Andrew Miller: Want to fix healthcare crisis? Start by asking frontline workers

Nurses have saved my patients’ lives more than a few times, even though they had to shout sometimes to be heard over my deafening ego.

Around the country they are engaged in escalating industrial action, which to me is like hearing that the coral backbone of the Great Barrier Reef is bleaching.

Our healthcare ecosystem was damaged even before the pandemic cyclone destroyed entire shorelines.

However, the big fish do not look at the reef as a whole, they just get hungry now and then, so they commission a report or sack somebody.

There are dozens of ageing recommendations recycled on to power-points by smart-enough detached management consultants. They recite the jargon for the usual fee plus expenses, like bikie defence lawyers.

“Your Honour, my instructions are that my client, the Health Department, is entirely innocent.”

As managerialism and bureaucracy have grown, health leaderships’ disconnection from patient care makes it expensive, unwieldy and ineffective.

“We spent lots of money, what more do you want?”

We want honest executives who don’t scapegoat staff for poor outcomes.

The buck has to stop eventually; the excuses are just not making it around the S-bend any more, despite the squadron of government media managers wielding plungers.

People expect nurses to be a trope of European mononyms: Florence, Teresa and a soupcon of Madonna, the pregnant virgin Nazarene, not the “Like a Virgin” Michigander.

Nurses are often guilted into enduring toxic conditions because of duty to their patients. It’s an abusive expectation.

The scope of professional nursing and midwifery practice has evolved from basic care implementation to underpin every single service that is provided to patients.

Like every other professional in our market-economy, their reward should reflect the skills and workload.

If you think it reasonable to execute junior nurses by reporting them to medical watchdog AHPRA before any enquiry even started into Aishwarya Aswath’s death, you misunderstand the milieu.

It was a confirmation: the bosses will immediately shaft clinical staff if something goes wrong in the midst of chronic under-budgeting and poor system implementation.

Burnt out nurses unsurprisingly seek to avoid further moral injury, by retiring or pursuing less stressful roles.

Denial of access to high-grade personal protective equipment at the start of the airborne pandemic was a final straw.

Federal bureaucrats, denying obvious airborne spread, claimed nurses working on COVID wards wearing inadequate surgical masks probably caught it on the bus. It was disgraceful gas-lighting.

Trust is hard to build and easily shattered.

Conservatively, the WHO estimates SARS-Cov-2 has killed 115,000 healthcare workers.

Many nurses spend more time on Sisyphean documentation than looking after patients. That is another reason why senior staff walk, taking their irreplaceable knowledge and experience.

The geniuses running King Edward Memorial Hospital sent routinely exhausted nurses and midwives a “thank-you” a while back; one teabag and one Mentos each. God help us.

The game is on to find more nurses and midwives to throw on the fire. From university, overseas, over east, or some magician’s hat.

WA nurses are now the second lowest paid in the nation, though the State’s surpluses cast a bigger shadow than the pyramids.

Victoria is not perfect, but nurses get much higher pay, and that State will fund your entire training if you accept their guaranteed job for two years. Plus, they have coffee in grungy laneways, which is apparently a good thing.

They enforce legislated nurse-patient ratios to prevent the cup and ball game that WA plays with patient safety.

WA nursing courses are under-subscribed for 2023. There is talk of dropping the ATAR for entry as low as 50.

Management consultants, different day, another outfit, are pointing to “alternative care providers”. Under-qualified equals cheaper.

Here’s an idea. Our Premier could go to dinner and chat with some nurses, midwives and doctors. Reschedule the multi-nationals and Grangey property developers.

Radical perhaps, but if you listen to nurses, some day they will save your life.