This year, while we were still in PPE, and working in and around COVID-19, other things also influenced our professional and personal lives, and those of the communities we serve.
Severe and tragic climate disasters impacted our two nations. We saw the repercussions of many years of delayed care influence presentations to ED. Staffing levels got even worse. And access block remained our most challenging issue.
On a socio-political level, we entered a binational recession and cost of living crisis, with the most marginalised members of our communities disproportionately impacted.
It is vital that we continue to act as the safety net for more vulnerable members of society who turn to us when they need help most, and often find there is nowhere else to go.
However, we know the safety net is stretched. We also know that it is possibly so pulled out of shape it may struggle to bounce back.
But with challenge comes opportunity. When managed strategically, difficulty and adversity can breed ingenuity and strength.
We have seen the emergency care workforce come together during times of crisis, and fight to uphold patient care in emergency departments despite the failings of our current healthcare systems. We have been solution-oriented, and have tried to be generous towards others, even when it has felt impossible.
I am so proud of the social justice and advocacy that our community of emergency medicine clinicians engage in.
This year, the College advocated for health reform across Australia and Aotearoa New Zealand, with the release of the inaugural annual State of Emergency report. Our influence in the NSW Upper House Ambulance Ramping Inquiry, and pledges made by the Australian, South Australian and Victorian governments, can be linked to our advocacy efforts.
We hope that the new Australian federal government delivers on their proposed steps towards system-wide healthcare reform. We all know that genuine redesign is urgently required.
Next year we will see will elections in Aotearoa New Zealand and New South Wales. ACEM will continue to work with government stakeholders to enact positive change and implement meaningful improvements to health services and systems.
Recently, the College board held a strategy day. I was delighted to see so many past and present board members attend, as well as three trainee representatives and other members of the ACEM community.
Among other things, we discussed re-establishing quality improvement for education and assessment, and finding better ways to support our trainees.
This is especially important after such a difficult few years for doctors who are early in their emergency medicine careers. They have not only had some aspects of their training altered by the switch to online teaching, and changed access to certain clinical conditions and procedures, but have also missed out on social opportunities which keep us inspired and connected.
This holiday season, there are many of us who may not be able to take a proper break. Staffing shortages are widespread, and leave can be hard to come by. For those of us who are working through to the new year, please take the days you do have off to properly rest and recover.
I know I often fall into the trap of placing an arbitrary timeline on myself at the end of a year to complete all the things I’ve been meaning to do and to start the new year afresh. But with the chronic intensity of our professional lives, it’s important to instead use the time we do have to properly rejuvenate – despite how counterintuitive this may feel to many of us.
Try not to feel pressured into finishing all those mounting projects. Instead, try to relax and reset in a way that feels right for you – for me, an afternoon at the piano, or a doing a jigsaw puzzle, is the perfect way to unwind, but for you this may look very different. If nothing else, just find a few minutes to take a deep breath and stare at the sky.
Please remember to check in with each other as much as possible – a problem shared is a problem halved. We are a unified specialty, but our strength comes from our diversity: of experiences, skills and backgrounds, all contributing to a greater whole.
We are coming out of another difficult and turbulent year, but with challenge comes the opportunity for growth and reform.
Thank you to every single one of you – FACEMs, trainees, other members and College staff, as well as our colleagues and allies across the healthcare system, government and other health bodies, who are dedicated to working toward better, media who publicly elevated healthcare issues, and friends, family and whānau who supported us all through turbulent times.
Please look after yourselves, and each other, during this festive period. This can be a very difficult time for people in so many ways - physically, emotionally and financially – especially after a year like this.
Thank you for all that you do, and for the extra lengths you have gone to during such a challenging time.
I have hope that 2023 will be gentler, on us all, and that we can come closer to achieving a truly equitable health future for all people living in Aotearoa New Zealand and Australia.
Dr Clare Skinner