Staff morale at Wairarapa Hospital is hitting a new low.
Emergency Department head Dr Norman Gray told Morning Report staffing issues had been chronic but the situation is becoming acute.
Doctors and nurses are no longer describing it as a staffing crisis - its now a full blown catastrophe.
"Emotive terms like crisis and catastrophe are useful in trying to get some sort of response from an otherwise silent system."
Dr Gray says it is getting hard to keep the department running normally, and closure could be a possibility.
"Hopefully won't come to that, but it is getting to that tipping point."