SA Health today confirmed that “contingency plans were enacted at Balaklava Hospital” in the state’s mid-north on Good Friday and Easter Saturday “due to late notice of unavailability for onsite medical officer coverage”.

The nurses union said on Friday’s early shift “the most senior member of staff in the hospital was a second-year registered nurse who was left to run an emergency department”.

“The idea of the hospital remaining open for business – including emergency presentations – whilst having no medical coverage, shows a level of dereliction of duty of care not seen before in any Local Health Network to our knowledge,’’ said Australian Nursing and Midwifery Federation SA boss Elizabeth Dabars.

“Balaklava members have stated that management were aware of the lack of medical support on the preceding Thursday and made no provisions.

“All staff on the weekend felt overwhelmed by the situation and greatly under-supported.”

She said SA Ambulance units “were still arriving with unwell patients and staff were simply informed to send all patients they were concerned about to the Lyell McEwin Hospital for assessment”.

York and Northern Local Health Network CEO Roger Kirchner said in a statement: “Our staff were kept up to date with the plans and strategies during this time and we appreciate their patient-focus and hard work, as always.”

He said on-call medical support was available across the two days – “via telephone”.

“Arrangements were in put in place with Medstar via the SA Virtual Emergency Service digital equipment [and] SA Ambulance were also notified and the service enacted priority support where it was required,” he said.

Dabars said: “This failure of leadership is unacceptable.”

“In both metro and regional areas, hospitals are operating ridiculously over-capacity and under-staffed, putting both patient and nurse safety at terrible risk,’’ she said.

“Not only are staff across the state stressed, fatigued and fearful of making a catastrophic mistake, they are also too frightened to speak out for fear of retribution from a health system that refuses to acknowledge or address its own ineptitude.”

SA Health has been under siege in recent days, with the release of a damning report into ambulance ramping, Women’s and Children’s Hospital doctors speaking out about fears of patient and staff safety and outgoing Mental Health boss John Mendoza igniting a storm of protest about the state’s unfolding mental health care crisis.

The union declared the situation a “health disaster unfolding in our state”, noting increasing pressure on several hospitals.

“At Mt Barker Hospital recently 96 patients presented to the four-bed emergency department within a 24-hour period… and wait times for transfers from Gawler to the Lyell McEwin Hospital blew out to between 13 and 24 hours,” the union said in a statement.

“On Tuesday night 60 children were either waiting to be treated or waiting for a bed post-treatment at the Women’s and Children’s Hospital emergency department, putting staff under enormous stress.”