keeping the system happy picture


As Tess sat on the toilet in the hospital she knew she would have to be brave to get through this.

She was a survivor, as anyone who knew the 93-year-old would tell you.

Born in Holland, she had endured being raped by first the Russians, and then the Germans, during the war.

The attacks, close together, resulted in a plethora of physical and emotional wounds. And a pregnancy.

Her kind son, now middle-aged, does not even know the nationality of his brutal father.

That was in the past and Tess had survived, though she wondered if she had the fortitude to survive her latest crisis.

Just last week she had left her nursing home bed to use the bathroom. The carer who helped her get dressed neglected to put non-slip socks on Tess and she slid, knocking into a trolley which then fell on her.

She broke her hip and ended up at Nepean Hospital, in Sydney’s western suburbs.

Now, sitting on the toilet and looking at the sign opposite which clearly stated that people at risk of falling were under no circumstances to be left alone in the bathroom, Tess was wondering if the nurses would ever come back to help her into bed.

She was sore, and cold, and tired.

It had taken two of them to get her from her bed to the little ensuite she shared with another patient.

Then they left her. She finished her business and buzzed using the button near the toilet, but no one came.

She called out for help in a feeble voice, strained with pain and fatigue. Still, no one came.




A visitor to the other patient sharing her room went in search of a nurse. At the nurses’ station, the nurses were all frantically working on computers to fill in endless details about each patient, as they are required to do.

Finally, she was helped back to bed and she tried to calm her distress at being left so long with gratitude for the fact she wasn’t forced to urinate in her bed as her former roommate had.

That poor lady, also suffering from a broken hip that required surgery – it was the rehab ward after all – had waited more than 45 minutes for someone to answer her call.

By the time a nurse arrived, the woman’s bladder had given up its fight and she was lying in her own urine.

She wasn’t treated to clean sheets though, as it was the middle of the night, so a towel was placed under her and she spent the night lying there helpless as the wetness seeped through the towel, chilling the bed and chafing her skin.




Tess assumed the nurses didn’t want to disturb her by changing the lady’s sheets but she was already disturbed – disturbed that this patient had buzzed for help and waited so long, though she had suffered a heart attack in the hospital just days before.

Too bad if she was in the throes of another heart attack.


keeping the system happy picture


Tess continued with her thoughts of gratitude as she remembered another patient who endured agonising pain when a paediatrician who, for some unknown reason was doing the rounds in the old people’s wards, decided to change all her pain medication. Without consulting either the patient, her GP or the pain clinic under whose care this patient had been for about 30 years.

Sounds like fiction doesn’t it? This is a true story, though in real life Tess has another name.

The necessity of satisfying the bureaucracy has resulted in no nurturing for people.




This problem crosses professions but is particularly sad for those in pain and relying on the underpaid and overworked nurses for their care.

A friend of mine who used to be the head nurse at an aged care facility said her job had transformed from hands-on nursing to administration and she was forced to spend hours each shift filling in the necessary paperwork to keep the system happy. Seems no one cares about keeping people happy anymore.

This friend found herself working up to two hours of unpaid overtime each shift in order to keep up with the paperwork.

“I trained to be a nurse, not an administrator,” she said.

“I feel guilty when I don’t spend enough time with the patients.”

Most nurses, aware they are already underpaid, are not prepared to do unpaid overtime so they do their paperwork at the patients’ expense.

Another friend who is a full-time career at a nursing home said that by the time she has completed all the necessary formwork, she spends about 20 minutes of individual time with each of her 12 patients during an eight-hour-shift.

It’s not just health care patients who suffer from the insatiable needs of The System.




I saw it happen during my own work as an art therapist for people with disabilities.

When I started in the role, working for several day centres, the team leaders spent time engaging with their charges, sharing activities and having meaningful conversations.

Little by little the team leaders started spending less and less time with the clients and more time locked away in their offices, completing paperwork.

One even confided in me that she had started to hate the demands of her job that took her away from the clients.

“It’s not what I signed up for,” she said.

This is even an issue for people dealing with children, such as teachers and daycare works.

I have another friend who works in a daycare centre.

She is required to detail every moment of the children’s day – noting when they eat, sleep, speak, play, and every other activity imaginable.

She is given just an hour a week during working hours to do this, so finds herself spending hours of time at home, neglecting her family, to get the job done.

Aside from not getting paid for that extra time, she finds she no longer enjoys playing with the kids as she is always thinking about how she will write her reports and keep the system happy.

When carers are forced to do endless hours of administrative work, who is left to care for the people?

What are your thoughts?

Have a gleeful week, Tamuria.









  • It’s scary that filling out forms and documentation have now become the primary job of caregivers, not caregiving.

  • This is heartbreaking and I’ve seen first hand and heard similar stories over here. Nurses, caregivers, anyone trained and designated to help patients should do exactly that. These hospitals and care facilities need to hire more admin. help. The medical staff should be tending to the patients only. And I won’t even go into the amount of school required for the med care staff vs. an admin. This is wrong on so many levels, and again, just heartbreaking.

    • You are so right. There are definitely different jobs there and they shouldn’t be melded together in the name of streamlining and efficiency. It’s a shocking waste of training and in the end, it’s the people who need care the most who suffer.

  • Oh, have I ever gone through this, Tamuria. With both my parents, at different times. What will happen with the system, I have no idea. But what I did–and about the only thing I could do–was to be an advocate. Which meant, being there. My mother’s last month in the hospital, I had a fight a day with the staff. Literally. I think I’m still not welcome there. But, my mom got the care she needed. There seemed truly no other way . . .

    • It’s easy to forget the stress this neglect puts on loved ones of the patients. What a horrible thing to have to face while being the support for your parents, Susan. I don’t know how we can stop this trend but we need to find a way. People should come first.

  • This story is becoming the norm in so many nursing facilities and hospitals–it goes beyond sad and horrible! As a society, we value the wrong things, whether that be copious amounts of paperwork to cover administrative requirements or cutting costs at the expense of patients. Tess’s situation is a nightmare–and one that many of us may face one day. But I don’t know how improvement and change can happen.

    • Meghan you are so right, we have our values screwed up. As the population ages, there will be more and more people in need of care and they shouldn’t be made to suffer to fulfill the whims of a system that clearly is not working.

  • Tamariua,
    I have to say I enjoyed your article immensely. I agree with you on the issue about not melding jobs together such some health care facilities and mental health. I am in the United States and their health care system is different, but still has some of the same issues.
    Having a system that continues to remain broken makes it difficult for professionals to do their job. I still continue to be active, but It remains difficult Thank You for a wonderful article.
    Thank You,
    All The Best
    Lori English

  • Wow – that story is such a bummer. Yes the system is broken – and it sounds like not just in the US, but in Australia as well. I guess it really suggests that loved ones need us to be their advocate – even when we think they are in good hands. It makes me really sad because I think most health care providers really entered the profession to make a difference.

    • Yes, so sad for health care workers whose goal was to help the patients, not fill in piles of paperwork. You are right, Audrey,the only obvious solution is to be the advocate for our loved ones. Makes it extra sad for those who are alone, though.

  • Thanks for ‘exposing’ this crack in the healthcare system, as it is happening everywhere. As you know my mother just had emergency surgery (at age 100!) and although she has done amazingly well, the complaints about lack of attention from the care workers, is frightening.

    I had to actually ask the pharmacist (the doctor is virtually unavailable), why she was still on blood thinners, two weeks after she had surgery and was already in rehab in a new facility. He asked “Oh, is she up and walking?” She had been up and walking since the day after her surgery. Unfortunately everyone needs an advocate now to speak for them.

    I see how care workers are overworked and taxed with admin duties, which ultimately deadens them, and compassion and sincere caring seems to be a thing of the past. Thankfully my mother has a strong will and somehow has survived the ordeal and is going home tomorrow. It can’t come soon enough for her. The stories she has about care workers who don’t appear to care, are staggering.

    • I’m so glad your mum is doing great and going home, Beverley. My mum could not wait to get out of the hospital after she had her surgery. Yes, everyone needs an advocate to speak for them. Sadly, there are so many people without the support of family to help. What happens to them?

  • This is an increasing issue. My heart breaks open every time I read something similar. I am bothered, hurt and confused by it. Surely many are. Surely we will find an answer. I want to empower (yes that is likely an overused word) but I still want to be a support behind a conscious, visionary entrepreneur who will bring forth a way to alleviate this issue. Thank you for being a voice of change too.

  • Lordy me! I wish that these facilities would take inventory of the work…determine what admin tasks take up valuable time and then ask “which of these can be eliminated”. They may answer “Very few”, because they are used to the way things are done. But that is an artificial limitation–the question to ask is how it can be changed…how might it be possible. It may take thinking radically different. I know this is just wishful thinking on my part.

    • Due to fear of liability, Rachel, I’m sure most of the tasks will always seem vital but it would be better to have administrators do that job and let the carers do the work they trained for.

  • I’ve worked in education for over 12 years and the change is insane. At my longest job with mentally ill students who had to be in a separate facility away from their peers; in the end, I was doing lots of documenting off the clock. I would wish for cameras and microphones in the room. My team had nothing to hide.

    When I was in the hospital for surgery, last year, I found the difference between the day shift and the others to be glaring. During the day, there were so much bureaucracy in the building, even though there was more staff, my care was worse.

    And my sweet father and his rehab care. We were very fortunate that my mother was able to be there every day. Those are the patients that get the best care. Not enough severely underpaid STNAs to go around means people are not cared for appropriately.

    Such a wonderful post.

    Thank you!

    • It seems to be a growing problem in every sector, Latrelle. Putting paperwork before people work makes no sense and it is the vulnerable people in our society who are most affected.

  • It’s terrifying, isn’t it? And the worst part is that you know the nurses themselves (who are only doing their best) would be the scapegoats for a systemic failure.

  • It’s frightening to think that the very patients whom the caregiver is supposed to care for get neglected because the caregiver has to complete the bureaucratic paperwork. Maybe the system is happy but are the patient and the caregiver?

    Part of the problem is medical liability insurance and the need to show the insurance company that the hospital staff has performed its job with due care.

    We need a major reboot!

    • Yes, so frightening Vatsala. For the people in need of care its a disaster and for those giving it, the system must be so frustrating as they are not given the time to do what they trained for.

  • I’m an OT, was a Rehab Director for years, was the Medicare liason for over 90 therapists who worked on long term care facilities and my mom is living in an assisted living facility. I know this topic well and couldn’t agree with you more. Sometimes when I hear of a high school student who plans on going to medical school I wonder if they really understand the paperwork and regulatory issues that will impact the care they provide. Yes our system needs to be fixed and endless rules and regulations breaks the system more than it fixes it

    • Thank you for visiting, Crystal, and sharing your insight from within the system. Seems like everyone is so busy covering their backs they have forgotten why they chose their profession in the first place. I agree, we have way too many rules.

  • This is so sad yet so true in so many rest homes, Tamuria 🙂

    Appreciate you talking about this issue in your post this week. Sharing this will hopefully get people to realize what is REALLY happening to our loved ones…..

    Makes me wonder when the caretakers will get back to being more caring and taking the time to care for people, as we are all human, after all.

    Great share, as always 🙂

  • Yes our system has become a system of keeping the system happy instead of the people happy. That is so wrong, but I don’t see it changing anytime soon. We each need to find advocates to help us with we go through the medical system.

    • It has become a case of people more interested in covering their backs than helping those who need it, unfortunately, Karen. I don’t see it changing anytime soon either but it’s very bad news for those who don’t have an advocate.

  • How horrific. Recently read a similar story from Joan Potter. How sad for the professional staff who care about the patient, the patient and the family. Fortunately, we have not had any nursing home or hospital situations but do know the key is to always have an advocate, be it a family or friend.

    • It’s a sad situation for the staff and the patients, Roz. I know it really distresses my friends in the care sector. There are so many out there who do not have advocates. What happens to them?

  • Oh my God, what awful stories! My heart goes out to everyone caught up in the grinding teeth of “the system.” It won’t make you feel any better, I’m sure, but the same is true here in the U.S. It’s getting the point when I don’t want to go see my doctor because I’m tired of hearing him complain about the paperwork! So much of what happens in our world is a version of CYA and the people who need help the most are those who end up suffering the most.

  • So terribly sad and distressing. Aged care work is such a thankless job, I really admire caregivers and nurses.

  • Tamuria – What a great article. This is a subject near and dear to my heart, and you’ve very eloquently presented us with the heart of the matter. I think that nurses’ unions are quite possibly a good start. Also, just re-designing the structure of hospitals may be a game-changer. Imagine if there were pods built like wagon-wheels. There’s a nurse’s station in the hub, and 3-4 patient rooms like spokes in the wheel – leaving no patient more than approximately 15 feet from his nurse. Again, it would be costly to restructure, especially with lighting, etc., but for God’s sake, if we can put a man on the moon …

    • The hospital design sounds like a great idea, Joan. It’s such a shame they don’t seek advice from the people who actually know what is needed when designing things like hospitals.

  • It’s become a nightmare to document everything, presumably for data gathering for performance records and legal protection. We so seriously need to return to the human touch and caring and it says that advocates are needed more than ever. Thank you for writing about this and I hope it raises awareness for more people.

    • I guess all we can do is try to raise awareness until enough people are ready to push for change, Joyce. It is disastrous that we have lost the human touch to this extent.

  • This is really sad, and scary! The first night after my son was born via c-section, I was in horrific pain, and couldn’t get a nurse. Then when I did, she was a sub nurse (??) and couldn’t give me anything for the pain and basically told me to deal with it… I think they were short staffed, but it was one of the worst nights of my life. I can’t imagine being 93 and left in the bathroom with a broken hip. Just heartbreaking.

    • I was truly heartbroken when I spoke to the patients, Kimberley. It is so frightening to be at the mercy of a system that doesn’t care. What a terrible experience for you, must have been terrifying.

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