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Critical shortage of healthcare staff: ‘Wake up every day with a heavier feeling’

Joke van der Goot (36) has worked for eight years at the Gelre hospital in Apeldoorn as an IC nurse. Joke enjoys her job, being able to provide good care is her top priority. But the longer the corona crisis lasts, the more difficult it becomes. “In recent weeks we have had an absenteeism rate of 20-25 percent. Just think: a quarter of your colleagues are at home. The pressure on us is increasing.”


Busy hospitals

According to Joost Dekkers of the professional association for nurses V&VN, the pressure on hospital employees is enormous. There are several reasons for this, but the main one is the shortage of staff. “We miss caregivers because they are in quarantine, because they have contracted corona themselves, but especially because they have to provide more and more care with fewer and fewer people. They become overloaded and burnout because the work becomes too heavy.”

This high pressure does not only apply to hospital staff. People who work in district nursing and nursing homes also have a hard time. “Nurses are not surprised if they have to work double shifts in a day or if they do not work four but nine shifts in a week. The rosters are becoming less and less full.”

V&VN argues in favor of more robust measures, because the scale is continuing to scale down. “Hospital care has now been moved to phase 2d, the phase for code black. This has serious consequences for patients, but also for the staff. The pressure, both mentally and physically, is great, they no longer do the work they love so much. do. People drop out or quit.”


IC nurse Joke says that she normally treats a maximum of two patients – without corona. Now there are sometimes three. She often also supervises an IC nurse in training, then there are two more. Meanwhile, more and more of Joke’s colleagues drop out. According to her, this is mainly due to the persistent work pressure. “My work gives me energy when it’s not just peaking, but that’s not the case now. The bucket is full and overflowing.”


Ernst Kuipers, chairman of the National Acute Care Network (LNAZ), said in the House of Representatives on Wednesday that absenteeism in the ICUs has risen to almost 10 percent, and in the nursing wards to 9 percent. There are now 2,845 corona patients in Dutch hospitals, according to hospital figures from the LCPS. 595 of those patients are in an intensive care unit and 2250 people are in the nursing wards.

‘Heaven, how can this go on?’

Loes van Koolwijk (46) also notices this. She is a Nursing IG (Individual Healthcare). She increasingly has to go out in protective clothing to care for her clients. In addition, she has to do it with less and less manpower in her team. Loes actually works in a team of nine, but due to staff dropout, this now consists of five. Her colleagues are overloaded, have burnout complaints or corona, she says. “We are increasingly scaling down our care, sometimes even at the expense of patients we have cared for for years.”

‘Heaven, how should this continue?’, Loes sometimes thinks. According to her, the shortage of staff is becoming more acute. “In this work I have become accustomed to coming to people’s homes and stepping over mountains of emotions, but even that is no longer possible. The stock of staff is running out, colleagues are getting sick. It is enough.”


She sees the vulnerability in her colleagues. “I know they can fall over for the slightest thing. I’m keeping balls in the air as I see the work not getting less but more.”

Mental impact

‘What do I find again?’ is the feeling with which IC nurse Joke leaves for work every day. She increasingly wonders how much longer she can handle this: not being able to provide the care she wants to provide. “Sometimes I can’t speak to the family of an IC patient because I have to move on to the next patient. That is terrible.”

There is no longer a stable schedule for Joke. Because she has to work so many parts of the day, sometimes a morning shift, then an evening or night shift, her rhythm is disrupted. But Joke is doing it, increasingly often in recent weeks, with fewer and fewer colleagues. It is physically difficult, because moving IC patients takes a lot of strength, especially with fewer colleagues, but it also takes a lot of mental effort. “How do I keep a balance between my work and home? What can I no longer give the patient? Do I still know my own limits?”


It is even more difficult when Joke has to choose between two patients who both ask for help. “If I have that one shift, I’ll get over it. But if I face that choice day in, day out, it does something to me mentally.”

Demotivated

Ambulance brother Jan Hoefnagel says that the crowds in the hospitals also have consequences for the ambulance staff. They do not drop out due to stress, but they do become demotivated. It is not self-evident that you choose the hospital where the patient will go, explains Jan. “I recently had to transfer a patient from Rotterdam to Zwolle. Then I think: do I really have to go all the way there? Sometimes I have to drive two hours before I can lose a patient.”

But in contrast to hospitals, few staff drop out. “The sector is different. We are taking people to hospitals all day long, but we are dealing with fewer moments of stress,” says Jan. He does note that some colleagues are afraid because the violent incidents against ambulance personnel have increased in recent months. “Not everyone sits quietly in their chair anymore. You shouldn’t have that kind of stress when you’re busy.”


Jan thinks that ambulance care will also be extremely busy in the coming period, due to corona and catch-up care. “Every hospital that is full will move patients out. But how long is that feasible? It is confronting to see that emergency rooms close regularly and you have to take more patients much further. That is also difficult for patients and family, which leads to indignation and anger.”

Worries grow

Concerns about the loss of staff in the hospital are growing by the day, says Joke. Every day she receives an app asking if she can work extra. “Sometimes I almost feel guilty when I say no because I want to recover on my day off. Some colleagues even leave the app because they get palpitations with every message.”

It is increasingly difficult for Joke to get satisfaction from her work. Yet she knows very well why she does it. “If I make a difference. If I make sure that a seriously ill patient becomes stable again. That I look at my colleagues and think: we did this nicely again.”


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