The Hawke's Bay District Health Board has been served with a health and safety notice relating to conditions at Hawke's Bay Hospital in Hastings.
The New Zealand Nurses Organisation (NZNO) announced the move late on Thursday, alleging repeated attempts to escalate concerns about dangerous working conditions that threaten patient safety had been ignored or minimised.
A Provisional Improvement Notice has been issued relating to Emergency Department conditions, claiming the HBDHB has failed in its primary duty of care under the Health and Safety at Work Act 2015.
PINs legally require an employer or service provider to address a health and safety issue before a certain time, and the DHB has been given until October 5.
DHB chief operating officer Chris Ash says the DHB will work through the process in an "open, transparent and compassionate manner", committed to resolving the concerns which have been raised and to put a health and safety action plan in place.
Battling increased seasonal demands of acutely sick patients, compounded by the RSV outbreak, Covid-19 challenges and pressures on numbers of beds available, the DHB takes its responsibility of providing a safe working environment "very seriously", he says, and it is focused on continuing to make improvements, where it can, to better support staff.
Recruitment in recent months had included appointing five additional senior medical officers and 10 additional nursing staff, adding that "redesign work" to support "better patient flow" is in progress.
NZNO organiser Sue Wolland says issuing the PIN became necessary because repeated attempts to escalate concerns about dangerous working conditions that threaten patient safety have been ignored or minimised.
"Staff are working under incredible pressure which is severely impacting their physical and mental health," she said. "The department is well beyond capacity every day which means staff are unable to respond to people needing emergency care in the time required to best ensure their wellbeing."
Issues include: patients being 'housed' in inappropriate or hazardous places such as corridors; dangerous delays in triage and assessment, seriously unsafe and inadequate staffing levels; nurses too overworked to take meal and other breaks, patients missing out on essential care, increased risk of error; and staff feeling unsafe and anxious while at work, Wolland says.
"ED staff, including those in leadership, have repeatedly raised these concerns with the DHB and minor solutions have been proposed that never seem to eventuate," she says. "Our members have made these approaches in good faith, but sustained lack of progress has been the tipping point for issuing this PIN."
Wolland says it is "a serious or sentinel event just waiting to happen, resulting in avoidable patient death and the potential end to nursing careers."
"These concerns need to be urgently addressed, including contingency plans to cover staff sickness and to ensure staffing meets levels required for safe and acceptable standards of patient care," she says.
The notices can only be issued by trained health and safety representatives when other avenues to address a serious area of concern have been exhausted, the NZNO says.