Urgent care clinics are under increasing pressure as more patients walk through the door and not enough staff to keep up.
With both general practice and hospital emergency departments under strain, emergency care clinics sit somewhere in between.
Dr. Oruba Khalil could not recall a time in her long career when health care workers were under such strain.
She has worked at The Local Doctors Otara, an emergency care and GP clinic, for 24 years.
Now a year away from retirement, she was considering an early exit from the profession.
Due to the long overtime hours, Dr. Khalil was unable to keep his non-work schedule in check, and struggled to find time for exercise and coffee breaks.
“When I see people waiting for three or four hours, I can’t afford to go to lunch.
“I know that if I go to lunch, the wait will be another 30 minutes.”
Dr. Khalil said this year has been particularly difficult, with waves of Omicron in March and July and more staff out of work due to sickness.
Also, as Christmas approaches, emergency clinics can be overburdened as general clinics are closed for the holidays.
“Our staff need a break.
“Other GPs are closed for a while so we don’t usually have a good time over Christmas because we feel a lot of pressure from other clinics, other GPs and patients in general… There will be more accidents during Christmas, so we have to deal with all of this.”
Earlier in his career, Dr. Khalil said clinics never sent patients home unseen, but now scheduling appointments for the next day was sometimes the only option. .
“Waiting times are long, people are frustrated, and sometimes patients are abused. This happens because of the pressure.
“I understand how patients feel when they go to the hospital for four or five hours and are not seen.
Registered Nurse Sonam Swastika Ram usually started work at 8am.
By this time, there was already a long line of patients at the entrance.
Barring an emergency, these people can still find themselves waiting hours for a doctor to see them.
Nurses had to send some patients away because there were too many patients to handle.
“If you have a huge number of patients in the queue, let’s say 90 or 100 or more waiting, and you get a sick call and you’re running low on doctors… do a full triage and Determine if the next patient can come in. For example, ACC follow-up or those who don’t need to see a doctor immediately can wait until the next day.”
The nurse told the patient that if his condition worsened, he should go to Middlemore Hospital or Ascott A&E.
People with mild symptoms such as coughs and colds were often told it was best to buy a cough medicine mixture from the pharmacy and rest at home, with nurses checking on them by phone.
Swastika Ram said nurses’ job descriptions have been expanded in many areas to reduce the burden on doctors.
But the nursing workforce is also in short supply, which can put additional stress on nurses.
“We have to do the usual triage, we have to do the treatment, we have to do the vaccinations because we do it all in this clinic.”
Bipin Thakkar, regional director of Tāmaki Healthcare, said emergency care clinics have always taken on overflow from general practice.
But it has increased dramatically since the start of Covid, he said.
“People need more attention and help during this time and doctors are [around us] Couldn’t manage… Many patients come from other doctors.
“They need help, and we will provide that help.”
Thakkar said the clinic receives referrals from all over Auckland, including overcrowded hospitals.
Thakkar said the clinic’s ability to handle large numbers of patients can vary from day to day.
At the peak of Covid, emergency care clinics were handling up to 550 patients per day. This is up from a pre-Covid average of around 300.
Since the pandemic began, the average number of cases has remained higher than pre-Covid-19 levels, he said.
The number of staff working in the clinic also fluctuates daily. Today, there were 6 doctors in the morning, 9 doctors in the afternoon, 3 doctors in the evening, 5 nurses in the daytime, and 3 nurses in the evening.
“During Covid, uncertainty is every day,” Tucker said.
“Someone could test positive and be unable to go to work, so you never know what’s going to happen next.
Also, sometimes there is enough staff, but sometimes it is too rushed to respond. ”
The government has several initiatives to strengthen the workforce, such as helping internationally qualified nurses register in New Zealand and covering salaries for international doctors during induction courses and internships. I got
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