With the COVID-19 pandemic, Australia’s health and aged care workforces have faced one of the largest challenges experienced in living memory.

While the outbreak in Australia was relatively contained by global standards, for nurses, midwives, and carers working across settings without confirmed cases of COVID-19, 2020 was a year of unprecedented stress and concern.

Health and aged care workers are one of the highest at-risk groups for COVID-19 infection and even staff who do not work with patients with COVID-19 can face significant challenges, threats, and stressors. These can impact their physical, mental, and emotional safety, health, and wellbeing due to; long shifts, regularly wearing PPE, the risk of infection, aggression from patients and community members, concerns for personal safety and the safety of loved ones and patients. In addition, the lack of access to resources and support pose a heavy burden for even the most resilient of workers.

In collaboration with all ANMF’s Branches as well as the ANMF Federal Office, the Rosemary Bryant AO Research Centre has published their report, COVID-19 and workforce wellbeing: A survey of the Australian nursing, midwifery, and care worker workforce.^[1] The research stands as the largest 2020 COVID-19 survey amongst Australian nursing, midwifery and care workers with almost 12,000 participants from every State and Territory.

The report consisted of two main parts:

1. COVID-19 specific issues addressing the workforce; and
2. domains of the workforce climate.

The objectives of the research were to:

• assess factors regarding occupational wellbeing, including stress, anxiety, and burnout in nurses, midwives, and personal care workers across different work settings;
• determine upstream and downstream factors that impacted occupational wellbeing; and identify opportunities to improve Australia’s workforce preparedness for significant health crises in the future.

The survey was open over 12 weeks from August to October 2020 and was widely promoted by the ANMF Branches.

Registered nurses made up the largest participant group (71%) followed by enrolled nurses (14.65%), and personal care workers (6.66%). Perhaps unsurprisingly, due to when the survey was open and the case numbers in those States, participants from Victoria (45.33%) and New South Wales (25.53%) were strongly represented.

As a large, multi-dimensional survey that collected a diverse range of data across many issues, this article can only focus on selected key results. Future publications, reports, and conference presentations are planned to drill down regarding many of the project’s findings. Selected key results were:

• 82% of respondents reported often or always having the right types of PPE.
• Most respondents (58%) agreed that they were supported by their workplace regarding any PPE concerns and requirements.
• Almost half (46.74%) of all respondents felt their workload had significantly or moderately increased since the pandemic.
• Overall, 18.75% of respondents were redeployed to a different area, hospital, or speciality of work due to COVID-19.
• Fewer than half of respondents in aged care reported that their employer had a plan to deal with COVID-19 in the workplace.
• At least 20% of respondents reported having to manage staff abuse, access to workplace mental health support, and access to alternative accommodation.
• At least 30% of respondents rated their workplaces’ ability to deploy more staff if required and debriefing processes as poor or very poor.
• The workplace with the highest proportion of positive COVID-19 results among staff was residential aged care facilities (4.45%).
• Over half of the respondents were moderately or extremely concerned about having adequate staffing levels and the right skills mix in the workplace.
• 35% of respondents who worked in aged are were moderate or extremely concerned about job security.
• Respondents working in nursing homes and hospitals showed the greatest risk of burnout compared with those working in primary care and other workplaces.

Overall, the findings depicted a resilient and dedicated workforce. Nurses, midwives, and care workers rose to the challenge despite many facing concerns about the impacts of COVID-19 on their health, wellbeing, homelife, and the work environment. Perhaps understandably, due to the known systematic failings and issues that have plagued the residential aged care sector including widespread low staffing levels and skills mixes, those working in residential aged care facilities reported the poorest outcomes across several occupational wellbeing indices including high levels of workplace demand, role conflict, work/life conflict, and the lowest level of job satisfaction of any group.

It is critical that employers continue to ensure the safety and wellbeing of the nursing, midwifery, and carer workforce by implementing evidence-informed plans, open communication and engagement with staff, policies, and procedures for major health crises, including the provision of appropriate PPE.

Whilst the community was felt by participants to be supportive of the professions, one third of participants reported experiencing greater incidence of abuse and threats by members of the public. with those working in hospitals (36%) and nursing homes (33.90%) more likely to report this. Participants who identified as Asian reported experiencing more abuse or feeling threatened outside of work in comparison with other ethnic groups (18.05%).

It is critical that employers make it a priority to actively engage with their workforces, particularly during such extreme events, by seeking their feedback and concerns, and working to support and maintain their safety and wellbeing. Indeed, keeping Australia’s nursing, midwifery, and care workers safe is an integral part of ensuring the health of the wider Australian community.

Ensuring the safety and wellbeing of healthcare workers will increase the stability of staff who are critical during major health crises such as COVID-19.

Reference

[1] Adelson P, Fish J, Peters MDJ, Corsini N, Sharplin G, Eckert M. (2021) COVID-19 and workforce wellbeing: a survey of the Australian nursing, midwifery, and care worker workforce – A report prepared for the Australian Nursing and Midwifery Federation [Online]. Rosemary Bryant AO Research Centre, Clinical and Health Sciences, University of South Australia. Available: https://unisa.edu.au/contentassets/0429d3a6ea70464b80a0b37aa664aa0c/covid-19-and-workforce-wellbeing-survey_report_final.pdf

Authors
Micah DJ Peters PhD, works for National Policy Research Unit (Federal Office), Australian Nursing and Midwifery Federation (ANMF) and University of South Australia, Clinical and Health Sciences, Rosemary Bryant AO Research Centre

Pamela Adelson works for University of South Australia, Clinical and Health Sciences, Rosemary Bryant AO Research Centre