By Michelle Aranda

I am a registered nurse (RN) and have worked in both the private and public health sector. In my 22 years of nursing practice here in Australia, I have experienced working in Brisbane and, for the most part, in Melbourne.

Private

Private hospitals have its perks – a private room, nice meals, dinner with red wine and lovely desserts, even priority listing in surgery if you have an substantial private health cover.

Unbeknownst to most patients, the nurses in the private hospital are usually understaffed, overworked, overlooked. They sometimes take the role of a doctor, physiotherapist, social worker, dietitian and occupational therapist for the patient. 

When the doctors are not around, the nurses are expected to contact them if the patient needs an expert assessment prior to prescribing any new drugs.

Oftentimes, a physiotherapist is not around when a patient with mobility issues needs assistance. The nurse is expected to take the patient out of bed, without expert physiotherapist’s assessment, nor a recommendation of what is safest for each patient to mobilise on, with walking aids or not. 

At times when there is usually no social worker around to refer the patient to deal with their social issues so they can safely go home, the nurse is again expected to liaise with the patient’s social network and support at home or wherever they live – like in an aged care facility or nursing home, or whether they need community health services. 

The nurse has to take down the patient’s dietary preferences and keep it updated on the hospital’s ward menu records, work out whether this patient needs a soft diet or a regular full diet, or forget about dietary supplements. It’s because there’s not always an expert dietician around to provide a piece of advice and reference. 

If the patient needs special cutlery or drinking cups to be able to manage to eat properly, if they need a pick up stick aid or a shoehorn to get by with their ADL (activities of daily living) – the nurse is again expected to work it out as if he/she is an occupational therapist. 

On top of all the extra workload, health facility providers also expect the nurses to make the beds and clean it after the patients are discharged. It’s like doing the tasks of a cleaner! 

Of course, expect the nurse to do the rest of their nursing duties: feeding the patients, giving their meds, and an EN-enrolled nurse’s patients’ medications (if they are not medication endorsed), check the patients’ vital signs, take them to the toilet, clean them up, turn them for pressure area care, shower or give them bed sponge, write their reports, make sure all medications given and charts completed and signed, make sure the ward area is clean, and make sure all issues and abnormalities of each patient’s conditions are reported either to the charge nurse and/or to the doctor. Whew! 

What a great role to fulfil – only in the private hospital ward.

Public

In the public hospital system, where I have worked the longest, I have seen patients provided with manageable nurse-patient ratios so nurses are not overloaded with work. 

Allied health personnel such as a social worker, physiotherapist, dietician, occupational therapist, speech therapist are provided for in a public hospital. There’s even a podiatrist these days that follow up on patients’ needs as referred to by the primary nurse. There is also the presence of a wound nurse specialist/stomal therapist and even pastoral care. 

Patient care attendants are available to wash and make the beds once a patient has gone home. There is just so much extra manpower provided for in the public healthcare system. The patient is ushered through and looked after, up to the discharge phase of the patient to their residence whenever it may be needed. 

If patients need community health services, there are liaison officers provided for such. If they need the RDNS (Royal District Nursing Services) for wound care management and insulin administration for diabetic management, it’s provided for as well in the public system. 

A HITH (Hospital in the Home), PAC (Post Acute Care), RITH (Rehabilitation in the Home) are available if an RN deems it necessary. And most importantly, the Resident Medical Officer is always around in the hospital on pager for the patients to be consulted on. The senior treating doctor, the Medical or Surgical Registrar is also mostly on pager as well, if not present all day in the hospital site on-call. 

And they also have the highest of consultant specialist doctors, professors in medicine and surgery that go on their rounds with the whole team of treating doctors, physiotherapists, charge nurse, supervisor, etc. all looking after the patients’ needs.

No wonder most of my colleagues and fellow nurses do not have a full private hospital or health insurance cover like me since we see the majority of health services needed are available and very accessible in the public healthcare system. 

Medicare makes the public health care system work, especially for low-income earners. They get benefits for medications and hospitalisations and other health care services. Discounted dental treatment in the community health centres is also available.

This is why I prefer serving in a public hospital and if in an unfortunate situation that I require treatment, I would prefer going to a public hospital.

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