"It's bedlam. We're buckling under pressure."
So said Scott Grant, NSW Nurses and Midwives Association (NSWNMA) Manning Hospital Branch secretary, who works on the frontline in the Emergency Department (ED) at the hospital.
The huge surge in COVID-19 cases over the last couple of months has overwhelmed the ED at Manning Base Hospital, with ambulances ramping and nurses overworked.
"ED is so overrun at the moment we do not have capacity and do not have enough workers to safely look after patients," Scott said.
"On Sunday I think we had 24 COVID patients admitted to hospital.
"At times we've had COVID patients stuck in ED for up to a day because they are no beds upstairs.
"When we're really busy it's not unusual to have four ambulances ramped waiting to offload for a couple of hours. They're just stuck. There's nowhere to offload.
"When ambulances can't offload and are ramping, patients who are COVID positive stay in the back of the ambulance as we have no COVID area in ED for arrivals or, for that matter, no COVID ward (in ED), even though one was set up but not opened.
"This becomes very uncomfortable for elderly patients and can cause ongoing pain as they are uncomfortable, with pressure areas and toileting issues."
At times we've had COVID patients stuck in ED for up to a day because they are no beds upstairs.- Scott Grant, NSWNMA Manning Hospital Branch secretary
In addition, Scott says there are not enough nurses to deal with the extra patients and work involved.
"You've got COVID patients in ED where one nurse could be looking after both COVID and non-COVID patients.
"We have no clean nurses in ED supporting direct care nurses looking after COVID patients.
"This means that these direct care nurses are continually donning and doffing (PPE) just to go and get the simplest of things to do their job, like medications and equipment, which puts them severely behind in their workload and with their other patients and duties.
"It is a vicious circle, and they never catch up which can compromise patient safety."
Scott has been looking at data and says that COVID is the fourth highest presenting health care complaint since the start of January and the sixth highest reason for admissions to hospital.
Manning Hospital general manager Jodi Nieass confirmed the hospital is currently caring for 11 COVID patients, with six on the ward and five in ICU.
Patient care and safety is also compromised because nurses are often working double shifts, regularly working from 1pm to 7.30am the next morning, Scott claimed.
"And when you're in you're always busy. It's a long shift and you do burn out," he said.
"With the workload and the nurse to patient ratios, it's dangerous. Mistakes are made, unfortunately and it can compromise patients."
With the workload and the nurse to patient ratios, it's dangerous. Mistakes are made, unfortunately and it can compromise patients.- Scott Grant
However, according to Hunter New England Local Health District chief executive officer, Michael DiRienzo, the Manning Base Hospital is coping with COVID "really well."
"It looks like we are over the thick of it. The staff (at Manning Base) have coped really well," Mr DiRienzo told the Manning River Times this week.
The shortage of nursing staff is not a new issue, but COVID-19 has exacerbated the issue with a "massive exodus" of experienced staff, due to both burnout, and unvaccinated staff having to leave, Scott says.
"Experienced nursing staff have left in this time that we just can't replace. And it takes years to get that experience back on the floor," he explained.
He says the health system is broken and lays the blame for the predicament at the feet of the State government, saying the government will not come to the table and talk about safe nurse-to-patient ratios.
NSWNMA Manning Hospital Branch president, Renee McBridge, who also works in ED at the hospital, says that in her 20 years of nursing she has never seen the sheer physical and emotional exhaustion of nurses that she is seeing now.
"We have been campaigning for ratios and pay increase for years and with the COVID surges it is even more imperative the government listen, and management support us," she said.
"Perhaps if the government listened and provided our pay increase as promised, hazard pay for wearing eight hours of sweating PPE, and (fixed) ratios, we may have some hope of salvaging the health system."
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