Middlemore COVID-19 case: NZ Nurses Organisation concerned about shortages after 29 staff forced to isolate

The NZ Nurses Organisation is concerned about staffing levels at Middlemore Hospital after 29 staff members were forced to isolate after a patient tested positive for COVID-19. 

The COVID-positive patient went to Middlemore at 5pm on September 4 with atypical COVID-19 symptoms. After routine COVID exposure questioning, they weren't identified as a risk and were moved to an adult short stay ward from the emergency department.

At 7am on Sunday, they were moved to a surgical ward - 34N - where concerns about their condition resulted in them being tested for COVID-19. They then tested positive at 3pm and were moved to the respiratory ward dedicated to COVID patients.

Of the 29 staff that are stood down, there are 11 doctors, 13 registered nurses, two health care assistants, a phlebotomist, cleaner and ward clerk.

NZ Nurses Organisation President and kaiwhakahaere Kerri Nuku told The AM Show having 29 staff members out of action is a "significant issue". 

"These are skilled health professionals… this is a significant issue to have so many staff down within a hospital," she said on Wednesday. 

Nuku said nurses are frustrated because there isn't a prepared plan for dealing with a situation like this. 

"We've got frustrated nurses. They're frustrated that we haven't got a prepared pandemic plan, a prepared plan that recognises that we've got chronic nursing shortages. 

"It places huge pressure on the nurses that are existing. But also a significant amount of staff being taken out of any healthcare workforce, or any workforce, is going to have a significant emotional strain."

She said nurses are worried about how they will provide the necessary care to patients under increased pressure. 

"We've talked a lot about this workforce being quite scared. Scared in terms of ensuring there is adequate protection for them, for their patients, and that they don't take anything home."

She said a lot of support is needed to ensure the hospital can operate on a "business as usual" approach.

"What we've got to ensure is that we are not putting extra pressure on the staff and that they've got the support required to run the wards."

The Ministry of Health said extra support staff are being sent to Auckland to help with the COVID-19 response

"The Ministry of Health are working with metro-Auckland DHBs to match available staff to need and will continue to deploy staff as required to ensure they have the resources they need.

"Metro-Auckland DHBs are working closely together to manage the COVID-19 positive cases needing hospital-level care. The hospitals have been constantly updating their planning for surge capacity which includes preparations for staffing and resourcing additional beds in dedicated COVID-19 wards." 

Middlemore Hospital has closed four wards to new admissions and all patients and staff who were potentially exposed between 6:35am and 4:30pm are classed as contacts.

Timeline of COVID-positive patient's movements in Middlemore, from the Ministry of Health

September 4

  • 1700hrs a patient presented in ED with abdominal pain. When asked screening questions, patient denied having contact with COVID-19 or having been in a location of interest

  • He was triaged into main ED assessment where staff are in full PPE (N95s and goggles). He stayed in an open curtained room and seen by ED staff

  • 2039hrs he was moved to adult short stay into a four-bedded room, where he awaited test results

  • 2242hrs he had a CT scan and returned to adult short stay.

September 5

  • 0305hrs he was seen by the surgical registrar

  • 0700hrs was admitted to ward 34N. At this stage there were no symptoms that gave teams reason to consider he may be COVID-19 positive, based on HIS indicators. He was admitted into a four-bedded room at the front of ward 34N. Ward staff were wearing appropriate PPE for a surgical ward (i.e. surgical masks).

  • He developed a fever during this time. There was still no cause identified for the abdominal pain

  • 0955 the consultant surgeon ordered swabs observing fever symptoms; clinical documentation records no cough, no loss of taste or smell, and patient had not been to any locations of interest

  • Patient remained in the room post-swab because there were no isolation spaces on the ward. On advice from IPC the patient wore a surgical mask and curtains remained closed

  • 1500 test result received with a low CT value

  • 1620 patient moved to Ward 7 for COVID19. Full PPE was observed.