‘The worst I have ever seen in our hospital system’: Another shocker night in our EDs despite pause on elective surgery

A top doctors union chief said this is ‘the worst I have ever seen our hospital system” after another horror night in SA’s metro hospital emergency departments.

“Staff are f***ing broken”. This was the first, blunt message from a frontline hospital doctor besieged by overwhelming demand when their union rep came to check on them at the Royal Adelaide Hospital.

As the embattled health system lurches from record ramping to elective surgery cancellations and chronically full EDs, SA Salaried Medical Officers Association (SASMOA) chief industrial officer Bernadette Mulholland warned ED clinicians are burnt out and fed up.

“In my view it’s the worst I have ever seen in our hospital system,” she said.

“There has been years of pressure on clinicians in EDs and it is the same thing day in, day out, just relentless pressure.”

On Wednesday morning, the Lyell McEwin Hospital was again on Code White — treating more patients than official capacity — and an average wait of almost six hours to be seen at Flinders Medical Centre at 7am.

The Queen Elizabeth Hospital was on Code White by 8am treating 33 patients in its 29-capacity ED.

The “pause” on most elective surgery in metropolitan hospitals to free up ward beds and ease pressure on EDs is now coming up to two weeks after officials initially hoped to limit it to one week, when it was imposed on May 30.

Restrictions have been lifted in country hospitals.

It follows code whites on Monday night — treating more people than their official capacity.

Across the metropolitan system on Tuesday morning there were 110 patients stuck in EDs who had been treated but were waiting for an appropriate bed, 42 of them for 12 hours or more, adding to the frontline gridlock.

The mounting stress on the health workforce now sees Health Services Union members taking industrial action.

SA Health’s occupational therapy workforce have imposed a ban on unreasonable overtime and flexitime, are not recording non-clinical statistics and not completing vehicle logbooks.

The union says the action is to counter the workload pressures from OT workforce shortages.

HSU state secretary Billy Elrick said: “While we are carrying consistently high vacancy rates, OT staff simply cannot meet demand and see all patients who are referred to our service.

“Without a weekend OT service there is an inability to discharge patients who require OT input over the weekend. These issues cause delays that significantly impact bed block and ramping and places unrelenting pressure on workers.”

The Ambulance Employees Association state council is considering a request by the Opposition for a meeting as ramping hit a record 4773 hours in May.

Opposition leader David Speirs’ letter notes “this is now the third time the Opposition has sought to meet with the Ambulance Employees Association.

“While I acknowledge your grievances of the past, after more than two years since the former Liberal Government was in office, I ask that in the interests of your members and all South Australians we meet and discuss the current health and ramping crisis,” the letter states.

AEA state secretary Leah Watkins said the issue was with state council for consideration.

On record ramping, she noted the increased resources for SA Ambulance Service was about improving response times for emergency calls, but that ramping hinges on factors including appropriate places for mental health, NDIS and aged care patients ready to be discharged, as well as the promised 606 extra hospital beds.

“They are critical to addressing ramping,” she said.

Meanwhile frontline doctors are facing burnout from the unrelenting pressure in EDs.

People have written on Ambulances that have been ramped at the New Royal Adelaide Hospital. Picture: facebook

“Clinicians are fatigued, sick and tired, and people are leaving, they’re just being worn down.

“The dedication and care is there for patients but it is an unrelenting pressure that does not seem to have a solution.”

At 4pm on Tuesday the system was again buckling with metropolitan ED clinicians treating 355 patients despite an official combined capacity of 317 places. Most hospital EDs were on code white, treating more patients than their official capacity

To publicly emphasise the point, SASMOA has updated its X handle to include the provocative: “South Australia’s public hospitals are at breaking point.”

Ms Mulholland listed a confronting series of incidents ED doctors have faced in recent weeks.

On an inspection of the flagship $2.7bn Royal Adelaide Hospital, on May 17, she found one patient in the ED who had been waiting more than 102 hours for a suitable bed after being treated.

The 69-capacity ED was crammed with 52 patients treated but waiting to be moved on, creating a gridlock as new arrivals waited for beds.

She said the first words she heard from a doctor as the safety inspection commenced was: “Staff are f-ing broken.”

Four days earlier doctors advised SASMOA that one mental health patient in the RAH ED had been waiting 95 hours for a suitable bed and five such patients had been waiting around 60 hours.

ED staff are burnt out and at the breaking point. Picture: NewsWire / Kelly Barnes

SASMOA has posted a series of powerful graphics online to reflect the situation including one “just in case the health employer and SafeWork SA are unclear about what is happening to frontline health workers daily in our hospitals and health system.”

It included banners reading: “Burnt out,” “I am scared,” “That was humiliating,” “I can’t sleep,” “This place is toxic,” “I can’t stop seeing it over and over,” and “I am emotionally exhausted.”

Health Minister Chris Picton said he is incredibly grateful for hardworking clinicians who are working tirelessly during this period of extreme demand on our hospital system and thanked them for their commitment and dedication to patients.

“We know our hospital system needs more beds to create capacity and that is exactly what we are building,” he said. “Over the course of this year and next we will open more than 330 new hospital beds – that’s more than the equivalent of adding a new Queen Elizabeth Hospital to our health system. Those 330 beds are part of our overall commitment to add more than 600 beds to the health system.

“We’re also recruiting the staff to operate the beds. In our first two years in government, we recruited 1432 extra frontline health workers above attrition, including 691 nurses and 329 doctors.”

However, as hospital ED continue to struggle with surging demand Ms Mulholland said: “You just see it in peoples’ faces — there is a lack of confidence in the administration that it can be fixed.”

However, ongoing heavy demand exacerbated by a surge in respiratory conditions including Covid, flu, RSV, whooping cough, mycoplasma and the common cold has kept the pressure on EDs.

There are 21,374 patients listed as “ready for surgery” on the public health elective surgery list including 4196 listed as overdue.

Originally published as ‘The worst I have ever seen in our hospital system’: Another shocker night in our EDs despite pause on elective surgery