Hospital a 'war zone'


DOCTORS at Coffs Harbour Health Campus say the city's public hospital could find itself in the same situation as Sydney's Royal North Shore Hospital, due to a shortage of consulting physicians in the Emergency Department.

But North Coast Area Health Service CEO Chris Crawford says a new model of care is on the way which will relieve the pressure on Emergency doctors.

Royal North Shore's ED hit the spotlight last week when 32-year-old Jana Horska, who was 14 weeks pregnant, collapsed in the emergency room toilet while miscarrying after waiting two hours in the waiting room without medical or nursing support.

The incident has been linked to wider concerns about funding, management and staffing at RNS, especially the hospital's emergency department.

Dr Jon Waites, the Chairman of the Medical Staff Council at the Coffs Harbour Health Campus, said Coffs Harbour was down 'at least two' on the number of consultant physicians it should have in the emergency department.

He said this was creating major problems not just for the department but for the rest of the hospital, since it could lead to up to 10 or 12 patients lying in the department overnight.

Fellow council member Dr Alan Tankel said the Coffs Harbour Emergency Department was 'like a war zone' and two more emergency consultants were desperately needed.

"It is the most stressful place to work," said Dr Tankel.

"It is one of the busiest non-metropolitan emergency departments in Australia, but we have half the number of emergency staff that Lismore (hospital) has.

"The junior staff work their fingers to the bone, but the senior staff make the difference, because they can competently discharge people."

Dr Tankel said they had been trying to meet with North Coast Area Health Service CEO Chris Crawford on the issue for two years.

But yesterday Mr Crawford disputed both assertions, saying he had received a submission from Dr Tankel in March and while Lismore had 'slightly' more ED staff, this included one full time equivalent position to provide support for the lifesaver rescue helicopter, which is based in Lismore.

Mr Crawford, who will meet the Medical Staff Council doctors in Coffs Harbour on October 24, said it was not fair to compare doctor numbers at Coffs Harbour to Lismore, because of particular problems in Lismore.

An increase in the nursing staff at Coffs Harbour ED in the last six months has drawn praise from both nurses and doctors, who have also paid tribute to campus manager Margaret Bennett's work in trying to help the department's problems.

Chris Crawford said by November Coffs Harbour would be one of several North Coast hospitals using a different model, whereby patients arriving at Emergency with less serious or chronic complaints, for example cellulitis, diabetes or chronic heart conditions like arrhythmia, would be diverted to an Express Care Clinic, which would consider their problems more holistically and work on 'hospital in the home' plans which would provide patients with long-term treatment.

Port Macquarie already has an Express Care clinic.

He said the Royal North Shore incident had already led to a decision to change policy, so that women who were miscarrying would not go to Emergency but to the Maternity Unit where they would be under the care of trained midwives.

"We will try to introduce this as soon as possible," Mr Crawford said.

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