Emergency departments have been operating beyond capacity, with patients being treated in corridors. Photo / RNZ
By Rowan Quinn of RNZ
Auckland emergency department nurses say this winter is the busiest they have seen – and one wants patients to bombard the Government with complaints.
The Middlemore and North Shore nurses say patients are arriving sicker and are often having to stand to wait, or be treated in a public thoroughfare.
East Auckland woman Karen said she was shocked when she went to Middlemore for a broken bone this month.
“One lady was crying in a wheelchair because she couldn’t lay down because there were no beds. She had a slipped disk. One chap was telling me he’d been there 24 hours, another 17 hours. One lady did faint. The doctors and nurses rushed out and took her in,” she said.
Many people were standing, others already had lures in their arms for medicine or fluids, and she helped an elderly woman who needed to elevate her feet but had no spare seat, Karen said.
A Middlemore nurse said Karen’s description did not surprise her at all.
“That sounds like a typical in ED, which is sad to say in the south,” she said.
Anecdotal evidence suggests there had often been more than 210 patients at Middlemore a day this winter, a number that a few years ago was a record.
“There are so many patients sitting in the waiting room in pain and uncomfortable. Sometimes they’re walking up and down pacing because they are that uncomfortable. We, as nurses, try to get to them and try and keep them as comfortable as we can,” the Middlemore nurse said.
She had to attend Middlemore’s paediatric ED with her child and said it was incredibly under pressure there as well.
On the North Shore, a nurse said the hospital system to measure the patient-to-staff ratio, showed the ED has regularly been at 200% capacity in the past few weeks.
She was always running, she said.
The department was designed to prevent patients being treated in corridors – but now they were filling them anyway.
She had to ask personal medical questions when others were in earshot – and even took heart readings, known as ECGs, in the corridor.
“I’ve got a gentleman who’s not even in a stretcher, he’s elderly, he’s had a collapse, we don’t know what’s caused it and I’m having to bare his chest and hook him up to a machine. Now, that’s just not on,” she said.
Another North Shore hospital nurse said the patients were sometimes being treated in a corridor outside the department in what was “a public fairway”.
Like other health staff in the region, she agreed that this winter was the worst conditions had been.
She felt like she could not give patients the full attention and dignity they deserved and that was heart-wrenching.
While some people would get angry, most were very polite and understanding.
“I just wish these people would bombard the Government with complaints. They almost just accept that this is how it is because they don’t want to upset us [the nurses],” she said.
Karen, the Middlemore patient, wanted Prime Minister Christopher Luxon or Health Minister Simeon Brown to spend a day at the hospital to see what it was really like.
She just wanted them to prioritise the health system, she said.
Brown said he regularly visited hospital emergency departments and knew many people waited too long.
The Government was already taking action, he said.
It was focusing on shorter ED wait time targets and was investing in GP-level care to try to help people get care before they need an ED.
Frontline health workers were doing an incredible job, Brown said.
The nurses agreed investment in primary care was crucial because many ED patients were turning up sicker, and with more complex medical conditions.
All the nurses in this story were speaking as members of the Nurse’s Organisation, which meant they had some protection.
RNZ approached the union after hearing multiple accounts from other patients or hospital workers about EDs in Auckland this winter.
Health NZ Northern acting deputy chief executive Dr Vanessa Thornton said staffing had been increased at Middlemore emergency department, but the number of people arriving at peak times had been higher than expected.
The flu had made people especially unwell this year, and the winter illness season had extended into August.
People having to stand as they waited was “not what we would like for patients”, she said.
“The staff are obviously very hard to make patients comfortable and obviously treating the sickest patients first.”
Staffing levels were matched to likely demand in ED, but more patients were coming in at certain times than expected. “Surges can happen at different times of the day and that’s part of the challenge that we have.”
Adding infrastructure such as more wards took time, but new wards had opened at Waitematā DHB and one at Middlemore, she said.
Te Whatu Ora/ Health NZ was asked for winter capacity figures for emergency departments in all the country’s main centres nearly two weeks ago but it said it would take time to provide them.
It wanted to reassure people in the region that if they need urgent hospital-level care they would never be turned away.