System 'falling apart': Nurses Organisation

UNDERSTAFFED AND UNDER PRESSURE. Gisborne Hospital is short of 41 nurses and 28 doctors. A nurses union delegate says nurses are exhausted, have nothing left to give, and the chance of making a mistake is high. Gisborne Herald file picture

Gisborne Hospital short of 41 nurses, 28 doctors.

Nurses at a desperately understaffed Gisborne Hospital are exhausted and have nothing left to give.

“That is when the risk for mistakes is high,” New Zealand Nurses Organisation (NZNO) Gisborne delegate Christine Warrander says.

The hospital is short of 41 nurses and 28 doctors, says Te Whatu Ora Tairāwhiti lead of hospital interim and specialist services Lynsey Bartlett.

The hospital was experiencing staffing shortages and recruitment difficulties across all areas.

“This situation is the same nationally and internationally.”

The hospital had been able to secure locum doctor cover for some of the vacancies to maintain essential cover of services, she said.

The doctor shortages consist of 10 vacancies for resident medical officers and 18 for senior medical officers.

Late last year NZNO issued a Provisional Improvement Notice (PIN) to urgently fix serious issues in Ward 5 (medical ward) which was six nurses short.

“We continue to work with the Ward 5 team and WorkSafe (workplace health and safety regulator) on solutions to the ongoing challenges,” Mrs Bartlett said.

“There have been delays to this work due to the cyclone.

“We would like to publicly acknowledge our staff for the work they are doing as we face staff shortages in a number of areas.”

Ms Warrander said the situation had got worse since last year, with more staff leaving.

Ward 5 now needed approximately 12 more full-time employees (FTEs), she said.

Nurses at Tairāwhiti remained under extreme pressure.

“On the medical ward, we are meant to be staffed with five nurses in the morning, five in the afternoon and three at night.

“Due to our high FTE vacancies, the roster is often only two or three nurses for the morning and afternoon.

“The employer is refusing to reduce beds, which makes unsafe workloads, compromising patient care and wellbeing.

“We used to be stretched taking five patients each. Now it is not uncommon to have eight patients each, which is completely unsafe and exhausting.

“If the fact that staff are working under immense stress and fatigue with unsafe workloads is raised to management, we are often told there is nothing they can do as the whole hospital is short.

“The system is falling apart and no one is listening,” Ms Warrander said.

‘We don’t know what the answer is’

"The system is falling apart and no one is listening,” Ms Warrander said.

“As an example of how unsafe it is, I recently worked a shift where there were only three nurses on, we had only a few beds left on the ward and we were getting admissions, so we were having to overflow patients to other wards.

That alone was time-consuming.

“It was raised with the duty nurse manager that we were drowning and it was unsafe.

“We had started the shift approximately nine hours in the negative (the number of hours of nursing required to provide the level of care for the patients on a shift as determined by patient acuity tool TrendCare), meaning we needed help.

“The duty nurse manager informed me that it had been escalated to management, but they had gone home for the weekend and there was nothing that could be done.

“A casual nurse from the emergency department (ED) was able to come and help for a little bit.

“We ended the shift with having taken nine admissions and approximately 12 hours in the negative.

“We don’t know what the answer is anymore but it shouldn’t be on the nurses to come up with solutions,” Ms Warrander said.

Mrs Bartlett said ED remained busy with periods of peak presentations putting staff under pressure and times of increased waiting times.

ED numbers had increased by about 9 percent over the past two years.

“ED pressures have been ongoing and admission rates have been rising.

“The effect of the Covid-19 period is that we are now seeing our community coming in with health issues that should have been treated earlier.

“A contributing factor to this situation is the changing climate and that traditional winter pressures are now being seen year-round.

“We have worked closely with the clinical teams to change our workforce in response to these increases.”

Mrs Bartlett said 96 percent of patients were being admitted, discharged or transferred from ED within six hours.

“We have the best rate in the country.

“This is in part due to our incredible ED team who are committed to equity of care for Tairāwhiti and have implemented novel workflow and triage processes to meet this target.”

Unvaccinated staff were not being employed, she said.

Mrs Bartlett said Te Whatu Ora Health New Zealand recently completed internal consultation on an organisation-wide vaccination policy and this was being finalised.