Covid 'tsunami coming': Emergency nurses anxious

Photo: RNZ
Photo: RNZ
An Auckland emergency nurse says overworked nurses fear hospitals aren't ready for the Covid-19 tsunami - and often think about quitting.

Hospital admissions have climbed 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 finish shifts wondering if they would come back for the next one.

"The nurses are really, really feeling it - feeling really anxious. They feel like there's a tsumani coming. They can see it coming ... and what do they do? Do they run towards it or do they back off?"

Her own ED was often short by three or four nurses, or a couple of health care assistants, a shift, she said.

"On a daily basis we are getting texts to say, 'can you pick up this shift?'. It is becoming a dire situation right now," she said.

It was made worse because staff regularly needed to isolate because they were case contacts, she said.

The nurse, a delegate for the Nurses' Organisation, said if they could not staff the shifts, it made for a high pressure day for those left behind, she said.

They tried to stay positive at work, she said.

"But when we go home we think back and we think 'do I have to go in tomorrow? Do I have to face the same old issues I've been facing in the past month, past two months?'," she said.

Several nurses had quit her ED in the past weeks and months, some of them senior, she said.

With already critical nationwide shortages, they were virtually irreplaceable.

The district health boards were doing their best but it was frustrating they had not done more earlier, she said.

She worried about where they would put Covid-19 patients if it the ED became too full as they could not go in the corridors like other patients sometimes had to.

"More nurses, more negative pressure rooms, more ICU beds ... but that is all going to take time because we haven't been prepared for this. We haven't had the forethought for the future," she said.

Her comments were backed by her union which said it was regularly hearing from stressed and worried nurses - and not just in Auckland.

Auckland and Waitemata DHBs declined to comment. Waitemata was 100 nurses short across its hospitals earlier this year and had not been able to fill all those vacancies.

Counties Manukau Health's director of hospital services Vanessa Thornton said Middlemore Hospital ED actually had fewer than a handful of nurse vacancies. But it would have to rely on surge plans when more cases started to come through its doors.

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

The hospital's modelling showed there were likely to be 20 Covid-19 cases a day coming through the emergency department by next month, she said.

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

A tent has been set up at Middlemore's ED and was being trialled this week for triaging patients for Covid-19.

Staff were well versed with dealing with Covid-19, with 113 presentations in the pandemic, a maximum of eight in one day, she said.

The Government announced there would now be 300 places a month reserved for health workers in managed isolation and quarantine (MIQ).

The nurse said that was great news - but they were needed yesterday.

Minister moves to reassure workforce 

Health Minister Andrew Little has assured the workforce the Government is doing what it can to prepare for a rise in Covid-19 hospitalisations.

Little told RNZ's Morning Report programme today that pressure on health workers is always front of mind for the Government, and he understands their anxiety with rising Covid case numbers.

"I understand that there's a lot of anxiety around in the nursing workforce, and those in ED and other parts of hospitals too.

"Because we are at that point now where things are starting to change, people are concerned about the rising number of cases.

"The whole way that this government has managed Covid-19 cases right back to last year, one of the critical issues we've had on our mind is the impact to the health system and making sure that the decisions we make and what we do minimises that impact, so that we do see overwhelmed hospitals."

Little said the health workforce should be assured that the pressure they are under isn't unnoticed, and the government is working to have the system as ready as it can be should hospitalisation rates increase.

He told Morning Report that at the moment rates were steady, but about 14,000 extra nurses had now been trained to work in an intensive care unit, and more workers would be joining the system in about a month after MIQ rooms were put aside for them to enter the country.

Further numbers of migrant workers would be joining the system in about a month.

Between 120 and 130 nurses have also been brought in to Auckland from other parts of the country since the Delta outbreak started in August.

Auckland's Middlemore is predicting 20 cases a day through its emergency department by next month.

"At the moment the hospitalisation rate is roughly 5 percent, the ICU rate is hovering between half a percent to 1 percent," he said.

"That's been steady one for at least a couple of weeks. We know that a lot of people who are turning up at hospital are unvaccinated."

The minister said his daily briefings from the Ministry of Health indicated that ICU bed capacity hovers around 325 across the system and the surge trend workforce is adequate to deal with raising numbers.

Little added he was comfortable with the decision announced yesterday to open up Auckland secondary schools to senior students, even though it may increase case numbers in the city.

"The age group that's going to be allowed back to school can be vaccinated, many are vaccinated and there will still be measures in place, requiring them to wear a mask, to maintain social distancing," he said.

Our journalists are your neighbours

We are the South's eyes and ears in crucial council meetings, at court hearings, on the sidelines of sporting events and on the frontline of breaking news.

As our region faces uncharted waters in the wake of a global pandemic, Otago Daily Times continues to bring you local stories that matter.

We employ local journalists and photographers to tell your stories, as other outlets cut local coverage in favour of stories told out of Auckland, Wellington and Christchurch.

You can help us continue to bring you local news you can trust by becoming a supporter.

Become a Supporter