The Gauteng public health system is under severe pressure as admissions due to Covid-19 soar to an extent that one intensive care unit (ICU) nurse cares for four patients instead of one.
Severe staff shortages have led to situations where the doctor to patient ratio has risen to 1:15.
Unions are warning about overworked healthcare workers getting burnt out as one ICU nurse at Tembisa Hospital looks after four patients while a doctor at Pretoria's Steve Biko Academic Hospital serves up to 15 patients.
The province's hospitals are now beefing up staff to meet demands created by rising admissions due to the third wave.
Despite the provincial government having increased bed capacity, most facilities have few or a lack of staff to cope with the surge in the number of people visiting the health facilities.
Several hospital CEOs who spoke to Sowetan highlighted problems of fewer nurses, doctors and other medical personnel available to attend the thousands of patients flocking to the hospitals.
Tembisa Hospital on the East Rand is already more than 90% full in the Covid-19 ward and acting CEO Ashley Mthunzi said the demand for oxygen and beds is already unsustainable.
Tembisa Hospital has 151 Covid beds and 140 of them are occupied with more Covid-19 patients continuing to visit for medical assistance.
“This is unprecedented. The situation is becoming dire by the day. Four patients are now competing for one port of oxygen as opposed to the first wave when one patient was on one port of oxygen,” Mthunzi said.
The hospital sees no less than 250 patients a day and all of them must be tested, with its ICU already at full capacity with 10 patients.
Mthunzi said 20 additional high care beds are being created to ease the pressure but the problem was getting health professionals to man the additional capacity.
“Currently the ratio at the ICU is one nurse for every four patients. The norm is one nurse for each ICU bed," Mthunzi said.
He said specialist nurses such as those for the ICU are not readily available. "We’re not getting posts created timeously so that we are able to fill them,” Mthunzi said.
Chris Hani Baragwanath Academic Hospital is also facing pressure but it has more capacity in terms of beds but fewer staff members. Hospital CEO Dr Nkele Lesia said staffing is a competitive process and that recruitment has not been easy.
She said the hospital has 435 confirmed Covid-19 patients and 75 are under investigation, excluding those at casualty waiting to be allocated to wards.
Despite the hospital having opened a special Covid-19 500-bed facility, it still needs more nurses and needs to hire.
"It is not like you find people readily available. We are all competing for the limited number of people even with the private sector," Lesia said.
Secretary of the National Education, Health and Allied Workers Union (Nehawu) at Baragwanath hospital, Thembi Ntsane, said the shortages were dire and the entire hospital is now affected.
"When the new hospital was opened, they took the contract workers which were working in the main hospital, creating a shortage in the main hospital which still has Covid-19 wards," Ntsane said.
She said the shortages included professional nurses, who were hard to find. "Even if people are allowed to work overtime that doesn't help because they become very exhausted," Ntsane said.
President of the Young Nurses Indaba Trade Union (YNITU), Lerato Mthunzi, said creating additional capacity is more than just making more beds available.
"Complaints from our members are genuine, our argument is that creating capacity cannot just be a new bed, it should be well-equipped with oxygen and there must be a nurse to do bedside nursing," Mthunzi said.
"There's no point in creating new beds but you are not staffing those units and not bringing other material resources so that patients have a good chance of surviving."
CEO of Steve Biko Academic Hospital Dr Mathabo Mathebula said her facility was also experiencing pressure. The hospital has 279 Covid-19 beds and already 200 are occupied. "It has 39 ICU Covid beds and 20 are already occupied," Mathebula said.
Mathebula said the other ICU beds are not occupied due to “lack of staff to man them”. Currently the hospital has a ratio of one nurse per three patients in the ICU depending on the acuity of the patients.
One doctor now serves 15 patients, which also varies depending on the level of illness per patient.
Gauteng premier David Makhura’s spokesperson, Vuyo Mhaga, said: “We have adjusted the budget of the province to avail more money to the department of health so that more health workers can be recruited."
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