Winter illnesses and a surge in emergency department arrivals are stretching Nelson Hospital.
The hospital had to postpone some elective treatments, including at least one surgery, during the week after becoming gridlocked.
The Nelson Marlborough District Health Board said that on Wednesday and Thursday, the hospital's day stay unit had to be used for overnight patients because of a lack of available beds.
The unit is used by surgical patients who don't need to stay overnight, and as a surgical admission unit. It also manages elective medical procedures such as infusions and cardiac catheter patients.
Service manager surgical services Dorothy McKeown said the hospital was running at 92 per cent capacity yesterday, with seven patients in the day stay unit.
"We've been at 95 per cent or over since last Thursday, and actually been at 101 per cent this week and we've had to cancel some elective work."
Charge nurse manager of patient care, Kerri Shaw, said the hospital had been operating in a gridlock situation.
"One thing we don't like to do is to cancel a person's elective procedure. Unfortunately, we've had to cancel some surgeries this week. There's an awful lot of work that goes into getting a patient to the surgeon's door."
The main causes had been winter illnesses and an increase in emergency department (ED) patients.
Ms Shaw said Thursday had been a particularly busy day at the ED, with pneumonia, surgical problems and "quite a significant amount" of elderly patients.
A busy day at the ED put a lot of pressure on the hospital, because it was the main way people were admitted, she said.
Ms McKeown said it was the first time the hospital's winter plan, created this year, had been put into action. It had strategies to assist operational staff in times of high bed capacity.
"Patients should be assured that the hospital would go to great lengths to ensure those who need to be in hospital have a bed," she said.
As for patients having to be sent home early, Ms McKeown said "the clinical need of patients is always the guiding factor in terms of readiness for discharge".
Ms Shaw said staff had been fantastic.
Because the day stay unit was not usually staffed at night, finding extra cover had been difficult, she said. Nurse educators had been reorganised to help with shifts, and many staff had been working longer hours to help cover shortages.
"We've had to be quite creative. We have mobilised casual staffing resources and have been very fortunate that staff from all areas have come on board to cover shifts, and we greatly appreciate this."
She said the winter surge had arrived later than last year, when it hit in July, though the hospital did not have to use the day stay unit for overnight patients then.
"We have a plan, which we will work on and reform."
Nelson GP spokesman Dr Graham Loveridge said the past few weeks had seen a spike in winter illnesses.
"It's laid a lot of people low and led to hospital admissions. It's probably not been helped by the weather."
He said he had seen a lot of very unwell people, some of whom were too sick to stand or walk.
Those people had been referred to the hospital, but he said generally, people were encouraged to stay home or visit their GP where possible, to avoid unnecessary hospital admissions.
This winter, more than 1 million New Zealanders have had a flu vaccination, with more still expected to take up the offer.
Health Minister Tony Ryall said it was the second time New Zealand had reached the milestone. The other was in 2010, the second year of the swine flu scare, when 1.02 million people were vaccinated against the flu.
Last year, 990,000 doses of the flu vaccine were distributed.
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