Fears patients could die waiting for treatment in Dunedin Hospital's beleaguered emergency department have prompted staff to take legal action demanding urgent improvement.
Pressure of high patient numbers and low staffing levels routinely meant staff went into the toilets to cry, emergency department health and safety representative Anne Daniels said.
Last Thursday, after a nurse told her there were no toilets free to cry in, Daniels lodged a provisional improvement notice (Pin) with the Southern District Health Board.
The notice, an action under the Health and Safety at Work Act, requires a workplace to display the notice and take steps within eight days to address the safety issues raised or face possible further action.
''This nurse said, 'Who gives a damn? Someone will die','' Daniels said.
''The Pin is the last straw. We have been living this for the past 18 months.
''We have been compromising and making do for too long, and we can no longer do that.''
The notice said staff had experienced ''emotional, psychological, ethical and physical harm'' while in a workplace which did not meet Australasian guidelines for triage patients.
Daniels said ED management and staff were united in demanding improvement to the way their workplace functioned, and that patient safety had to be paramount.
''We can no longer meet our obligations under the Health Practitioners Act or under our various professional requirements.
''Our department heads have been fighting very hard to be heard by the [SDHB] leadership team.
''They put in proposals months ago which had no traction.
''This has the total support of all the staff, including our leadership.''
Yesterday at noon, Dunedin Hospital was at code red, the step below code black, when emergency action is taken to ease pressure of patient numbers.
Daniels said all nurses were asked to work extra shifts or overtime and that such calls to work extra hours were routine.
''This is a normal type of text, apart from the code red, we get these desperate 'I'm begging you on my knees' every day and we have been getting them for a long time.
''We are unable to care for our patients safely.''
SDHB senior staff met Daniels and emergency staff and management on Monday to discuss the Pin and will meet again tomorrow.
Specialist services executive director Patrick Ng told a SDHB board meeting yesterday that while patients numbers were relatively static, more seriously ill patients were arriving at ED and that they were taking longer to treat.
''We have worked out a way in which we are going to respond to the notice.
''We believe there is some nursing we can supply in the short term and some reprioritisation which can make a meaningful difference.
''We are going to explain in our response what we think the longer term solution is.''
Daniels said the department was ''hemorrhaging staff'' and could not recruit replacements.
''Staff are leaving because they can no longer emotionally, ethically or professionally work in the department.''
A provisional improvement notice (Pin), an action taken under the Health and
Safety at Work Act, demands Dunedin Hospital emergency department needs to
have on duty:
• Three registrars and one house surgeon on night shift seven nights a week.
• Two resuscitation nurses on each eight hour shift.
• One extra triage nurse in the waiting room on each shift.
• One extra associate charge nurse manager on each shift.
• Two healthcare assistants on each shift.
• One clerical staff member to cover rush periods and meal breaks.
• One mental health nurse practitioner.
• Two security staff on all afternoon and night shifts.
• One orderly per shift.