Overseas-trained nurses in Australia are frustrated they can’t work in New South Wales hospitals which are desperate for staff to deal with Covid patients, because of a requirement to sit an in-person exam in Adelaide.
State border closures mean nurses in NSW can’t travel to South Australia for the test which is necessary for some foreign degree holders to be registered to work in Australia.
As NSW hospitals prepare for their busiest period during the pandemic and are projected to become “technically overwhelmed” in October, nurses are lobbying for the “inflexible licensing system” to be changed.
“It is a real warzone, and I am sitting at home numb and helpless, having a vast experience in critical care,” said a Colombian nurse who is unable to gain registration in NSW.
Chiara Godio completed her masters in nursing in Italy and worked as a nurse for five years before flying to Australia in February 2020 on a working holiday visa. She moved to Orange, and, unable to work as a nurse, has since worked as a waitress and barista.
“It’s just bizarre to be told we can’t help out, even if it’s for something like vaccinating people. I don’t understand why we can’t help out colleagues here in Australia out, it’s just so stupid.”
While some foreign-trained nurses are able gain registration online during lockdown, the Australian Health Practitioner Regulation Agency (Ahpra) requires those who have qualifications “relevant but not substantially equivalent” to Australian standards to take a series of tests. This includes an in-person “objective structured clinical exam”.
Nurses who studied and worked in Italy, Philippines, Colombia, Nepal and India are among those unable to gain Australian registration online.
A spokesperson for the Nursing and Midwifery Board of Australia (NMBA), an associated nursing partner of Ahpra, confirmed that Adelaide is the only city in which the exam is conducted. There are only two more exam dates scheduled this year, in November.
The spokesperson said the in-person exam requirement was “a matter of public safety and ensures a rigorous evidence-based assessment of clinical skills”.
“We acknowledge that the Covid-19 pandemic has impacted the delivery of some components of the OBA [Outcomes-Based Assessment] pathway, including access to Australia and South Australia, which is controlled by Australian governments.”
At the same time as sidelining nurses already in NSW, the state is preparing to fly more nurses in from overseas.
The NSW health department is in discussions with the commonwealth to fast-track the credentialing of overseas qualifications to make it easier to fly in nurses to bolster the workforce ahead of the predicted Covid peak.
Sydney health workers desperate for extra help have launched a change.org petition pleading for Ahpra and its associated nursing partner, the Nursing and Midwifery Board of Australia, to ease its “inflexible licensing system” and “urgently find a temporary alternative” to the in-person exams.
The petition had obtained more than 23,000 signatures as of Thursday, and organisers claim to be aware of at least 1,000 potential nurses in Australia in a Facebook group they run, eager to become registered with Ahpra.
“We are a group of internationally qualified nurses living in Australia desperate to serve our communities,” the petition’s organisers said.
The pressure on NSW hospitals was highlighted this week with Covid spreading to six wards at Liverpool hospital in south-west Sydney, infecting 21 patients and five staff, and sidelining many more staff due to isolation requirements.
On Wednesday, Guardian Australia revealed regional hospitals had begun recruiting nurses from Queensland and Western Australia by offering to pay for their flights, accommodation, meals and return hotel quarantine, as well as $500 weekly bonuses if they take up six-week contracts ahead of the predicted peak in hospitalisations.
Godio, 29, started the process to get registered to work as a nurse in Australia in January. She said she received a response from Ahpra two months later, and when she tried to complete the next stage of the process – which required getting a registration code – she had to wait a further three months.
She was then asked to do one test remotely, however she is now unable to complete the final exam because centres in Sydney are not open. Only the Adelaide facility is holding the exams, however she is unable to travel there due to state border rules and movement restrictions in NSW.
“I have waited so long already, and they (Ahpra) just say it’s not their problem, and you have to wait until lockdowns end,” Godio said.
Without being able to work as a nurse, Godio will only be able to remain on her extended working holiday visa, and she is now planning to leave the country ahead of it expiring in February.
“My visa is expiring now, that’s the problem, and I know others like this too. If we don’t get registered, we have to leave the country.
“It doesn’t make sense to only have the one test in Adelaide, when you have big cities all around Australia, when we’re locked down, and the hospitals really need the help.”
Godio lives in western NSW local health district, where the health system is under pressure from the Covid outbreak in Dubbo.
This week, Guardian Australia revealed the Western NSW LHD was in dire need of surge intensive care and emergency department nurses, offering travel and pay incentives “never seen before” in the industry on six-week contracts.
“I’m more happy to stay in a regional area than to stay in a big city. I know they need nurses here right now,” Godio said.
NSW’s private hospital workforce and bed capacity has already been incorporated into the public Covid response in recent weeks, and lower-qualified nurses have been upskilled for ICU work. Retired nurses have been recalled to the frontline in recent months.
ICU nurses who spoke to Guardian Australia warned nurse-to-patient ratios in non-Covid ICUs were not being met throughout August, and reported increasing sedative doses to “knock patients out” in order to manage nurses’ workload.
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