FRAN KELLY:
Nurses are at the epicentre of the battle against the COVID-19 virus but with a doubling of the number of intensive care beds to treat this pandemic, the race is on to train more nurses in critical care. And today, the Federal Government has announced a program to upskill 20,000 registered nurses. This comes amid an aggressive recruitment drive to encourage 40,000 retired nurses, doctors, midwives and pharmacists back to work to meet the coronavirus challenge head on. Alison McMillan is the Chief Nursing and Midwifery Officer for the Commonwealth. Alison, welcome to RN Breakfast.
ALISON MCMILLAN:
Thank you, Fran.
FRAN KELLY: We won't get through this crisis without nurses and we really appreciate the work they do for us every day but we will need to train more to work in intensive care, that's clear. How many are you hoping to upskill to be able to have those skills to work in intensive care units?
ALISON MCMILLAN:
Well Fran, the course is designed for 20,000 new online places to educate nurses in order for them to be able to work in intensive care or high dependency units across the country.
FRAN KELLY:
Now, it's no small thing I imagine, upgrading to an intensive care standard of nursing. How long would it take?
ALISON MCMILLAN:
The course comes in three components and its 40 hours of study. The individual would pace that study themselves based on their experience.
FRAN KELLY:
And this is an online course. How do you – how do you teach someone that online when, you know, there's obviously key skills you need to know about intensive care nursing for this virus in particular which is intubation, ventilate – attaching ventilators, that kind of thing. How do you do that online?
ALISON MCMILLAN:
You do it through a whole range of training materials. So it's got lectures, it's got webinars, it's got quizzes, it's got technical information so that the individuals, based on their current knowledge, can upskill their – their knowledge in their own time with what suits them. And it's covered in three key topics which is acute respiratory management, high dependency unit nursing and critical care nursing.
FRAN KELLY:
And are you worried about the skill levels if we're – because, as I say normally I think it takes if not a year, years for nurses to specialise. This is a specialisation that we're trying to do this in such a speedy and online way? Should we be confident in this?
ALISON MCMILLAN:
Yeah. I am confident. The companies that we have contracted to do this have got more than 25 years of experience in this type of education. They've got a broad range of staff – of medical and nursing staff with, with enormous experience in this. So we, we rely on their knowledge and expertise in adult learning to do this. But I think, Fran, that it's important to remember we already have a really highly skilled and educated nursing workforce out there that we rely on every day wherever they're working.
FRAN KELLY:
Oh, no doubt about that.
ALISON MCMILLAN:
It's just building on those skills.
FRAN KELLY:
Yeah. No doubt about that. I mean we also have a highly skilled experienced workforce – nursing workforce – that's just retired or recently retired. And there's another scheme that begins today to try and mobilise that retired workforce too, sending out e-mails to, I think, it's 40,000 former doctors, nurses and midwives and chemists to see if they'll return to work. What kind of numbers are you looking at there in terms of nursing staff?
ALISON MCMILLAN:
We're looking to maximise the numbers as best, as many as we can, Fran. So everyone will have received that notification if they have – from APRA – and we're looking for them, obviously, it depends on their, their circumstances and the situation. But if there's a desire to return to the workforce, we're encouraging them to do that.
FRAN KELLY:
So we've got these two schemes – the 20,000 for nurses who want to upskill online and then we've got the separate scheme if you retired recently and you want to just get your registration through and come back. We're asking a lot of nurses, aren't we? To put up their hands to take up ICU nursing at a time like this when they've all looked around the country I'm sure, around the world and seeing the scenes in in hospitals in New York City, in Italy, in Spain currently. It's a dangerous job, we're asking them to do?
ALISON MCMILLAN:
I don't think it's a dangerous job. It's certainly a challenging job, Fran. There is a third part to this, we – two weeks ago released a, probably ten days ago now, we released a course through the college, Australian College of Nursing, and that was a refresher course. Again, online, can be completed self-paced, that just refreshes anyone who may have been out of the workforce for a short period of time but is still eligible to work, just to re-orientate them back into the system. We've already seen the number of those, of people complete that training, so we're taking many approaches and not – these are not the only efforts that are being made. Hospitals across the country are working with ex-staff or staff exists that they currently have, perhaps to increase their hours to, to build the capacity and we've been doing this for a number of weeks now so that we can be prepared for this situation as it develops.
FRAN KELLY:
I supposed I'm just probing, Alison, because I'm sure you've heard as I have heard from nurses directly and from friends and families of nurses who are nervous and worried, and some of them very anxious, about being drafted to the frontline of the fight against this virus. Because they are worried about what they've seen, they are worried about the lack of personal protection equipment in their hospitals, they're- some of them are very anxious about this. You must have heard this too?
ALISON MCMILLAN:
I have, Fran. And of course, as you'd imagine, I've got a lot of my friends for many years are telling me these things as well. And so, we're providing as much information as we possibly can, we're being very frank and honest with the workforce about PPE, about what we are hearing and seeing from across the country. And we're building that capacity together so that we can be prepared for the surge in demand that we are anticipating.
FRAN KELLY:
And it's really important that we upskill this workforce. How short are we at the moment of nurses with these skills to work in an ICU unit given the surge we're preparing for? What do we need?
ALISON MCMILLAN:
Well, Fran, we're not short at the moment. We have an existing highly skilled and trained intensive care nurse population out there who are meeting the demands today. Each – this won't happen all at once, it's a slow growth, and so we're building that capacity over time so that we can be prepared. But what's really important is that to remind everyone of their responsibilities around the social distancing that I know everyone hears constantly all the time: that we need to both slow the growth, or that curve we've been talking about so that demand is managed in a controllable way while we build that capacity as well. Not one thing will make a difference; it's all of the different parts of this that will mean we can meet the demand when called upon.
FRAN KELLY:
Yeah, hence the catch cry from health force workers: stay at home so that we can stay safe. It's a really important message.
ALISON MCMILLAN:
It is.
FRAN KELLY:
Within the nursing workforce in hospitals, in our public hospital system, and it soon all will be public for the duration, Alison, can nurses say, 'No, I don't want to move from being a nurse in the general ward to the ICU frontline'. Can they refuse?
ALISON MCMILLAN:
Yeah of course, Fran, they can refuse. We're not going to conscript people to do this, they have to be comfortable that their skills and knowledge is – and this is something they want to do. I think we will find there will be many nurses out there that will want to take on this training, it's a great opportunity, it's provided free. And it will be in a very supported environment. Remember with all, as I said, those already highly trained ICU nurses who will work with them as a part of a team, and they'll be well supported to do that across the system.
FRAN KELLY:
And just back to the…
ALISON MCMILLAN:
Fran, can I…
FRAN KELLY:
Yes, go on. Go Alison.
ALISON MCMILLAN:
I think it's important for me to say to nurses and midwifes, we really do appreciate that this is a worrying time, and to remind them that there are lots of support services and people they can talk to if this is worrying them in any way. It's really, the supports are there, and they should be drawing on them to help them work through the anxiety and their fear so that, you know, they don't get unwell in this situation.
FRAN KELLY:
Yeah. Just – that's important – and just back to PPE and I'm sorry to harp on about it, but I personally have heard from a numbers of friends of mine who are nurses who are being directed to: use their mask three times when in the past the practices used to be use them once; wash your own goggles; perform certain procedures without any kind of PPE because there's not enough. I've counted now at least five hospitals that I know firsthand where these directions have changed. Is that good enough?
ALISON MCMILLAN:
The advice is very clear, Fran, and it's out there for all of the health professionals to see and about when and where they should be using the appropriate PPE. I do appreciate that there are people who believe that they should be wearing it all the time, but we've been very open and frank about the limitations of our current supply. And so, we need to preserve the supply of PPE as much as we can by making sure it's only worn at those times for when it's indicated, and that advice is really clear to health professionals about when and where you should be wearing PPE.
FRAN KELLY:
Sure. But is it safe? As the Nepean Hospital's reported – it's reported today that staff had been given an email, one mask per day to wear. Or as a friend of mine, who's a senior nurse in an emergency department, they were told to wear their mask for three patients in a row. Is that safe?
ALISON MCMILLAN:
The wearing of PPE advice has been given by a whole range of these hospitals, I'm not going to try and counter the advice provided by these hospitals because I don't know the context in which they're, it's being told. But you can – you don't have to wear a mask, replace a mask every time when you deal with another patient, you can keep a mask on for a period of time. Yeah.
FRAN KELLY:
Okay. Alison McMillan, thank you very much for joining us.
ALISON MCMILLAN:
Thank you, Fran.
FRAN KELLY:
Alison McMillan is the Chief Nursing and Midwifery Officer.
Contact
