Hospital accused of bullying and understaffing
Working conditions at Taupo Hospital have been labelled "toxic" by a former nurse who says staff shortages have seen midwives called in to assist in the Emergency Department.
Former ED nurse Paula Carstensen, who worked at the hospital for six years, before being dismissed, said bullying, over worked staff and budget cuts were causing real problems for the department.
She said shortages were so bad midwives have been called into the emergency department to assist staff and paramedics often have to stay behind with patients they brought in.
Lakes District Health Board [DHB] disputes the claims.
Lakes DHB chairman Deryck Shaw and chief executive Ron Dunham both declined to be interviewed in person or over the phone, with questions answered via the board's communications advisor Sue Wilkie.
Wilkie said that Lakes DHB had increased resource allocation to Taupo Hospital as demand has required.
"What can be said is that there has been a growth of over 40 per cent in patient numbers coming to the Taupo ED in the last five years," she said.
"This sort of increase has not been matched by population growth."
She also disputed bullying claims saying "the DHB has a long established policy of zero tolerance for bullying or harassment in any form."
Carstensen's concerns have been echoed by Taupo paramedic Yoad Halm who said he'd also seen the ED short staffed on many occasions.
The New Zealand Nurses Organisation [NZNO] also confirmed there had been issues with bullying in the past.
"But senior management at Taupo Hospital and NZNO have worked together to greatly improve how we go about addressing problems as they arise," NZNO's Selina Robinson said.
Carstensen, a nurse with more than 38 years experience, said she was speaking out now because she was fed-up and wanted answers.
"I've never seen an emergency department run as badly as Taupo's," she said.
"I am an old-school nurse and patient care is my number one priority. What is happening now is the quality of care is entirely dependant on who is on, how tired they are and if there is even enough staff to care for everyone. It's Russian roulette really."
Carstensen says the ED was getting by on the skin of its teeth and a major incident could knock it out completely.
"The department will run well 80 per cent of the time," she said.
"But it is on those 20 per cent nights, which is really what the emergency department is all about, where we struggle to cope."
She said that any funding increase there had been was not enough and the hospital was being starved of resources.
This was leading to a lack of qualified staff and nurses to cover when critical incidents occurred, she said.
And because the Hospital has to transfer patients away from the hospital often, under their model of care, they often lose nurses on transfers.
"One night a chap came in with his jugular vein sliced from ear to ear, it was me and the doctor left," Carstensen said.
"He was fighting against the paramedics who brought him in. I thought 'holy shit we are in real trouble here'," she said.
"I put out a call for help and was surprised when I saw a midwife standing in the emergency department.
"She was the only person in the hospital who could help. Midwives are not trained in emergency and would not be allowed in the ward under normal circumstances.
"I told her to write down everything I told her which at least freed us up to check on the other patients. There was no one else to help so we were stuck with the midwife that night."
Carstensen said the Lakes DHB model of care, where Rotorua Hospital takes the bulk of the work, was leaving patients needing lengthy transfers needlessly.
When the nurses are away on these transfers the hospital had to call off-shift nurses back onto active duty.
"I've had to ring people in the middle of the night who have just come off duty and are due back in the next morning," she said.
"They always say yes to coming back in because that is who they are, but it is not good. It is stressful and dangerous to be working those long hours but there is nothing else that can be done."
Paramedic Yoad Halm, speaking on behalf of First Union, said he often had to stay with patients they'd transported to Taupo Hospital and help out.
"We can tell they're understaffed and we can tell they do not have enough nurses," he said.
"When transfers come up they'll send a nurse with them but this leaves them even more short staffed. If there is a major event it could be possible for all the staff and ambulances to be out. What happens then?"
Carstensen, who was dismissed after a complaint from a doctor was laid against her, said speaking out against bullying had put her at odds with hospital management in the weeks leading up to the dismissal incident.
"People are scared to speak up in fear of retribution. They just have to put up with it."
Carstensen said her decision to speak up now not was not a case of sour grapes with her former employer, but rather frustration that things were still bad at the hospital. are seeing the same cycle continue at the hospital.
"If no one says anything, or is too scared to say anything nothing will change."
But Wilkie disagreed with the bullying accusations, saying Lakes DHB had a low number of official bullying complaints.
"The DHB has a long established policy of zero tolerance for bullying or harassment in any form," she said.
Robinson said NZNO members were reporting to her that they are happier than previously and were no longer afraid to raise issues via this partnership approach.
Nurses spoken to by Stuff said the NZNO do not have a fair idea what the current work conditions were like at Taupo Hospital.
Information released under the official information act shows Taupo has dismissed three employees in the last three years with two personal grievances filed.
Those nurses did not feel comfortable speaking on the record for fear of losing their job.