‘Internal ramping’ and ‘corridor care’ on the rise, distressed nurses say and call for government action

The Australian Nursing and Midwifery Federation warns it’s “only a matter of time” before tragedy strikes, as emergency patients are left on trolleys in corridors with “no oxygen, no privacy, no dignity.”

The nurses union is demanding an end to “internal ramping” and “corridor care” as the health system continues to struggle to cope with demand.

With EDs constantly short of beds this month — at 2.30pm on Wednesday clinicians were treating 364 patients despite the combined metropolitan system having just 333 places — patients are being put in corridors on trolleys.

Nurse union boss Elizabeth Dabars at a press conference criticising internal ramping and corridor care at RAH ED. Picture Brad Crouch.

Australian Nursing and Midwifery Federation state secretary Elizabeth Dabars said the union is sick of government “platitudes” on ramping and wants action.

She said internal ramping is putting patients at risk, giving the example of a critically ill patient who nearly ran out of oxygen while stuck in a corridor.

“They got a new bottle to him just in time,” she said.

Nurses demand end to internal ramping Internal ramping at the RAH. Picture: ANMF

Patients are being put on trolleys behind screens in corridors due to lack of ED beds. Picture: ANMF

Ms Dabars said the union had tried every avenue to deal with the situation without success and decided to go public “because the problem is hidden behind closed doors.”

“We want no patients being internally ramping, getting corridor care,” she said.
“They have no oxygen, no suction, no call bell, no privacy, no dignity. It is only a matter of time before there is an adverse patient outcome.”

The union wants senior clinicians rostered 24/7 to help with patient discharges to open up beds more efficiently, and for nurse practitioners to have more authority and autonomy.

Opposition health spokeswoman Ashton Hurn said: “From 15 hour waits on the ramp, record ramping, doctors demanding stab-proof vests and patients on beds in corridors, it’s clear to anyone that this is a system in complete crisis.

“Labor has got to get its priorities straight and start acting with urgency to fix ramping and health like they promised.”

Ambulances parked at the Royal Adelaide Hospital. Picture: NewsWire / Kelly Barnes

Health Minister Chris Picton rejected the term “internal ramping” or that suggestions patients were being put in corridors to reduce external ramping number.

“We’re going to see over 180 extra beds coming online and open in the next six months, and record numbers of doctors and nurses are being hired across our system,” he said. “We are throwing literally everything that we can in terms of making sure that we’ve got the capacity to meet the very significant demand that our hospitals are seeing.”

He noted it was difficult to speed up some discharges as some patients had nowhere to go.

“At the moment, it’s very hard to be able to get people out of hospital into aged care, into other supported care,” he said. “Over 260 people in our hospital system at the moment have been medically cleared for discharge but we can’t get them into aged care.”

Central Adelaide Local Health Network chief executive Dr Emma McCahon said: “At times when the ED is well over capacity, some patients are cared for in spaces such as near nurses’ stations where they can be closely monitored while waiting for a bed to be allocated in a ward.

“These are patients in hospital care and this is consistent with SA Health’s Statewide Demand and Escalation Policy. This is not internal ramping.”

Ms Dabars also called for separate zones in hospitals, or entirely separate facilities, for people suffering mental health episodes or needing to detox from drug or alcohol use.

“The violence and aggression continues to escalate and it is absolutely appalling,” she said. “There is a commitment to zero tolerance, and now an inordinate amount of security personal in EDs, but the reality is it is a Band Aid solution.”

Ms Dabars said people suffering mental health episodes or affected by drugs like meth need a calming environment — not the stimulation of a bright, noisy ED where they may end up stuck for many hours, even days, waiting for a ward bed.

Originally published as ‘Internal ramping’ and ‘corridor care’ on the rise, distressed nurses say and call for government action