Emergency department staff picket outside Thames Hospital where an extra 21 full-time nurses are needed. Photo: RNZ / Natalie Akoorie
Someone is going to die.
That is the concern from the New Zealand Nurses Organisation (NZNO) about a dire shortage of nurses at Thames Hospital emergency department.
NZNO delegate and Thames emergency department nurse Donna Sarjeant said the situation had become dangerous.
"It feels like patient acuity is higher than ever. We're triaging patients into the waiting room that a few years ago would have been directly into a bed and worked up straight way because they are really sick and they need instant care," Sarjeant said.
"But it's quite normal now for them to sit in the waiting room for hours and often they don't even end up waiting to see a doctor - they go home again.
"I think it's becoming quite dangerous and we definitely can't provide the care that the community expects to receive."
About 26 nurses picketed outside the hospital on Tuesday to voice frustration at what the union says is constant understaffing and increased workloads in the department.
Calculations under the Care Capacity Demand Management (CCDM) programme showed Thames ED needed an extra 21 full-time nurses, NZNO said. Currently there were 44.
Sarjeant said the flow-on effect meant nurses were stretched across too many patients, nearing burnout and often could not take breaks, worked overtime to complete tasks such as transfers to Waikato Hospital, and were regularly called in on days off.
"We're tired. I do believe that patients could die. They certainly are going to suffer. If patients are leaving hospitals without waiting to be seen when they are sick, outcomes are going to be worse for everybody."
She said among those patients left waiting were some with chest pain, renal failure and other potentially life-threatening conditions who had already been referred to the hospital by their GP, and often who had travelled long distances to attend the emergency department.
NZNO Hauraki/Coromandel organiser Nigel Dawson said no-one within Te Whatu Ora had been able to tell the union at what stage the recruitment phase was for Thames Hospital ED.
Approval to advertise for the nurses had not materialised despite Dawson saying there were unemployed nurses wanting jobs at the hospital, which services the entire Coromandel Peninsula.
He said he had fielded phone calls from nurses on their way home from a night shift, having worked two hours overtime, in tears asking what could be done.
"Nurses get what's called a moral injury when they can't get what is required for their patients. But not just that - they go home exhausted.
"Their big fear, the worst of all, is somebody's going to die. It's just a real concern."
Dawson said the CCDM council endorsed the extra nursing staff in June but the positions have not been advertised.
"They keep telling us there's no vacancies but we know there's 21 vacancies here - that's been endorsed but hasn't had sign-off and nobody can tell us where it is in the process now."
New Zealand Nurses Organisation delegate and Thames Hospital ED nurse Donna Sarjeant is worried a patient will die because of a nursing shortage of almost 50 percent in the ED. Photo: RNZ / Natalie Akoorie
NZNO president Anne Daniels, who joined the picket, said the extra nurses were needed to keep both staff and patients safe.
She said the CCDM programme formed part of the NZNO contract with Health New Zealand meaning Te Whatu Ora had an obligation to honour it.
"The contract is being breached as we speak and that is just totally unacceptable because it's putting people, our patients, our nurses, our communities at major risk and it's avoidable," she said.
"The patients that are coming here, because it's a rural hospital, are actually getting sicker and are more compromised and that actually is a problem.
"I think it was Whangārei nurses in ED recently said someone will die. That is absolutely true."
She said Te Whatu Ora must hire nurses under the CCDM process.
"So the question is why aren't they doing it? And the question for us is how long are we going to actually be stonewalled before our union decides to act."
Daniels said the issue was potentially heading to court because "it's the safety of nurses and patients that are at risk here".
Te Whatu Ora regional director of hospital and specialist services Chris Lowry said patient and staff safety were its highest priorities.
Lowry said NZNO staff who joined the protest did so in their own time, without stepping away from their hospital duties.
In a statement, Health NZ said it was pleased with its progress around clinical recruitment and was determined to maintain momentum in recruiting key clinical workforces.
"Overall, we have exceeded our expectations in recruitment across different professions.
"This includes more nurses employed by our hospitals now than ever before, with nearly 30,000 full-time equivalent (FTE) nurses employed by Health NZ across the country - an overall increase of 2900 over the past year.
"That said, we acknowledge that there are still some nursing gaps, particularly in specialist areas such as mental health and addictions, and critical care.
"Although a temporary pause on recruitment for non-frontline roles remains in place while we realign budgets to continue prioritising ongoing funding for front-line services, clinical recruitment continues, led by regional leaders working within region and district budget parameters.
"This means decisions are made where local needs are best understood and prioritised."
Labour spokesperson for health Dr Ayesha Verrall said it was incumbent upon the government to provide the resources to make hospital staffing safe.
Verrall said the nurses' concerns were valid.
"Staffing levels are associated with patient safety. The government needs to honour that commitment to its workers and the safety of patients."