42 per cent less in contributions.
Victorian Health Minister Martin Foley has been contacted for comment.
Nurses seeking support can access the ANMF's Nursing and Midwifery Health Program on 9415 7551 or firstname.lastname@example.org.