Nurse shortage major pressure at hospital
The Southland Hospital emergency department sees 86 per cent more patients than Dunedin, despite the latter serving a population 46 per cent smaller.
The hospital’s overstretched emergency department (ED) is one of the aspects a new Southern District Health Board taskforce is reviewing as it looks for ways to ease pressure amid bed blocks.
In mid-December, the pressure from staff shortages and increased ED presentations reached a head when elective surgeries had to be deferred for at least two weeks.
One month since the Patient Flow Taskforce was established, staff shortages have been identified as a major contributor to hospital pressure.
Chief medical officer Dr Nigel Millar said there were 15 vacancies for nursing staff across Southland Hospital’s ED, the medical and surgical wards, and the assessment, treatment and rehabilitation ward.
Millar said nurses had been recruited to fill these gaps but these staff still had to work out their notice elsewhere.
The new nurses would allow the hospital to open more beds, he said, but it was difficult to calculate how many beds the 15 nurses would equate to, as nurses were rostered on based on the needs of the day.
Yesterday, the hospital advisory committee heard chief executive Chris Fleming had approved at least four more nurses for Southland Hospital’s ED.
ED presentations reached a peak in December with an average of 127 patients a day, as opposed to its normal average of 108. It is still unclear why demand has increased so dramatically but possible explanations include the emotional and wellbeing impacts of Covid-19, patients delaying seeking medical advice, and limited access to GP appointments.
But the ED, Millar said, was just one cog in the hospital system and the taskforce was systematically working with departments to look for small improvements to help patients move through the hospital faster.
‘‘We would like to work towards a model where we can give patients an estimated discharge date,’’ Millar said.
Executive director of specialist services Patrick Ng said the board was exploring the option of adding more ED beds to free up ward space but more robust data about resourcing levels and demand was needed.
He expected to present a proposal to the board within two months. In the meantime, waiting lists for orthopaedic surgeries had grown after coming to ‘‘a virtual standstill’’ in Southland in December, Ng said.
The board outsourced 283 surgeries to Southern Cross Hospital in Invercargill and 556 to Mercy Hospital in Dunedin between July 2020 and January 2021 – many of them urgent cancer-related procedures.
Ng will be meeting with the South Canterbury DHB on Friday to discuss using its facilities to provide surgeries.