We have known about the issues for well over a decade, not just here in Tasmania but across the world.

It was predicted that by 2025 there would be significant shortages across the globe, with nurses and midwives retiring in droves.

The Global Financial Crisis in 2008 delayed this somewhat, but we are now seeing increasing numbers of nurses and midwives retiring each month.

I have no doubt that COVID-19 will be a contributing factor - based on the fatigue and mental health impacts the pandemic has had on many of our members.

The Australian Nursing and Midwifery Federation Tasmanian branch has advocated for a workforce plan for more than 10 years, knowing this crisis was coming.

The state government is currently consulting on a broad health workforce plan, but the plan has not been forthcoming and the crisis is upon us. Where once we may have relied on interstate recruits to fill vacancies, COVID-19 has reduced the interstate workforce, as each state and territory faces similar staffing challenges.

At present, there are some significant vacancies in the North of the state which are continuing to drive unsustainable overtime and double shifts for nurses and midwives.

In fact, Calvary Health Care have noted nursing and midwifery vacancies as key factors in driving up workload issues in their Northern Private Hospitals - St Vincent's and St Luke's. During recent Enterprise Agreement negotiations with Calvary Health Care, the employer agreed to implement a range of strategies in order to expediate recruitment of nurses and midwives to address the workload issues these vacancies were causing. This clearly demonstrates that solutions are required.

In 2018-2019, the ANMF lobbied the Tasmanian government to implement recruitment and retention strategies as part of the Public Sector Nurses and Midwives Enterprise Agreement negotiations.

This included employing more clinical nurse educators and clinical coaches so that Tasmania's 300-plus nursing graduates could be given permanent positions and supported with additional educators and support at the clinical interface. This Log of Claims item was rejected early on in Enterprise Agreement negotiations yet is now the key to securing the future of the nursing and midwifery professions in Tasmania.

Tasmania now faces a two-fold risk: A retiring workforce leaving large gaps in skills and knowledge bases, putting at risk safe staffing levels; the creation of issues around the skill mix, as it isn't as simple as just filling vacancies. There needs to be enough experienced nurses and midwives to support the early career nurses and midwives and ensure their safety as well as support for their patients.

The toll that high vacancy rates are having on the existing workforce is also significant. Currently at the Launceston General Hospital, a number of workload grievances have been raised on behalf of nurses and midwives.

This is a result of unsustainable workload pressures and unsafe skill mix not allowing for adequate support for early career nurses and midwives who are now consistently filling the vacancies left by now retired experienced nurse and midwives. These issues are already causing enormous fatigue and illness, causing nurses and midwives to go on sick leave, further exacerbating the existing problem.

We can no longer rely upon Tasmania as a lifestyle destination of choice as the only recruitment incentive. The reality is our graduates can earn up to $20,000 more in other areas of Australia, while paying similar rent and outgoings as they do in most parts of Tasmania.

All of this goes to show the nursing shortage in Tasmania is real. Where once the Government may have been able to dismiss the concerns of nurses and midwives as their Union Representatives being provocative, now the vacancy rates and roster gaps cannot be denied.

All the major public and private hospitals are competing fiercely with each other over a finite nursing and midwifery workforce. This will only intensify as Tasmania's ageing nursing and midwifery workforce retires over the coming years.

We need a plan put in place that will see all graduates safely supported to begin their careers in - and stay in - Tasmania.

The ANMF is calling on the Tasmanian government and the major private hospitals to offer competitive packages to secure sustainable nursing and midwifery professions across all sectors, ensure staff retention by delivering clinical support and guidance and prevent the loss of nurses early in their career to burn out and disillusionment due to unsustainable workloads and unsafe skill mix.

The crisis is upon us, it is time to act.