Patients die waiting in Queensland hospital queues as ambulance ramping gets worse.
Patients are dying while stuck in queues for emergency treatment because of workload, staffing and overcrowding issues, Queensland Health documents show. overcrowiding and understaffing are costing the lives of patients in public hospitals, Queensland Health's own documents show.
"Ramp time nearly three hours," the documents detailing circumstances surrounding the death of the second patient stated. "Workload, staffing (and) overcrowding issues" were listed as having affected the cases of both patients.
United Voice Ambulance Union co-ordinator Jeanette Temperley said "ramping", which involved ambulances lining up for entry to emergency departments, was a "big issue".
My very first visit to the hospital when I was five years old, with a badly infected foot, will stay in my mind forever. I was pushed in a stroller up to the hospital at 8am by my father. My Mother said that we had to get there early as the outpatients was always crowded. Well, when we arrived at 8am, the waiting room was full. Dad stood until a seat was available for him to sit down. Well we waited. And waited. At around 10am, Dad had to leave so he told the Nurse he had to go, but would come back. I was in a lot of pain, and feverish and can still remember drifting in and out of consciousness. I was pushed into a corner, where I must have fallen asleep. Dad apparently came back several times during the day, but I was in and out of consciousness. When awake,I was crying but no-one attended to me. I had a raging thirst but no-one gave me water. As I drifted in and out of consciousness, I remember TO THIS DAY my childhood wonder at how so many people were walking, talking and laughing in the waiting room. They did not look at all sick like I was!!
ReplyDeleteWe eventually saw the Doctor at 8PM! The Doctor and Dad came to blows because my foot was very badly infected and I was so sick with infection. The Doctor said we should have been up to the hospital before the infection got so bad. After a shouting match and blows being exchanged, Dad and I were turfed out of the hospital and Dad took me to the local Ambulance Station where an ambulance officer gave me immediately a drink of sugary fluid (NO ONE HAD GIVEN ME ANYTHING TO DRINK ALL DAY), dressed my wound, and arranged for me to have an antibiotic injection. That young ambulance officer probably saved my life. Dad and I arrived home at around 10pm. That was 1960. Nobody today has to wait TWELVE FULL HOURS before seeing a Doctor!!
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ReplyDeleteThis is the first of a few posts because it is so long...
ReplyDeleteRoss, the reasons for this mess are many. I will pass comment based on my 24 years as a nurse, 19 years ED experience, working in many health settings including major public hospital, GP's, regional centres and remote / rural towns, and a JCU educator
First and foremost is the inappropriate use of health resources in this country. As the generations have evolved (?) society has become 'softer' and when one would once 'tough it out' or turn to Mum or Gran or the neighbour for some health advice for that runny nose, rash or fever now they go straight to their GP. Of course for those out of the blue health issues on the day, GP's are booked out, so the next point of call is the 24 hr Medical Centre or Emergency Department.
A simple trip to the pharmacist would possibly have sorted out the minor ailment.
Next is the problem of litigation. There IS such thing as a simple headache. Take 2 Panadol and you'll be ok. With litigation in mind, attend the pharmacist and they will tell you to go to the GP., try the GP and they'll be booked out. Off to ED and you'll have to be fully investigated including bloods and maybe a scan. Litigation is costing tax payers a fortune without a solicitor even being contacted!
Next are our overcrowded hospitals. We have an aging population and a large number (a third at CBH at times) are aged or disabled people waiting for placement in a supported care facility (nursing home). They do NOT need acute care. In some cases they can do most things for themselves but can't be left to their own devices (Alzheimer’s) or can feed themselves but just need a meal provided and a hand to set themselves up. The do not need a Registered Nurse to care for them in a major public hospital. They CAN be cared for at home (either their own or living with a family member) with the help of Community Nursing, Home Help, Meals on Wheels, etc AND their family. Sadly, the latter is too often the problem and these days too many people don't want to care for their elderly or disabled family members. The alternative is to be cared for in a nursing home by AIN's and EN's instead of the more expensive RN's, but places in these facilities are limited and people may sit in an Acute Hospital bed for up to 3 months waiting for a bed to become available.
What does this do to our hospital system? It constipates it of course. They are taking up beds that ED patients, surgical patients, acute medical patients etc need. That's one of the reasons waiting lists are so long for surgery. Before a surgeon runs the scalpel across your skin you need to have a bed!
Build more Nursing home beds? Of course. We have an aging population. It makes sense. But that is a Federal, not State issue! The left and right hand have to agree. But that's not the only solution. Families have to take on more of the responsibility of caring for their family members if and when they are able. Wait till WE are geriatrics. I don't think there will be a choice. Besides, just how much do we want the government to spend on health care? Sure, the govt can look after everyone in hospitals and nursing homes but who is going to pay or suffer because of it. Higher taxes or pinch from govt spending elsewhere?
So finding appropriate placement for patients is one way of freeing up beds in hospitals. Should we also build more hospital wings and open up more beds? If you want to further exacerbate the Nursing crisis that would be a wonderful idea. Why?
Keep reading...
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ReplyDeleteEvery day and almost every shift the CBH is desperate for nursing staff. There are vacancies on rosters that cannot be filled due to the nursing shortage so they rely on casuals to fill the gaps. These are not the only gaps. There is of course unplanned leave - sick, family and bereavement leave. I am contacted by the hospital almost every day and sometimes a few times a day begging for RN's to work. There are not even enough casuals around to adequately staff the hospital. Patients MUST be looked after. A nurse MUST be found. That means they have to beg the nurses on duty to work overtime, double shifts or come in on their days off. Is it such a big deal to work a double shift? If you're working in ED on an afternoon shift and have to stay and work the night shift, then your workday will commence at 1pm and finish at 7.30am the following morning. That's 18 hours! Awake all night. Run off your feet. Calculating drugs! Saving lives! Making life and death decisions! You bet it's a big deal. If you're having a heart attack or stroke, is this the nurse you want to be looking after you? Likewise, on the wards if you start on an early shift at 7am, and do an afternoon shift thereafter, you will finish at 11pm. 16 hours. This happens every day! You can bet nurses are sick of being asked to work overtime, doubles and come in on their days off! An airline pilot is restricted by flying hours and so are flight attendants. But someone thinks it's ok to let Dr's and nurses do this. ???
Is it any surprise that nurses are leaving the profession in droves and there are currently 30,000 Registered Nurses NOT working as nurses because they choose not to?
Now, back to increasing beds. Given that the above is the current reality, what do think will happen when they open their 170 beds in the new wing at CBH? Who is going to staff it? The stressed, tired, overworked nurses who have already had a gutful? Costly recruiting drives are limited in their success. Many overseas nurses return home after their contract is up or move on elsewhere around Australia when they realise they can’t stand our wet season. But Australia is not the only country poaching internationally, and there are plenty of Aussie nurses enticed to distant shores with great travel opportunities, accommodation packages, flights thrown in and great pay rates – think Emirates for example. There is a finite number of nurses in the world and that number is shrinking….
Some say increase the Uni intake? Retention in the nursing course is dreadful. Only about one third of those who commence 1st year will complete their degree. Some of those will never nurse, and instead choose to side-step into another Allied Health profession by picking up a few other subjects. Once these qualified nurses hit the workforce, about another third will decide that nursing is not for them and leave the profession. Why? Read on…
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ReplyDeleteWhich Y-GENer is going to put their hand up to be a nurse and tolerate abuse, overwork, the emotional drain and physical strain? Not really their bag when the University world is their oyster and in this day and age they can enter any uni degree and come out with a better paying job and better conditions. Become a nurse and wipe bums, clean up spew, dress purulent exuding wounds, and cop abuse while your mates have gone to Tinaroo skiing for the weekend or become a teacher, or physio, or lawyer and work Monday to Friday, 9-5 (ish) and get paid a bucket more. There is a high number of mature-age women taking up nursing once their kids have grown up or at school. Perhaps motherhood has ‘toughened’ them up a bit. Recruiting these mature-age women into the nursing degree is still only a short-term solution. Let me share some stats… Most of the nursing workforce is in their 40’s, with the mean age around 45 years. Almost half of them (49%) only work part-time, so in terms of EFT or FTE they are not very efficient. Furthermore, 90,000 of them will retire by 2020 – just 9 years time. Recruiting toughened-up mature age students places them in this age bracket and they too will look at retiring in that time . And the Y-gener’s are not replacing them at the rate that they are leaving…
So who is going to man those 170 CBH beds? Who will man those beds in the new Edmonton Hospital? We need to consider the value of nurses, what they cop now, and what we as a community can offer them to enter the profession, to STAY in the profession. Personally I want out because I’ve had enough of all of the above after my 24 years in the profession. And for the last 16 years, despite gaining an extra Graduate Certificate in Advanced Nursing, Graduate Diploma in Emergency, experience, projects, professional development courses and conferences etc, my pay level has stayed the same. If I put all that time, effort and my own money into professional development as say a solicitor, I know I’d be earning a whole lot more than $34/hr. I know an AO5 who didn’t finish school and only gained on the job experience & training who is on $85K. If I worked full-time 9-5 like her, my annual gross income would be $67K. That’s almost $20,000 less. Why go to Uni & do nursing?
So who do we blame for the issues in the health system? OURSELVES. We have become a soft world and we undervalue nurses. Is it as simple as giving them all a pay rise? Hell no. Let’s say we increased the nursing pay rate by $10 / hr. That would about bring it in line with that AO5. 100,000 nurses currently practicing may mean there are about 20,000 nurses on the job at any given time. That’s an extra $200,000 the govt & tax payers would have to come up with.
But it’s not just about the nursing CRISIS. We need to take more responsibility for our own health and I would urge the govt to spend more dollars in Health Promotion, Illness Prevention and to educate the public on how to better use Health Resources – like use your ED for emergencies, see your pharmacist when you’ve got a cold, tough it out for a few days if you get sick, etc. WE have contributed to the problem. WE have got fatter, lazier, softer, etc. It’s time to stop turning to the government for solutions and started considering what WE can do to help ourselves and our family.
This is very simplified and only touches on a few of the issues, but I hope it brings some enlightenment.
Oops, this was the middle entry...
ReplyDeleteEvery day and almost every shift the CBH is desperate for nursing staff. There are vacancies on rosters that cannot be filled due to the nursing shortage so they rely on casuals to fill the gaps. These are not the only gaps. There is of course unplanned leave - sick, family and bereavement leave. I am contacted by the hospital almost every day and sometimes a few times a day begging for RN's to work. There are not even enough casuals around to adequately staff the hospital. Patients MUST be looked after. A nurse MUST be found. That means they have to beg the nurses on duty to work overtime, double shifts or come in on their days off. Is it such a big deal to work a double shift? If you're working in ED on an afternoon shift and have to stay and work the night shift, then your workday will commence at 1pm and finish at 7.30am the following morning. That's 18 hours! Awake all night. Run off your feet. Calculating drugs! Saving lives! Making life and death decisions! You bet it's a big deal. If you're having a heart attack or stroke, is this the nurse you want to be looking after you? Likewise, on the wards if you start on an early shift at 7am, and do an afternoon shift thereafter, you will finish at 11pm. 16 hours. This happens every day! You can bet nurses are sick of being asked to work overtime, doubles and come in on their days off! An airline pilot is restricted by flying hours and so are flight attendants. But someone thinks it's ok to let Dr's and nurses do this. ???
Is it any surprise that nurses are leaving the profession in droves and there are currently 30,000 Registered Nurses NOT working as nurses because they choose not to?
Now, back to increasing beds. Given that the above is the current reality, what do think will happen when they open their 170 beds in the new wing at CBH? Who is going to staff it? The stressed, tired, overworked nurses who have already had a gutful? Costly recruiting drives are limited in their success. Many overseas nurses return home after their contract is up or move on elsewhere around Australia when they realise they can’t stand our wet season. But Australia is not the only country poaching internationally, and there are plenty of Aussie nurses enticed to distant shores with great travel opportunities, accommodation packages, flights thrown in and great pay rates – think Emirates for example. There is a finite number of nurses in the world and that number is shrinking….
Some say increase the Uni intake? Retention in the nursing course is dreadful. Only about one third of those who commence 1st year will complete their degree. Some of those will never nurse, and instead choose to side-step into another Allied Health profession by picking up a few other subjects. Once these qualified nurses hit the workforce, about another third will decide that nursing is not for them and leave the profession. Why? Read on…
Well said Lisa. And of course, if today, any father was to take his very sick and feverish five year old daughter with her leg swollen with infection into an emergency room, the little girl would receive immediate attention, under the "triage" system. Even as I write this, 51 years after it happened, I still remember the pain and fever I suffered and the long agonising day of waiting.
ReplyDeleteI have to admit to being a procrastinator when it comes to illness. I also use the Dial-A-Doctor service more often than not and have found it very helpful and much faster than my GP to get an appointment. I have been admitted to hospital several times in my life and each time I found it to be the best situation for a bad situation. Lisa has raised some issues that are extremely important and her knowledge in this area is obvious. Hopefully the new GP Superclinics (including one being built in Edmonton) and the new mental health hubs that were announced in the last budget will alleviate some of the problems. The Dial-A Doctor service is excellent for parents as your child can be examined in the home. The health facility in Edmonton should be fast-tracked as the need is already there for it. The large Aged Care facility in Gordonvale should free up more beds as well. There are many innovations in the health arena and they will work. What is not being addressed though, is the most important part of Lisa's comment......nursing. We have a need for more Specialists as well. Those things need to be addressed immediately and effectively or all other new facilities mentioned above will not make a scrap of difference.
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