Nurses at the New Maitland Hospital say they don't have enough workers or government-funded beds to cope with the influx of patients that are now coming from a wider section of the Hunter.
The NSW Nurses and Midwives Association says the state government has not provided any extra money or staff to help meet the demand the hospital has seen since the move to the new facility in Metford in January led to an expanded patient catchment area.
Internal data shared with The Mercury shows an unprecedented increase in patients from Raymond Terrace and Thornton - as well as a 23 per cent increase in patients from Maitland.
The new hospital is now 8.7 kilometres closer than John Hunter Hospital for Raymond Terrace residents and 4.7 kilometres closer than the Mater Hospital.
Staff say they are seeing patients from as far away as Tanilba Bay and even Taree.
The association says a Newcastle hospital would have previously seen these patients, and staff at the Mater Hospital have noticed a decline in the number of people coming into the emergency department in recent months.
On top of this, Maitland is still the main hospital for Upper Hunter residents who need more complex care. Cessnock is now the closest hospital for suburbs west of Lochinvar and the association says a lot of those patients end up being transferred to the new hospital.
A Hunter New England Health spokeswoman told The Mercury the new hospital "experiences periods of increased activity and these fluctuations can be difficult to predict" but those with the most urgent conditions were treated first in the emergency department.
She said the new hospital "provides the same level of services and staffing as the old campus" and it had "80 per cent more beds and treatment spaces that would come online as required".
The association's Maitland branch assistant secretary Kathy Chapman said staff were forced to use beds that weren't funded because there were so many patients.
She said it happened so often that it had become "the normal situation".
With no additional staff to care for the patients in these extra beds, Ms Chapman said nurses were run off their feet, dealing with fatigue on a daily basis and frequently told to work overtime.
Hunter New England Health (HNEH) said additional inpatient surge beds were "opened in times of increased activity to reduce the transfer of care time from ambulance to the Emergency Department".
Ms Chapman said the wards were also experiencing this problem.
She said management told hospital staff the wards could hold 28 patients but it would be capped at 22 for the time being. She said nurses had been forced to override that direction.
"Surging means you're using beds you haven't got funding for and you are going to use the same number of staff. If you think about that over a 24 hour period 7 days a week - you've only got enough staff to look after 22 patients and you've got more patients than that. What's happened as a result is the fatigue among the nurses is really bad," Ms Chapman said.
"Nurses are being directed to take overtime, some are doing up to three overtime shifts a fortnight, and it's getting to a worrying place.
"That's the impact of opening up the beds without the skilled staff to service them."
The association's Hunter organiser Ashley Dobozy said the hospital needed more staff as well as funded beds to cope with the influx.
She said experienced nurses were leaving the profession because they were overworked and under too much pressure.
"It's great the new hospital has the capacity to grow but the time to do that is now," she said.
"We've had a government who are so quick to say they are putting hundreds of millions of dollars into regional areas but when you look at the figures most of that money has gone to building the new hospital and not funding the new bed base for the growing demand on those services.
"Look at the number of new suburbs being built which is adding to the number of people who are coming to the hospital for help. This issue needs to be addressed very quickly."
When The Mercury asked HNEH about the change in the catchment area it chose not to provide a response on the record.
However, the spokeswoman did say that "beds currently being used within the emergency department are fully funded" and "some patients, whose cases are less urgent, may wait longer than others."
"The $470 million Maitland Hospital provides an excellent standard of care, staffed by highly skilled and dedicated nurses and clinicians," she said.
"Wait times in the Emergency Department are continually monitored and reviewed to ensure patients receive safe, timely and high-quality care."
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