Emergency departments are seeing ‘extreme’ numbers of patients


A senior nurse says conditions in the emergency department at Palmerston North Hospital are pushing staff to their limits.

His comments come after RNZ reported how an 84-year-old woman waited almost a day to be transferred from the emergency department to a ward.

Christina Emerson, workplace delegate for the New Zealand Nurses Organization, said workers were filling out reports every day about what was happening, but nothing had changed.

This had a detrimental effect on staff morale.

“Most of the time it’s just absolute chaos. We’re very busy all the time. We’re running at 90% capacity, 76% of the time. Other emergency services across the country are running at 90% capacity. their capacity, 30% of the time.

“We only see extreme numbers.”

The department was old and built for 17,000 people a year, but three times as many.

Emerson said the department had 24 beds where staff were assigned, but people were often placed elsewhere while they waited, places “that don’t have nurses assigned.”

“They don’t have equipment. They don’t have curtains. They can be sitting in a chair in a hallway. There’s no privacy for the patients.

“I think about grandma’s test. I think if it was my grandma I’d be happy with the treatment she’s getting, and most of the time I can’t say yes to that question,” said said Emerson.

This left staff discouraged that they could not do the job to the standard they wanted and led to high turnover.

“These poor patients waiting for beds… 24 hours is not unusual and it’s just demoralizing when you know you’re coming back to it again and again.

“Things don’t seem to be changing,” she said.

“I worked [last] weekend and my shift started at 7 a.m. on Saturday. The first patient I saw had been waiting since 5:30 the day before. The second patient I saw had been waiting since 7:30 the day before.

“It’s not uncommon. It’s happening more and more. We would typically have between 40 and 60 patients in the ward.”

Last year, the organization offered to escalate the issue to WorkSafe, but that was averted after an interim improvement notice was sent to the MidCentral District Health Board (DHB).

Emerson said some short-term improvements followed.

Lyn Horgan, operations manager for acute and elective specialty services at MidCentral DHB, said all incidents in the emergency department are reviewed by the department’s leadership team and followed up with staff “as appropriate to ensure a wellness support is available if needed.”

All staff could access support, including individual or group support. The board of health has encouraged staff to take planned time off to ensure their well-being.

Horgan said after the interim improvement notice was issued, the health board’s response included ‘a budget increase across key staff groups’, ‘an increase in the wellbeing resource structure staff” in the emergency department and “an increase in the number of facilitators, such as cleaning, support services”.

“A major constraint remains the limited availability of nursing and medical personnel, not only at the local level, but also at the national level. All recruitment opportunities are actively and vigorously sought.

“We continue to focus on recruitment and explore all possibilities, however, the international market is further constrained by Covid. This is an issue across all services.”

The DHB acknowledged that the problem of patients facing long waits was “multifaceted”, including issues such as the size of facilities and the flow of patients to other parts of the hospital or their discharge.

“There are a number of projects and new positions being created to help move delayed patients into inpatient beds and facilitate discharge,” Horgan said.



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