Nurses could take industrial action after Armidale hospital was left without a doctor for 14 hours on the weekend

Nurse and unionist Warren Isaac said nurses have been left terrified that their registration is at risk, because they can't guarantee safe clinical care.

He said nurses were discouraged from taking a high-level first line emergency care course, designed to train them to perform some of the tasks of doctors last year, because "there would always be a doctor here 24/7".

Despite the assurance, for the first time ever, the hospital was left without a single doctor from 5.30pm on Sunday until 8am Monday morning, he said.

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The Armidale hospital went into "bypass", directing ambulances to continue on to Tamworth rather than stop at the emergency room.

But the community itself wasn't told of the staffing shortfall, leaving patients taking their own vehicle to the hospital in the dark, he said.

"In a town this size, which is also receiving patients from all around the New England, you expect that there's going to be a doctor there all the time," he said.

"You just assume that there is a number of doctors in a place this size."

A spokesperson for the Hunter New England Local Health District assured the community that they can continue to receive appropriate medical care at Armidale, Inverell and Glen Innes hospitals.

"Locum medical officers have been increasingly challenging to secure and the COVID-19 pandemic and subsequent border closures has further impacted on their availability," she said.

The spokesperson said that all of the district's hospitals have "robust" business continuity plans in place in case medical coverage isn't available on site, or if a patient presents with a complaint too complex for them to deal with.

"Due to circumstances out of the district's control, sometimes there are gaps in medical coverage that cannot be filled, despite efforts from management," she said.

It was just the latest crisis in an ongoing shortage of doctors that has hit hospitals in Armidale, Inverell and Glen Innes, among others, for weeks.

The secretary of the Armidale branch of the NSW Nurses and Midwives Association said staff would vote on Tuesday night whether to take part in state-wide industrial action next week, calling on the government to meet patient-nurse quotas.

"We need safe nurse-patient ratios. And we believe that would have provided enough staff to cover for what is now the vacancies," he said.

"There were massive staffing problems for nurses and doctors way before COVID hit. This has been coming for ages."

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Dr Miriam Grotowski, chair of the North West Health Professionals Network, said the local health district had struggled with staff shortages for years.

"I'd say that what we're seeing is an ongoing medical workforce shortage, with episodes of crisis," she said.

"I think some of that has been impacted by the current COVID surge in our region. But really we've got an ongoing problem with recruiting and retaining doctors with the right skills, who are prepared to be and supported to work in place across the region."

She said the solutions for doctor shortages were long-term, and wouldn't necessarily show the sort of immediate results communities were looking for.

The group aims to help give doctors the best opportunity to have the best experience working in a rural area as they could, she said.

Mr Isaac said the problem was going to get worse before it got better.

"Nurses are feeling bad that they can't provide the clinical care that's needed," he said.

"And they're also feeling bad that potentially they're putting their registration at risk.

"Because nurses have to provide safe clinical care. And at the moment they're unable to do that."

A spokesperson for the Hunter New England Local Health District said they had increased their workforce by an additional 1,633 full time equivalent staff, an increase of 15.5 per cent including 400 more doctors, 905 more nurses and midwives, and 156 more allied health staff since 2012.

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