Hospital patient safety 'compromised'

BY REBECCA TODD

Patients and doctors are at risk because of understaffing at Christchurch Hospital, junior doctors say.

The doctors have been backed by Christchurch Hospital out-of-hours clinical co-ordinators, who have written to the Canterbury District Health Board's chief executive saying shortages were compromising patient safety.

Resident Doctors' Association spokeswoman Deborah Powell said there were too few junior doctors on duty over the past four weekends at Christchurch Hospital.

Powell said last weekend there were three out of the necessary five junior doctors on duty in the acute area.

There was no orthopaedic house surgeon and no acute-surgical house surgeon at the weekend, and again last night.

"Weekends are already minimum staffing levels, so to drop below them does cause consternation," she said.

"One weekend you can cope with, but four weekends ... no.

"We are relying on the goodwill of those who are left, but that is evaporating quickly."

Junior doctors had started saying "no" to requests to cover weekend shifts because it was getting "too much".

"Any human is going to get exhausted with that kind of pressure," Powell said. "They are fed up. They don't want to go home wondering at night, `Lord, what did I miss?'."

Powell said resident (junior) doctors had been leaving DHBs, and the problem would get worse until the boards did something about it.

Understaffing could be the final "push factor" sending junior doctors overseas, she said.

Christchurch Hospital's clinical team co-ordinators – who manage the clinical workload outside normal hours – wrote to CDHB chief executive David Meates last week to express their concern.

"Expecting the hospital to manage with so few doctor resources is not realistic and completely unsustainable," the letter said.

"The loss of one [house officer] would ordinarily pose a significant clinical risk, but coupled with no orthopaedic house officer left an extremely unsafe position with patient care and safety compromised."

Powell said the RDA had also written to the CDHB about its concerns, but was being "fobbed off".

The association had informed the health board that it was taking a case to the Employment Relations Authority over insufficient staffing outside normal hours.

Christchurch Hospital resident doctor Julia Taylor said weekends and night shifts were often understaffed, which was "very stressful for all concerned".

"Everyone tries to help each other out and cover the work that's required, but really it's stressful and unsafe for those doctors working, and their patients."

There had been no major incidents for patients, but it was "only a matter of time" before that could occur.

"We are all asked on a regular basis to pick up extra duties, but people are already working really long hours," Taylor said.

"It makes it really tough on the people who are committed to working in New Zealand as permanent doctors.

"I'm personally committed to a career here, but only if working conditions are preserved and improved."

CDHB chief medical officer Dr Nigel Millar said it was "really challenging" dealing with unexpected short-term vacancies.

"I can understand their [resident doctors'] concerns," Millar said.

"We have a process for ensuring good co-ordination across the hospital out of hours.

"The key thing for us is to ensure we have covered, as far as possible, all the risks."

It was a difficult time of year because Canterbury relied on resident doctors from overseas. Those from Britain and Ireland tended to leave in early July, and the next group would not arrive until late August.

- © Fairfax NZ News