Healthcare assistants and triage nurses have been asked to cover toilet breaks and pick up more paperwork. Photo: RNZ
Front-line healthworkers in Northland are being asked to "fill in" on reception to let overworked administration staff take toilet breaks.
Outages of critical IT systems for radiology, lab results and phone services have also added to the pressure on staff.
Northland is regularly down to just one person on overnight - instead of two - to cover admin for Whangārei, Kaitaia, Bay of Islands, Dargaville and Rawene hospitals, the switchboard for both Whangārei and Bay of Islands, and staff Whangārei Hospital's emergency department reception between 11pm and 7am.
Healthcare assistants, triage nurses and duty managers have been asked to cover that person's toilet breaks, pick up more paperwork, and avoid using the switchboard.
Resident Doctors' Association head Dr Deborah Powell said that was a safety risk.
Frontline health workers asked to answer phones, do paperwork
"It takes clinicians away from patient care to do work they're not very good at, to put it bluntly."
Te Whatu Ora Te Tai Tokerau group director of operations Alex Pimm said the hospital was recruiting for one position following a recent resignation.
Meanwhile, a staff member who "usually works elsewhere" had been trained to provide break relief and back-up, as was "common practice".
"Relief staff have been trained to answer emergency or 'code' calls when the evening switchboard staff member is on a brief break if there is only one person working," Pimm said in a written response to RNZ.
"Their workload is balanced during the shift to enable them to do this. If their usual department needs additional support, we have a variance response nursing and healthcare assistant team that can respond."
To reduce pressure on the switchboard, staff had been asked to contact phone extensions directly rather than routing through the operator.
"This is more efficient and often quicker. Phone numbers have been distributed across clinical areas to assist our teams in adopting this process and we thank them for their willingness to this small change."
However, Whangārei Hospital emergency doctor Gary Payinda - speaking to RNZ in his personal capacity - said co-opting healthcare assistants to answer phones was not a good solution, as they were already "flat out" doing their own work: delivering blood, taking patients for urgent scans and supervising patients with dementia.
"There's an incredible shortage of them. And to think we are now training them up for additional duties that are administrative or clerical in nature, just seems wildly inappropriate."
Some emergencies require up to 12 people to be called in from home, including surgeons and imaging technicians.
Deborah Powell - who also represents medical imaging technologists - said it was unreasonable to expect clinical staff to cross-reference various rosters and find the right phone numbers.
"It's not as simple as just looking up a number and picking up the phone and making a call.
"So we're finding a lot of our people are getting called when they're not on call, so they're getting disrupted sleep as a result of this."
IT problems add to workload
Northland staff have also had to contend with multiple IT problems.
Clinicians lost access to patient x-rays and scans for a couple of hours last month, while the internal system for lab results also went down.
Staff resorted to making notes on paper or in Word documents to paste in later.
Whangārei's switchboard was hit by intermittent faults last Thursday, which caused delays for non-emergency calls.
Payinda said it all added to the frustrations for clinical staff and wait times for patients.
"It has direct impacts on patient care if you can't access labs, or x-rays or CT scans for hours, and if rural hospitals can't see the imaging studies their patients have had. That can be dangerous for patient care."
Health NZ said staff worked with the phone company to fix Thursday's switchboard problem as quickly as possible, and services were back to normal by 4pm.
During the time the clinical portal was off-line, laboratory results were provided "manually" and patient care continued.
The IT issue was fixed quickly the following day.
An expired network certificate was to blame for the problem with the radiology system.
A temporary solution was put in place so clinicians could see the medical images and processes had been updated so it did not happen again.
Association of Salaried Medical Specialists regional industrial officer Sarah Thompson said it was an awkward workaround.
"Doctors had to actually delay patient care while they traipsed across the hospital to the radiology department. In one case, a patient had been transferred from Bay of Island because their condition was too acute to be dealt with there, and on arrival they had to be re-x-rayed, so their scans could be viewed."
With Te Whatu Ora scrapping millions of dollars in IT upgrades, hospitals were likely to experience more outages to their ageing systems, she said.
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