Document exposes the pressures on hospital staff
A SCATHING assessment of the practices at Dalby Hospital has been highlighted in a document released this week about alleged professional misconduct from five years ago.
The document is the decision from the Queensland Civil Administrative Tribunal, in relation to a professional misconduct charge of an employee in 2013. It makes reference to staff being "overworked" and being encouraged to take shortcuts as part of a "deeply ingrained culture".
The decision relates to the practices undertaken by the employee during a three-month period.
A representative for Darling Downs Hospital and Health Service said in response to the claims: "Dalby Hospital has had a change of management and staff are accountable to a new values-based culture."
The judgement said medication was prescribed without the appropriate doctor approval, patients were not examined properly and patients were discharged without doctor approval.
The decision stated the director of nursing at the time of the investigation "sympathised with (the employee's) lack of desire to contact medical officers in the middle of the night to seek approval to administer medications".
One nurse stated nurses were "heavily persuaded to work outside our scope of practice after hours by most of the permanent doctors" and to "not contact them out of hours ... for anything they perceived as non-urgent".
The hospital at the time was described as "a clinical setting that has an intimidating and threatening approach against some employees".
A reference provided by asenior medical officer for the employee during the legal proceedings described the harsh expectations on staff. "Whilst (the employee) acknowledges that she has worked outside her scope of practice at times, we feel that this is due to a deeply ingrained culture in the hospital," the affidavit read.
"This has been propagated by overworked, overtired medical staff and under-resourced nursing and medical practitioners."
The employee was downgraded from a clinical nurse to a registered nurse as part of disciplinary measures against her, according to the judgement. The staff member was also required to complete additional training and work under supervision conditions.
The representative for the DDHHS said the appropriate action had been taken in response to the allegation.
"It is difficult to provide an accurate comment on the working environment at Dalby Hospital five years ago, due to the amount of time that has passed," they said.
"It is standard process for matters of professional misconduct to be referred to external bodies for independent investigation."