Shortage of nurses hurting care centres

When the Covid-19 virus started to spread in March 2020, nurses were overworked without rest while new ones were hired to accommodate the rising numbers of patients in government hospitals.

However, not many are aware that this has an indirect impact on senior citizens, especially those who are living in care centres and old folk homes.

During the pandemic, some senior citizens had to battle with the virus, including those living in care homes. Some were placed under quarantine or sent to hospital for treatment. Sadly, most did not survive.

Centres had to deal with not only the spread of the virus and the prevention of possible outbreaks in their premise, but also a shortage of nurses to care for the residents.

“We need about 6,000 caregivers and nurses in all of our centres nationwide,” said Association for Residential Aged Care Operators of Malaysia (Agecope) president Delren T. Douglas.

Delren said prior to enforcement of the MCO in March 2020, (graduate) nurses were put on standby or “pending replacement” status while waiting for an opening or position at a government hospital.

The “pending replacement” period is between six months and a year, and once there are places available, nurses would get to work in a hospital.

“It’s the norm. This is one of the reasons the government decided to close down nursing colleges, as there were a high number of nurses waiting for placement in government hospitals,” explained Delren.

While waiting for placement, (graduate) nurses would work with nursing homes and old folk centres, and that solved the problem of a lack of nurses at such facilities.

When the nurses get employed in a hospital, a new batch of graduate nurses would replace them.

But this was not the case when Covid struck two years ago.

There was a rise in the number of infected patients at hospitals, and “pending placement” nurses were sent to work at hospitals.

Delren said some others were offered jobs on a contract basis, leaving many centres without any nurses during the two-year MCO period.

The shortage is still felt even today.

“We have a lack of nurses nationwide. Currently, less than 3,000 nurses graduate in a year and the bulk of them are taken by hospitals overseas, while the remaining are hired by private hospitals,” he said.

At times, hospitals abroad sponsor the education or give scholarships to the nurses, which means they are bound.

The number of the remaining graduates is not sufficient to fill the void at assisted living centres for the aged.

Referring to statistics that Malaysians aged 60 and above would reach 15.3% of the population by 2030, Delren said we should not wait until then to employ the required number of nurses.

Mindful of the fact that there are only eight years before 2030, Delren proposed reopening nursing colleges to resolve the shortage.

“Closing down nursing colleges makes it difficult for students to study the course,” said Delren, who operates Pusat Jagaan Orang Tua dan OKU Dzenith Homes.

He also said nursing course entry requirements were increased from three SPM credits to five.

“If a student has five credits, they would normally opt for other courses and not nursing,” he said, adding that there was a lack of caregivers as well.

Delren suggested that in the meantime, the government allow unemployed locals to work in the nursing home sector or subsidise training programmes offered by colleges or universities to allow them to study.

Although there are short courses for caregivers, there is currently no proper standardised syllabus for caregivers nationwide and such courses are expensive for unemployed or school dropouts.

He said as the position falls under the category of “dirty” and “demanding” jobs, locals would not want to do it.

Even if they do join, they would most likely be school drop-outs with no proper training.

“Not many people have the patience to take care of other people’s parents in nursing homes,” he said, and suggested allowing foreign workers to be hired for a stipulated period, with a working permit of one of two years given just to fill the gap until a new batch of nurses graduate.

Delren said right now, no permits are given to foreign workers to work at homes for senior citizens or any care centre.

According to him, some owners of such facilities have resorted to merging two care centres into one due to the lack of adequate staff such as nurses or caregivers, while others had to serve as workers at their own centres to ease the situation. The Sun


Nurses facing burnout, psychological and emotional distress post-COVID, study finds

A cross-country survey of nurses and midwives in the UK has found deep repercussions due to the COVID-19 pandemic: many nurses and midwives report feeling unaccustomed to redeployment, which involved caring for high numbers of critically ill patients and witnessing a high number of patient deaths. Researchers at the University of Surrey, who conducted the survey, have called for a national COVID-19 nursing workforce recovery strategy to tackle the issue and help restore nurses’ psychological well-being.

Despite the distress and trauma faced by frontline nursing staff, it was revealed that the stigma that arose prevented them from accessing counseling services during the first wave of the pandemic. Some participants referred to the notion that nurses seeking counseling would be viewed as a “sign of weakness.”

Those who did seek out counseling often did so through anonymous sources such as charities or Trade Unions suggesting a lack of trust in the confidentiality of resources offered by employers.

The survey also identified a lack of trust between existing and redeployed nurses – many were forced to carry out tasks that they felt insufficiently trained to do, and were justly concerned that their professional registration may be endangered.

“Nurses and midwives put their own health and psychological well-being on the line for the public during the pandemic and many unfortunately lost their lives; others experienced burnout, high levels of moral distress and PTSD (post-traumatic stress disorder),” said Dr. Jill Maben, Professor of Health Services Research and Nursing at the University of Surrey.

To prevent a mass exodus of the nursing and midwifery workforce, Dr. Maben suggests a new national strategy to acknowledge and address their harrowing experience.

Some of the nurses and midwives interviewed for the study – part of the ongoing Impact of COVID on Nurses (ICON) longitudinal interview study – suggested the researchers provided some therapeutic space and comfort just by listening to their grievances.

“We have a duty as a society to take care of frontline staff who experienced such extreme psychological and emotional distress during this pandemic. The support currently offered is a good start in improving well-being, however, more needs to be done at organisational levels (not just letting the responsibility rest with the individual nurse or midwife) as a one-size-fits all approach does not work.”


Holographic patients help doctors and nurses in-training

A new, superior medical training application called “HoloScenarios” is helping soon-to-be doctors and nurses hone their skills using mixed reality learning. Developed by Cambridge University Hospitals (CUH), in partnership with the University of Cambridge and Los Angeles-based tech company GigXR, HoloScenarios will introduce a medically-accurate holographic patient that can be interacted with, creating a unique clinical environment to learn and practice vital, real-time decision making and treatment choices.

Medical instructors are also able to change patient responses, introduce complications and record observations and discussions in person in a teaching group or remotely to multiple locations worldwide over the internet.

Learners wearing Microsoft HoloLens mixed-reality headsets can additionally also watch, contribute to, and assess the holographic patient scenarios from either an Android or iOS smartphone, or tablet.

“Mixed reality is increasingly recognised as a useful method of simulator training,” said Dr. Arun Gupta, Consultant anesthetist at CUH. “As institutions scale procurement, the demand for platforms that offer utility and ease of mixed reality learning management is rapidly expanding.”

The technology is able to provide immersive learning opportunities to be delivered and shared across the world, with its first module featuring a hologram patient with asthma, followed by anaphylaxis, pulmonary embolism, and pneumonia. Further modules in cardiology and neurology are in development.

HoloScenarios is available for license to learning institutions everywhere, amid extensive analysis as a mixed reality teaching and learning tool for higher education.

“Our research is aimed at uncovering how such simulations can best support learning and accelerate the adoption of effective mixed reality training while informing ongoing development,” said research lead Professor Riikka Hofmann at Cambridge’s Faculty of Education. “We hope that it will help guide institutions in implementing mixed reality into their curricula, in the same way institutions evaluate conventional resources, such as textbooks, manikins, models or computer software, and, ultimately, improve patient outcomes.”

Junior doctor Aniket Bharadwaj is one of the first to try out the new technology: “Throughout medical school we would have situations where actors would come in an act as patients. With the pandemic a lot of that changed to tablet-based interactions because of the risk to people of the virus.

“Having a hologram patient you can see, hear and interact with is really exciting and will really make a difference to student learning,” he said.