2 Sep 2021

Auckland DHBs would need ICU nurses for 'ideally a month at a time'

12:45 pm on 2 September 2021

Auckland hospitals under pressure with Covid-19 patients would need extra nurses for up to a month at a time, but may not require all 30 they have asked for, the DHBs' spokesperson says.

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Auckland DHBs have asked for up to 30 intensive care nurses to be diverted from around the country to help with the Covid-19 response.

All three of Auckland's main hospitals are [https://www.rnz.co.nz/news/national/450565/auckland-s-three-main-hospitals-build-more-specialist-rooms-for-covid-19-patients building more negative pressure rooms to keep up with the Delta strain of Covid-19.

The hospitals are treating 32 Covid-19 patients; 14 at Auckland City Hospital, 13 in Middlemore and five at North Shore Hospital. Eight patients are in ICU.

Auckland DHB director of provider services Mike Shepherd, spokesperson for northern region DHBs, said the call for ICU nurses was a "preparatory step" and the hospitals had have enough nurses to care for the patients they have.

The DHBs were thinking about the next few weeks and months, but would need the nurses "reasonably quickly, mostly to start an orientation process and to build that workforce availability."

"I think it's quite possible that these nurses may come for orientation and not be required a great deal, but I think that's the step that we're taking next.

"We expect that people will probably come for a week, two weeks, ideally a month at a time."

The health system would pay accommodation costs, he said.

"We're certainly seeking or have organised accommodation for these nurses, as well as transportation and other critical parts to being part of the workforce."

Shepherd said there had been a "fantastic response" from DHB colleagues and nurses around New Zealand.

The pressure on Auckland hospitals from the Covid outbreak has also forced some patients to be transferred elsewhere.

Some spinal cord injury patients who would normally be sent to Counties Manukau for treatment, are being diverted to Christchurch.

Shepherd said so far only spinal cord patients had been sent elsewhere.

"We haven't sought to divert any other patients at this stage.

"Those are patients from outside Auckland already anyway, and so that that seemed like a prudent step. because we know that spinal cord patients can require at times quite prolonged ICU stays.

"We haven't done that with other groups yet, and we know that we can't do that for some specialty groups that Auckland cares for, for the country."

New Zealand's College of Intensive Care Medicine chairman Dr Andrew Stapleton said the DHBs were prudent to plan they way they had.

"You've got to have a plan, and the plan in the first instance, if all the Covid is in one place, is to send staff to the Covid rather than patients away from Auckland or from the Covid area.

"My understanding is that it's taken the form of an expression of interest so that they know who would go should they be needed.

"Auckland hospitals employ a large amount of staff, many of whom have been at locations of interest themselves and are currently self-isolating, so they've got an acute shortage of nurses, particularly just for the time when they're getting busy."

The average length of stay for a Covid patient was 10 days, he said, so hospitals could quickly be overrun if case numbers increased.

Some high-risk surgeries likely delayed

An intensive care specialist at Middlemore Hospital, Dr Rob Bevan, told Nine to Noon the hospital has had to "scale back" on some of the work it would normally do, in order to create capacity.

Patients who have had very high-risk surgery, such as elective cardiac surgery or extensive cancer surgery, will potentially have some of those surgeries delayed, he said.

"Our capacity for business as usual does leave little fat in the system, and in the context of an evolving pandemic we have had to scale back on some of the work that we would normally be carrying out in in order to create that space and capacity.

He says if intensive care units became too full, health boards could divert nurses from other areas.

"But as we spread those teams thinner it's possible that the outcomes, the percentage of patients that we're able to get through this, would inevitably deteriorate.

"So that is why we are so focused on providing the best care under the best models. And we have got room to do that right now."

Bevan, who is also vice president of the College of Intensive Care Medicine, said public health measures, including vaccination and lockdown, must be the first line of defence.

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