A staff survey in Whangārei Hospital's Tumanako Mental Health Unit paints a picture of a service in crisis.
''I'm afraid each and every day, always worrying is this the day I get hurt.''
That's the grim response to a Whangārei mental health worker to a survey about her workplace.
A survey of staff at Whangārei Hospital's Tumanako Mental Health Unit has revealed workers worried they will be assaulted, or worse, at work and say bullying and drugs are being accepted as part and parcel of a unit and it's must a matter of time before one of them is seriously hurt.
The Tumanako Quality Improvement Survey was carried out in February, this year by the PSA union, which represents many of the staff in the unit, and got 34 individual responses from staff at the unit, which is just over a third of staff.
Northland District Health board said it was initially very concerned about the survey results and took immediate steps to investigate concerns and to communicate and cooperate with the unions to work toward solutions. The DHB said the situation had since improved at the unit and more improvements were being made. The DHB said there was a relatively small uptake in the survey, with just over a third of staff responding.
However, Whangārei PSA organiser Mark Furey said while there has been some improvements, a lot more was still needed to make the staff feel safer in the unit as the unit was in crisis.
The survey asked a number of questions of the staff and asked them to rate their response from agree to disagree.
Questions included if they enjoyed the job; felt safe working in the unit; if they felt supported in the workplace; how they felt the leadership was dealing with inappropriate behaviour in the unit and asked them to list their most pressing concerns. It then asked them for comments on each question.
Comments included:
''The fear I have coming to work every day now overrides my passion I had for the job. Hope every shift that I get home to my family unharmed.''
''Anxious and scared most times.''
''Most days I'm worried to come to work.''
''I'm afraid each and every day, always worrying is this the day I get hurt.''
''The nature of this environment can be draining and assaults on staff are unacceptable.''
''When I heard there was a death at Tumanako, I expected it to be a staff member. It's not a case of, if someone gets seriously hurt, it's a case of when. I have witnessed several assaults and at least three of my colleagues have lost their job after being assaulted at work and have received injuries that will affect them for the rest of their lives.''
''As a female I no longer feel safe in the unit, having to work in an all-male patient ward, who have assaultive behaviour histories.''
''Tumanako has been referred to as more dangerous than a prison, by staff, clients and their families as well as experienced doctors.''
Staffing numbers and safety on the unit is seen as the two most pressing concerns of the staff.
Ian McKenzie, general manager Mental Health and Addiction Services for NDHB, said the survey was facilitated by the union without the knowledge of the DHB. McKenzie said the DHB was initially very concerned and took immediate steps to investigate concerns and to communicate and co-operate with the unions to work towards solutions.
''The DHB received feedback from a number of Tumanako staff expressing concerns that they did not feel the survey accurately represented positive feedback that they had provided,'' he said.
''Despite the relatively low uptake of the survey with just over a third of staff responding, a number of initiatives have been agreed with the representing unions.''
Data analysis was undertaken to investigate some areas of concern for example staff turnover, staffing statistics, trends and the numbers assaults.
Investigation also took place using the DHB incident reporting and complaint management system to substantiate concerns about lack of management and follow up of and events. as well, he said, Human Resources met with the unions to clarify the DHB's processes for staff to raise bullying concerns and the DHB's process for investigating and resolving bullying issues.
''An action plan was developed and endorsed by Tumanako staff union delegates and Union with Mental Health & Addiction Services senior leadership. An escalation process was clarified for disclosure of any potential conflict of interest regarding employment and recruitment activities,'' McKenzie said.
The plan agreed with unions has key areas of focus, including rostering and staff skill mix; assaults/accidents and staff safety; leadership development and staff education and development.
He said senior management in the unit have committed to a leadership improvement programme to improve communication about future directions and resources.
''When staff formally raise concerns about their managers, the complaint would be investigated by an appropriate MHAS manager. While there were some staff who had raised concerns about their managers in the survey, no specific complaints were received in support thereof, and hence no outright investigation could occur,'' McKenzie said.
Subsequent to the union survey being undertaken, and despite the relatively low uptake of the survey with just over a third of staff responding, it was agreed with the representing unions that the relevant managers should be supported with coaching and mentoring skills. Consequently it was agreed they would attend joint education as a group to develop and consolidate skills and develop a consistent approach to leadership so as to support the growth in both confidence and competence of the IPU workforce.''
However, Furey said staff were genuinely concerned for their safety in the union and it was disappointing the DHB was playing down their concerns by saying it was "only" a third of staff.
''There has been some improvement since the survey. But it's abysmal and appalling that it has to get to the stage of virtual collapse before things improve. It was a unit in crisis,'' he said.
''These people work at the coalface and they understand it can be a difficult place to work, given the issues with some of the patients involved, but they shouldn't be going to work in fear of being assaulted."
He wondered why it took the survey for the DHB to become aware of the issues among the staff and suggested it should have already known.
''We will also do a follow-up survey to see if things have really improved,'' Furey said.
Reported Assaults by Patients on Staff at Tumanako:
■ 2016/17 period reported 30 events in 12-month period
■ 2017/18 period reported 35 events in 12-month period
■ 2018/19 period reported 42 events in 12-month period
Reported Assaults by Patients to Patients at Tumanako:
■ 2016/17 period reported 6 events in 12-month period
■ 2017/18 period reported 12 events in 12-month period
■ 2018/19 period reported 9 events in 12-month period
Incidents reported of Use/Possession of Prohibited Substances in Tumanako:
■ 2016/17 period reported 13 events in 12 month period – 10 cannabis, 1 meth, 2 unknown
■ 2017/18 period reported 13 events in 12 month period – 11 cannabis, 2 unknown
■ 2018/19 period reported 8 events in 12 month period – 6 cannabis, 1 meth, 1 unknown
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