Night shift for district nurses cut
The Midcentral District Health Board has decided to scrap its overnight district nursing shift from the end of April, despite the board’s chief medical officer warning against the move.
Primary, public and community health operations executive Debbie Davies says the need for night care in the community is steadily decreasing.
And much of the care the night nurse provided could be carried out during the day shifts, between 7am and 11pm.
But the board’s chief medical officer Ken Clark has counselled against making the cut.
He said it was contrary to the board’s long-term goals to shift more health services out of hospitals and into people’s homes.
On the day board members heard about the planned change, acute and elective specialist services clinical executive David Sapsford had talked about a future of health care where the hospital was no longer at the centre.
He said hospitals could not continue getting bigger and bigger to cope with growing demand, and services needed to be delivered in the community, as much as possible in people’s homes.
Clark said cutting a service to people at home ran counter to that vision.
‘‘In time, demand will increase for night services in the community.
‘‘It may be the right decision right now, but we need to think it through. If we do want our people at home more and more, we need to provide 24-7 cover.’’
Davies said no other district nursing service in New Zealand had an overnight shift and few even provided on-call care.
She said service use had dropped over the past five years, with the night-shift nurse busy with patients for an average of two hours or less each night.
Davies said much of the care that was provided by the night nurse would have been better done during the day shifts, but those nurses were sometimes too busy.
One of the main tasks was helping people with catheters, but many of those visits could be shifted or avoided with better daytime planning and resources.
Loss of the night shift would enable more nurses to be rostered during the day.
A small amount of the district nurses’ night work was in supporting Arohanui Hospice patients.
Davies said that work amounted to about nine hours a month during the night shifts.
Arohanui Hospice chief executive Clare Randall said although having access to a district nurse at night had been a valuable support in the past, it was rarely needed.
Advances in medication and technology, along with working smarter to prevent care needs arising through the night, made it unlikely patients and families needed night visits.
Randall said staff at the hospice could take calls through the night and would be encouraging people to call in early so they could be visited before 11pm if needed.
There would be three months before the night service stopped, so staff could ensure affected patients had a plan for after-hours care.