Hospital ED staff extend deadline

Nurses in Palmerston North Hospital’s emergency department have given the Midcentral District Health Board an extra eight days to fix pressures they say are causing them psychological distress.

The staff issued a provisional improvement notice using Worksafe processes on July 13 giving the board until last Wednesday to respond.

New Zealand Nurses’ Organisation professional nurse adviser Wendy Blair said the board had since provided psychological support in the overloaded department.

‘‘They have acknowledged it’s a legitimate issue and, for the staff, that’s quite important to have that acknowledgement.

‘‘They are managing a very busy environment in good faith, but the constraints are huge.’’

Blair said the nurses recognised it would be harder and take longer to put solutions in place that would help relieve pressure on the department.

They wanted the board to put in place the actions identified in a health and safety action plan in January, and give senior managers the ability and resources to help department nurses keep themselves and their patients safe.

Blair said given progress so far, and knowing it would take time to make further improvements, they had chosen to extend the deadline rather than escalate the matter to Worksafe inspectors.

Midcentral Health operations executive for acute and specialist services Lyn Horgan said the staff concerns were caused by increased demand in the emergency department and the inability to find other places to put patients within the hospital.

‘‘Our union partners, staff and district health board management have created an action plan, and the board has been notified of the notice and remedial actions.’’

Horgan said the eight-day extension meant the board, staff and union could continue to work on solutions to the outstanding issues.

Blair and nurses’ union organiser Donna Ryan said the hospital was full beyond its bed capacity.

Ward 24 had been closed to new admissions because of a norovirus outbreak and acutely unwell people who needed emergency department attention kept arriving at the front door in increasing numbers.

Early on Wednesday morning there were 19 patients admitted to hospital but waiting to be moved to beds in the wards, with 10 of them being cared for temporarily in the transitory care unit, releasing some space for others in the emergency department.

Blair said while a lot of the pressures seemed worst in the department, it was a hospitalwide problem, with delays in finding in-patient beds for those needing admission.

A lot of planned care, apart from cancer treatment and those in most acute need, was being postponed in an attempt to create bed space in the hospital.

But Blair said those measures were likely to see those whose care was postponed get sicker and return later in more acute need.

‘‘The problem is that the hospital is just too small. We need a new build that is future focused. It has become critical and it is just not sustainable.’’

Ryan said emergency department presentations were more serious than problems with people finding it hard to get an appointment with their GP team for primary health care.

‘‘The people presenting to ED are really sick. We continue to encourage people who need ED services to attend.’’