Workers at He Puna Waiora say they are facing a"high likelihood of serious injury" Photo: RNZ
Mental health workers at a secure Auckland unit have filed an official complaint after a staffer suffered a head injury while trying to restrain an elderly patient.
Fifty workers at He Puna Waiora at North Shore Hospital filed a notice under health and safety laws last month, saying they faced a"high likelihood of serious injury".
The staff told Health New Zealand (HNZ) they wanted four elderly patients moved out to a better equipped specialist unit, but the agency refused, saying the patients fit the criteria to be at the secure unit.
But in the September letter - seen by RNZ while it was investigating an earlier complaint, alleging bullying and violence at the unit - Health NZ said it was reviewing how the staffer was hurt, and workers' "trauma... is real and valid".
HNZ said on Wednesday its registered nurses were trained to mitigate health and safety risks, supported by other services and the use of PPE gear.
'Walking frames may be used as weapons'
The workers' notice - issued on 19 September - said two of the four older adult patients were known to be "assaultive".
"We are aware of one worker... who has sustained a serious head injury following an incident of assault related to one of the older adult patients," it said.
"Many workers have been traumatised either after witnessing the incident or the aftermath of it."
It is understood the worker was attempting to restrain a patient when they fell and hit their head on a hard surface.
The notice also said "accessibility aids such as walking frames may be used as weapons".
The workers said the four patients should be in the nearby specialist Kingsley Mortimer unit and asked management to shift them.
But Health NZ replied: "We are unable to action this recommendation."
Behind closed doors till now
The 35-bed secure He Puna Waiora unit has a troubled history, including a 2020 inquiry into two patient suicides,
and Ombudsman findings in 2019 and 2022 of staff shortages, overwork and poor leadership.
It was meant to have more than 40 beds when it opened a decade ago, but ran with 35 until 2022, when staff shortages saw those cut to 28 beds.
The latest problem only came to light after RNZ made inquiries about an earlier staff notification to Worksafe in February, alleging unmanaged violence from patients and bullying from management.
Worksafe had closed that case by July, and Health NZ told RNZ this week that it had taken action.
But last month the new complaint was laid, which HNZ summed up in a letter on 26 September as "increased risk of physical violence; serious injury, traumatised workers and patients who use mobility aids who have behavioural concerns".
The staff said in their notice that they had complained about the issues earlier but "no notable action has been taken and no improvement has been noted".
Their notice of health and safety recommendations also revealed "daily flooding" of bathrooms that had anti-ligature fittings getting in the way of drains, leading to an infection risk from faeces.
"The faecal matter and/or urine is spreading through the hallways and patient rooms."
The staff made seven recommendations, including for a review of what patients were admitted, a better mix of experienced and newer staff, and a better alarm system.
Health NZ pushed back on most of them.
'Non-discriminatory care'
In its September response to the workers' notice, Health NZ said it recognised the staffer being injured had a significant impact but "at the same time, it's important to reaffirm our shared commitment to providing compassionate, non-discriminatory care".
The four patients could not be moved out, wrote acting general manager of specialist mental health and addictions services Megan Jones.
Specialist staff were trained for this, but more training could be given.
In a nine-page letter, Jones said management was collaborating well with workers, that there was safe staffing that could be added to in an emergency, and that reporting systems were up to scratch.
"We'd like to acknowledge that accessible and timely incident reporting processes are already in place," she said.
Jones said an upgrade to the unit's alarms was possible.
A a fix for the drains was due to be done next week, the agency said on Wednesday.
'It's been shut down'
RNZ sought to speak to the workers, but the Public Service Association (PSA) said it was difficult for them to do that.
National secretary Fleur Fitzsimons said that violent assaults happened regularly.
"It's been shut down, it's been minimised and it's not good enough," she said.
"Health and safety representatives have been discouraged from talking about them because of privacy issues."
Health New Zealand had to "stop accepting assaults as inevitable".
Its letter had tried to shift the blame to staff, she said.
"The staffing levels are not safe and the issues raised here are part of the reason that these workers are taking strike action on October 23."
A meeting with management - set for next week - had been delayed until 28 October, Fitzsimons added.
Health NZ director of operations at Waitematā Brad Healey told RNZ they were talking to staff directly.
"There are dedicated weekly meetings for staff to raise any health and safety concerns" which they responded to in a "reasonable timeframe".
The February complaint
RNZ learned last week that a staffer at He Puna Waiora in February this year notified Worksafe "alleging failure to manage occupational violence, failure to maintain effective worker engagement practices and bullying and harassment".
No employment proceedings were taken, said Health NZ.
But it carried out a review and found "the need for a greater focus on work related stress/work demands".
It also worked on better reporting systems and better staff-management communication, it said.
Worksafe sent in inspectors who interviewed the notifier, staff and managers, and went through documents.
"We believe Health New Zealand were committed to continuing this work," Worksafe said.
When it saw improvements, it closed the case on 9 July.
Two months later, the 50 staff at the unit filed the notice about violence, alleged understaffing and inaction.
Healey said Health NZ was strengthening incident reporting systems, addressing environmental safety concerns and developing a greater focus on health and safety.
It was recruiting to fill vacancies to maintain "safe staffing levels".
National risks
Health New Zealand has been grappling with what to do about psychosocial risks, including bullying, fatigue and overwork.
An internal July memo warned of "severe consequences... in the last 12 months, including serious psychosocial harm".
The memo was sent to senior leadership to discuss setting up a first-ever national system to deal with the risks.
Health NZ told RNZ it had "serious dedication to addressing these issues and our ongoing drive to improve".
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