A woman with terminal cancer waited more than 30 hours in Wellington Regional Hospital's emergency department before a bed could be found for her in a ward, a doctor claims.
The doctor, who works in the hospital's ED and spoke to the Herald on the condition of anonymity, also raised concerns about junior nurses being put in charge of triage duties.
Sometimes one nurse could be left to triage more than 40 people, the doctor said.
Wellington Regional Hospital's ED has been close to full capacity for months on end. It has been full for more than two thirds of each day since March, resulting in higher than usual wait times.
A recent increase in patients with respiratory illnesses has increased demand during July.
The doctor said every day there were at least four or five people who wait in the ED for more than 24 hours before being shifted to a ward.
The doctor said a family member who was accompanying the woman with terminal cancer was understandably upset during a 31-hour wait for a hospital bed.
"It's just upsetting, it's demoralising. You just walk past these people waiting and everyone is looking at you and hoping you're going to make some sort of difference.
"The state of the ED is just a reflection of how packed the hospital is."
Hutt Valley and Capital & Coast DHB Director of Provider Services Joy Farley said increased demand both in the ED and across the wider hospital affected patient flow.
"As a tertiary provider, we deliver services for patients from across the lower North and upper South Islands and often operate at 95 per cent occupancy or higher. Periods of high occupancy can lead to patients waiting longer in ED for a bed to become available on a ward, or to be discharged."
The doctor also raised concerns about "very junior nurses" stepping into triage roles because there was no one else to do it.
Sometimes one nurse had to assess 40 people, who were each waiting between 30 to 45 minutes, the doctor said.
"The sheer volume that these junior nurses are having to look after in the waiting room is the hardest part."
Farley said nurses underwent specialised training prior to working in triage and in general this occurred after 12-18 months of working in the ED.
Ratios were not used in triage and the ED has two nurses undertaking those duties during the day, two in the evening, and one at night, Farley said.
"It should also be noted that patients in the waiting room are often accompanied by support persons and, while this increases the busyness of the waiting room, not all of those waiting are in need of care themselves."
Farley said several measures were being taken to manage patient demand and keep staff safe.
These included improved monitoring of clinical staffing during periods of exceptional demand, ensuring the ED has access to Security Orderly support during these periods, and a review of the visitor policy.
High demand in the Emergency Department was an issue being experienced across the country and was not specific to Wellington, Farley said.
Improving patient flow across hospitals, bed configuration, and better use of spaces across the hospital network was helping to address these challenges, she said.
"We continue to identify options for additional capacity at each of our sites, we will undertake additional investment in 2021/22, and are also investing in services in the community – enabling people to remain well and access the services they need closer to home thereby reducing their need for hospital-level care."