Medical Staffing & After Care in Australia

This blog is my Perspective, as a Patient and a Minder.. On the subject of  'Medical Staffing & After Care in Australia'

This is a story of my experience IN and OUT, of Hospitals both regional and big city establishments, plus emergency ambulance and helicopter rides 1937 to 2025.

1 General Medical Practitioners. (The Wooden Spoon)

These people are some of the most lethargic operators. They are normally protected  by poorly trained receptionists. They rarely look at patients, but get close up to their computers- where AI type messages come through-up comes the prescription- an arm reach's out for the door and $80 please at reception.

Few do actual medical procedures. The late Dame Thatcher was after them years agoe- Without much success. GP's are now usually of Indian or Chinese background. When recommending specialist's they are nearly all of same basic race. Indians tend to come direct, complete with the correct documentation!.

The Chinese Doctors like their dentist counterparts, tend to come via the back door, usually New Zealand were they qualify first, then one flight they are here, set up practice and with luck they are on the gravy chain. Dentists in particular.

 European, again direct, usually with no intention of staying.

As we all know,at the moment, they have computer guidance on identifying patients problems and possible treatment. The future it is easy to identify, AI with its power to identify, trolling through thousands of identifications and treatments, simply in seconds. the need would be say just one doctor per practice, to over see the prognosis before publication and Action.

 The 2025 general election was won, by the past and now present Prime Minister, waving a Green Medicare card, saying something like "Here you are, access to Urgent Care Clinics, at no cost and relieving GP's waiting time. Giving them more time to relax. The PM did not mention the wording on the promotion leaflet "Please call on the day before, to confirm clinic availability". Yes waiting time for Urgent Care--Oh dear.

Psychologist's and Psychiatrist's

An odd lot, some say they are as nutty as their patients.Not quite true of course, but where there is smoke , fire will follow ---joke , I think.

In the public domain at least, those People that left recently in  NSW. NSW is probably better off, particularly the younger ones, who cannot get past,prescribing  drugs to quieten things down and to control and almost incapacitate patients. One case in a southern.district hospital, where a patient in her section had been in care for years, of over drugged and the last time I saw her, she was sitting on a kerb spaced out. I checked that she was safe. The so called Psychiatrist, simply said she did not know of the case and walked away   -- Hopefully she was one who left that hospital.

These thoughts, are simply my observations, based on facts as I remember them.

 3.  Surgeons and Staff  Assisting,  Operate almost like Barristers with Barrister Assisting and in this case Surgeon assisting plus with their large supporting personnel, they are always there when needed.

Last year I was very ill, admitted to casualty, where a very astute doctor sensed there a something very wrong,Ambulanced off to a full scan. Wow, a nasty leaking stent done some years before. I said, why am I still on this trolley, quiet Malcolm, we will be off in a minute. 

Back in the ambulance and off  `------ to a local playing field, where all the lights were on and a big  Helicopter was waiting---oh dear. Winched in and attended by a doctor and an assistant. the Pilot came and asked is every thing OK?, goodness, I thought he is so young.  where are we going?, Wollongong, I observed, we are taking along time but by then we were landing, actually in Sydney! - Prince of Wales Hospital. there on the Pad were a team of medico's. A session in their big scanner and then there was the Surgeon and his team.

The big city Hospitals are of course training units and this was no exception. Mostly qualified Doctors from overseas, in my case I think they would return home, qualified in Vascular Work.

All these people in and around the Operating Theatre are dedicated personnel, even at the early hours of the day--- to save my life, me "That little grain of sand trying to get,his message out,against the winds off the desert" 

4   Nurses Great and Small. 

 Through out my life, Nurses have been the baine of it.

At the moment there s a considerable number of  Indian Continent men and women , party and fully trained being taken on by major and country hospitals. Like Pacific arrivals, they tend to operate in packs  with a lead person in charge. Maybe its that they live together. and teach the younger ones how to use those commputor trollies, with their too small print.

They fall into three categories

 The  Plain useless, through medium interest in the job, to the excellent experienced mature variety!.

 A.---   .Plain useless

 Usually young, of limited experience as caring individuals.  They rely entirely on their Computer mounted on a trolley. Informing them  what to do, not how they should do it.----with kindness and understanding.!! 

Example - Young nurse comes along- takes patient temperature and blood pressure, offers a plastic cup with pills- patient refuses for a moment and whoose she is gone. Minutes later an older nurse comes along and its hello - I don't like taking pills either, takes them out of the cup and done.!.

To me it was and is the older nurses, who show any real empathy with the patient. My sister would be appalled  at the lack of attention of the so called  modern Sister of a ward not taking  the nursing staff around the patients at least once a DAY., as do all Surgeons. 

There are now what is called Director of Nursing, again little attention to patients .Unless 'There is trouble at Mill ' with someone like me.

This is my experience with both district and major city hospitals.   

 Example 2 Major Hospitals take young inexperienced over seas nurses-One young Chinese tries to give an injection in the night  ouch! soooory, again ouch - go away damn it girl. Along comes an older lady, lets see what I can do. There how is that - fine thank you.

I think and recommend that nurses should be on Piece Work, ie paid for time spent with a patient, like Doctors. The so called Ward Sisters and Nursing Directors, would have to up their act,on administration.

Oh dear where are you my sister= Queens nurse;was it 240 baby's some famous parents, most not, your lace  and all things strictly Ballroom.  It was a burst upper Aoata, blue light to a main London Hospital, but too late. She died too soon - packed church for the funeral.

Nurses yes in the main paid very adequately, some far too much. But precise figures is difficult, they all use percentages, of  what, I ask----silence, but I know in general.

5.  Paramedics and their Equipment.

To me these people take the Gong for Excellence and Dedication to the job in hand--Any job.

They are at the pointy end of Life and Death, Blood and Gore, of what life throws at them.

They operate all the advanced equipment within vehicles they drive as safely as possible at all times. One particular make Mercedes Benz appears to have cornered the market Worldwide- look at Gaza etc.my old company the Austin/Morris with the J4 as the standard, for many years.The only compliant I have with the Australian operator of the Mercedes is that they insist on 60psi tyre pressure, where I recommend  maximum of 45/50. I have of course been in one and the ride is terrible.

6.  Hospital General Staff.

Here I am talking about, Ward assistants (Trolley and bed pushers-many beds etc are powered these days).; Cleaners; Distributors of meals and tea breaks etc; Maintanence people, including the Generator operators and Specialised equipment.

The distributors of meals etc are particularly, good at patient interaction and friendliness, something many young nurses could emulate.

Final Thoughts - for the moment!

Top of the list are PARAMEDICS, those people at the pointy end of life the blood and gore we people throw at them. Always polite caring and patient, sometimes with, ungrateful souls. These closely followed by SURGEONS and their staff. Mind you, again, they are like Barristers with Barrister assisting,ie Surgeon Assisting, wonderful isn't it!.

So, down through the list ,to General Practitioners (The WOODEN SPOON). So loved by politicians.  

6.  After Care in Australia

The most difficult subject to talk about, as it contains so much unknown and so much controversy in and out of Government financing.

Essentially there three  categories of care.

A.Hospitals

When all else fails in getting care- Respite and Permanent, Hospital care is the only option. Unfortunately beds are taken up ,causing delays for general care; surgery; birthing wards etc.

These hospitals can be Private and General. Where 'Pensioner Concession' and our current Prime Minister's favourite ,the Green 'Medicare, Cards' comes in useful. Once in my case a scan was made in a private hospital and the Stent operation, in a general hospital--Green card I think.

Dedicated care depends on the class of nurse staffing.as indicated earlier. In my experience it does not matter City or Country (Regional) Hospitals.

B Nursing Homes

Two main types here. 

The Large Corporate Company Run ------Absolutely Profit orientated, sites 'dot com'. when they can get away with it, do not accommodate 'Respite Care', as a corporate strategy, even though the client has to pay without Government assistance at around $70/80 per day. Do they get government assistance I know not. 

They must be getting money from somewhere, looking at the car park and buildings/equipment clearly on show. Like I say, there are so many unknowns on what goes on between Governments and these Large Corporate operators. It all seems so unregulated and unsupervised, as we will see over all.

Small and large - not for profit operators ------, usually with a   dot gov site.

I have experience of one, a Catholic run enterprise, a respite patient facility added.

Staff are dedicated to the comfort and well being of there client, they do their best,but do not always listen to ideas and requests, but by golly, if a patient is it trouble, they are right there to help and call in a doctor, if necessary.

Ah yes,   Be sides  all the paper work, which is enormous for respite or permanent, you must have a designated GP who will be on call. which usually means having TWO doctors. Your normal GP being too lazy to get out there. Vets do, why not GP's, so loved by Governments. Mind you, some do telephone consultations, they are supposed to ring at a designated time, but if its too near five o'clock, no hope.

Now we  come to a real problem. After the Federal Government  "Myagedcare" people have done their assessment on the Level of care, that will be provided, for permanent assistance, for Residential or Home package.   A $ figure per year is provided. for drawing down, recipient, then must find an approved PROVIDER,--- very tricky

I found. a provider will  be willingly come along to explain, how the system works, which is good, but I felt  it was really to sign us up to their business. With no equipment other than an office /computer etc, they are on the way to a lucrative future,with Care management fees and Package management fees which can be more than the recipient care expenditure.

This is where the difficulty comes in.and is indetermanent by we mortals. We have all heard about NDIS on cost controls and scams of one kind or other.

Governments must set up a dedicated department to oversee, providers of all systems and get out there and personally visit  providers at very short notice. This, for detailed inspection of their books etc.and on occasion visit clients,  for their take on matters.pertaining.

Always look at their car park-----not an old car in sight. 

At this point I must repeat  My Blogs are stories based on facts as I remember them,. and are open to discussion by all.Yes this Grain of Sand trying to get his word out, against the winds off the desert.

All the best, in this lightening rod World

Malcolm E Mason

email masonedgar@gmail.com

X@mlcolmemason

NB.   Uniforms

Whether it is Hospital or Age Care Homes, I have great difficulty in distinguishing Nurses at various levels of Trainee nurse; through  levels of experience; Ward Sisters; Director s of nursing and general ward staff,

 Different colour clotheve never seen s and identification  of status and not just first names.could be the order of the day. Remember jt is difficult to read badges etc dangeling from a waste belt.

Look down at he feet and shoes. The tendancy is for those 'Walker" shes, that pick up all sorts of little nasties . I think plastic covers should be the order of the day, like police use at incident sights.

Finally for now I was once, waiting in a clinical area, next to an operating theatre. The clinical room doors opened and in came a Water man and his dirty oily trolley, wearing terrible boots. 

FIN    

 Not quite, just few notes before I go to see my dear wife of 63 years in hospital. Can we find a respite place for her,very difficult. Myagedcare is getting complicated.

 1. Plastics- I have never seen such use and waste of plastic bin liners. Everyday a person changes the liner wether it is filled or not. Everything seems to be packed in plastics of one kind or another

Referring to he last note of the blog, I strongly believe, all people entering Wards should put on plastic so covers  as do Police and some pad carers, at their exspence.

2.Cost reduction Committees should be set up like may industries. eg All Nurses should buy tier own uniforms and do there own laundry!.

3. Financial based Swat teams to be established,make un anounced assessment of  performance and complience with government guidlines. This appllies to both aged care homes and Care Organisationms. ie  Management fees of home care packages. 

4. I have witnessed what I Thought was over staffing and under utilised facillites.

5. Reduced pay for those people not performing their Job descriptions adequetly. Getting back my three standards of nursing.!!

As I always say my blogs are based on facts as I remember them.

Definately                                          FIN 

 

 

 

 

 

 

 

 

 

 

 

.