Head-in-the-sand health bureaucrats in Australia

Queensland ambulance bosses were warned months ago about chronic understaffing and overworked paramedics suffering severe fatigue on the job. Confidential workplace health and safety documents obtained bt The Sunday Mail reveal that stressed frontline troops raised concerns as long ago as 2005. They warned that driving ambulances while fatigued threatened paramedics, patients and the public.

One said it was not uncommon for paramedics to have micro-sleeps at the wheel. A supervisor submitted a report to the Qeensland Ambulance Service workplace health and safety officer in May, outlining specific problems in Southeast Queensland. He recommended a review of fatigue policies: using other staff to drive fatigued officers back to the station and then home; and communications officers being more vigilant about overtime. He also called for an investigation by an independent agency.

Sources said yesterday that the report was ignored by QAS management. Stanthorpe ambulance Officer Julie Clark last week gave The Sunday Mail details of a nightmare shift of 36 hours. Ms Clark, 43, a trainee paramedic, said there were major safety concerns for all people involved and that someone could have been "in- jured or worse, killed" if she had fallen asleep. Ambulance Commissioner Jim Higgins said long shifts were "rare" but conceded the Clark situation "could have been managed better".

Paramedics were critical of Mr Higgins' claims and said marathon shifts were common. Several recently complained to their supervisor, who filed a report with the QAS workplace health and safety officer. "As the immmediate supervisor of staff who are regularly driving while fatigued, I have great concern about the safety of these officers and the members of the communitv that are exposed to these fiatigued officers." he wrote. "The QAS itself has identified that fatigue as an issue ... (but) this has not translated ... because we are quite regularly working 16 hours plus.

The supervisor said officers strongly believe that the community deserved better than being treated by a fatigued officer who couid possibly make an incorrect decision about the emergency health treatment given, which could lead to long-term ill-health or even death. Emergency Medical Service Protection Association president Prebs Sathiaseelan said it was just the "tip of the iceberg". "QAS management has known about the problem for a longtime. They received documentation through the normal channels of communication, but it was ignored," he said. Emergency Services Minister Neil Roberts said he had asked Mr Higgins to send a notice to all ambulance officers tomorrow reminding them of measures in place to alleviate fatigue.

The above article by Darrell Giles appeared in the Brisbane "Sunday Mail" on November 11, 2007






Australia: Public hospital neglect 'killed mother'

"DON'T leave your loved ones alone at Royal North Shore Hospital." That is Lindy Batterham's advice as, one year after the agonising and preventable death of her mother, Joyce, she struggles to come to terms with the negligent care the 90-year-old received at RNSH, and the cover-up that followed. Left at the hospital overnight, simply so that her heart medication could be assessed in the morning, Joyce was dropped on the floor by a nurse, broke her hip, suffered a stroke during surgery and died six days later. "I'll be traumatised by my mother's last six days for the rest of my life, having flashbacks of witnessing her dying in a nightmare of pain," Ms Batterham, 52, said.

Her account of her mother's last days, revealed to The Australian yesterday, is one more RNSH horror story embattled NSW Health Minister Reba Meagher doesn't need as she prepares to front a parliamentary inquiry into the hospital this morning. The inquiry has been forced on the NSW Labor Government following the case of Jana Horska, who was left to miscarry in a toilet adjacent to the hospital's emergency unit in September. Ms Horska's case provoked an avalanche of complaints against the hospital.

When Ms Batterham left her mother at RNSH around midnight on November 10 last year, Joyce, who lived with Ms Batterham, was alert and in sound health. After arriving by ambulance at RNSH emergency at about 6pm with breathing difficulties that had been successfully treated before, Joyce did not see a doctor until 3am the following morning. Those nine hours were spent in great discomfort.

As the result of a pressure sore and poor circulation causing pain in her good leg, Joyce spent much of the time sitting on the edge of her ambulance stretcher, dangling her leg over the side. The doctor said there was nothing much wrong with Joyce and that she could stay overnight in the hospital's aged-care ward and see a specialist about her medication the following morning. Exhausted, Ms Batterham went home, little imagining she would never speak to her mum again.

"She could still be with us now, but because one nurse tried to move my mum, who was a large woman with only one leg, from her wheelchair to a hospital bed without a rail or anything for my mother to hold on to, she was dropped to the ground, resulting in a broken hip," she said. "When I arrived about an hour after Joyce had been dropped, I found they had put her back in the wheelchair and given her painkillers to address the extreme pain she complained of, then left her, with no access to a buzzer. "It was only after I intervened and insisted she be seen by a doctor and X-rayed for a possible fracture, and laid down on the bed instead of with her leg dangling, that these things finally happened." Three hours after being dropped, Joyce was finally seen by an orthopedic surgeon.

But there were more bungles ahead. Joyce's surgery the next day, Sunday, was postponed - without her or Ms Batterham being told. And when Ms Batterham phoned on the Monday morning to ask when the surgery would happen, she was astounded to hear it had already begun. She was unable to comfort her mother before surgery and was denied the opportunity to speak with her again, since Joyce was unable to communicate following a stroke on the operating table.

But what really angers Ms Batterham, as she prepares to lodge a submission with the parliamentary inquiry, is the hospital's lack of accountability and the way key details were airbrushed out of the written report she finally received on Joyce's death, which is being investigated by the Coroner. There was no mention of the fact Ms Batterham had to beg for her mother's hip to be examined by a doctor. No mention of the fact her pain was misdiagnosed by nurses as being the result of poor circulation. Above all, there was no admission that the attempt by a nurse to lift Joyce by herself, with no handrail, was a dangerous practice.

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