College of Emergency Nurses NZ (CENNZ) chair Sue Stebbeings wrote to the Health Minister Andrew Little in March to “highlight our ongoing concerns regarding the impact of hospital overcrowding on safety in the emergency department”.
CENNZ members around the country were expressing concern about patient safety and professional risk “due to staffing and department capacity being overwhelmed on a daily basis”, the letter said.
Safe staffing was key to a healthy workplace, Stebbeings wrote. “Daily short-staffing, requests to work double shifts, fatigue and burnout are not. The staffing shortages within our emergency departments have reached crisis point.”
Stebbeings told Kai Tiaki Nursing New Zealand problems with short-staffing and overcrowding were “not new but had grown to be almost overwhelming”. There was “no capacity” to move patients needing hospital admission out of ED, leaving emergency staff scrambling to care for them as well as new patients coming into ED.
EDs were like “barometers” for systemic problems in hospitals or the health system, Stebbeings said, describing the problem as “complex and multi-factorial.
“It is absolutely a systemic problem. It’s not a new problem, it’s an escalating problem that has reached crisis point and is widespread in the majority, if not all, of our EDs.”
The letter asked for “robust” data to inform safe staffing requirements. CEENZ was also unhappy the implementation of safe staffing system care capacity demand management into EDs had been delayed “without consultation”, the letter said. “Further delays to finding solutions for this complex issue will only exacerbate the dilemmas faced by nurses each day and increase the risk of poor patient outcomes.”
Stebbeings told Kai Tiaki Nursing New Zealand CENNZ was deeply concerned for its members, and “the moral distress nurses feel when they cannot give the care they would like. They are concerned that the environment is unsafe for our patients and our staff”.
NZNO professional nursing adviser Suzanne Rolls said demoralised and stressed ED staff were exposed to professional critique by the Nursing Council and complaints from the public – which were increasing at all district health boards.
The minister had not responded to Kai Tiaki Nursing New Zealand by deadline. However, Stebbeings said Little had acknowledged the letter, saying he had asked officials to advise him on this matter and would respond “in due course”.