A nurse’s letter to the next State Government 

12 December 2021

Article from January 2022 edition of INPractice
Fix this mess before more patients are left to sleep rough in car parks.
COVID-19 has turned our world and our hospitals upside down. 
Governments past and present have worked to improve the health care sector and have also failed the health sector, with funding cuts and reduced staffing.
We’ve seen community management of patient care through general practice doctors, and home-visiting nursing and midwives. For patients with adequate housing and family support, such care can be managed. However, this support is entirely inadequate for the disadvantaged population in our community. 

I am a midwife who often works with sick newborns. Mothers are discharged when ‘criteria’ is met. 

This allows for discharge of mothers even just hours after giving birth. However, for many of those mothers, they are not supported by family. Some mothers are assessed and discharged but their babies require ongoing care in the hospital. The hospital then provides mothers with a border bed in a shared room. 

This has a cost attached for the bed and meals. These beds are often used for existing and incoming maternity patients. 

This practice has come about because we have no off-site local accommodation or in-hospital designated and secured accommodation for mothers. 

Our hospital is in need of a house similar to the Women’s and Children’s Ronald McDonald House. We need close off-site accommodation to provide safe and secure support for new mothers needing ongoing care. At present, even designated/secured border beds with no cost would make a huge difference. 

There are growing numbers of unseen homelessness in our community. Those that ‘couch surf’, sleep in cars, garages and backyards. 

My recent and distressing situation was of a young mother whom I had no accommodation to offer. 

Her new born required three-hourly breast feeds and this mother was discharged from the hospital as she had met ‘early discharge criteria’. 

Having given birth less than 24 hours earlier her options were limited. 

She had no one to drive her to and from the hospital, no local accommodation and no funds to pay for a border bed and meals. The latter comes with the added stress of possibly being asked to leave the hospital overnight due to an inpatient bed shortage. 

This situation was overwhelming and depressing for this new mother and for myself. 

I gave this young woman a drink and a sandwich. Her plan was to have a rest in her car and try to work something out. I believe she was sleeping in her car in our hospital car park between feeding her baby. What would you do? It’s an impossible situation. 

I cannot believe that in this day and age, in First World Australia, that a young mum is left to seek shelter in a car park. 

Lack of safe lodgings is a common issue in our area. Our community turn to their public hospital in their most desperate times of need. Nursing, medical and midwifery staff are left feeling disillusioned, frustrated and exhausted.
Hospital staff have struggled with understaffing, poor skills mix, endless overtime, missed meal breaks and lack of resources well before COVID-19 existed. What the virus has done is expose this under-resourcing and brought it to light. 

The car park mother is one example of the human side of cutbacks in health that have created daily stressful problems, causing burnout in our hospital sector workforce. 

The litany of issues include double shifts attended under pressure, under payment or no payment for overtime, bullying and threatening staff by withholding permanent positions and or withholding full time contracts. If staff SLS situations they are rebuked by management and told they are not up to the task. 

Then of course there is the awful daily verbal, sometimes physical, abuse of staff by patients, many of them addled by alcohol or drugs.
We are certainly not allowed to publicly voice our concerns, however justified, for fear of being sacked. 

Governments, executives and management must work with people at the coal face. We must find solutions to deliver best practice. We all want the same outcome - that is a health sector supporting our community with an equity of health care delivery.
For the sake and safety of our patients and for that of nurses and midwives, we need the next State Government to make fixing health top of the agenda. 

How bad does it get when a new mum, just hours after a milestone moment in her life, has no option but to sleep rough in a car park? 

Yours sincerely, 
Anonymous (because I have a mortgage to pay).
The ANMF (SA Branch)’s Health Policy Position Statement includes strategies to address the social determinants of health and the well-being of the community. At the time of print, we have requested a response from SA’s political leaders by early 2022 that we will share with you. 

Click here to read the January 2022 edition of INPractice