A study of every intensive care unit across Australia has found that there are now fewer manned beds than there were at the start of the pandemic.
A team of researchers counted 2,183 manned ICU beds, 195 fewer than 12 months ago, and that is a number that could limit capacity growth during severe COVID outbreaks.
“Last year we were worried about the beds and equipment, but in fact the equipment has definitely been sorted. We have enough fans now, ”said researcher dr. Ed Litton The New Daily.
“The very limiting step to our ability to increase our responsiveness is staff – critically trained nurses.”
Dr Litton, a clinical associate professor at the University of Western Australia, was one of the team of 13 researchers from across Australia.
Although various state governments have announced their growth capacity in recent outbreaks, the researchers found that there are only enough qualified staff to operate about half of the extra physical capacity at ICUs nationwide.
There are not enough staff to cover the 2627 extra overhead beds outside intensive care units.
“All other things being equal, starting from a lower baseline of ICU beds will make the reactions more challenging and potentially put more strain on the system,” said Dr. Litton.
The largest decrease in ICU capacity was seen in regional areas and in private hospitals.
Part of this has to do with the general upheaval of the pandemic.
Regional hospitals in particular have smaller pools of staff to draw on, so when nurses are sent to vaccine clinics or other staff receive COVID-19 and have to take time off, they are difficult to replace.
Despite the reduced number of manned ICU beds compared to last year, Australian hospitals have otherwise adapted to the demands of the pandemic.
States have routinely canceled elective surgery during major outbreaks, and it has freed up beds and staff that overlap with ICU wards.
“A really big part of the workload on intensive care takes care of patients after major elective surgery,” said Dr. Litton.
However, COVID patients on intensive care may continue to take up beds that would otherwise be necessary for other patients, such as survivors of car accidents.
“They are younger, they are staying longer in intensive care, and they need care that cannot be given elsewhere on the ward,” Nhi Nguyen, an intensive care specialist from Sydney’s Nepean Hospital, told reporters in August.
Dr. Nguyen also contributed to the research on ICU capacity.
The way forward
Throughout the pandemic, intensive care units have relied on nurses, doctors and other critical care staff working under unprecedented conditions.
“I am confident that they will continue to take up the challenge,” said Dr. Litton.
“So one of the things that worries me is sustainability – that people take up the challenge because they do not want to go away in a crisis.
“But this is a disease that has become endemic and really requires a whole change in the approach to the critical care workforce.”
Many ICU employees now experience burnout, anxiety or even traumatic stress.
Dr. Litton said health authorities need to ensure that this line of work remains an attractive career opportunity, as well as supporting ICU staff with the various strains of the pandemic.
“How do we ensure that there are sufficient resources to ensure that we are ready for future surges?” he asked.
“Other places around the world are on their fourth or fifth wave, and there will be more pandemics in the future.”