Breast care nurses epitomise what it is to be a national hero and it is with great privilege the Morrison-McCormack Government is able to continue supporting the McGrath Foundation’s breast care nurses with a $3 million investment in 2021.
The funding will support these wonderful Australians as they continue to protect and save the lives of so many Australian women and men with breast cancer.
The investment will also fund a scoping project that will seek feedback from patients on what aspects of breast care nurse support they value the most.
Acting Prime Minister Michael McCormack said Jane McGrath Day, as part of the Sydney Pink Test, was a highlight on the Australian calendar.
“Despite the COVID-19 pandemic, it is great to see the Sydney Cricket Ground still awash with pink and the determination of the cricketing community and the wider Australian community to carry on Jane McGrath’s legacy is as strong as ever,” the Acting Prime Minister said.
“Australia’s breast care nurses are at the core of this, particularly in regional communities. They are supporting our breast cancer patients and their families with vital care and genuine compassion.
“They improve the quality of care in so many ways, from fewer specialist appointments, to improved understanding and clarity, to more confidence and reduced anxiety. They are Australian heroes by every definition.
“I thank Glenn, Holly, Tracy and everyone at the McGrath Foundation for their tremendous work, and express my deep gratitude to McGrath breast care nurses and all breast care nurses for their unrivalled commitment to supporting breast cancer patients.”
The Minister for Health and Aged Care, Greg Hunt, said feedback from the scoping project will help inform the ongoing development of advanced cancer care nursing roles.
The McGrath Foundation will form a stakeholder working group to guide this project and will provide a report to the Government in the second half of 2021.
“When listening to breast cancer patients I often hear them describe their care nurses as their own personal ‘angel,’ and I think that’s a pretty accurate description,’ Minister Hunt said.
“Australia still has one of the highest survival rates for breast cancer in the world. The five‑year relative survival for people with breast cancer was 91.1 per cent from 2012‑2016, but we must aim higher.
“It is critical that as a Government we continue to pursue improvements across the board, and support the ongoing development of cancer care nursing roles so that breast cancer patients receive the greatest care possible.”
Australia’s network of breast care nurses (BCNs) work within multidisciplinary teams to coordinate care from diagnosis and throughout treatment, free of charge.
The Minister for Women, Senator Marise Payne thanked Australia’s breast care nurses, saying they helped women and men with breast cancer and their families navigate through the often complex world of hospitals and cancer wards.
“These nurses are improving lives across Australia. They listen, guide and support people with breast cancer and their families with health advice and quality care,” Senator Payne said.
“This holistic care includes physical, psychological and emotional support for people with breast cancer and their families.”
Breast cancer is the second most common cause of cancer deaths in Australian women. Tragically, nearly 3,000 lives were lost to breast cancer last year.
Breast cancer is the most common cancer in Australian women, with an estimated more than 19,000 women diagnosed with breast cancer in 2020, as well as more than 160 men.
The Government already provides funding to support the recruitment, training and employment of specialist breast care nurses through the McGrath Foundation.
This funding is in addition to the Government’s funding of $38 million to the McGrath Foundation from 2019–20 to 2022–23 to increase the number of Commonwealth-funded breast care nurses from 57 to 102 positions.
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The coronavirus health crisis facing the United Kingdom is dire, this week forcing the country back into lockdown until at least mid February as authorities brace for the potential of hospitals being completely overwhelmed.
There are routinely more than 50,000 new cases being recorded each day as an aggressive new strain of the virus takes hold.
Health workers are stretched to the limit, and among them are many Australian professionals.
Here, three Australian nurses tell first-hand of their experiences.
Emily Regan, 29
Perth-born nurse Emily works in accident and emergency at a major London hospital
I’m in one of the best, most safely staffed hospitals in the UK, but even we no longer have enough doctors, nurses or beds. On my past three shifts we’ve been between three and six nurses down.
In Accident and Emergency (A&E) we’re seeing 300 to 350 patients a day. That’s about the same as during the first wave, but their acuity has increased, meaning they are sicker and need greater care.
We’ve also got lots of people turning up with non-emergencies because they can’t see their GP.
In April, we had extra doctors redeployed from other areas and a special COVID intubation team. Hypoxic patients could be instantly intubated and in ITU (intensive care) within 30 minutes if necessary. The efficiency was amazing.
But now we have limited extra support because other health services like outpatient clinics and non-emergency surgeries are still running.
We’re also accepting ICU transfers from hospitals that have no capacity. It’s great we can offer that support, but soon we’ll have to stop because we won’t have capacity ourselves.
At one point last night, we had eight ambulances waiting outside to deliver patients, and a wait time of about 1.5 hours.
The anxiety when you’re walking into a shift is huge. We know it’s going to be hard, but just how hard is the question.
There have been times when I felt like I wasn’t able to give my patients the care they needed, or I’d not advocated well enough for them. I’ve just been scrambling all day, not taking toilet breaks — or not even needing a toilet break because I haven’t even had time to drink enough water.
That’s the hardest part: feeling like you’ve not given someone the care they deserve.
Luckily, I’ve stayed healthy so far. I’ve been on the Oxford vaccine trial since June, so I’ve been swabbing weekly for that, as well as doing COVID sensitivity tests twice a week.
‘People don’t want to have an educated discussion’
I am lucky to have good mental health, but it’s been hard to see colleagues struggling. I have seen some brilliant nurses just be done with it all and leave. It is such a loss.
On Boxing Day, morale was really low. We were just so busy and understaffed, and I found myself becoming easily irritated. My colleagues noticed I wasn’t my usual upbeat, joking self. I try to put on a friendly, happy face for my patients but it can be draining, so my colleagues aren’t getting the best version of me when they need it the most.
Occasionally, I run into COVID deniers protesting outside the hospital. It no longer shocks me. I just don’t engage. I originally did but there’s no point anymore. People don’t want to have an educated discussion.
Once someone’s seen a patient who is hypoxic from this virus and is aware of the time and resources directed at saving their life, then they have the right to an opinion. Otherwise, stay in your lane. I’m not going to waste my limited time on you.
‘Things are terrible and it’s only the start’
Seeing everyone at home lead normal lives is difficult at times, but I’ve lived in the UK for four years now and built a life here.
As hard as this past year has been, I love my job and have incredible friendships with my colleagues. I don’t want to walk away from all of that.
But we’re burnt out, and it’s made harder by the necessary restrictions. We can’t socialise and blow off steam outside work like we used to. We can’t visit friends and have them make us a cup of tea and just look after us for a little while.
About 60 per cent of the staff in my department are from overseas, so many of us don’t have families here either. We’re all just really tired. Things are terrible and we know it’s only the start of the next wave.
Louise Faint, 25
Louise is a nurse from Perth and works at a hospital in the West Midlands
I work in A&E in one of the UK’s worst-hit areas.
It’s pretty much as close to the COVID front line as you can get and the situation is deteriorating.
A few weeks ago we could go a few hours without seeing any patients in the “hot” area, where COVID cases are treated, and now we’re seeing 10 or more every shift.
It doesn’t sound like many, but most of those are quite poorly and require lots of care and close monitoring. And like everywhere, we are short staffed.
If hospitals are overwhelmed there’s a greater chance people will die unnecessarily simply because we won’t be unable to provide the care they deserve.
‘Their cries and distress are haunting’
I’ve been a nurse for a little under three years but I only joined A&E last January.
In this past year, I’ve experienced my first CPR, my first resuscitation attempt and my first patient deaths.
Last week, I had two patient deaths over two shifts. One was somewhat expected but the other was a normally fit and well 30-year-old who was brought in in cardiac arrest.
Seeing their families is usually what upsets me the most. Their cries and distress are haunting.
It’s been heartbreaking to see very sick patients go through it all alone because visitors weren’t allowed.
I’ve held the hands of lonely, elderly people while they fought for breath. I’ve tried to reassure families about their loved ones over the phone when I wasn’t even sure myself.
‘I made myself sick from overworking’
I’ve battled loneliness too. The pandemic began not long after I moved over, and then the national lockdown was announced and my boyfriend’s move from Perth was delayed.
I was working seven days a week just so I could be with other people and not alone with my thoughts. It was a really low time. I was stressed, bordering on the edge of depression, and I made myself sick from overworking. In May, my boyfriend arrived and things got better.
Now, though, a lot of staff are totally burnt out. We have short fuses and get worked up over small things that would normally not be an issue, such as doctors requesting another x-ray after we’ve already taken the patient for one.
I struggle to sleep before my shifts and I’ve stopped seeing the good in my day-to-day life. I never feel like I’m rested or have had a break. On my days off I barely have the energy to move off the sofa.
‘Staff often feel like they at risk’
The way the UK Government has handled things has caused a lot of confusion. The tier system is terrible and restrictions change so suddenly that making plans is next to impossible.
Even for medical staff, the rules change a lot. There are constant updates to policies and regulations surrounding PPE, swabbing, results timeframes, admission criteria, and trying to determine what’s potential COVID-19 and what’s asthma.
Staff often feel like they are out of the loop and being put at risk.
But I have a stable job and I have learnt so much.
Travel home out of the question
I came to the UK because I couldn’t get a job as a newly qualified nurse in Western Australia. I went to an NHS nursing expo in Perth in March 2019 and was offered one on the spot.
Living overseas has always been a dream of mine and I knew that if I didn’t take the leap of faith then I never would.
I’d love to go back and see my family soon but with flights costing at least 3,000 pounds ($5,303) it’s not going to happen in the foreseeable future.
Sarah is a nurse from Sydney working at a London hospital
At the start of the year, when it became clear we were facing a pandemic, I was retrained to work in intensive care.
My background is in respiratory nursing but I had never worked a day in an intensive care unit (ICU) before, not even in university rotations.
I was petrified, but it was essential.
‘I went home and just cried’
Intensive care shifts are 10 times more stressful than other shifts.
Patients are so sick, and COVID patients deteriorate so much faster. A normal shift might have one deterioration a day. A COVID ICU shift will have multiple patients deteriorating and multiple patients dying.
Normally, one nurse will look after one or two patients on breathing machines in an open space. That is the safe ratio. During COVID the ratio is more like one to four or five, and now they are all in single rooms, making them effectively invisible if they deteriorate.
My first ICU shift was in the middle of the night. I was meant to be doing a “shadow shift” — following a nurse around to get an introduction — but we had no staff, so as the most senior of the learning nurses I was asked to take a patient.
During the shift my patient deteriorated and could no longer tolerate the breathing machine.
They were intubated at 5:00am. It was a tricky intubation with a lot of different medical professionals involved. I had to quickly learn about new medications, a new breathing machine and complicated new settings. I have never been more stressed in my life.
Sadly, the patient passed away. I went home that morning and just cried.
Scared and angry, but determined to help
The numbers now are higher than they were in April. That is terrifying.
People don’t seem to understand, or care, how dangerous COVID is. They aren’t taking it seriously anymore, or they think they are invincible.
I have one friend who thinks it’s made up. I can’t even bring myself to argue with them now because I get too angry.
The hardest thing has been pretending to loved ones in Australia that I’m fine when really I’ve been very scared and homesick.
I’ve nearly gone home on multiple occasions, but I stay because I feel I have a duty to the NHS and to the sick people of the UK.
Some days it’s almost impossible to be strong for my patients. I’ve cried with husbands and wives, sons and daughters on the telephone. I try to put them at ease when deep down I don’t whether the person they love will survive or not.
It scares me that my own family are so far away and I have no way of getting home to them quickly. But I love my hospital and I’m so proud to be part of the NHS. None of this is their fault.
*Not her real name. Kate Guest is an Australian journalist based in the UK
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A survey of nurses caring for children with heart issues reveals that more than half are emotionally exhausted. The findings, recently presented at The European Society of Cardiology (ESC) Congress 2020, also show that good working environments are associated with significantly less burnout.
“Nurses’ well-being is central to ensuring the best outcomes for patients,” said study author Dr. Annamaria Bagnasco of the University of Genoa, Italy. “When wards have poor leadership and fragmented teams with no development prospects for nurses this should raise an alarm that there is a risk of burnout.”
Previous studies have shown that burnout rates are higher in pediatrics than in other specialties, and that burnout is connected to patient safety. Strategies to reduce burnout and its impact on patient safety are needed.
In the new study, the researchers evaluated emotional exhaustion in nurses who were providing routine care on pediatric cardiology wards and also looked at whether their exhaustion was related to the working environment.
Data were obtained from the RN4CAST@ITPed study. A web survey was distributed to 2,769 nurses working in children’s hospitals throughout Italy between September 2017 and January 2018.
A total of 2,205 (80%) nurses responded, of whom 85 worked in cardiology wards and intensive care units (ICUs). Additional data were collected from hospital administrations.
The study looked at workload (how many patients each nurse was caring for, or nurse-patient ratio); skill mix (the education level of nurses working in one unit and the number of nursing assistants providing support during each shift); work environment and emotional exhaustion.
Work environment was measured with the Practice Environment Scale of the Nursing Work Index (PES-NWI), which covers issues such as: having a nurse manager or immediate supervisor who is a good manager and leader; opportunities for advancement; opportunities to participate in policy decisions; and collaboration between nurses and doctors.
Emotional exhaustion was evaluated using the Maslach Burnout Inventory, which measures feelings about work. For instance, feeling emotionally drained, used up, fatigued in the morning, burned out, frustrated, working too hard, stressed, or “at the end of my rope.”
The study focused on responses from the 85 nurses working in cardiology wards and ICUs at five hospitals. Interviews were also conducted with these nurses. The findings show that more than half (58%) of the respondents were emotionally exhausted. The main causes were related to working conditions, including being responsible for high numbers of patients and the complexity of caring for sick children.
“The most important consequence was that 30% of the nurses we interviewed wanted to either go and work in another hospital or even change their career,” said Bagnasco.
The research team then evaluated the link between emotional exhaustion and the working environment. Improving the workplace environment was tied to an 81% drop in emotional exhaustion, even with the same skill mix and nurse-patient ratio.
“Our study shows that nurses value good leadership, being involved in decision-making, having chances to develop their career, and team working,” said Bagnasco. “The lack of these conditions is connected to burnout, which we know from prior research could compromise patient safety.”
Bagnasco noted that pediatric cardiac nurses must work with children and their families, who often feel concerned and afraid.
“Establishing a trusting relationship is essential but burned out nurses may find it ‘too heavy’ to bear emotionally. If the working environment is positive for the nurses who work in it, children and their families will receive better and safer care,” she said.
The soaring rate of new infections this fall, even in states that had managed to keep the virus at bay over the summer, has prompted health and government officials to sound the alarm.
Forty-one US states have reported record increases in COVID-19 cases in November, while 20 have seen a record rise in deaths and 26 reported record hospitalisations, according to a Reuters tally of public health data. Twenty-five states reported test positivity rates above 10 per cent for the week ending on Sunday, November 15. The World Health Organisation considers a positivity rate above 5 per cent to be concerning.
The United States crossed 11 million total infections on Sunday, just eight days after reaching the 10 million mark.
Several state governors and city officials have imposed new restrictions on indoor gatherings in recent days in an attempt to stem the spread of the disease, with the prospect of widely available vaccines still months away. At least 14 states have issued new public health mandates this month.
Several state officials also have urged citizens to exercise caution around the Thanksgiving holiday and not travel or socialise with extended family for the traditional indoor feast.
“I know this is difficult & frustrating, especially with the holidays right around the corner,” Vermont Governor Phil Scott wrote on Twitter on Tuesday, referring to his ban on multihousehold gatherings. “But it’s necessary & we need your help to get this back under control.”
New Orleans Mayor LaToya Cantrell was even more forward-looking in her holiday warnings, announcing on Tuesday that the city’s Mardi Gras parades would be cancelled in February.
“Experts are predicting a ‘winter spike’ in cases this winter in December and January – right when our carnival calendars get rolling,” Cantrell said on the city’s website.
The number of coronavirus patients hospitalised in the United States hit a record of 73,140 on Monday and hospitalisations have increased over 46 per cent in past 14 days, according to a Reuters tally.
The Midwest remains the hardest-hit US region. It reported 444,677 cases in the week ending on Monday, November 16, 36 per cent more than the combined cases of the Northeast and West regions.
Iowa alone has registered more than new 52,000 infections over the past two weeks, about the same number reported from March to mid-August, with COVID-19 accounting for one in every four patients now hospitalised in the state.
“Now is the time to come together for the greater good to do everything we can for each other,” Iowa Governor Kim Reynolds, a Republican, said on Tuesday, a day after announcing that all indoor gatherings in her state would be limited to 15 people and outdoor gatherings limited to 30, weddings and funerals included.
The NSW Government has earmarked $46.8 million over four years as part of the 2020-21 NSW Budget to deliver 100 new school-based nurses to support the health and wellbeing needs of students and their families.
The expansion of the successful Wellbeing and Health In-Reach Nurse (WHIN) program will see the highly skilled nurses embedded in more schools to ensure students can easily access health and social support when they need it.
Treasurer Dominic Perrottet said the new funding would mean thousands more students across the State would have access to a nurse at school.
“With the added stress of COVID-19 on our young people, the further expansion of this program will ensure children, young people and families don’t miss out on the support they need,” Mr Perrottet said.
“NSW Health will fund these positions, however the practitioners will work with the Department of Education, with data and evidence to be used to place the nurses in areas of most need.
“This commitment is an investment in the mental health of young people across the state and will build a more resilient post-pandemic NSW for the future.”
Minister for Mental Health Bronnie Taylor said an evaluation of the pilot sites found the wellbeing nurses had successfully supported vulnerable students for a range of health and mental wellbeing issues.
“With the pilot program, we saw that school children often go and see the nurse about general health issues and once they are there, open up about other problems they have been experiencing,” Mrs Taylor said.
“The nurses will be given mental health training but are also there to deliver general health care and advice at the right time.
“We are making sure we are delivering quality services for everyone, no matter their age or where they live.” Minister for Education Sarah Mitchell said WHIN nurses are currently based in secondary and primary schools in Young, Tumut, Cooma, Deniliquin, Murwillumbah and Lithgow.
“These nurses are an important asset in our schools and as part of a combined approach with school counsellors and mental health training, our students will have every possible access to help when they need it,” Mrs Mitchell said.
The WHIN program is a joint initiative of NSW Health and the NSW Department of Education, which launched as a pilot in 2018 in Cooma, Tumut and Young and extended to three other regional communities in 2020.
An extra source of support has been made available for Australian men with prostate cancer as they navigate their diagnosis and treatment choices.
A federal program is funding specialist prostate nurse positions across Australia
Prostate cancer diagnoses are expected to rise significantly in coming decades
A musician undergoing treatment in Adelaide is helping support other patients
A group of 25 newly appointed specialist prostate cancer nurses has begun work supporting men across the country.
Prostate Cancer Foundation Australia director of nursing programs Sally Sara said the demand for prostate cancer services was growing and the extra staff would make a big difference for Australian men and their partners.
The program is similar to the McGrath Foundation’s support service for women undergoing treatment for breast cancer and is funded through a $23 million Federal Government package.
“We’re expecting a 70 per cent increase [of the disease] through to 2040, so it’s vital that our prostate cancer specialist nurses service grows to meet that growing demand in the years ahead,” Ms Sara said.
“Last year, our statistics show our existing cohort of nurses, of which there [are] 55, saw 8,000 new men.
Jasmin Mazis is one of four recently appointed prostate cancer specialist nurses in South Australia.
“When they’re first diagnosed, that can be quite a scary time for patients,” Ms Mazis said.
“There’s lots of treatment options and treatment choices.
“Part of my role will be to look at the gaps and find what we’re not actually currently providing patients.”
Eight new nurses have been appointed in New South Wales, four each in Western Australia and Victoria, three in Queensland and one each in Tasmania and the ACT.
A further 15 prostate cancer specialist nurses will be recruited next year.
‘Some fellas don’t have support networks at all’
Prostate cancer patient Greg Carmody — who prefers to be known by his stage name Bobby Blues — is undergoing radiotherapy treatment at the GenesisCare cancer centre in Adelaide.
He was diagnosed with prostate cancer in March.
“Some fellas don’t have those support networks at all.
“It is really crucially important to have those prostate cancer specialist nurse positions there, and we’d like to keep them.”
The 59-year-old writes songs and plays the harmonica to help other patients and their families at the clinic.
“Playing the harmonica is one gift I’ve got that I can share with other people, and I just want to brighten people up because it’s not the happiest place for people,” he said.
“When I meet other fellas that don’t like to talk too much it’s just a nice thing to do.”
He added that he benefitted from an early diagnosis and that men over the age of 50 should get tested for the disease.
“We got in early, which is great — and I’ve got a wonderful support system.”
The nurses’ union has backed a group of doctors continuing to call for a cardiac surgery unit at the Women’s and Children’s – despite it being effectively ruled out by authorities – agreeing with warnings that more baby deaths could occur, on top of four in the past month.
Australian Nursing and Midwifery Federation state secretary Elizabeth Dabars today told InDaily there was “a very real risk” of more deaths without a local surgery unit.
“It could give rise to significant patient care risks and concerns,” she told InDaily.
Her comments echo concerns by prominent obstetrician Associate Professor John Svigos, following a “second opinion” review released yesterday by SA Health, which reiterated findings from an initial review that a paediatric cardiac surgery unit should not be established in South Australia because there wouldn’t be enough cases to ensure its sustainability and safety.
Svigos, who is convenor of the WCH Alliance lobby group, this morning said: “We did not wish to participate further in this debate in public, but faced with the prospect of more deaths caused by political game-playing, we felt we had a responsibility to make our position clear.”
The deaths of four babies in four weeks at the hospital were revealed in a parliamentary committee hearing last week by Svigos and South Australian Salaried Medical Officers Association chief industrial officer Bernadette Mulholland.
In a statement issued this morning, the WCH Alliance said “we disagree with the decision to not establish cardiac surgery at the WCH”.
“Around 100 babies and children each year are transferred interstate for treatment. The many problems with this arrangement became apparent with the recent deaths of four babies.”
The second review by clinical experts found paediatric cardiac surgery at the WCH should not be reintroduced, but a heart and lung life support service known as ECMO (Extra Corporeal Membrane Oxygenation) should.
Adelaide is the only mainland capital city without a paediatric cardiac surgery unit or ECMO services.
SA stopped paediatric heart surgery in 2002 because of low case numbers, with a recent initial review rejecting calls to reinstate it.
Babies and children are usually sent to Melbourne’s Royal Children’s Hospital for life-saving heart surgery services but due to COVID-19 have instead been going to Sydney.
The findings of the latest cardiac services review argue while “it may be possible to set up a [surgical] programme that could work for a period of time… the risks of failure would be high and the consequences could well be severe, not only for the individual team members but also for the administration and reputation of the institution”.
The authors, Dr Tom Gentles, Dr John Beca and Dr Nelson Alphonso, noted there had been several “high profile system failures in paediatric cardiac surgery [which] have most often occurred at low-volume centres with few participating cardiac surgeons and/or low staff morale”.
“There has been a trend away from small volume centres internationally [and] it would be difficult to justify the establishment of a low volume unit based on a single paediatric cardiac surgeon in Adelaide,” they found.
But, they added, “in relation to the recommendation to establish an ECMO programme in Adelaide, we do not consider the absence of paediatric cardiac surgery to be a contra-indication”.
“There are many such programmes internationally, with excellent outcomes,” they said.
“We agree that a paediatric ECMO program should be established in Adelaide.”
However, they added that they believed the estimated 10-20 patients a year the original review suggested could require ECMO without related surgery “to be optimistic and most likely unrealistic”.
But the WCH Alliance said “based on our own expert information, it is clear that an ECMO (heart lung support) facility as suggested by the ‘review group’ is inherently dangerous in the absence of on-site surgical expertise”.
“This is why there are no ‘stand alone’ ECMO services in Australia, New Zealand or the UK. This danger was confirmed yesterday by local cardiac surgeon, Associate Professor Jayme Bennetts,” the alliance stated.
Bennetts, a paediatric cardiac surgeon at the WCH, yesterday told reporters that “most institutions do [ECMO services] that are associated with a cardiac surgical service”.
“ECMO is a high risk service associated with complications and high mortality just because of the nature of the indications of which babies are supported in the first place,” he said.
“Those risks mean that if you establish a service you have to be able to provide enough support structure and expertise around that that allows you to deal with complications and make sure you’re not actually exposing babies to a higher risk than if you had no service.
“There are current discussions underway about how that service can be established – how that can be done in a safe manner that allows that service to be delivered.”
Clinicians are now considering either an ECMO service supported by an interstate team or a full standalone service.
Asked whether a cardiac surgical unit was now completely off the table, Bennetts said: “It’s not that there might never be a service, it’s that at the moment the numbers don’t allow for those justifications to exist. That may change as things evolve and services change.”
Dabars labelled the proposal to have ECMO services without a surgical unit as “imperfect”.
“It sounds like they’re planning to have machinery or machines without the support and a backup plan required in order to make it work, first and foremost in the interest of patient safety but also in terms of just making sure that it can operate effectively,” she said.
Nurses’ union head Elizabeth Dabars Photo: file
Dabars said Svigos’s concerns “should be taken on face value” and she believed “it would make sense” to establish a local cardiac surgery unit.
“We would absolutely support having a system that makes sure that patients receive appropriate and timely care locally,” she said.
Dabars said the argument that there wouldn’t be enough cases in SA to make a surgical unit sustainable didn’t stack up.
“We do know equally that there are other areas that have a slim market… that they still manage to perform and sustain in SA,” she said.
“Liver and lung transplants are a small market but they still manage to perform those in SA, so one would have thought this cardiac surgery, even though it’s a slim market, should still be capable of being sustainable in SA.
“We do know that sending people to Melbourne has for a very long time been traumatic for the family of the children involved and so from that perspective it’s certainly undesirable let alone the immediacy of their treatment and care.”
Dabars believes there would be “sufficient activity” locally to make a surgical unit sustainable.
“From the numbers we’ve heard… we think there would be enough activity to sustain the practice,” she said.
“The current plan the department has announced we don’t think it’s productive.
“We think it’s very imperfect and could result in significant problems. We believe it should have a proper surgical backup.”
Senior cardiologist Dr Gavin Wheaton, who is the medical director of paediatric medicine at the WCH, said yesterday that he wanted an ECMO service established as soon as possible and he believed that would happen “within a year”.
“There are examples of ECMO services without an in-house cardiac surgeon elsewhere and we’ve certainly had a recommendation from the experts that we’ve consulted with that we can and should develop such a service in South Australia,” he said.
“I believe we can do that safely and it’s our undertaking to do that work as quickly as possible.”
SA Health is conducting a review into the recent four baby deaths.
Wheaton said he stood by the decision to temporarily stop sending babies to Melbourne because of COVID risks and he supported the review findings not to establish a local surgery unit.
“I don’t believe the lack of a local surgical service did have any significant impact on the unfortunate deaths of those babies, but we should not pre-empt the outcome of the formal review,” he said.
“We guarantee that children will have ready access to high quality surgical services whether that be in Sydney or in Melbourne.”
An open letter from a dozen senior WCH clinicians published last week by News Corp rejected “misinformation” being peddled by critics, saying: “In line with a recent external review we, as a group, do not believe that there should be paediatric cardiac surgery in SA until a safe, high-quality and clinically sustainable service can be assured with outcomes equivalent to national and international standards.”
However, the group remained open to a local ECMO service if it was proved “viable” and could lead to improvements in care.
Health Minister Stephen Wade said two independent reviews from renowned cardiologists had now made it clear “that a paediatric cardiac surgery service in SA would not be safe”.
“They’ve also come to the view that an ECMO service could be safely delivered in SA and that would be an appropriate enhancement to the services for SA babies and children,” he said.
“The government appreciates that advice needs to go to the (WCH) Board now for them to finalise their consideration but considering they’ve had two strong independent reviews validating that option I certainly believe it’s a legitimate option for the board to look at.”
Wade argued there were “many standalone paediatric ECMO services around the world”.
“The advice of nation leading cardiologists is that it could be safely delivered here,” he said.
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“The (WCH) Board hasn’t made a decision, the board will receive the second review and other advice at a later meeting and make a decision.”
He added: “When you’ve got two independent reviews that highlight that the caseload is just not there for SA to have a safe (surgical) service it would be surprising to see another conclusion.”
Opposition health spokesman Chris Picton accused the Government of “rushing to make a decision” on ECMO and surgery services before the findings from the investigation into the baby deaths.
“Clearly the status quo has risks,” he said.
“These (deaths) should properly be investigated so that we can balance the risks that are clearly inherent in the system at the moment before making any decision.
“If it wasn’t for those doctors revealing this publicly we may never have known what occurred and there may never have been an independent review undertaken.”
The deaths were revealed in a parliamentary committee hearing last week by Svigos and South Australian Salaried Medical Officers Association chief industrial officer Bernadette Mulholland.
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