Six-day wait for doc after admission at Waikato Hospital

Wednesday, 28 August 2024

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Patient safety is at risk at Waikato Hospital, claim doctors, with reports of at least one person not seen by a medic for six days.

The hospital was down 60% on medical registrars last weekend, New Zealand Resident Doctors Association (NZRDA) national secretary Dr Deborah Powell said, and patient care was suffering.

Another doctor spoken to by the Waikato Times said staff shortages were worse than during the Covid-19 pandemic, and they’d reported about 10 “patient harm” events due to delays in care.

Health NZ says last weekend’s problem was unplanned leave and a vacancy, but patient safety is a priority and new recruits are coming.

Medical registrars are the doctors who care for patients suffering heart attacks, pneumonia, strokes, diabetes, sepsis, respiratory failure, and other serious medical conditions.

“This three-month period we have half the number of medical registrars we need to staff the hospital, but things are getting worse with this last weekend down to 40% and next weekend looking equally if not more bleak,” Powell said.

“Waikato has no answer to the situation other than to reduce the care patients would normally get from their doctors.”

Registrar Dr Natalie Quin said staff shortages were “ridiculous” and an everyday occurrence, but peaked on weekends when she said only one or two medical registrars were on deck.

She said she felt “morally impaired, because we are not practising medicine properly”.

“We are doing the minimal amount to save people’s lives and then we move on to the next one.

“On the weekend, registrars are covering hundreds of patients all in different wards, and it’s just not sustainable to keep up this high acuity workload with under-staffing the way it is.

“This has been ongoing since Covid and has peaked at the moment.

“We know our managers on the ground are trying to fill the gaps, but there’s not enough people to pick them up.”

She said most doctors were already working 55 to 60 hours a week.

“To add another eight hours onto that - we just can’t do it - and patients are suffering.”

Quin said she had reported at least 10 patient harm events to management, “but they seem to have been ignored”.

“These were all due to delays in patient care, and I’m pretty sure others would have seen the same.”

She said one person had waited around six weeks in hospital for coronary bypass surgery.

“This has to change, when I stared in 2021 there were no shortages like this, it’s like we have been banging our heads on a brick wall for a long time.”

In a redacted email to registrars, after the hospital said it could not find cover for shifts last weekend, the hospital said it couldn’t accept any referrals and staff should “prioritise acute general medicine only” for those two days.

A front-line hospital staffer, who spoke on the condition of anonymity, said staffing levels were “dire”.

'I've been in situations where patients weren't seen by a doctor for five and six days respectively. Which raises a whole heap of questions about continuity of care and safety netting.'

The staffer said it also meant slower medical decisions and delayed discharge.

In some cases, they said staff were helping out 'for a few hours here and a few hours there'.

Powell said the NZRDA had been working with Te Whatu Ora to address the loss of doctors, “however this productive work has all but stopped whilst management redirect their focus to budgets”.

“For all the rhetoric about strengthening front line care, the fact is that both patient care and the workforce we need to provide that care are suffering and the situation is getting worse,” Powell said.

Health New Zealand/Te Whatu Ora Waikato operations group director Michelle Sutherland said support from senior medical officers and locums ensured services to patients continued over the weekend. The shortage of registrars was caused by unplanned leave and a vacancy, she said.

“Patient safety is always a priority and when the roster gaps were identified additional staff were rostered on to ensure critical patient services were not impacted.

“Rostering in a dynamic hospital environment is always a challenge and the co-operation and flexibility of our staff in managing these situations is appreciated.”

Sutherland said recruitment at the hospital continued and “a number of candidates have accepted offers and we expect Waikato Hospital to be fully staffed for medical registrars by the start of October”.

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