Saturday, November 27

Covid-19 ‘imminent tsunami’: emergency nurse says lack of planning causes anxiety

An Auckland ER nurse says overworked nurses fear hospitals are unprepared for the Covid-19 tsunami and often think about quitting smoking.

Healthcare workers participate in ICU training for Covid-19 at Hutt Hospital.

File photo.
Photo: RNZ / Dom Thomas

Hospital admissions have risen to 43, and Middlemore Hospital expects to see 20 cases a day through its emergency department next month.

The nurse, who works in one of Auckland’s emergency departments (ED), said many of her colleagues end their shifts wondering if they would be back next time.

“The nurses are feeling it really, really, feeling very anxious. They feel like a tsumani is coming. They can see it coming … and what do they do? Do they run towards it or back off?”

His own emergency department was often missing three or four nurses, or a couple of health care assistants, a shift, he said.

“Every day we get text messages to say, ‘Can you take this shift again?’ It’s becoming desperate right now,” he said.

It got worse because staff needed to isolate themselves regularly because they were case contacts, he said.

The nurse, a delegate from the Nurses Organization, said that if they were unable to attend shifts, it would be a high pressure day for those left behind, she said.

They tried to stay positive at work, he said.

“But when we come home we think backwards and think ‘do I have to go tomorrow? Do I have to face the same problems that I have been facing in the last month, in the last two months?'” He said.

Several nurses had left his emergency department in recent weeks and months, some of them older, he said.

With an already critical national shortage, they were virtually irreplaceable.

District health boards were doing their best, but it was frustrating that they hadn’t done more sooner, he said.

He was concerned about where Covid-19 patients would be placed if the emergency department got too crowded, as they couldn’t go to the hallways like other patients sometimes had to.

“More nurses, more negative pressure wards, more ICU beds … but all of that is going to take time because we are not prepared for this. We have not had the foresight for the future,” he said.

His comments were backed by his union, which said it regularly listened to stressed and worried nurses, and not just in Auckland.

The Auckland and Waitemata DHBs declined to comment.

Waitemata was missing 100 nurses in its hospitals at the beginning of this year and had not been able to fill all of those vacancies.

Counties Manukau Health’s director of hospital services Vanessa Thornton said the Middlemore Hospital Emergency Department actually had fewer than a handful of vacant nursing positions.

But it would have to rely on augmentation plans when more cases started pouring through its doors.

He would bring in nurses and health care assistants from other parts of the hospital, but could also send them to help elsewhere if the emergency department was quiet, he said.

The hospital’s model showed that 20 cases of Covid-19 a day are likely to arrive next month through the emergency department, he said.

However, that was just a best estimate and would be influenced by factors such as vaccination rates, alert levels and how well people stuck to the rules, he said.

A tent was set up in the Middlemore emergency department and was being tested this week to classify Covid-19 patients.

Staff were well trained to deal with Covid-19, with 113 presentations in the pandemic, a maximum of eight in one day, he said.

The government announced that there would now be 300 places per month reserved for Isolation and Managed Quarantine (MIQ) healthcare workers.

The nurse said it was good news, but they needed it yesterday.

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