Avoiding moral burnout with the right support, mentoring and resources

Registered nurse and paramedic Paul Haines moved from the UK to Australia 10 years ago. He decided initially to work only as a paramedic. Now he works across both professions, including as a clinical nurse specialist in the town of Yass, outside of Canberra.

“I had been nursing in the UK for around 10 years before moving to Australia. I went back to university for 3 years and retrained as a paramedic in London. I mostly worked in ED in big metro hospitals in the UK and the conditions were horrendous.”

Return to nursing – in a regional setting

When Paul arrived in Australia, he became interested in returning to nursing. He chose a smaller regional hospital. “I got my nursing registration here when we moved but I didn’t really think I would use it. We lived in a small town outside of Canberra and I was working as a paramedic when my wife suggested I get some work at the local hospital.”

Paul applied for the CNS role at the local hospital and was successful. He says working in a smaller regional hospital has its own challenges. “I have more autonomy and feel more like part of the community in my current job, but there are definitely some challenging issues in our workplace,” he says. 

Operations vs meeting staff needs 

The operational demands of the hospital often take priority over the education and clinical support needs of nurses and midwives, Paul says. 

“While I understand the operational needs, when you don’t have the education roles working as they should, things fall apart. My role is to be a mentor and to provide support to early career nurses, but the reality is that most of my time is spent plugging staff gaps in ED.”

Paperwork, workload, expectations rising

Paul says he has seen many changes in the health care system in Australia in the past decade. “Patient expectations have increased in relation to service delivery and access to services. There has been a huge increase in workload and a decrease in acuity. The other thing is an increased expectation from employers around paperwork and KPIs.”

The increased paperwork means healthcare professionals have less time to focus on patients, Paul says. “There is also the concern around litigation. People are more aware of litigation, and this can lead to a practice of defensive medicine, which is not always the best medicine,” he says. “It means paperwork is prioritised over patient care and that is morally compromising.”

Support for junior staff overlooked

Paul says another concern is the continual turnover of staff and an increase in junior staff who don’t have the mentors and support they need. “I saw the same thing happen in the UK many years ago and you can see that the National Health Service in the UK is on its knees right now. I don’t want us to go down the same slippery slope here.”

Nurses are experiencing ‘moral burnout’ in a system that doesn’t provide the resources and support needed to deliver the best possible care to patients, Paul says.