North Shore ED in Crisis: Nurses Report 'Feral' Conditions, Patients in Soiled Beds

At North Shore Hospital's emergency department, patients are waiting in beds soiled with their own waste. The corridors are packed so tightly that staff cannot move between them. The waiting rooms have overflowed into hallways lit by fluorescent lights where there is nowhere to hide, nowhere to recover with any sense of privacy or dignity. One hundred and twenty nurses who work in this department have written directly to Health NZ's chief executive, Dale Bramley, to say the emergency department is itself in a state of emergency.

Jean Classey, the charge nurse, describes the atmosphere as feral. The department has become so overwhelmed that basic care has become impossible. People cannot fit in the waiting areas. Incontinent patients sometimes remain in wet beds for extended periods because nurses simply cannot find the physical space to change them. Classey speaks of it as a nightmare, as war. She is one of the nurses protected by her role as a delegate for the New Zealand Nurses Organisation, which gives her some legal cover to speak publicly about what she is witnessing.

The numbers behind the crisis are stark. In July alone, nearly 14,000 patients moved through the North Shore and Waitakere emergency departments. The North Shore ED has operated at 300 percent capacity. Patients wait an average of 90 minutes just to be triaged. Heart scans that should happen immediately take hours. Some patients spend more than 50 hours in the emergency department waiting for a bed upstairs in the hospital. Others miss essential medications entirely. The nurses' letter to Bramley calls this crisis entirely predictable—the result of Health NZ's failure to adequately plan for winter demand.

Sharon Franklin-Smith, another nurse, describes looking down a corridor and seeing a line of grey heads—people in their 80s and 90s—receiving care in the hallway. She speaks of the broken hearts of staff who know these are someone's mother, someone's grandmother. Jean Moor, who has worked as a nurse for 35 years, says this is the worst she has ever seen it. The work itself has become unsustainable. Nurses are running constantly, their brains in overdrive, juggling their own patients, monitoring those waiting, and trying to organize assessments and treatments. Many go home each night hoping no one has died because they did not receive the care they needed.

The root of the crisis traces back to staffing promises that were not kept. Health NZ agreed to hire 25 new nurses for the North Shore ED. Only nine actually arrived. The nurses' letter describes this as a recruitment go-slow—a deliberate failure to follow through on commitments. The day after receiving the letter, Health NZ announced it would begin recruiting 50 new nurses across North Shore and Waitakere Hospitals, with nine designated for the North Shore emergency department. The organization also announced plans to hire 10 additional nurses and 14 health care assistants for a central team that could be deployed where demand surged.

Brad Healey, Health NZ's group director of operations, framed the new hires as a way to gain flexibility and respond to unexpected absences. He acknowledged that demand this winter had been much higher than in previous years, and that the organization's winter plan—which included moving care into the community and pushing patients through hospitals more quickly—had helped but was insufficient. Chief executive Dale Bramley urged seriously ill people to still come to the emergency department, where they would receive priority care.

But the nurses are clear: nine new hires are not enough. The department is already operating at three times its intended capacity. Health NZ had already failed to deliver on a commitment of 25 nurses. The organization has not responded to the detailed claims in the nurses' letter about the actual conditions of care. What remains is a department where elderly and vulnerable people wait in corridors without privacy, where basic dignity has become a luxury, and where the staff keeping them alive are themselves running on empty.