Commenting on the recent report from the "Putting the Patient First" governance group which suggests a new vision is needed for the hospital, Ms Lobb agreed changes were necessary.
"I think something has to happen because things can't go on as they are. It is very frustrating for our members, particularly in ED."
That frustration had also flowed into other wards, where nurses were having to care for patients in wards not suited to their particular conditions.
The candour of the report on Dunedin hospitals' services was appreciated, but the union was disappointed it was not involved with its production.
Ms Lobb said the report was saying things the union had been saying for some time.
"You have to spend money to make money and efficiencies. It would seem the DHB is just catching up."
However, as part of the Health Sector Relationship Agreement the union should have been more engaged with the process, she said.
The union had been involved with plans to introduce the new software system TrendCare, approved last week by the board, which allocates nursing staff. Such involvement was beneficial to both the board and staff.
Over several years the union had been involved in "lean" work processes at other boards and was quite supportive of them, she said.
Ms Lobb said she agreed with the view in the report that decisions made in the 1990s had made "it very difficult" for the hospital.
It was important that something was actually done about the issues outlined in the report and the union would be happy to work with the board, she said.
Miramare Needs Assessment and Service Co-ordination Agency manager Kerry Hand said he considered the analysis of the operating issues was "spot on" and many of the issues were not new.
What had been remarkable had been the lack of progress, he said, citing the example of concerns about the emergency department.
The hospital culture was "extraordinarily strong" and he warned that once change became imminent "all sorts of resistance comes into play".
That resistance had dominated to date.
The issues involving poor systems did not just apply to medical and surgical wards.
"When a client passes through the mental health inpatient wards there is not a routine system to inform the relevant community agencies of that.
"You can't blame the wards because there is not a system to inform them of whom they should let know.
"You would think that a simple thing to resolve. Clients would benefit. An automated email would do the job. But achieving that simple change has proved impossible despite more than a few tries."
Using the "lean" thinking methods showed services could be better and be cheaper at the same time, he said.
"Reduction in waste does produce resources for the necessary investments that are required," he said.
