Three Rotorua Hospital wards operated over capacity for more than 100 days last year, and a union says the impact includes nurses being “too busy” for bathroom and meal breaks.
Data received under the Official Information Act from Te Whatu Ora - Health New Zealand showed the surgical ward at Rotorua Hospital recorded 179 days over capacity, the orthopaedic ward 171 days, and the medicine ward 102 days in 2022. The hospital has 11 wards. Taupō Hospital’s two wards had no days over capacity.
Te Whatu Ora said access to aged residential care beds was a “significant” contributor to high ward occupancy. Other factors included how much intensive care a patient needed and balancing acute and planned care demand.
The New Zealand Nurses Organisation (NZNO) said nurses were, at times, at “breaking point”, while the New Zealand Aged Care Association said wards “overflowing with patients” was linked to underfunding.
Te Whatu Ora Lakes said it had overflow beds available and is working on initiatives to avoid the hospital being over capacity, including a new “discharge lounge”. Meanwhile, the national health authority said it was reviewing aged care service sector preparedness for rising demands.
NZNO Rotorua delegate Linda Logan said staff were “questioning why they are still in the nursing profession” due to hospital wards being over capacity.
She said many nurses were having health issues such as stress-related hypertension, palpitations and anxiety about going to work due to staff shortages and higher workloads.
Logan said nurses would “always put their patients first” and may forego using the bathroom or taking breaks “as it’s too busy to eat or drink”.
“We want to feel safe in our job areas to undertake the care our patient needs without the verbal abuse and frustration from patients who wait far too long for treatment due to us being short-staffed or not having enough resources.”
Logan said she believed more resources were needed and nurses should be “at the table” when looking at solutions.
In a media release, Aged Care Association interim chief executive Katherine Rich said it was hearing stories “almost daily” about wards “overflowing with patients”, long emergency department wait times and growing elective surgery wait times around New Zealand.
“This is all linked to aged care. Funding the aged care sector properly would improve the whole health system.”
Rich said aged care had been “chronically underfunded by successive governments”, resulting in a lack of capital investment in facilities.
Many providers had “no option” but to close beds - temporarily and permanently - meaning seniors stayed in hospital longer because they had “nowhere to go” if discharged.
Te Whatu Ora said the Lakes district had 244 hospital beds across 13 wards in Rotorua and Taupō Hospitals, excluding emergency department beds.
Asked how hospitals that are over capacity are managed, it said the district had 19 additional beds that were not resourced as part of business-as-usual practice, but could be used when “capacity demands”.
In May 2024, the Lakes district would have an additional 24-bed ward for overflow, winter contingency and pandemic management.
In a statement, Te Whatu Ora Lakes hospital and specialist services interim lead Alan Wilson said an “acute flow working group” with Rotorua and Taupō hospital staff was formed in December. It was working on initiatives aimed at managing hospital beds and patient flow in order to avoid the hospital being over capacity.
These included “early supported discharge” — using the allied health workforce and Rotorua’s QE Health to enable patients to receive rehabilitation at home — and increasing allied health support to Rotorua Hospital’s emergency department to better provide support at home and prevent “potentially unnecessary” hospital admissions.
A “discharge lounge” had been active since June 2023, where up to six patients due for discharge that day could wait for transport or paperwork instead of waiting in a hospital bed.
It had also opened four additional surgical beds and three additional beds in the older persons and rehabilitation services for the winter, Wilson said.
On the coming 24-bed ward, Wilson said a previous ward was converted from offices back to a ward earlier this year to be used while the birthing unit was being renovated. Once the renovations were done, the ward would be vacant and “potentially available” if further beds were required in the future.
Te Whatu Ora primary, community and rural interim director Emma Prestidge said the review of aged care support services included assessing the state of services, considering alternative funding models and recommending ways to create a “sustainable system”.
Prestidge said Te Whatu Ora recognised the staffing challenges faced by aged residential care providers and it was important their nurses felt valued.
She said Te Whatu Ora had boosted funding to aged care providers specifically for increasing nursing pay. Aged residential care was one of five sectors prioritised to receive this additional funding to enable them to lift pay rates for about 5700 nurses from April 1, 2023.
Te Whatu Ora was also overseeing the care and support worker pay equity claim, addressing “historical sex-based discrimination of these important workers”.
Prestidge said a settlement would likely mean “significant benefits” for workers and the services people received.
She said Te Whatu Ora had established a $6 million pilot for districts to pay for initiatives that facilitated discharge from the hospital. Funds could be used to cover “exceptional costs” that sit outside what aged residential care providers were expected to meet.
It also had a carer support subsidy aimed at reducing “carer stress” — a “significant immediate cause” of people needing residential care. The subsidy provided financial assistance so the main carer could have a break.
Te Whatu Ora agencies worked with people needing aged residential care to find places that best met their needs. Home support resources were provided at a “high level” to keep people safe in their own homes until they found a suitable place, she said.
Megan Wilson is a health and general news reporter for the Bay of Plenty Times and Rotorua Daily Post. She has been a journalist since 2021.