Chief Nurse and Midwifery Officer, Professor Alison McMillan's interview on ABC Radio National on 7 September 2021

Read the transcript of Chief Nurse and Midwifery Officer, Professor Alison McMillan's interview on ABC Radio National on 7 September 2021 about coronavirus (COVID-19).

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FRAN KELLY: Speaking of the load on our hospitals, modelling from the Burnet Institute for predicting intensive care admissions in New South Wales will peak at 947 in early November, the Premier Gladys Berejiklian acknowledging this will stretch the hospital system. In WA where there are no COVID-19 patients, hospital capacity is already at 100 per cent, we learned. So what does learning to live with COVID mean for healthcare?

Alison McMillan is the Chief Nurse of the Commonwealth of Australia. Alison McMillan, welcome back to Breakfast.

ALISON MCMILLAN: Good morning Fran.

FRAN KELLY: We've seen the Burnet Institute modelling, nearly 950 people needing ICU treatment in New South Wales in November- in Sydney in November. Will the hospital system be able to cope with these numbers?

ALISON MCMILLAN: I think, Fran, we've heard that they've been doing a great deal of work and we've all been doing a lot of work to plan for these types of peaks since this pandemic commenced, and they are working to ensure that they can make as much space available for the system. But I think it's important to re-emphasise the message that the best thing that we can all do to make sure that this demand is as low as it can possibly be is for everyone to get vaccinated.

FRAN KELLY: Sure. Space is one thing. Trained staff is another. The Burnet Institute modelling estimates already 3400 COVID and non-COVID patients will require hospitalisation in New South Wales in October, even before we're at peak numbers. We already know nurses are already sedating in intensive care, we've learned, so they can care for other patients. It's predicted they will be caring for more patients than currently prescribed under protocols for ICU, and staff will literally be working double shifts. As the Chief Nurse of the Commonwealth, are you concerned about this?

ALISON MCMILLAN: Of course I'm concerned, Fran, as are all of the nurse leaders across Australia. And that's why we've been working, as I say, for 18 months, looking at what we can do to supplement that nursing workforce and support them during what will be a very difficult time. It's not just the demand, Fran, but wearing PPE all day is very, very difficult to do. And it has a major impact on our amazing nursing workforce. But I have confidence that our nurses across Australia are some of the highest trained in the world and have risen to many occasions in the past. And it's important, that my message to nurses across the country is please do look after yourself. If you are struggling, do reach out to get support, and the community needs to be supporting nurses in the incredibly important job they do looking after people across the country.

FRAN KELLY: Couldn't agree more. And it's that notion of being able to look after yourself when the load is so much. I note the words of Dr Nhi Nguyen, ICU Clinical Advisor for New South Wales Health COVID Response. She said yesterday she fears a lot of nurses will quit the health sector because of the toll of the high workload. So what is the planning for that? A workforce that is overloaded, a workforce that- exhausted. In the 18 months, what is the plan to supplement this workforce?

ALISON MCMILLAN: So, there's been a number of things. If we start with intensive care, we did work with the Australian College of Critical Care Nurses to develop additional training. 16,000 nurses completed that training that will- it does not give them the type of training you would normally do to be a qualified critical care nurse, but it gives you the knowledge to work and support that. We're working- obviously, those nurses have been available and part of the system now for more- well, probably about 18 months. So that's a way to supplement the workforce, looking at shift patterns, ways to encourage nurses back into the system. We know that we've got a number of nurses who've retired in recent times. So bringing them back into the workforce in some way is a way to do it ...

FRAN KELLY:  [Interrupts] Is there a program to do that afoot now?

ALISON MCMILLAN: Yes, there is, and there has been through the entire pandemic. So it's called a sub register. Those who may have recently retired being put back onto the register at no cost to them so that they can return to the workforce that they choose to do so. Also, Fran, making sure that we've got our nurses working in the areas we need the most. So where we might have had nurses doing testing and vaccinations in significant numbers, we're looking at using undergraduate students in medical and nursing and allied health to support our vaccine program so we can potentially move nurses back into the primary health and hospital system.

FRAN KELLY: Okay. And again, is that happening now? Because this peak predicted by the Burnet modelling in Sydney is not far off. And in Victoria, at one Victorian hospital, we know 500 staff had to be furloughed already because of COVID-19 exposure. I mean, should we see modelling on hospitalisation and ICU loads for every state and territory now? Is that work being done so we can plan where and how much of this workforce we need?

ALISON MCMILLAN: Well, all of the states and territories are doing their own internal planning to look at where the peaks and demands might be ...

FRAN KELLY: [Talks over] Is there a Commonwealth eye on that? Is there a Commonwealth picture of that?

ALISON MCMILLAN: There is work that's being supported through the Doherty Institute. As you know, I think you spoke to Margaret this morning, looking at a whole range of aspects of this work, looking at what the demand patterns may look like in different states and territories.

FRAN KELLY:  Okay. So again, just to raise the issue of another state that's been in the media in recent days, if you ask the ambulance drivers, they'll say that almost every state and territory they attend is under pressure. They're ramping. A state like WA has apparently already got a hospital system at 100 per cent capacity. I mean, is that good enough? And is it reasonable, then, for a state like WA to be insisting on pursuing a zero COVID strategy? Is that the only way that their hospital system will cope? Is that the reality of it?

ALISON MCMILLAN: Fran, I'll take that big question that in a few chunks. Firstly, paramedics are a critical part of our support system. And we do value the work that they do. And we do know that they're often put under significant pressure when systems become congested. Western Australia clearly has some challenges at the moment in its capacity. I know that they are doing some work to try to understand what that is. It's a number of things coming together. But there is certainly an increase in demand in an environment where they don't have COVID at this point in time. So we're now looking ...

FRAN KELLY:  [Talks over] And someone's just written in to say the situation is the same in Tasmanian hospitals too right now.

ALISON MCMILLAN: Well, that's right, but I know that these are not unusual situations, we do see peaks and troughs in hospital demand over the years, and the system does adapt to those demands so that it can accommodate those patients. We are just out of the end of winter. And so, yes, we are seeing some system pressure where there isn't COVID.

FRAN KELLY: Okay. So just very briefly, if you would, the Prime Minister's assured states and territories the federal government will help build capacity in their hospital systems to cope with a surge in COVID hospitalisations. Is that being done in a state like WA or Tasmania, where they are at maximum already? Just briefly.

ALISON MCMILLAN: We are absolutely working together. We met just last night again as a group with Brendan Murphy and the chief executives of all of the health systems to continue to work on a regular basis on how we will mitigate this demand and how we'll meet this demand as we move forward in the plan, as I see our vaccination rates rise to 70 and 80 per cent.

FRAN KELLY: Alison McMillan, thank you very much for joining us again.

ALISON MCMILLAN: My pleasure. Thank you, Fran.


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