She particularly found seeing patients waiting and waiting to be seen hard, and asks how many times can you say sorry to a patient for the wait.
She would also be trying to triage patients aware there was no room in ED and no room in the hospital to admit people to wards. Doing that every day and apologising every day was grinding.
"What do you say to them, it's really hard, it's soul destroying."
Sometimes patients would be standing because there was nowhere to sit.
Gerke says bed numbers haven't changed for so long; staff are dealing with the same bed numbers, but patient numbers are "horrendous".
It is hard to get into a practice, and hard to get an appointment with a GP.
Gerke says people come in to ED saying their GP told them an ED doctor will see them straight away, but the reality is that is not going to happen most of time because there are other patients to be seen.
"These things they are saying on TV are all true."
Gerke always wanted to be a nurse. One of her friends recalls that when they were kids, all the young Maxine talked about was going nursing. One of her mother's sisters was a nurse, and one worked as a hospital aide.
However, Gerke was not allowed to when she left Manawatū College in Foxton because she had a medical condition.
Her first job was working in the office of a building firm then at Inland Revenue. She finally got a medical certificate when she was 21, allowing her to enter nursing, and in 1978 started as an enrolled nurse at Palmerston North Hospital.
She thought she was too old to do the registered nurse course. In 1981, she started her OE working in Brisbane and Alice Springs then travelled around Europe. She came back to the hospital in 1984 and started in coronary care. The charge nurse there encouraged her to train as a RN, so in 1986 she started training and was registered in 1988.
Gerke continued working at MidCentral while training. When she first started, nurses had to be addressed as nurse and then their last name. However, her maiden name was Dear and Nurse Dear didn't go down well with her because of the teasing she received. She told patients to call her Maxine, but got into trouble with the matron because nurses were not meant to give patients their first name.
Gerke also worked in Horowhenua, ward 24 orthopaedics, and anaesthetics and recovery.
In 1991, she started in what was then accident and emergency covering maternity leave. She was offered a permanent position and worked there until her retirement.
The mother of three was sick on and off for five years and was a patient in ED quite a few times and also got hospitalised a few times.
"I've been a patient a few times so I know what it's like on the other side."
When she started, nurses weren't supposed to talk to patients too much, they would get told off if they did sit down and yack to them. Interaction between nurses and doctors was more hierarchical. The use of technology has increased significantly.
Asked what makes a good nurse, she replies empathy.
Gerke met her husband, John, through nursing. They had mutual friends, but had never met. On her first day studying to be a RN she met a woman married to a man in Kimbolton. That woman, with whom Maxine is still friends, set her up on a blind date with John.
He is a sheep and beef farmer and a descendant of the original Kimbolton settlers.
In response to comments on MidCentral DHB's Facebook post about her retirement, Gerke wrote: "I am overwhelmed with the comments and your well wishing. I am sure I will eventually miss it but for now I am relaxing and taking time for me."
MidCentral District Health Board responds
The ongoing demands facing ED at Palmerston North Hospital are reflective of similar issues being experienced by hospitals throughout New Zealand, operations executive, acute and specialist services Lyn Horgan says.
The issues affecting ED performance include increases in patient volumes as well as increases in the acuity (severity) and complexity of the conditions people are presenting with. These issues have resulted in longer waiting times for some patients.
ED performance also continues to be impacted by high occupancy in hospital inpatient wards, which is contributed to by the increase in patient acuity, Horgan says.
"While this creates greater demand for beds at the hospital, we remain committed to high- quality assessment and treatment of patients throughout their acute health journey.
"To manage patient flow during periods of high demand, we utilise a range of options, which may include postponing elective surgeries to ensure beds for acute patients. We also work with general practice teams to discharge patients from hospital."
Eight inpatient beds were opened as a women's assessment and surgical unit in June 2020.
The DHB is also progressing plans to increase its acute capacity by building EDOA/MAPU pods adjacent to ED to assist with patient flow at the hospital. EDOA is emergency department observation area and MAPU is medical assessment and planning unit.
"Support structures are in place to assist staff to cope with any additional pressures," Horgan says. "This includes a health and wellbeing support plan, which includes staff undergoing a wellbeing check to identify whether they require additional support."
Anyone who requires emergency care should present to ED as soon as possible. However, people who are not in need of urgent care are encouraged to seek the care they need from a general practice team, a community pharmacy or by ringing Healthline on 0800 611 116.
