Custodians and Gardener Currently Caring for Dementia Patients During Severe Staffing Shortage

In a “horrendous” turn of events, an extreme staffing shortage has led to dementia patients at a New South Wales hospital receiving subpar care from untrained staff members.

Tamworth hospital, which serves about 100,000 people in a rural area, has begun asking their cleaning staff and gardener to look after dementia patients as the remaining overworked nurses and doctors tend to more complex cases.

“The cleaners on the ward have been asked to monitor and sit with the dementia patients,” says Eddie Wood, president of the Manning Great Lakes Community Health Action Group. “Dementia patients deserve the same level of care as anyone else […] it’s horrendous.”

Photo: Adobe Stock/Mat Hayward

Patients have compared the situation to going to a “pub without beer” or a “pet shop that doesn’t sell dog food.” What’s the point of being in a hospital if you aren’t going to receive care from trained nurses and doctors?

“When you see your hospital and your staff demoralised and leaving, it’s atrocious,” says Wood.

Now doctors, nurses, and patients are airing their concerns. A parliamentary inquiry has heard their frustrations, and the issue is being taken to Taree and Lismore for public hearings.

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“Houston, we have got a problem, and the problem I’d like to talk to you about is workforce,” says Dr. Simon Holliday, a staff specialist at Manning Base Hospital with three decades’ experience.

According to Dr. Holliday, less than five percent of Australian-trained doctors are currently choosing to practice in rural areas. This has put rural healthcare facilities in a difficult situation, and it has caused a “disaster” for patients living outside capital cities.

Dr. Holliday blames the Australian Medical Association for not endorsing medical conscription, a system in which doctors would be required to serve time in rural areas to help make up for the shortage.

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“Australia needs to start providing Australian-trained workforce for rural areas,” he told the upper house committee. “Today you’ve heard about the pain and anguish in our community, as in many other regions’ communities, and you have the weight of our expectations on your shoulders.”

Right now, overseas-trained doctors, mainly from developing countries, are coming in to help fill the void. However, this isn’t a long-term solution, as the staffing shortage is becoming global. Foreign doctors are having a hard time with burnout as they cope with being used as “cannon fodder” in understaffed facilities, with many working more than 80 hours a week.

Dr. Seshasayee Narasimhan points out that this is also a financial issue. Chronic underfunding has left rural hospitals “downgraded” and “not appealing for new recruits.”

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Wood claims that hospital administrators and local health district have refused to acknowledge the staffing issue, saying there are enough hospital staff members to go around. “You say that to the […] first-year graduate nurse who is put in charge of a ward,” he says.

And dementia patients aren’t the only patients suffering from the staffing shortage. In the absence of specialists to perform operations, the hospital is reportedly using “ghost” operating theatres as storage spaces and rooms for staff members to make phone calls. Some of the patients who are in need of operations will have difficulty getting them or may be waitlisted for lengthy periods of time waiting for someone to be able to perform their procedures.

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There is only one cardiologist for the entire region, and the area has the worst cardiovascular outcomes of any region in Australia. There have been reports of multiple unnecessary deaths in rural hospitals, including one where only a telehealth doctor was available, and a hospital cook was forced to care for a stroke patient in the parking lot.

Tamworth also has the busiest emergency department in a non-metropolitan area of New South Wales, making their staffing shortages particularly disastrous. Some patients will drive upwards of 150 kilometers to another hospital just to be able to be seen faster.

We can only hope this hearing has a good outcome and that Australia does something productive about ending this staffing shortage quickly. Too many people are suffering. Patients are not getting the care they need and deserve, and staff members are being forced to work long hours and take on more than what they were hired to do. It’s an all-around bad situation, and it’s going to take drastic action to remedy the crisis.

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