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Primary health care is any medical service that is provided outside the four walls of a hospital, including aged care, community health, general practice, custodial, schools and many other primary health care settings. Australia's 98,000+ primary health care nurses play a critical role in disease prevention and control to keep people healthy. They provide proactive care and health promotion to keep Australians well.
Source: APNA Primary Times Summer 2021 (Volume 21, Issue 2)
Since the start of the COVID-19 pandemic, Australia’s health-care workforce has played a critical role in protecting the broader community from the virus. While the broader community has experienced increased emotional distress, unease from greater uncertainty, and negative impacts to emotional wellbeing, the same goes for members of our health-care workforce.
Increasing pressure placed on the health system in addition to staffing and resourcing shortages have impacted the day-to-day experiences of most health-care professionals, especially those at the frontline treating patients with COVID-19, who are at increased risk of contracting the virus. Nurses, who make up the largest occupational group in health services, are particularly vulnerable to infection as a consequence of having direct and frequent patient contact.
In a recent survey of health-care professionals by Mental Health Australia, 86% of respondents said that working in health care during the COVID-19 pandemic had increased the amount of stress and pressure they experienced in the workplace, 73% said working in health care during the pandemic had had a negative impact on home life and 70% said COVID-19 restrictions had had a negative impact on their mental health and wellbeing.1
One of the first Australian studies to investigate the effects of the COVID-19 pandemic on the psychological wellbeing of hospital clinical staff found that nurses and midwives reported more severe symptoms of anxiety than doctors and allied health staff.2
These results, combined with anecdotal reports of increased rates of burnout in our health-care workforce, paint a clear picture that supporting the emotional wellbeing and mental health of our workforce must be a priority for the ongoing sustainability of the workforce.3
Morally, for health services, caring for and supporting the emotional wellbeing of staff is the right thing to do. But employers’ obligations extend beyond a moral obligation – there are legal obligations that employers must be aware of.
A recent paper published in the academic journal the Australian Health Review examined the standard of care employers are required to provide their staff under the current Australian legal framework.3 The paper highlighted that workplace health and safety laws require employers to eliminate or actively minimise hazards and risk. These laws apply to both physical and psychological risks that can impact an employee’s emotional wellbeing.
With an understanding that there is both a moral and legal obligation to protect staff and support their emotional wellbeing, the question then arises, ‘how can this be achieved?’ Unfortunately, there is no blueprint. However, throughout the pandemic, health services of different sizes and scopes have implemented various measures to benefit their staff and work towards improving emotional wellbeing.
One Australian intensive care unit (ICU) and emergency department (ED) introduced new strategies to address the anticipated short- and longer-term negative impact of the pandemic on staff and ultimately patients and families.4 The organisation embedded a stepped-care psychological service in the ICU and ED, which was sequenced to focus on prevention, early intervention and specialised intervention.
Removing the barriers to accessing care for a cohort that is particularly stretched for time was well received. A full write-up of this case study’s results is available on the Australian Health Review website: https://ahha.asn.au/ahr.
As we emerge from the peak of the pandemic, it is important to recognise that while the worst is (hopefully) behind us, our health-care workforce will be met with new challenges, such as responding to long COVID and the backlog of people seeking care for non-COVID-related conditions. This makes it all the more important that we continue to focus on emotional wellbeing and find ways that actively support our workforce throughout future crises.
1. Mental Health Australia, ‘Mental health and wellbeing during the COVID-19 pandemic’, Mental Health Australia website, 2021, accessed 28 October 2021. https://mhaustralia.org
2. S Holton, K Wynter, M Trueman et al., ‘Psychological well-being of Australian hospital clinical staff during the COVID-19 pandemic’, Aust Health Rev, 2021, 45(3):297–305.
3. J Dean, D Panaccio, D Kevat, C Farmer, S Pang and P Mahar, ‘Obligations of Australian health services as employers during COVID-19’, Aust Health Rev, 2021, 45(5):622–626.
4. C Galati, B Avard and L Ramsay, ‘Case study of a stepped-care psychological service for healthcare professionals working in critical care’, Aust Health Rev, 2021, 45(5):633–637.
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