ICU beds going unused

Beds are going unused in Dunedin Hospital’s intensive care and high-dependency unit because the Southern District Health Board cannot find nurses to care for the patients who should be using them.

Staff shortages have meant elective surgeries have had to be cancelled sometimes so as to leave ICU and HDU beds available for any incoming acute patients, board chief executive Chris Fleming said in a report to be considered by the board tomorrow.

Nursing vacancies had meant the ICU was running eight ICU and two HDU beds in its 12-bed facility, and just four beds were in use in the six-bed HDU on the fourth floor.

All DHBs are experiencing staff shortages.

Health boards must have a certain number of nurses on each day’s roster to meet safe staffing requirements, but Covid border restrictions have made it very hard for DHBs to recruit from overseas and vaccine mandates have further affected staffing.

As of a fortnight ago, across its entire nursing workforce, the SDHB had stood down 17 nurses for not having received their Covid-19 vaccinations and terminated 11 roles.

Mr Fleming said the situation was particularly difficult for intensive care nursing, as the College of Critical Care Medicine required at least 75% of nursing staff working in an ICU to have a postgraduate certificate in critical care.

"Fifty percent qualified is acceptable if there is an extra access nurse provided," he said.

"There has been good progression of nurses through the critical care course over the past two years, which has improved the target.

"However, due to recent resignations the percentage of staff qualified has dropped to 53%."

Some suitable candidates were enrolled for the course next year, but 12 were unable to do so because visa restrictions meant they were ineligible for funding.

"At present the total number of candidates for next year is 10 nurses who have applied for funding.

"A further 14 nurses should qualify at the end of 2021 in critical care nursing, which will put the percentage up to 65%."

The SDHB is still striving to open stage 2 of its much-delayed $14million ICU modernisation project due to issues with the hospital building’s ventilation system.

A draft plan to fix the issue, which has stalled opening of the much-needed upgrade, is now being considered by the board, but in the time it has taken to fix this first problem the staffing shortage has arisen.

Mr Fleming said the nursing shortage had also affected other departments in Dunedin Hospital and was also biting in Invercargill.

"There are significant issues in Southland, with beds being closed in the Southland medical ward on most days in October to ensure safe staffing.

"Vacancies in the Southland medical and surgical wards are expected to cause concern until late January-February."



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