To maintain current standards of care, the government would need to double the number of nurses in ICUs to about 20,000.
Australian College of Critical Care Nurses president Alison Hodak said Australia would not have enough specially-trained ICU nurses to quickly double the workforce, and would have to rely on registered nurses supervised by “highly qualified” critical care nurses – who have generally undertaken 12 months additional post graduate training.
Ms Hodak said the college would be concerned if the government moved away from the current workforce standard of one-to-one care for ventilated patients, as flagged in its coronavirus pandemic plan.
She said there would be concerns about the quality and the safety of care that a nurse can deliver if the nurse-to-patient ratio increased.
Australia’s chief nursing officer Alison McMillan said the government was “working to expand the capacity of our intensive care nursing workforce” by bringing in “other nurses who can be given some training, and work as a part of a team to be able to deliver and expand the care”.
Grattan Institute health economist Stephen Duckett has modelled the spread of the coronavirus and found Australia, which is doubling the number of confirmed cases every 3-to-4 days, is on track to push ICUs to capacity by mid-April.
“When we hit a trigger point of 12,000 new cases every day, then we know that we will hit ICU capacity shortly after if new cases continue to grow,” Dr Duckett said.
“Slowing the growth to doubling every five days would buy another week.”
A group of 8,000 doctors, including intensive care specialists, has written a second open letter to Prime Minister Scott Morrison calling for stronger action to slow the spread of the coronavirus, demanding a total shutdown of non-essential activity.
Ms Hodak said postgraduate-qualified critical care nurses should make up 50 per cent of each ICU’s nursing staff and that while it would possible to have up to four registered nurses supervised by one critical care nurse, this was not recommended for COVID-19 cases.
“The patients we’re talking about are going to be incredibly sick,” she said.
“Once they are in ICU, they are going to need incredibly intensive care. They’re really going to be quite critically ill – that’s what we’ve seen internationally.”
There were 12 coronavirus patients in ICUs across Australia on Tuesday afternoon, including some aged in their 40s and 50s.
A woman aged in her 70s, who had been a passenger on the Ruby Princess cruise ship, died in an ICU on Tuesday morning, bringing the total number of COVID-19 deaths in Australia to eight.
Mr Hunt said a further 5000 ventilators could be on the way, as Chief Scientist Alan Finkel works to increase production.
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Dana is health and industrial relations reporter for The Sydney Morning Herald and The Age.