Sarah* arrives at a Sydney hospital for a shift in the critical care unit and notices something that makes her nervous.
The road leading to the emergency room is congested with ambulances waiting to discharge their patients.
She said that seeing the ambulance bay filled worries her.
It gives her an idea that the patients are coming her way.
Sarah works in the hospital's intensive care unit, which is under tremendous strain.
Nurses who were previously responsible for one patient in need of intensive care are now responsible for two.
And, according to the NSW government, the worst is yet to come.
Sarah claims to be tired, and she is well aware that the COVID trend line is not working in her favor.
She said that they know from past COVID-19 experiences that every day of high instances will make it worse one to two weeks later.
It's like foreseeing a bleak and gloomy future. That's intimidating when I'm already exhausted.
She said that they are already exhausted, weary, and working in an understaffed, under-resourced system.
Overburdened and understaffed
Premier Gladys Berejiklian of New South Wales, which has the most COVID-affected health system in the nation, has admitted that healthcare staff are feeling overwhelmed.
On Sunday, we featured articles on healthcare professionals from pathologists to dentists who may not be at the forefront of your thoughts.
Despite the strain, Ms. Berejiklian has frequently stated her faith in the health system, assuring New South Wales residents that it "will cope."
Sarah lately stopped paying attention to the daily news briefings.
She realised that they have to portray hospitals as a secure place to go. However, she wishes there was more recognition of the difficulties they are facing.
The ICU where she works used to have a section dedicated to COVID-19 patients, but now all Sarah does throughout her 12-hour shift is cared for COVID-19 patients who need intensive care.
People whose lungs have been so severely damaged by the virus that they have been drugged and a tube through their neck so a machine can help them breathe are among them.
She said that as soon as we take over their ventilation, we have to carefully control it because they become powerless.
Nurses must also monitor their patients' medicines and blood pressure, keep an eye out for deep-vein thrombosis and pressure sores, care for their patients' eyes and mouth, and manage drains that support their physiological functions.
She is now caring for two patients at the same time and is concerned that she may miss anything.
She said that COVID has brought to light personnel shortage problems and shortcomings in our service.
'But what if it gets worse?'
Grace* is a critical care nurse who has worked at a Melbourne hospital treating COVID-19 patients throughout the epidemic.
She is concerned about what is going on in New South Wales.
She added that they feel for the nurses who are going through what they are going through.
Hearing politicians complain about the healthcare system's ability to cope has enraged Sarah.
She said that other times, I've chuckled at how ridiculous it is. When I hear people say, 'It's OK,' I think to myself, 'What about when it gets worse and it's not OK?
According to her, critical care capacity is more than just the quantity of ventilators; it is also about having enough nurses who are trained to care for patients who need them.
She said that although health officials could quadruple the number of ventilators, they couldn't immediately increase the number of highly qualified ICU nurses.
Grace felt that hospitals were still delivering safe care to patients, although not great care.
She was concerned, however, that hospital congestion would result in subpar treatment, making hospitals dangerous places for healthcare employees.
More than 4,000 healthcare workers were infected with COVID last year, and a recent epidemic at Royal Melbourne Hospital infected many staff members and resulted in the furloughing of 450 hospital employees.
Grace would want to see hospitals become safer places to work so that healthcare professionals are no longer seen as "heroes" just for performing their jobs.
Someone who goes to work in a safe atmosphere does not need praise since they are just doing their job.
'Mistakes can and do happen.'
Emma* works on a specialised ward at a major Melbourne hospital, where she and her colleagues care for suspected COVID-19 patients.
She said that the added pressure made them feel as though "the walls were closing in."
Specialised wards were now accepting patients from other areas of the system to handle the surge of COVID-19 patients.
Plastics nurses, for example, were now caring for cardiothoracic patients.
Emma said that mistakes can and do happen.
She's been wearing PPE for so long that she's developed dents on her face that appear like she was hit in the face.
It was difficult to care for individuals patiently whilst wearing head-to-toe plastic PPE, she added.
She said that trying to maintain your cool whilst sweat is literally pouring off your face is a kind of emotional labor I've never really experienced before.
They are receiving the sickest of the sick, and they need more skills and TLC.
It's an atmosphere where everyone understands that even the smallest error may have disastrous repercussions, but checks are being missed because employees just can't go through it all or keep up to date on the newest hospital policy.
Emma remarked that everyone was scared.
She said that she’s concerned that [someone] may die as a result of a policy [change]. It's a dread fueled by guilt.
' Several healthcare professionals who contacted us expressed worry about patients' end-of-life experiences.
Grace remarked that end-of-life treatment in the ICU during COVID is really horrific.
It is not only COVID-19 victims who are impacted. However, any patient whose life was cut short in the ICU during the pandemic.
And healthcare staff bear the hardship of seeing people die without the comfort of family, a chaplain, or adequate pain treatment.
Emma said that they weep and get irritated. It's difficult to recognise when you should be able to give something but can't.
Several nurses undertake their jobs because they want to help those in need, but the epidemic is making it almost impossible, according to many nurses.
Sarah was recently caring for a COVID-19 patient when it became apparent that there was nothing more they could do for her – she would die shortly.
She removed all of her tubes and monitors so she could die with dignity, but she wanted to do one more thing for the lady who was going to die alone.
Sarah said all she wanted to do was hold her hand.
However, she was summoned away just before she died, and I couldn't be there for her.
