Royal Hobart Hospital horror stories linked to bed shortages, inquiry hears
A suicide in the Royal Hobart Hospital’s emergency department waiting room and a patient “sexually touched” are among incidents aired at an inquiry into Tasmania’s acute health services.
Doctors and nurses have blamed several “terrible incidents” on bed shortages which are being exacerbated by the hospital’s redevelopment.
Witnesses at an Upper House parliamentary inquiry into the state’s acute health services have revealed a damning list of critical incidents at the hospital.
AMA Tasmania mental health spokesman Dr Richard Benjamin said the loss of 10 mental health beds in 2016 was having a significant impact.
“The effects of this bed block have been both widespread and dramatic,” he told the inquiry.
“Acutely ill psychiatric patients with various associated risks are no longer able to access specialist help in a timely way.
“There are now often four to six [mental health]patients waiting in the emergency department for a bed and on occasion there have been 10 or more.”
Among the incidents have been:
- A suicide in the emergency waiting room
- A young female patient sexually touched
- A young male hit
- A woman with an ectopic pregnancy resuscitated in the corridor
Dr Benjamin said urgent action was needed.
“The coroner made it very clear that at least one death has been due to bed block. The coroner is investigating another death that occurred in the waiting room of the emergency department,” he said.
“Something needs to be done very quickly to respond to the need or terrible things will happen, terrible things are already happening.
“People are being trans-institutionalised, they’re leaving the hospital, they’re being arrested, they not getting treatment, their manic illnesses are going for longer.”
Young patients missing out on care
The Royal Australian and New Zealand College of Psychiatrists’ Fiona Wagg told the inquiry adolescent mental health patients were not getting the care they needed.
“We had a suicidal young person who was there for most of a weekend lying in a bed,” she said.
“We had a 15-year-old young man with first episode psychosis who was in an emergency department bed overnight repeatedly trying to leave, terrified.
“In the past we were able to admit them to the adult ward but in a separable unit, but that no longer exists.
“We have nowhere to admit safely. The issues of how short of beds they are, and that you’d need to sacrifice a bed in order to create a safe space for a young person, has meant it hasn’t happened.”
Dr Wagg told the inquiry it wasn’t appropriate to mix vulnerable young people with adult patients.
“Unfortunately the last three young people we’ve had to admit to the adult ward despite them having one-on-one nursing and despite the best efforts of everyone involved have been traumatised in various ways,” she said.
“One young woman was sexually touched, a young man was actually hit and a young man, a disturbed patient, came into his room and he was very frightened.”
Professor Fiona Judd from RANZCP told the inquiry the layout of the Royal’s mental health ward was unsuitable.
In September it was revealed the RHH had been stripped of its accreditation for psychiatry care training.
“One of the things that was noticed by the college accreditation visitors who came was how unsuitable the layout of the ward is,” Professor Judd said.
“They were very taken aback to hear in the new ward that’s coming it’s going to be the same. How can you possibly do something else that’s blatantly unsuitable?”
Her organisation feared that when the revamp was finished, the hospital would continue to struggle with patient demand.
Pregnant woman resuscitated in corridor
Deanna Butler, an emergency department worker and Australian Nursing and Midwifery Union member, said the hospital was struggling to cope.
On a busy winter night this year a woman with an ectopic pregnancy had to be treated in a corridor.
“There was no bed available for the patient to go into and she did collapse in the waiting room and the trolley needed to be found again from all these cramped areas,” Ms Butler said.
“This patient then had to be resuscitated in the ambulance ramping corridor which again there would’ve been other people around.”
‘Cupboard’ solution for bed pressures
Nurse Andrew Ostler said staff were under considerable pressure.
“If there’s a cupboard you could put a bed in it at the moment,” he said.
“Staff walk around thinking ‘where else can we put beds’, but someone has already thought about it. It’s inappropriate spots, but that’s all we have.”
Health Minister Michael Ferguson said the Government was funding a new Mental Health Observation Unit to ease pressure on the emergency department.
But the unit’s design has been criticised by health groups.
Mr Ferguson said the observation unit had received in-principle support from senior specialists, but the other stakeholders would be consulted “so we get the model right”.
He said a dedicated Child and Adolescent Mental Health inpatient facility is being included in the RHH redevelopment.