Who cares for the healthcare workers?

While healthcare providers are indispensable for the delivery of healthcare, there is growing recognition that their own wellbeing and social needs are often overlooked.

This was the background against which a seminar on the challenges and opportunities for building a culture of care for healthcare workers, hosted by UCT's School of Public Health and Family Medicine on 13 March 2014.

Healthcare workers laid bare some of these many challenges, from long hours and low salaries to safety concerns when travelling to and from work and an infrastructure that is struggling to cope with rising numbers of patients.

Staff shortages

Barbara Ruiters, chair of the labour caucus at Groote Schuur Hospital (GSH), shared some of the experiences of her constituency: "The big issue in the public sector ... is the shortage of staff. We can't fulfil [the level of care that we are supposed to] because we don't have the necessary capacity."

Even attending school meetings was often impossible, said Ruiters, due to long shifts and reliance on public transport.

Colleen Sampson, a psychiatric nurse at GSH, said the high patient-load, high patient acuity (the severity of someone's illness) and a shortage of nurses made it virtually impossible to keep up with demand.

Nor were there enough specialised nurses to deal with the number of patients requiring, for instance, psychiatric treatment, said Sampson: "For every three patients that come through the door, there's one bed available at Groote Schuur Hospital. It's virtually impossible to keep up with demand. The facilities are woefully inadequate. "

Little payoff

"There is no work-life balance," said Sampson, explaining how the job took its toll on family life. "It's all work. On the days that you are off you are so tired that you literally want to crawl into bed and stay there. Forget about going to gym after a twelve-hour shift [on your feet]; forget about cooking a nutritious meal; forget all those fancy words they tell us about health and wellbeing. There just isn't time for that."

The arduous lifestyle was relatively thankless on payday, too, said Sampson.

"My husband and I both have four-year BSc degrees from UCT. What I earn now is what his starting salary was 23 years ago. And I'm one of the lucky ones that earn a decent wage. There is simply not enough money, and that perpetuates the debt cycle."

Looking for solutions

Susan Cleary of UCT's Health Economics Unit suggested some courses of action to improve conditions in the healthcare service.

"Firstly, grappling with the issues of unreasonable workloads. It's a really tough one given the high burden of disease, patient demands and limited budgets. But we need to realise that there is no way that health workers are going to be able to look after themselves if, as we've heard, the workloads are completely over the top. It's just not possible for people to overcome that and be all shiny and happy and fine."

Cleary also emphasised the need for sound leadership and investing in leadership building and developing capacity, as well as for leaders to be role models and "make it easier for people to help themselves".

Story by Yusuf Omar. Image by Raymond Botha.