The hotel quarantine inquiry shows how nurses were victimised

Testimony from front-line workers at Victoria’s hotel quarantine inquiry has shone a light on the perfect neoliberal storm that unleashed Victoria’s “second wave” of infections. Much attention has rightly been focused on the deregulated, profit-driven security companies that were contracted by the state government to staff crucial roles on Victoria’s front line. But testimony from two nurses employed in the hotel quarantine program indicates that the problems were more extensive than that. They painted a picture of a shambolic, cut-price operation in which health workers faced victimisation for attempting to remedy gross defects in infection control and medical care.

Michael Tait, a 19-year veteran nurse, worked for the for-profit labour hire company Your Nursing Agency. He was recruited to the hotel quarantine program via mass text message and ended up working at four different quarantine hotels.

He was sent to the Crown Promenade expecting to swab passengers as part of their COVID-19 tests, but he encountered a chaotic scene:

“During the first five days at Promenade, only about 25 guests were tested for COVID-19. This was because we did not have enough swab gear available to us. The nurses were also hesitant to do swabs because we did not have adequate PPE [personal protective equipment] to protect ourselves. We didn’t have medium gloves until day four. We did not get N95 masks until day eight. We never got hoods, face shields or shoe coverings even though we were told we would ... We also had lots of very sick and elderly people. It was just heartbreaking at times where young kids would infect their grandparents with COVID-19 and then the grandparent would be taken away to hospital.”

Another nurse, Jen, who worked for the same agency as Michael, took shifts in three different hotel programs. She reported adequate PPE at the Park Royal, but insufficient training on its use: “I saw a lot of security guards ... constantly wearing the same gloves throughout their shifts, going and making themselves a coffee with gloves on, using their phone, things like that. [They were] wearing their masks so that their nose was hanging out or that it was underneath their chin. Yes, that was constantly seen.” When she raised concerns and suggested a nurse provide training for security guards, she was ignored.

The Park Royal also lacked a program to limit contamination. The top floor of the hotel was open to the public during the entire time Jen worked there. The public would use the same doors and lifts as quarantined guests. International transit passengers used the same toilets as nursing, security and other staff until nurses advocated for their own facilities.

The paperwork was always behind and often inaccurate. Jen learned of a family who were in their room for a week without any contact from a nurse. After finding medical notes recklessly discarded, she set up her own documentation system and trained other nurses to use it.

Even though there was a shortage of work in hospitals, both nurses reported that the hotel quarantine program was understaffed. Michael explains: “On average it was about one nurse to every 100 patients, but it fluctuated and got to times where it was up to one per 150.”

The few nurses on staff were frantically fielding phone calls about guests’ different medical care issues, since screening prior to arrival was minimal to non-existent. Nurses were also expected to deal with inquiries about everything from dirty rooms and unstocked minibars to supporting domestic violence survivors and responding to medical emergencies.

These working conditions are unacceptable at any time, but when they also present a serious risk to the general public they are positively criminal. People in quarantine are more likely to be cooperative and responsible when they are well supported and respected. When people have their dignity and human rights violated, there’s far greater pressure to subvert quarantine protocols.

Nurses like Jen were routinely blocked from providing adequate care. Fresh air breaks were sparse to non-existent, allergies were ignored, diabetics were stuck with sugary food, and adequate pain relief was denied to an endometriosis sufferer. Those who asked for help were treated as a “problem”, and nurses who advocated for them risked retaliation.

Specialised mental health nurses were not always made available, according to Jen, meaning nurses with no additional training “were just assigned as the mental health nurse for that shift”. This practice didn’t change even after someone at another hotel committed suicide. In one case, a guest was threatening to commit suicide, and Jen said the department told them “they needed to stop threatening suicide just so they can get a cigarette”.

In the classic dysfunctional pattern of outsourcing, nurses and other workers were caught between many levels of management. They had to navigate their agency, hotel management, Qantas’ hospitality company and the health department, represented by an opaque layer of authorised officers and team leaders, people often pulled from other government departments with very little health expertise.

Michael describes the confusion. “If we needed something we did not have, we talked to the department team leader. The team leader mostly told us what we could not do, rather than what we could do. This team leader was always a new person every shift and there was no consistency. Additionally, as nurses we were not part of the ‘team’ led by the team leader.”

Unsurprisingly, none of this made quarantine safer. Quite the opposite. When nurses asked for help, they faced retaliation. Jen explains how her tenure at the quarantine program ended: “After the incident with the endometriosis patient escalated, department staff made a rule that nursing staff were not allowed to give their name to the patient or tell them who we worked for”. Jen was told not to give the names of health department staff either. She challenged the department on this, the department complained to the agency, and Jen was never offered a hotel quarantine shift again.

This wasn’t an isolated incident: after another nurse at the Park Royal insisted on a deep clean and a separate toilet for nurses, she too “never worked another shift at the hotel”. Michael’s employment ended after he sent an email to his manager at the nursing agency expressing concern about the ratios at the Metropol hotel and conditions. “After I sent the email”, he wrote in his inquiry submission, “[my manager] called me straight away... I explained that I was just trying to do what was safe, especially because I was taking swabs all day at work without adequate PPE”. Later, Michael’s manager called to tell him the department had cancelled Michael’s shifts, including the five he was rostered on for. He has not worked in the program since.

“Disorganisation, lack of appropriate staffing and lack of planning were the key problems in the Program”, concludes Michael. “Ultimately however, the experience made me very proud to be a nurse. We did an impossible task caring for these people while having to constantly adapt to poor and constantly changing [health department] policy.”

The costs of the current outbreak and stage four lockdowns are far greater than a well-funded and functional quarantine program would have been. However, a government steeped in neoliberal thinking and practices can’t shift gears fast enough to provide a sane response in a time of a crisis.

Instead, in one of the richest countries in the world, the heroics of workers trying to prevent disaster in the face of a monstrously dysfunctional system are met with blacklisting and the threat of the dole queue.