Christchurch Hospital staff ran between wards to pass on messages, took pulses manually and wrote patient notes on whiteboards or paper during a blackout last night, Te Whatu Ora says.
A network outage caused the 55 minute cut at 8.24pm.
Te Whatu Ora interim hospital and specialist services lead Lisa Blacker said generators did not automatically kick in for some buildings.
"The generators worked as they should for Christchurch Women's Hospital, but they didn't automatically connect to Christchurch Hospital systems last night. This is an extremely rare occurrence and why this didn't occur is what our teams are currently looking into," Blacker said.
"All systems were back up and running on mains power before midnight last night."
There were 478 patients affected, including 96 in the emergency department.
During the outage, staff had no access to phones, computers or some medical monitoring and support equipment.
Patient call bells were also down.
Clinicians manually checked in with patients instead and a tannoy system was used to communicate updates.
"Critical clinical areas had battery powered emergency lighting, while some non-clinical areas used torches. Thankfully, there was still some natural light when the power first went out," Blacker said.
Essential equipment was still functioning.
"Ventilators, ECG machines, cardiac defibrillators all have a battery back-up and continued working as they should. In addition, there's mobile battery powered equipment to record blood pressure and pulse," she said.
There was also minimal interruption to surgeries.
"There was one patient whose surgery was safely completed just as the power cut hit...Another patient was about to have a procedure which was deferred until after the power came back on.
"We had alternative operating theatres in [the] Christchurch Women's and Parkside [buildings] that could have been used if needed for an emergency."
The hospital was grateful for the additional support it received, she said.
Hato Hone St John staff cared for patients in ambulances outside the emergency department and helped triage those arriving.
The 24 Hour surgery centre across town also brought in additional staff to care for those with urgent needs, Blacker said.
"I am so proud and impressed with the way staff took things in their stride, and remained calm throughout the outage.
"Our staff did a magnificent job of keeping patients updated and wards and patients were calm during the outage. Everyone was well supported, continued to receive care and most importantly were kept safe."