Nurses fear mistakes in crowded EDs

Nurses are worried about making mistakes while caring for patients in overcrowded emergency department corridors in the face of unprecedented demand around the country.

Doctors and nurses have all voiced unease about the practice which has been ongoing ‘‘for years’’ but New Zealand College of Emergency Nurses spokeswoman Sue Stebbings warns the issue has escalated and has now reached crisis point as hospitals brace for the busy winter period.

Nurses in over-capacity emergency departments aren’t assigned to sick patients forced to wait in the corridor until space becomes available. This means patients may not get the care they need, face long waits and delays things such as reporting vital signs and pain relief.

‘‘It is happening across New Zealand and not just one department. It is not good for the people, and it is not good for the staff,’’ she said.

‘‘It is not meant to be used as a space for patient care. With the corridor, often there are no staff assigned to look after them. At the moment we are concerned about the risk of errors.’’

There are serious problems in providing care in corridors, such as lack of privacy and dignity. It also means there is no space for a sick patient’s support person, an issue which impacts older couples who come into the department, she said.

Meanwhile, the so-called ‘grey tsunami’ of sick older people were adding to department pressure, she said.

‘‘The ageing population was a factor, but equally there are vulnerable children [needing care].’’

The college had written to Health Minister Andrew Little asking for an increase in emergency department nurses, but there was no easy fix to the problem, she said.

‘‘It is a very complex situation. I know there are lots of people trying to come up with what to do next.’’

Most hospitals were full of patients, which made it difficult to move people from the emergency department and into other wards.

‘‘It is not just about emergency department,’’ she said. ‘‘We need to have an ability to admit people to the next place.’’

The latest data for Wellington Regional Hospital’s showed only 73 per cent of emergency department patients were admitted, discharged or transferred within six hours in February. This fell well short of the national target of 95 per cent. Dominion Post analysis found it had the longest ED waits in the country, falling from 92.1 per cent in 2018 to 80 per cent in 2020.

At Hutt Hospital, 84 per cent of emergency department patients were admitted, discharged or transferred within six hours in February.

Capital & Coast and Hutt Valley district health board director of provider services Joy Farley said treating patients in the corridors was a ‘‘symptom’’ of increased demand.

‘‘We remain committed, and continue our ongoing work, to address these issues in the short term and to determine the best options to resolve this issue in the long term,’’ she said.

But Stebbings said there was no ‘‘easy fix’’ and called for national acute care strategy to be looked at.

‘‘If it were an easy fix, it would be fixed,’’ she said. ‘‘It is an immense pressure that people are working under.’’