Hospital’s ED staff show strain

Waikato Hospital’s health bosses are bracing for a challenging winter as staff turnover and workload demands take a toll on front-line staff.

Since last July, more than 20 nurses have resigned from the emergency department, many citing stress.

Waikato Hospital’s emergency department was tipped into overload on May 23, prompting elective surgeries that weren’t cancerrelated or emergency-type to be rescheduled.

Alex Gordon, Waikato DHB medicine, oncology and emergency department director, gave a briefing on the crisis at the board’s May meeting.

Although the hospital responded well to the 24-hour overload, Gordon said concerns remained. A pressing issue is the ongoing stress on front-line ED staff.

‘‘We’ve been under quite a lot of pressure recently and there’s been quite a lot of nurse resignations. We’ve had 20 nurse resignations since July last year, which is quite significant,’’ Gordon said.

‘‘We’d naturally get a turnover of staff in terms of people going overseas to work and working in other DHBs, but certainly the issue of pressure within the department is being raised far more frequently.’’

The department had also experienced a change of personnel in its three most senior operational positions.

‘‘That meant last month, the month of April, we were quite down in terms of operational leaders, which caused some uncertainty in the department,’’ Gordon said.

In December, the Waikato DHB announced plans to boost doctor and nurse numbers in the hospital’s ED.

The department’s roster includes about 40 full-time equivalent doctors and 75 nurses.

Gordon said the recruitment drive would see nursing numbers boosted to 89 full-time equivalent positions.

Health Ministry figures for January to March show Waikato’s ED as the worst in terms of length of patient stays.

Waikato has never met the Government’s mandatory six-hour national target.

Board member Mary Anne Gill said Waikato Hospital’s ED was one of the busiest in the country, but she was concerned it continued to languish at the bottom in terms of performance.

Despite various initiatives, the hospital couldn’t seem to make significant improvements.

‘‘I guess what I’m singling out here is I think we need to start making a few inroads,’’ Gill said.

Gordon said staff didn’t want to be at the bottom of the country’s ratings, but winter will be challenging for the hospital.

Analysis showed a significant gap in terms of acute beds available in the months ahead.

Waikato DHB chief executive Dr Nigel Murray said improving the performance of the hospital’s ED involved a system-wide approach aimed at improving the flow of patients through the hospital.

‘‘There are many aspects to this issue that we’ve been working on: emergency deployment protocols, extra capacity. We’re constantly reviewing it and trying to find ways to improve,’’ Murray said.

‘‘We don’t discharge patients promptly enough for the incoming patients, so that’s another issue that the hospital is working on.’’

Board member Dr Clyde Wade said patient numbers going through ED had been growing steadily for years.

Health bosses had to make sure they provide enough resources to the department to meet current demands as well as in the years ahead.

Gordon said anecdotal evidence suggests people come to the ED because they struggle to access or afford primary healthcare.

They also know they will receive good quality care at the hospital.