'We’re completely overwhelmed': Whangārei ED nurses warn of burnout

Whangārei Hospital’s emergency department is so busy that staff fear someone will die waiting for help.

But Health New Zealand Te Whatu Ora says patient safety is the highest priority, with a system to reassess patients waiting for care.

Both Health NZ and hospital staff have said those who need urgent care will be prioritised and should not hesitate to come to the hospital.

New Zealand Nurses Union delegate Rachel Thorn said the number of patients coming to Whangārei Hospital’s emergency department (ED) continued to increase.

“This year, there has been more and more days when we’re completely overwhelmed.”

The numbers peaked on Monday when the ED treated 189 patients, she said. It normally had space to treat 32 patients at a time.

Thorn said the greatest fear for staff was that someone would die while waiting to be seen, as reportedly happened at Waikato Hospital in June.

“People are waiting six to seven hours to be seen at times; that’s really unsafe. We don’t have the staff at the front of house to keep on top of patients.”

Staff were exhausted from the “relentless” work and being constantly overcrowded at 150% capacity, said Thorn, who broke down in tears while telling the Northern Advocate about the pressure faced every day.

“Because staff are exhausted and pushed to their limits most days, staff are getting sick more often as people are just in burnout mode.”

While Health NZ had 71 extra hospital beds nationwide for winter, Thorn said, at Whangārei that meant more beds in the corridor between the ED and the intensive care unit (ICU).

She said there was little space for Whangārei ED to expand until the new hospital was built, but hiring more clinical staff would help reduce pressure.

Health NZ’s group director of operations for Te Tai Tokerau, Alex Pimm, said patient safety remained the highest priority.

“All patients presenting to the ED are clinically assessed and prioritised according to the urgency of their condition.

“Patients in the waiting room are regularly reassessed, and there are processes in place to identify any deterioration whilst they are waiting for further review or their treatment plan to commence.”

A nurse says Health NZ's extra winter hospital beds means more Whangārei patients are put in corridors, but Health NZ says they are treated safely. Photo / NZME

Pimm said that on forecast high-demand days, a doctor and nurse were dedicated to the waiting room and Health NZ was recruiting to expand this model.

He said additional spaces in ED and the hospital were used to safely care for patients “during periods of exceptional demand”.

“We would like to thank our ED team – we are incredibly proud of their professionalism, dedication, and commitment to delivering excellent care for our community."

Pimm said while demand and capacity fluctuated throughout the day at Whangārei ED, performance and waiting times over the long weekend and on Monday remained strong.

On Monday, 83% of patients were admitted, discharged, or transferred within six hours, with an average wait of 4.5 hours, he said.

While the target was for 95% of patients to be seen within six hours, Northland was among the four best-performing areas last quarter.

Health NZ Te Tai Tokerau group director of operations Alex Pimm says Whangārei Hospital ED has a strong response to high demand. Photo / Denise Piper

Pimm said the higher presentation volumes seen on Sunday and Monday were consistent with what was expected following a public holiday weekend and ongoing winter demand.

“Across the country we actively manage pressure, and people should continue to expect that if they need urgent care, they will be seen and treated.

“Patients are prioritised based on clinical need, so those who are most unwell are always seen first.”

Pimm said Health NZ makes a winter plan each year because it knows demand in emergency departments increases, particularly with respiratory illness.

“This year we’re focusing on improving patient flow through the hospital, supporting our workforce, and making sure patients are seen and treated as quickly as possible.”

Nationally, 378 fulltime equivalent roles were introduced for the winter plan, with 85% filled and recruitment ongoing for the rest.

In Te Tai Tokerau, winter measures included more weekday nursing at the front of the ED to better manage busy periods and introducing an after-hours clinical nurse co-ordinator to strengthen leadership and decision-making.

Other measures included using porters to transfer patients into wards more quickly and artificial intelligence (AI) tools in EDs to give clinicians more time with patients, Pimm said.

Dargaville had extended urgent care access, and there were plans to extend the opening hours at Whangārei’s urgent care clinic.

Pimm said that where suitable, Whangārei ED patients with less severe health needs were offered the option of a White Cross voucher.

“This allows patients to access care in the community and often be seen sooner, while helping preserve ED capacity for those requiring emergency care.”

Denise Piper is a news reporter for the Northern Advocate, focusing on health and business. She has more than 20 years in journalism and is passionate about covering stories that make a difference.