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Poor staffing criticised for death of elderly woman in Ōamaru

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The health watchdog has criticised inadequate staffing at Ōamaru Hospital’s emergency department after investigating the death of an elderly woman.

The 93-year-old was given the wrong amount of saline as a result of a prescribing error in November 2023.

Deputy Health and Disability Commissioner Carolyn Cooper said while she was concerned about the care provided to the woman after multiple errors by different staff, a postmortem found the prescribing error did not cause her death.

“While I acknowledge that individual staff were involved, I consider that the workload at the time meant that staff could not carry out their respective roles adequately,” she said.

Cooper found Waitaki District Health Services, which managed the hospital at the time, bore the responsibility of ensuring safe staffing and had breached the woman’s right to health care that minimised the potential harm and optimised her quality of life.

“I am critical that the ED (emergency department) did not have adequate staffing levels to manage high patient numbers and that this had an impact on the standard of care provided to Mrs A by multiple staff,” she said.

Cooper recommended Waitaki District Health Services apologise to the woman’s family and noted the organisation had continued to recruit and employ more staff and boosted training for nursing staff on the infusion of IV fluids.

She said Waitaki had guidelines in place relating to saline but steps had been taken to make the information more widely available.

A sole doctor on a busy emergency department night shift

The woman was seen by a hospital doctor who diagnosed her with pneumonia, urinary retention and severe hyponatraemia, or abnormally low sodium levels in her blood, in November 2023.

He prescribed her 100ml of three per cent saline at a rate of 200ml per hour before his shift finished and a different doctor took over her care.

Waitaki District Health Services acknowledged to the commissioner that the emergency department was busy.

“Dr C was the sole doctor covering Ōamaru Hospital on night shift and was responsible for all ED patients, the acute medical/ward patients, arranging transfers, speaking to consultants at Dunedin Hospital, and taking phone calls from nursing homes, as Ōamaru Hospital provides all urgent care to the region after hours,” the report said.

A registered nurse found a 1000ml bag and showed it to a nursing student, who told him the chart was wrong and it should read 1000ml not 100ml.

The night shift doctor prescribed a 1000ml bag to run over 10 hours because he believed it was a more cautious approach and asked for her levels to be checked in a few hours.

The doctor acknowledged he was not overly familiar with prescribing the saline solution and told the commissioner that there were no hospital guidelines and staff had not raised any concerns about his decision.

Staff noted there was an audible crackle while she was breathing but her condition did not appear to have deteriorated and she was alert.

It was not until the night shift doctor checked her sodium levels just before the morning handover that he realised the rise was too rapid, telling nurses to stop her fluids immediately.

When her original doctor arrived at work, he realised the error and started reversing the sodium correction but the woman soon became unresponsive and died.

A postmortem found she died from pneumonia and sepsis and the sodium correction had not been too rapid.

Workload “at the limit”

Cooper raised concerns about the night shift doctor’s actions because he prescribed the larger saline bag despite being unfamiliar with the solution and did not look up the hospital’s guidelines.

“Severe hyponatraemia in a severely ill elderly respiratory patient is such a red flag, and ultimately Mrs A’s care was the responsibility of Dr C despite his suggestion that staff did not raise concerns on reading his prescription,” she said.

Cooper said the woman’s treatment was a moderate departure for the accepted standard of care because the prescribing error was not responsible for her death and the workload was “at the limit of what can be considered safe”.

She also criticised the shift leader and nursing student who administered the dose despite concerns the prescription was incorrect, saying the shift leader did not adequately supervise the student.

Cooper found the woman’s deteriorating condition might have been noticed earlier if her vitals had been better assessed and documented.

She recommended Health New Zealand Southern, which took over operations at Ōamaru Hospital in July 2024, provide training for emergency department staff and rural hospitals on managing abnormally low sodium levels, update the commissioner on staffing levels, confirm different saline bags were kept in separate places and show it was improving its documentation.

~ RNZ

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Trump administration denounces CNN for airing Iranian leaders’ messages

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The Trump administration denounced CNN on Thursday (local time) for airing a portion of the new Iranian supreme leader’s public statement, the second time in three days the network has been targeted for reporting on how the regime is responding to the American attacks.

The attack illustrated the care news outlets must take in reporting during wartime, and the responsibilities of American journalists to report the perspective of countries its government views as enemies. It also exposed inconsistencies.

The message of Supreme Leader Ayatollah Mojtaba Khamenei during his first public statement since he succeeded his father, who was killed in an Israeli airstrike, was widely available elsewhere.

The White House said on social media that “fake news CNN just aired four straight minutes of uninterrupted Iranian state TV, run by the same psychotic and murderous regime that prided itself on brutally slaughtering Americans for 47 years”.

Earlier CNN interview criticised by Trump’s communications leader

Two days earlier, White House communications director Steven Cheung took issue with CNN anchor Erin Burnett’s interview with Hossein Mousavian, a former Iranian nuclear negotiator. Burnett asked Mousavian what he had been hearing about the Iranian government’s interest in having talks with the United States. There wasn’t much, he said.

“Ever notice how CNN just regurgitates quotes and unverified information from Iranian terrorists?” Cheung wrote on X.

“Total disgrace. They have become the murderous Iranian Regime’s version of Pravda,” he said, referring to the official newspaper of the former Soviet Union.

CNN did not address Cheung’s statement but did respond to the White House attack on Thursday. It noted that CNN, Sky News and Al Jazeera also showed portions of the ayatollah’s statement live.

“The world is watching with anticipation which direction this war will take,” CNN said. “Purported remarks from Iran’s new supreme leader are a critical component in helping audiences understand where this conflict is heading and were aired for their obvious news value.”

Other news outlets, including The Associated Press, sent out alerts on what Khamenei said. His vow to keep up attacks on other Arab countries in the region and plans to choke off the world’s oil supply were headlines.

Mojtaba Khamenei, the son of Iran's Supreme Leader, Ayatollah Ali Khamenei, center, attends the annual Quds, or Jerusalem Day, rally in Tehran, Iran, May 31, 2019.

The New York Times led its website with a story on the speech in its immediate aftermath, later writing that the speech “was an early indication of how the new supreme leader would approach the war, as well as how he would lead the country”.

CNN has long been a favoured target of President Donald Trump, dating back to his first term. It’s a particularly vulnerable time for the network with Paramount Global’s agreement to purchase CNN’s parent company, Warner Bros Discovery, raising questions about its future editorial independence.

CNN showed a news anchor reading a portion of Khameini’s remarks in Farsi, with an English translation. It did not air them in full. After the speech, correspondent Nick Paton Walsh gave a debrief to anchor Kate Bolduan, noting how the non-appearance of the leader — reportedly injured in an air attack — was as important as what he said.

“We were waiting to see the face of the man to have proof of his health and survival,” Walsh said, “and they’ve not met that moment. Instead, a handwritten message, it seems, that mostly reiterates things we kind of already knew.”

A social media message board for Iran’s point of view

The Tech Transparency Project has reported that several Iranian leaders and institutions maintain verified accounts on X, formerly Twitter, owned by Trump ally Elon Musk. CNBC said Thursday that Khamenei has one of them, and an X account with his portrait posted the text of his remarks, available in Farsi and in an English translation.

Even though Khamenei’s father is dead, an account with his portrait was active on Thursday, mainly reposting messages from his son. “The revenge we have in mind is not just because of the martyrdom of the illustrious Leader of the Revolution,” read one message posted Thursday. “Every member of the nation martyred by the enemy is a separate case that demands we seek revenge.”

X is officially blocked in Iran, although many use a virtual private network to bypass restrictions. A message sent to the platform on Thursday was not immediately returned.

There’s a long history of journalists seeking interviews with world leaders, even when they are regarded as enemies of the United States. Most notable was 60 Minutes correspondent Mike Wallace’s interview with Iran’s Ayatollah Ruhollah Khomeini in 1979, when that country was holding Americans hostage.

Thursday’s remarks by Iran’s new supreme leader were absolutely newsworthy and legitimate for CNN to air them, said Jane Ferguson, a veteran international correspondent and founder of the journalism platform Noosphere. It’s not the job of government leaders to pick apart what CNN is reporting, she said.

“We’ve always faced this,” she said, about when reporters interview leaders or other figures hostile to American interests. “This has been a bit of low-hanging fruit for a while.”

Historian Douglas Brinkley of Rice University said that it’s unfair for CNN to be singled out in this instance. He, too, believes it is newsworthy to learn what leaders of an adversary are thinking, but it’s important to make sure that journalists are careful.

“You have to be leery of being used as a propaganda tool by the Iranian regime,” he said. “On the other hand, knowing what the enemy is saying and looking for a sign of a peace offering or a nuance is important … It’s a difficult balance.”

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University of Auckland building on fire

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A fire at the University of Auckland law school building has now been extinguished.

A Fire and Emergency spokesperson said there had been a fire at the University and six fire trucks were at the scene on Short Street. The call to 111 came through at about 2.40pm.

FENZ said the fire was now extinguished but crews will stay near the building this afternoon.

Staff and students were seen going in floor by floor, starting with level 6, to retrieve any belongings left behind

A student who was evacuated from the fourth floor of the building said it seemed the fire started on level two.

Police were at the scene talking to students who have been evacuated.

Student Talisha Lal said when the fire alarm went off she, and other students, thought it was a drill.

Lal said once she was out of the building, she could see smoke.

More to come…

~ RNZ 

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Teacher struck off after filming explicit videos at school

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An Auckland teacher has had her registration cancelled after recording explicit videos of herself urinating on the floor of a classroom and on a student’s belongings.

The New Zealand Teachers Disciplinary Tribunal found Lisa Marie Edmondson had committed serious misconduct.

The school was alerted to the content after the deputy principal of the school was approached by a member of the public who had come across a video on TikTok and recognised the setting. A search for the username led to a pornographic account.

The account contained more than 30 explicit videos which had been recorded at various locations over a period of two-and-a-half years.

In one of the videos, Edmondson appeared to urinate on the floor of a classroom with genitalia clearly visible. A second video showed the teacher urinating on a hat with a student’s name clearly visible in a lost property box.

The summary of facts stated there was an “ongoing urine smell” in some classrooms during the time of her employment which had been attributed to rats and mice. Bait stations had been set up during the school holidays but no rodent activity was noted. The tribunal said her students were “likely to have been adversely affected” due to evidence of an “unpleasant smell that required deep cleaning”.

While she was not visible in the videos, the teacher was recognised due to her voice and clothing.

Edmondson resigned in May 2023 after receiving notice of a formal investigation.

Following her resignation, Edmondson worked as a relief teacher at a second school before being invited to apply for a fixed-term position.

The tribunal found that Edmondson had failed to disclose her full employment history when applying for – and subsequently working at – a new school in 2023 and failing to inform her employer that she was the subject of a mandatory report and current investigation by the Teaching Council.

In her reflective statement, Edmondson acknowledged that she had let her students down and “was not the role model that I should have been for them”.

“I have accepted that the likelihood of returning as a teacher has ended. This has been a very difficult concept to accept because I loved teaching, loved being in the classroom and loved my students and their whānau.”

The tribunal noted Edmondson failed to address the conduct head on or express concern for her former students and colleagues.

Edmondson’s registration was cancelled and the former teacher was issued a formal censure. She was ordered to pay $3,255.87 towards the Complaints Assessment Committee’s costs and $582 to the Teaching Council.

‘I have let down so many people’

In a statement to Stuff, Edmondson said she had no choice but to accept the ruling, but regretted her actions.

“During a two-year period which covers this time I was suffering from extreme anxiety, I can’t explain why I did it other than self sabotage and treating myself badly for things that had happened. By the time it was reported, I really did not even remember and hadn’t done anything else.”

Her actions had impacted her children and her ability to provide for them.

“I can’t change what I have done, but can make sure it never happens again.”

~ RNZ

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