Gail Reynolds’ sister Kate Wester and daughter Kathy Mason show photos of Mrs Reynolds’ legs. (ABC News: Manika Dadson)
Tasmanian pensioner Gail Reynolds is in hospital recovering from the surgery she had to amputate most of her right foot and left big toe after they became gangrenous.
- Gail Reynolds’ surgery for gangrene was delayed three times
- Her foot was amputated six months after doctors told her she needed the procedure
- It comes amid increased pressure on the Royal Hobart Hospital, where ED numbers have doubled in the past 12 years
Photos of the 70-year-old diabetic’s blackened, septic feet are too graphic to be shown. Her family is speaking out, angry and aghast at what has unfolded.
“It was horrible, horrible. No-one knows the smell mum had to go through … her feet were bad and she had to live like that, sleep like that,” daughter Kathy Mason said.
Doctors at the Royal Hobart Hospital told Ms Reynolds in April she needed an amputation to stop the spread of gangrene.
It took six months for her to get the surgery.
In that time the gangrene ate away at her right foot.
She also had the big toe on the other foot amputated.
Ms Reynolds’ sister Kate Wester and Ms Mason said she had been let down by the health system.
Ms Reynold’s surgery at the Royal was cancelled three times, even after Ms Wester contacted Health Minister Michael Ferguson’s office.
They were told there were not enough staff or operating theatres.
“I was absolutely horrified by the Tasmanian health system, it seems to be one of the worst in the whole of Australia,” Ms Mason said.
The third time Ms Reynolds was told her surgery was cancelled was after travelling from Launceston.
She was waiting in a hospital gown, and it was 7:00pm.
Ms Reynolds’ surgery was eventually completed at Launceston General Hospital on September 27.
Her family expect her to need a wheelchair for the rest of her life.
Ms Wester says the six-month wait for surgery has affected her sister’s mental health.
“She has expressed to me that she wants to end her life, and that is hard to hear when you know that this could have been fixed way back in April.”
Patient numbers doubled in 12 years
Ms Reynolds was listed as a category-two patient, and statistics show 34.8 per cent of people on that list wait more than 90 days for elective surgery.
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The number of category-one and two patients waiting more than 90 days in Tasmania has more than halved in an decade, but the state still has the highest percentage of people waiting longer than the national benchmark.
Demand at the Royal Hobart Hospital has increased year-on-year by about 5 per cent.
The hospital’s ED is seeing double the number of patients compared to 12 years ago.
Dr Frank Nicklason from the Royal Hobart Hospital Staff Association said a shortage of beds at the hospital was putting the hospital under strain.
“The pressure to discharge quickly, the inability to be able to be efficient to get elective surgery done quickly, seeing people, for instance, large joint replacements, hip and knee a year or two down the track from when they should have had it done.”
People are presenting sicker and requiring more emergency and elective surgery.
Level four — the highest escalation level — is triggered on an almost weekly basis, and sometimes multiple times a week.
When level four is activated, elective surgeries are cancelled.
It has become an almost weekly occurrence and medical professionals say it contributes to longer wait times.
In June, category-one patients across Tasmania waited an average of 49 days beyond clinically recommended timeframes.
Category-two patients waited an additional 101 days, and category-three patients waited an extra 55 days.
The 2018 Report on Government Services shows that compared 2016-17 data, Tasmania had the worst average wait times for the elective surgery categories like hysterectomy and coronary artery bypass grafts.
The report showed:
- Urgent cases for outpatient needing audiometry are waiting 574 days
- Ear, nose and throat semi-urgent cases wait the longest at 1,124 days
- Non-urgent neuro-surgery patients wait 1,917 days — more than five years
Morale at Royal Hobart Hospital low, staff say
Monica Werner says cancer patients are waiting longer than they should to start treatment. (ABC News: Rhiana Whitson)
Cancer services nurse Monica Werner said cancer patients were also waiting longer than they should.
“On the waitlist you’ll have new patients that are coming on, that need to start their treatment, and often they need to start their treatment to get the best chance of survival,” Ms Werner said.
Ms Werner, along with emergency department nurse Deanna Butler and nursing manager James Lloyd, can speak out about the pressures at the Royal because they are protected by the Australian Nursing and Midwifery Federation (ANMF).
They have told the ABC staff morale at the Royal is low, and nurses forced on to double shifts are extremely fatigued.
Deanna Butler says morale is low and staff are extremely fatigued. (ABC News: Rhiana Whitson)
Giving evidence at the Legislative Council inquiry into acute health services, the ANMF said the pressure on the hospital had resulted in avoidable deaths.
The ANMF’s concerns have been backed by health unions and organisations, and by the College for Emergency Medicine, which said people die when EDs are overcrowded.
The nurses union said there had been a “massive increase” in the number of adverse events at the hospital, and there have been avoidable deaths.
A spokesman for the Tasmanian Health Service (THS) disputed the union’s claims, and said hospital mortality had been stable for the past few years.
Ms Butler said staff were doing the best they could, but the pressure on the hospital had resulted in the delivery of unsafe care.
“We are forced to do ‘waiting room medicine’, and the doctors and nurses are looking after patients inside rooms, and they’re not getting best treatment,” she said.
James Lloyd says the emotional toll on nurses is at a “dangerous” level. (ABC News: Rhiana Whitson)
Mr Lloyd said the pressure was taking an enormous toll on nurses.
“We are always stepping up into that abyss, into that canyon, where it gets really dangerous … and we reach a point where ‘oh my god it is going to break’,” Mr Lloyd said.
The new K-block build is due to be completed next year, but relief is at least a year away.
The new facility will have the capacity for 250 extra beds, but the Government says the opening will be staged over five years.
More beds should mean the hospital does not operate at level four, leading to fewer elective surgery cancellations.
The beds will have to be staffed though, and with about 200 current nursing vacancies across the state, that could prove difficult.
Tensions over the Royal’s bed shortages boiled over in August when a senior clinician tackled Health Minister Michael Ferguson at a media conference.
Dr Frank O’Keeffe’s interjection created a social media backlash against the Minister but was praised by frontline workers and the public.
Dr Nicklason said with Victoria and New South Wales currently on a nursing recruitment drive, staffing issues were paramount.
“Having new beds without staff to support those beds clearly does not make sense,” he said.
“The worst case scenario is the redevelopment of the K-block won’t solve the problems that we are seeing now.”
Frank Nicklason says providing beds is not going to help if enough staff can not be hired. (ABC News: Leon Compton)
Until then, staff and patients will be left waiting.
“It makes me so sad that I see we cannot deliver the standard of care that we expect of ourselves and our patients deserve,” Ms Werner said.
A spokesman for the Tasmanian Health Service said escalations were a normal way for hospitals to help manage higher demand “enabling additional resources to be utilised to help ensure patients receive the care and services they need”.
“There have been more than 10,000 surgeries performed at the RHH in 2018, with fewer than 40 elective surgeries postponed due to level four escalations,” he said.
It’s unclear how many elective surgeries have been cancelled for other reasons.
The Health Minister’s office was contacted for comment.