ICU nurses' open letter to NSW Premier: 'We can't deliver the care'

Nurses in NSW have warned the hospital system is in crisis, demanding the NSW government address intensive care unit (ICU) staffing levels as the state braces for a surge in Covid cases.

Over 500 ICU nurses have signed an open letter – seen by Yahoo News Australia – addressed to Premier Gladys Berejiklian, warning the hospital system is “in crisis” and demanding the standard ratio of one nurse to each patient in ICU be guaranteed.

"We are extremely concerned about our ability to provide safe nursing care under current staffing levels afforded by the NSW government to ICUs around this state," the letter reads.

Hundreds of  ICU nurses signed an open letter to the NSW premier. Source: EPA via AAP
Hundreds of ICU nurses signed an open letter to the NSW premier. Source: EPA via AAP

"The added demands of the Covid-19 pandemic, testing capacity and surging admissions is forcing our clinical workforce to the brink, placing our registration at risk on every shift and compromising safe patient care.

"We urge you and your government to urgently fix the ICU staffing crisis. It cannot wait."

The letter stated that healthcare workers' own health and safety is constantly at risk both physically and mentally.

The letter comes as new modelling released by NSW Health predicts the number of patients in ICUs is expected to triple in the coming weeks.

Brett Holmes the General Secretary of the NSW Nurses and Midwives’ Association said the letter represents what the baseline ICU staffing levels should be in "normal" operating circumstances.

“But we know these professional standards of one-to-one care for ICU patients were not consistently being met prior to the pandemic," he said in a statement to Yahoo News Australia.

"We have raised concerns about critical care staffing levels and the need for ACCESS nurses in ICUs with the Ministry of Health for some time.

"After they shoulder the burden of this current crisis, our members do want to sit down with the Premier and Health Minister to discuss their concerns firsthand and seek assurances that a one-to-one nurse to patient ratio is mandated for critical care patients.”

ICU demand to surge in October

Modelling from the Burnet Institute reveals even at the pandemic's worst phase for the hospital system — expected in late October and the first half of November — authorities don't believe ICU occupancy will reach anywhere close to the surge capacity of 1550 patients.

"You may be moved to a different hospital than the one closest to your home. You may have slightly different surroundings to what you would normally," Premier Gladys Berejiklian said on Monday.

The modelling shows there could be 947 Covid patients in ICU by the end of October. Source: NSW Health
The modelling shows there could be 947 Covid patients in ICU by the end of October. Source: NSW Health

"But the bottom line is anyone who needs that care will receive it."

The modelling suggests that case numbers will continue to increase until mid-September in Covid hotspots, reaching up to 2000 cases per day.

The estimated peak of patients in ICU is 947, of whom 560 would be Covid-19 patients and 387 with other ailments.

The modelling shows ICUs in South Western Sydney, Western Sydney, Nepean Blue Mountains and Northern Sydney Local Health Districts are already approaching capacity.

At that point, some ICU patients will be treated in other spaces like operating theatres. Doctors and healthcare workers will be caring for a larger number of patients than usual.

Some critically ill patients, who would be in intensive care were it not for the pandemic, will be treated outside intensive care units.

NSW recorded 1,281 locally acquired Covid-19 cases on Monday, taking the state's outbreak of the Delta strain to 29,265.

with AAP

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