‘Staff are broken’: Code Yellow called for RDH and Palmerston Hospital for first time in 11 months

NT Health chief executive explains why a Code Yellow has been called, while peak body says action welcome but staff leaving shifts in tears with capacity issues ongoing.

Palmerston Regional Hospital and Royal Darwin Hospital have declared code yellow. Picture: Pema Tamang Pakhrin

Royal Darwin and Palmerston Hospitals have declared a code yellow due to “capacity challenges” for the first time in nearly a year.

The Health Department issued the code yellow late on Tuesday afternoon at both hospitals citing an “increase in the number of patients requiring ongoing acute care”.

The calling of the code, which signifies an internal crisis, follows just weeks after the NT Health Minister and NT Health chief executive said they had not needed to call one since August 2024 due to new processes being in place at RDH.

Speaking to this masthead on Wednesday, NT Health chief executive, Chris Hosking, said he has always maintained that if the set of conditions for a code yellow were reached, he would have no problem issuing the call.

NT Health chief executive Chris Hosking. Picture: Supplied/Georgia Politis.

“When the hospital management came to me yesterday afternoon and said, ‘Look, all of the preconditions for a code yellow have been met, we’d like to call it’, I signed it off immediately,” Mr Hosking said.

Previously, the Health Minister, Steve Edgington and Mr Hosking, were questioned on the lack of code yellows issued and said any changes to the notification and identification had not changed.

Mr Hosking said a change in processes such as moving patients to available beds quickly had helped to reduce bed blocks and that RDH was “not in crisis”.

However, this was criticised by Australian Medical Association (AMA) NT president Dr John Zorbas who said the daily reality was that RDH remained “dangerously full”.

‘Our nurses and doctors are broken’

Dr Zorbas said the AMA welcomed the issuing of the code yellow.

“We know the hospital has been over full for quite some time now,” he said.

“During the week, we’ve had doctor after doctor come to us with fairly horrible situations in the hospital.

AMA NT President Dr John Zorbas said staff are leaving their shifts in tears.

“It’s clear that the hospital is too full to function properly.”

He said it provides a “circuit breaker” to help deal with the current capacity crisis but does not fix the long-term capacity issues.

“We need to talk about capacity and the fact remains that RDH is full, remains full and will continue to be full once this Code Yellow stops,” he said.

“We’ve seen nurses and doctors who are going home in tears from their shifts.

“They’re absolutely burnt out and every shift that they walk out of like this is another reason to leave the NT and we don’t want that at all.

“They are broken.”

If the new wards at RDH are fully staffed and funded, he said it could help the issues but Dr Zorbas agreed with Mr Hosking that aged care was one of the biggest blocks.

“In context, we have half the number of aged care beds per capita compared to any other state or territory,” he said.

Mr Hosking said Royal Darwin Hospital is busy “pretty much every day of the week”. Picture: Pema Tamang Pakhrin

If Top End had more aged care facilities ‘we probably wouldn’t be in a Code Yellow’

To help mitigate the increased pressure, Mr Hosking said NT Health put out messages to ask people who are experiencing more minor health issues, to go to a GP or urgent care clinic instead of hospital.

But for those needing urgent care, he urged them to call triple-0 and still attend hospital.

He said staff would continue to increase their daily “huddle” meetings to increase patient flow by identifying patients who can be discharged or transferred.

“The main thing for me really would just be to express my appreciation for our staff and the work they do,” Mr Hosking said.

“They’re working in difficult conditions there and they turn up every day and they do a b****y good job.”

One of the main ongoing issues to bed pressures each week is the amount of patients who should be in an aged care facility.

Over 40 beds are being used by aged care patients waiting to be transferred to a facility at Palmerston Regional Hospital. Picture: Pema Tamang Pakhrin

With 42 beds being used by long stay aged care patients in Palmerston Hospital on Wednesday alone, he said having an aged care facility would provide some relief to the public system.

“We would have 42 beds available to people for delivering health care and we probably wouldn’t be in a Code Yellow,” he said.

“We’re working really hard with our Commonwealth counterparts to try and establish some more capacity here in the Territory.”

When asked if the ongoing developments at RDH, the new mental health ward and general bed ward, will also help with capacity, Mr Hosking said it would “absolutely help”.

Despite it remaining a “challenge” to attract qualified health professionals to the Territory, Mr Hosking said he was “confident” in their ability to staff the new wards thanks to ongoing work and extra funding allocated in the 2025 budget.

What is a Code Yellow?

The term is used in hospitals to signify an internal emergency.

Mr Hosking said it tends to be looking at the number of beds occupied, patients waiting in ED waiting to be admitted and the projected number of people due to be discharged.

“When those numbers start to not line up, if we’ve got 30 people waiting to be admitted and only 10 coming up for discharge, that’s creating a problem,” said Mr Hosking.

This week, he said the hospitals have had an unusually high number of patients with infections which requires more PPE, care and space to help isolate them to stop an infection spreading and increased numbers of mental health presentations.

While patient presentation numbers are not higher, the acuity of patients presenting is.

“In simple terms, they’re pretty sick and they need more care than we would normally see,” he said.