NSW Health Minister Brad Hazzard's office should anticipate a flood of correspondence over coming days, with more than 200 attendees at Wednesday night's health community meeting (and 50 more watching online) urged to email the minister with their concerns about the Tenterfield Health Service.
The email address is firstname.lastname@example.org. Many who wanted to attend couldn't due to fires or road closures.
One notable (and noted) absence was anyone from Hunter New England Local Health District. HNELHD's Operations - Rural & Regional Health Services executive director Susan Hayman was an apology, saying the extreme fire situation in her area meant that no appropriate senior representative could attend.
That left everyone in Tenterfield Memorial Hall on the same page, full of praise for their nurses but labelling HNELHD the worst in the state.
"The only operation I want to see is 'Hunter' excised from 'New England'," Councillor Bronwyn Petrie said.
The gathering heard more horror stories of patients with life-threatening conditions waiting many hours to be transported south, against their wishes, or resorting to being driven in a private vehicle to Queensland specialists risking tragedy along the way.
While such stories abound, and MP Janelle Saffin promised to share them in parliament next week, deputy mayor Greg Sauer said it all comes down to numbers, He said it's important to collate those number to support a case for three nurses for every shift in the short term, and an upgraded hospital down the track.
He's been told that only those admitted as inpatients are counted in the statistics, meaning all those successfully treated in the Emergency Department and sent home aren't taken into account. If they were, it could potentially justify a workforce five or six times bigger than the one registered nurse and one enrolled nurse currently rostered.
It would be hard to estimate the additional count of those like Liz Tobin who don't present at all because they know the nurses are overworked and don't want to bother them, or those who make their way to Wallangarra and call an ambulance there so that they end up in the Queensland system.
NSW Ambulance Hunter New England area inspector John Lawler was able to clarify that with fatigue a major problem from officers being on the road for up to 20 hours, they have a strong preference to transport patients to Stanthorpe rather than Armidale. He said there are concerns with taking patients to Lismore, given the treacherous road and poor radio service.
"There's no reason NSW Ambulance can't travel in Queensland," he said.
"We can't understand why. There have been a number of meetings to get things changed.
"Two-and-a-half hours to Armidale for a CT scan does not make sense."
One of the nurses present said the issue was with Ambulance Coordination in Dubbo, which refuses requests for transfers north. NSW Cross Border Commissioner James McTavish was in attendance and said he would address this when in Dubbo next week.
The crux of the matter, however, remains staffing levels, highlighted by the death of a patient at the hospital during the six day period with no doctor. The only two nurses on duty were required to perform resuscitation and coordinate with remote doctors until help arrived in the form of paramedics.
It was an impossible task, according to union general secretary Brett Holmes. While there are a four or five GPs in town none have Visiting Medical Officer (VMO) accreditation at the hospital.
There will be an inquest into the case, but Mr Holmes said it will be several years before there is an outcome, far too long for the current situation to persist. A RCA (Root Cause Analysis) has been initiated by HNELHD, but he said the details are 'privileged' and only final recommendations will be released.
In the meantime nurses are going above and beyond what they're required to do.
"HNELHD have them on a 'guilt' roster, unwilling to leave their community and colleagues in the lurch," Mr Homes said.
Ms Saffin and Cr Sauer will meet with Minister Hazzard next Tuesday to relay the concerns of the community. Council is pushing for a 12 month trial of 3x3x3 (three nurses per three daily shifts) and then a review.
Ms Saffin said they want to walk out of the minister's office with an agreement and time frame regarding doctors and nurses, and cross-border transfers.
With known incidences of people like Penny Anderson looking to relocate from the town they love to other centres purely due to the lack of medical services in Tenterfield, the growth or even maintenance of population levels could be at stake.
There's little consolation in the fact that Tentefield is just one of a number of small towns throughout the state suffering a health service crisis. Local nurse Frances Overell said 17 such hospitals were without doctors the same weekend as Tenterfield.
The others are keeping a keen watch on what a consolidated action from the Tenterfield community on the health department can achieve.