Hardworking health staff need good facilities
ON the editorial and opinion pages of last Monday’s ODT a letter from Dr
John Chambers, a member of the former Southern District Health Board and a Dunedin Hospital emergency department clinician, faced an article by Dunedin Hospital local advisory group chairman and sometime SDHB chair Pete Hodgson.
Mr Hodgson’s article concerned the new hospital build, discussing not the hospital itself, but the project’s effects on Dunedin, labour, education and training, gender and ethnic opportunity and equity, and business development. Those issues are real, but Dr Chambers’ concerns — that essential structural changes approved by the outgoing DHB to improve patient care in the emergency departments of Dunedin (an 18bed medical assessment unit) and Southland (upgrading the central sterilising unit) Hospitals have been put on indefinite hold by Health New Zealand — raised both immediate and future alarm bells.
Dr Chambers wrote, ‘‘It is now common that patients spend more than 24 hours waiting for inpatient beds in the emergency department, which is unprecedented.’’
Coincidentally, later that day one of Civis’ family developed dull, left chest pain while walking uphill, leading to a 111 call, rapid arrival of an ambulance and a trip to Dunedin Hospital’s ED about 2.30pm. The patient noticed, while being wheeled through the space beyond the ambulance entrance, patients in beds lined up along the side of that space, but was taken directly to a cubicle in the central part of ED, had an electrocardiograph taken and was monitored, questioned, examined, had blood taken, was Xrayed and was cared for in exemplary fashion by nurses, healthcare assistants and doctor.
With an initial blood test borderline normal, repeats at intervals were planned, and the patient moved to the observation area, where lights could be turned off and they could snooze, while the accompanying daughter could work on papers for a board meeting.
She’d noticed, on arrival, that the waiting room was overfull, with several standing. When she returned after driving her other parent home, it was even fuller. By the time of discharge, with a recommendation for further cardiological investigation, the space through which the patient had come on arrival was still lined with patients on beds, but ‘‘angle parked’’, rather than parallel to the wall, to fit more into the space.
The patient was deeply impressed with the staff’s work: they were cheerful, helpful and seemed committed to the best possible care of their patients despite the pressure. They need to be supported by adequate facilities.
Will the new hospital have enough beds to prevent this accumulation of patients awaiting admission? MP Michael Woodhouse, in June last year, claimed ‘‘bed days are projected to increase by over 40% due to an ageing population with more complex health needs’’.
The present hospital has 388 beds. In March last year, Health Minister Andrew Little said the new hospital would have 474 beds but the detailed business case finally approved only provides 421.
It’s claimed that acute assessment units associated with ED will reduce the need for admissions (so why was Dunedin’s medical assessment unit blocked?). Civis suspects an 8.5% increase in beds will prove inadequate, and that the present prolonged waiting in ED for admission may just occur elsewhere, in those units. Will that really ‘‘enhance patient and staff experience’’, as the new Dunedin Hospital website suggests?
Last Sunday’s Dunedin Symphony Orchestra matinee concert was a blast!
Beethoven’s 4th Symphony, played enthusiastically as the conclusion for the afternoon, was the only ‘‘conventional’’ work.
In the first half, Biber’s Battalia a 10, for nine string instruments and harpsichord, was, for a 1673 composition, startlingly ‘‘modern’’ in the sounds employed: a suitable precursor to Tan Dun’s Crouching Tiger Concerto, written from melodies and for instruments indigenous to areas traversed by the Silk Road, and transcribed for western instruments. The brilliant performance by an augmented DSO (five percussionists!) and outstanding luminousgreenclad cello soloist Ashley Brown transfixed the audience, who demanded an encore.
Syabas! Well done!