Five Minutes With The Clinical Lead Of An Emergency Department


Last week I was lucky enough to steal five minutes with Dr Vanessa Thornton, the Clinical Lead of the Middlemore Hospital Emergency Department, to find out how her and her team are preparing for the many challenges that lie ahead. 

How does a hospital like Middlemore prepare for the Coronavirus in terms of staffing and resourcing? Do you ask staff to work extra shifts or contract in additional staff from other facilities?

We’ve been using the expertise of epidemiologists to assist us in forecasting the number of patients we might see. Based on that information, we will do a combination of things to ensure we have enough staff for the acute service of treating Covid-19 patients:

– We halt all elective clinics and surgeries and redeploy those staff to the acute service. This includes non-urgent surgical procedures like cataract surgery. By halting anything non-urgent, it also helps conserve hospital space and personal protective equipment for healthcare workers.

– We bring qualified staff back from non-clinical duties such as teaching into the acute service.

– We use staff from private facilities that have had to close due to the lockdown announced by the government.

– We ask staff who typically work part-time hours to increase to full-time if they are able.

– And we’ve also been really fortunate that old colleagues who had left our service have offered to return. For example, young nurses and doctors who had resigned with plans to go on their OE and are now unable to travel due to the government lockdown have offered to return to the hospital. 

Friends and whanau are accustomed to being able to visit their loved ones when they’re in hospital – but in order to minimise community spread this will have to change. How is Middlemore planning on managing visitation rights and communicating this with patients?

This has been a tricky topic but to minimise risk to visitors and to other sick patients in the hospital we have had to restrict visitation at the hospital to the point of no visitation except on essential or compassionate grounds. We’ve made sure that whaanau can still keep in touch with their loved ones by phoning the hospital and asking to be put through to the ward or area where the patient is. While the current number of patients in Counties Manakau remains low, we are yet to see if the measures taken by Prime Minister Ardern will be enough to flatten the curve so essentially we are preparing for the worst but hoping for the best. We communicate our new visitation restrictions extensively with patients as soon as they enter the hospital and we’ve also been speaking to our community through the Counties Manukau Health Facebook page.

I can imagine that one of your greatest challenges will be maintaining and protecting the health of your staff – essentially making sure they don’t contract the virus while caring for patients. How will you minimise risk exposure? How do you prepare for this? 

South Auckland is one of the most at-risk places for the Coronavirus and we could see a sudden onslaught of cases, so we have spent the last six weeks reinforcing the use of our standard personal protection protocol with staff. This involves reminding staff how to use PPE (personal protective equipment like masks, gloves and gowns) appropriately when treating patients, and it’s the best way we can safeguard our staff against contracting the virus.

Header image by Holly Burgess for The Twenties Club