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Speaker 1: The line is Cath Hatcher from the Nursing and Midwifery

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Speaker 1: Federation of the Northern Territory, the Secretary. Good morning to you.

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Speaker 2: Cat Oh, good morning, Katie, Kath.

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Speaker 1: Another couple of code yellow sort of last week. There

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Speaker 1: was one it was lifted Friday. There was one prior

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Speaker 1: to that that was lifted on the twenty eighth of March.

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Speaker 1: How are things going from your perspective?

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Speaker 2: The hospital kind of sits at about one hundred percent

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Speaker 2: capacity or just under and then it fluctuates up to

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Speaker 2: you know, one hundred and twenty one hundred and thirty capacity.

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Speaker 1: Wow.

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Speaker 2: And when it gets to those type of levels, then

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Speaker 2: they reach out to all staff hands on deck and

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Speaker 2: the way that they do that is to court coder sorry,

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Speaker 2: to call a code yellow, and that means that everyone

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Speaker 2: comes out and helps, and it means that there's much

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Speaker 2: double bunking happening in the emergency department, or they've got

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Speaker 2: excess patients sitting on the wards that they need to

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Speaker 2: admit plus or minus need to send patients home, and

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Speaker 2: they try to send them to the discharged lounge, which

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Speaker 2: is on the ground floor to try and alleviate those beds.

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Speaker 2: So they can get the new patients in. That's just

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Speaker 2: shortness of staff, but it's the complexity of patients around

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Speaker 2: the top end. And you know we also take on

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Speaker 2: board patients from Catherine and Gove and right across the

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Speaker 2: top of the NT and sometimes across the top of WA,

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Speaker 2: so impacts. They also try to buy beds at the

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Speaker 2: private hospitals well to try and put public patients across

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Speaker 2: there as well. So it's a big complex issue.

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Speaker 1: Cas a we short staff allviate like are we short

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Speaker 1: staffed when it comes to nurses? I know you and

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Speaker 1: I have spoken about that before. Has it been much

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Speaker 1: work done in terms of boosting those numbers.

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Speaker 2: They? I mean, as you know, we had at Christmas

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Speaker 2: time about four hundred and forty for full time equivalent

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Speaker 2: staff down. That has got slightly better by about one

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Speaker 2: hundred and twenty eight full time equivalents. The rest of

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Speaker 2: about ten percent filled with agency staff and right across

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Speaker 2: the territory apparently is a vacancy rate of about four percent,

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Speaker 2: but some areas don't have any vacancy rate, which is

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Speaker 2: a minority, and then other areas like wild Dull and

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Speaker 2: Palmston hospitals would probably have somewhere around the twenty percent

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Speaker 2: or give or take percentage of vacancy. So then they're

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Speaker 2: trying to look at their casuals, their pull staff agency

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Speaker 2: and full you know, people with permanent jobs at the

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Speaker 2: hospitals filling in by doing extra shifts through the week

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Speaker 2: to try and compensate. But everyone is tired of doing

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Speaker 2: their extra shifts and there needs to be Yes, they

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Speaker 2: need to get more staff across from agency paying them

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Speaker 2: their high amount of dollars per hour, trying to try

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Speaker 2: and entice them across to become a permanent employee with

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Speaker 2: the Department of Health and the same is happening around Australia,

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Speaker 2: but it's just not happening because the nurses want to

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Speaker 2: have flexibility and they want to be able to say

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Speaker 2: work two months on, have a month of where you

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Speaker 2: can't well not always get that within the department.

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Speaker 1: Yeah, yep. So then sometimes working as an agency work

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Speaker 1: gives you that gives you that flexibility, I'm assuming.

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Speaker 2: Yep, yes, absolutely, you know.

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Speaker 1: We also have have obviously seen this morning it's been

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Speaker 1: reported by the NT Independent that essentially the neonatal Intensive

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Speaker 1: care Unit at Royal Daht Hospital is no longer treating

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Speaker 1: children born before thirty two weeks gestation because of a

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Speaker 1: lack of staff Kav what do you know in this space?

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Speaker 2: Yes, we were alluded to this a few weeks ago

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Speaker 2: as well, and it's very unfortunate that, you know, time's

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Speaker 2: gone past. They have had the highly skilled and trained

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Speaker 2: nurses that can look after the little babies from twenty

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Speaker 2: four weeks right through to thirty two weeks yep. And

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Speaker 2: in that time that they need to have that the

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Speaker 2: nurses need to have that extra certific with looking after

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Speaker 2: the natal intensive care little ones with intubation or seapat machines,

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Speaker 2: and unfortunately at the moment, there's apparently only one nurse

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Speaker 2: that is qualified to do that at the moment, so

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Speaker 2: they've had to make a rough, very hard decision to

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Speaker 2: stand down any other pregnant women or babies born before

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Speaker 2: thirty two weeks that they need to go into state.

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Speaker 1: Wow, so only one nurse in the territory at this

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Speaker 1: point in time that's got that qualification.

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Speaker 2: Will Darwin?

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Speaker 1: Yeah, Darwin, Yeah, Like is that quite surprising to you?

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Speaker 2: It is quite surprising. I mean, the twenty four years

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Speaker 2: that I've worked here in the territory and nineteen of

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Speaker 2: those working at Yal Darwin. They've always had enough staff

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Speaker 2: to be able to accommodate basically any baby born before

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Speaker 2: thirty two weeks that's bible from twenty four weeks onwards.

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Speaker 2: Occasionally they might have had a big influx, you know,

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Speaker 2: in March and September things to be the bigger months

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Speaker 2: for babies to be born, and occasionally they might have

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Speaker 2: had overflow and have had nowhere to absolute put them.

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Speaker 2: So they've transferred them into state so to be able

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Speaker 2: to manage what they've already got and so everyone is

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Speaker 2: getting the best care that they have can give.

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Speaker 1: Y Kath, just going back to what you said there,

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Speaker 1: you know that a nurse in that neonatal intensive key

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Speaker 1: unit requires that additional training to be able to intubate

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Speaker 1: a baby of you know that is that young. If

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Speaker 1: we're then if we're now in a situation where where

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Speaker 1: a baby is having to be taken by care flights

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Speaker 1: interstate with their mum, you know, when they are born

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Speaker 1: that early, like, is there a risk here that that

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Speaker 1: things could go very badly if you don't have somebody

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Speaker 1: that's that's qualified to do that while they are here

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Speaker 1: in the territory during what I would think are pretty

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Speaker 1: vital hours.

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Speaker 2: Yes, certainly, so if you know potentially they would be

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Speaker 2: getting transferred to Adelaide, well, then the team from Adelaide

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Speaker 2: with their expertise, a pediatrician or ninatologist who specializes in

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Speaker 2: little infants and a nurse that has got that extra

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Speaker 2: qualification can come up and pick up the baby and

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Speaker 2: take it back to Adelaide. Or if there was an

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Speaker 2: expertise of that one nurse available and a ninotologist here,

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Speaker 2: then you know, they could take the patient down to Adelaide.

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Speaker 2: But besides having only one qualified nurse in a ninato

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Speaker 2: intensive care you know, I also believe that they haven't

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Speaker 2: got a permanent neonatologist either here at Royal Dah and

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Speaker 2: Palms In Hospital, which is also exacerbating the problem. So

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Speaker 2: they need to have a permanent at least one, if

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Speaker 2: not too permanent near natologists, and they need to have

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Speaker 2: you know, many I don't know how many staff they

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Speaker 2: require that they need more than one qualified as a nurse.

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Speaker 1: I don't want to be, you know, like I don't

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Speaker 1: want to be causing alarm for the community in this space.

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Speaker 1: But look, I've you know, I've got two kids in

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Speaker 1: my own they're grown up now. I know how frightening

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Speaker 1: it is, or you can feel when you're pregnant, and

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Speaker 1: I cannot imagine how frightening it is for some expectant

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Speaker 1: mums if they then go into labor in the very

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Speaker 1: early stages of their pregnancy, before thirty two weeks, it

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Speaker 1: would be incredibly frightening. Is there a risk here for

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Speaker 1: these mums and their bums if we don't have a

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Speaker 1: neonatologist and those specialized nurses or I don't have enough

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Speaker 1: of them. If a mom is in a situation where

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Speaker 1: she goes into labor very very early, you know.

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Speaker 2: There's risks either side. So yes, they're Rodney and apologists

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Speaker 2: and at least that one Sequit Niku nurse here at

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Speaker 2: Royal dal In Hospital. So they've made the right decision

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Speaker 2: under the bad circumstance at the moment to have the

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Speaker 2: community mothers and babies being cared for elsewhere, which is

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Speaker 2: always at a risk, and it's unfortunate for moms to

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Speaker 2: go down into state, away from their family and communities, etc.

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Speaker 2: To have the care that they need and then they'll

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Speaker 2: be able to come back after the babies at least

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Speaker 2: thirty two weeks above that. But you've got to also

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Speaker 2: look at yes, if someone went into labor at twenty

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Speaker 2: one or twenty eight weeks per se, they the people

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Speaker 2: in the clinics out in communities, or the doctors and

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Speaker 2: nurses and midwives within the hospital, they would give them

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Speaker 2: some medication to try and suppress be the pregnant sorry,

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Speaker 2: the labor potential labor, and if they're stable enough, they

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Speaker 2: would transport that mother with the baby still inside down

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Speaker 2: to Brisbane or Adelaide or Melbourne with accompanying midwife plus

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Speaker 2: or minus pediatrician or obstetrician to go down to the

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Speaker 2: other states to get that care.

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Speaker 1: All right, So there are therese and you know, I know,

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Speaker 1: like I always say whenever I speak to nurses or

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Speaker 1: doctors people in this space, they are absolutely incredible at

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Speaker 1: what they do and in those difficult emergency situations as well,

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Speaker 1: they you know, they know better than anybody how to

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Speaker 1: deal with them. So it does sound as though there

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Speaker 1: is definitely some measures there in place to any expectant

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Speaker 1: mums listening to the show this morning that might be

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Speaker 1: quite concerned really upon hearing that we no longer are

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Speaker 1: able to care for babies if they are born PREMI

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Speaker 1: before thirty two weeks that they are going to obviously

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Speaker 1: have to head into state. Kath. We've got a few

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Speaker 1: messages people coming through really about the state of those

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Speaker 1: code yellows and people asking if you've sort of got

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Speaker 1: any idea when it comes to those emissions admissions I

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Speaker 1: should say in emergency is have we got a lot

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Speaker 1: of alcohol related you know, presentations? I guess is the

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Speaker 1: right word.

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Speaker 2: Yes, they certainly do have alcohol and other drug presentations

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Speaker 2: to the emergency department on every shift, every day, and

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Speaker 2: they can be a small percentage to sometimes being quite

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Speaker 2: a number of clients turning up that are in distress

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Speaker 2: because they have alcohol or other drugs on board and

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Speaker 2: they're needing mental health support or drug support. Unfortunately, you know,

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Speaker 2: if they're in a crisis, the ED is the person

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Speaker 2: the place to go. But hopefully they are already in

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Speaker 2: the system that they can access their care worker and

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Speaker 2: their support worker and trying to for the mental health

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Speaker 2: support team that they can try and avoid emergency department,

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Speaker 2: but sometimes that's unavoidable and they do need that urgent

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Speaker 2: care like other people do. But yes, it is a

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Speaker 2: concern and it can be very time consuming and worrying

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Speaker 2: for other patients that are in the ED as well

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Speaker 2: with a vulnerable type yelling out with alcohol and other

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Speaker 2: drugs on board.

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Speaker 1: KAS one of the other things that we have had

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Speaker 1: raised to us over recent weeks. And look, I know

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Speaker 1: it's kind of it's it's probably not one for you,

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Speaker 1: but I'm just wondering whether it's something that you've been

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Speaker 1: alluded to as well, and that is some really quite

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Speaker 1: long delays for people needing things like ultrasounds for you know,

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Speaker 1: for lumps in breast, needing, things like ultrasounds for you know,

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Speaker 1: for for different issues that they may have in terms

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Speaker 1: of you know, their their stomachs and those kinds of things.

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Speaker 1: Is that something that you've sort of heard about in

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Speaker 1: recent weeks.

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Speaker 2: Yeah, I have heard that over the last you know,

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Speaker 2: twelve to eighteen months that not just nurses, midwives, doctors,

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Speaker 2: other healthcare workers, but also radiologists snographers are also short

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Speaker 2: staffed as well, so they're trying to continuously recruit to

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Speaker 2: those positions throughout the territory and they do have the

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Speaker 2: similar issues across Australia, so they're trying to do their

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Speaker 2: best and recruit to their team and trying, you know,

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Speaker 2: not to have those delays of a month until you

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Speaker 2: have an ultrasound of the breast you know before say

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Speaker 2: for suspicious lump, etc. And it is concerning that, you know,

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Speaker 2: having to wait for over a month is stressful, etc.

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Speaker 2: But yes, I have heard that they have been delayed

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Speaker 2: and that's unfortunate because of staff shortages as well. Yeah.

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Speaker 1: I wonder as well, longer term, what it's going to mean.

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Speaker 1: I suppose in terms of some of those those different

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Speaker 1: illnesses and those you know, those different yeah things like cancer,

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Speaker 1: whether it does mean that people's diagnoses are sort of

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Speaker 1: prolonged and they're not being picked up as early as

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Speaker 1: what we may like.

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Speaker 2: Yeah, I hope I hope not too. And I hope

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Speaker 2: that as soon as it's discovered that the treatment is

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Speaker 2: pretty quick and not delayed for staffing or any other

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Speaker 2: you know, healthcare concerns.

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Speaker 1: Yeah, well, yes it is. And look it's I guess

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Speaker 1: it's across the board, isn't it. There's quite a few

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Speaker 1: things there for us, you know, to think about. Cath Hatcher,

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Speaker 1: I always appreciate your time. I know that you're incredibly busy.

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Speaker 1: Thank you so very much for having a chat with

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Speaker 1: us this morning.

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Speaker 2: You're welcome, Katie. I was just going to say about,

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Speaker 2: you know, the delays in these ultrasounds, and then you've

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Speaker 2: got the code yellows happening in the hospital. Ye. What

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Speaker 2: happens with the code yellows is that they delay the

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Speaker 2: elective surgeries. Although something like a lump in the breast

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Speaker 2: that is canceroers won't be an elective surgery. It'll be

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Speaker 2: a category to type surgery, so they shouldn't be delayed.

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Speaker 2: So just letting the public know that the simple things,

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Speaker 2: you know, like a need replacement, even though it's very

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Speaker 2: painful and you need the knee replacement, it's not life threatening.

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Speaker 2: Whereas a lump in the breast, if that's delayed, then

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Speaker 2: it won't be for these code yellows happening at the hospital.

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Speaker 1: That is good to hear because I think that you

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Speaker 1: know that for a lot of people, it, like you said,

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Speaker 1: if you need your knee replaced or something, it is

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Speaker 1: absolutely something that you want to have happened as quickly

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Speaker 1: as you can. But if it's not life threatening, I

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Speaker 1: think it is good to know that those kinds of

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Speaker 1: surgeries aren't being delayed. No, No, correct Kath thank you.

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Speaker 1: Thanks so much for your time this morning. I really

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Speaker 1: appreciate it.

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Speaker 2: No, you're very welcome. Thanks, thank you.

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Speaker 1: That is Kat Hatcher there. She is indeed the head

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Speaker 1: of the nursing and with Reunion here in the Northern

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Speaker 1: Territory or the nursing and with Refederation, I should say,