EDs in flood areas operational, planning for future disasters needed

However, the Australasian College for Emergency Medicine (ACEM) and the College of Emergency Nursing Australia (CENA) warn that urgent investment in the healthcare system, and greater communication and coordination with emergency departments, is required for future disaster responses.

ACEM President Dr Clare Skinner said, “Emergency departments across flood-impacted regions of Australia have largely returned to business-as-usual and are working hard to provide care to those in need. We encourage people who need emergency care to attend their local emergency department. While things may sometimes look different, and care may take longer, medical emergencies will always be prioritised.”

The Colleges warned, however, that business-as-usual isn’t good enough and called for greater investment to make health systems disaster-proof.

Dr Skinner said, “Unfortunately, returning to ‘business-as-usual’ isn’t entirely a good thing, as, due to a lack of resourcing and investment across the health system, it means a greatly under-resourced health system that cannot meet the needs of Australians – and that’s on a good day.”

“Our members tell us that despite floods, COVID-19, and fires, our biggest stress remains access block and hospital overcrowding. Business-as-usual means seeing people in corridors because there are no ED beds free or treating people on stretchers. Business-as-usual means ramped ambulances and huge waits for people experiencing mental health issues. This isn’t normal. It isn’t safe. And it can be fixed with greater investment, including more inpatient beds and staff.”

“Climate change is here, and climatic events will continue and worsen. We can’t just staff and resource the health system for a regular day. We must staff and resource for a high-demand or disaster day so we can always be prepared.”

The Colleges received reports from members on the ground in some flood areas that – despite undeniably good intentions from decision-makers – coordination with emergency departments was lacking across the disaster response, which sometimes meant that unneeded resources were deployed while important needs went unfilled.

Dr Skinner said, “We have witnessed tremendous public and organisational goodwill in responding to the natural disaster events in Australia in the last few years. It is imperative that there is good communication and centrally coordinated disaster responses to ensure that resources across the health system are distributed in the most useful and equitable manner.”

“As EDs are on the front line of disaster responses, nurse managers and ED directors must be included in disaster planning.”

CENA President Associate Professor Julia Morphet said that CENA supports the call for additional funding for emergency departments and the health system in general as well as greater consultation and involvement in decision making.

Associate Professor Morphet said, “It is clear that many EDs and front-line healthcare workers are overloaded in their day-to-day operation and responsibilities. Instances such as the recent floods, the impact of COVID-19, bushfires and other unforeseen events simply highlight that the system is already operating beyond capacity.”

“While we acknowledge the work that has already been done, CENA supports additional funding and greater consultation with front line healthcare workers to understand and address choke points in the system that negatively impact the standard of care that is offered to the community.”

ACEM and CENA acknowledged the tremendous efforts of healthcare workers during the floods.

Dr Skinner said, “As usual, we have heard stories of healthcare workers going above and beyond to meet the health needs of the communities they serve: a nurse who canoed through the floods to get to work; a doctor who was the only one at the hospital for days; healthcare workers who lost their houses still showing up to their shifts. We are so proud of their efforts, and thank every single healthcare worker for their strength, dedication and courage in providing care in tremendously difficult circumstances.”

The Colleges encouraged all ACEM and CENA trainees and members impacted by the floods to reach out to their College for support.

ACEM and other medical Colleges recently declared climate change to be the biggest threat to the health system and called on the federal government to urgently come up with a plan to protect Australians and the healthcare system from the impacts of climate change.

Background:

ACEM is the peak body for emergency medicine in Australia and New Zealand, responsible for training emergency physicians and advancement of professional standards. www.acem.org.au

The College of Emergency Nursing Australasia (CENA) is the peak professional association representing emergency nurses across Australia and internationally. www.cena.org.au/

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