‘The job eats away at you’: Hillmorton Hospital staff facing burnout, anxiety over working conditions

Source: Radio New Zealand

Nurses and care workers at Christchurch’s Hillmorton Hospital say they’re facing burnout and anxiety over working conditions, which included chronic understaffing, broken doors, faulty alarms and rat infestations.

A New Zealand Nurses Organisation survey of around 180 Hillmorton staff found the vast majority felt unsafe, reported working in dilapidated facilities, were scared to report their concerns for fear of retaliation and felt the conditions posed risks to vulnerable patients.

Health NZ said it had contacted the union to work through the concerns raised in the survey, and a senior Health NZ leader had committed to visiting the hospital this week.

Hillmorton Hospital registered nurse and NZNO delegate Sarah-Jane Perkin said she regularly battled dread before going to work, knowing she would likely be redeployed from her ward to plug staffing gaps elsewhere.

Redeployment was not an unusual part of the job, she said, but she experienced it almost every shift.

“Without redeployment moving us to different wards every shift, the hospital wouldn’t function.”

Survey respondents described the practice as “cannibalising staff” from one unit to another, and said it meant care was rationed, missed, delayed or compromised.

Other survey findings showed four out of five nurses and care workers had felt unsafe at work in the past month due to understaffing.

The NZNO said Te Whatu Ora’s own Care and Capacity Demand (CCDM) system data showed the Whaikaha forensic ward – a specialised secure unit – was staffed below safe levels 91 percent of the time last year, and a further eight wards were unsafely staffed or close to it for around half of all shifts.

Almost nine out of 10 workers – 87 percent – reported negative impacts on their well-being from working at Hillmorton.

One third reported experiencing burnout and a further third reported feeling constant stress and anxiety.

An inquiry into Canterbury’s mental health services that followed the 2022 murder of Laisa Waka Tunidau by a Hillmorton forensic mental health patient, released last year, found “significant failings”, including critical staffing shortages.

Monitoring visits since then by report author, Director of Mental Health Dr John Crawshaw, had resulted in reports that “visible progress” had been made, but front-line staff were not spoken to, the NZNO said.

Nurses and care workers had told them staffing levels and conditions were worse now than when the report was released, the union said.

In a statement, Dr Crawshaw said he was undertaking quarterly visits as part of a year long monitoring programme to assess progress against the recommendations in the report.

He had always had a good level of engagement with staff, including nurses and front-line staff, and a third visit was planned for this week, Crawshaw said.

He would be checking with Health NZ on work underway to address the concerns raised, he said.

But nurses reported feeling like they were “containing” rather than treating patients and described patients remaining unnecessarily long periods in seclusion because there was not enough staff or rooms for them to be moved.

Nine out of 10 staff reported working recently with broken or faulty equipment.

Some reported dangerously decrepit facilities, including doors that did not lock and some that jammed shut, cameras that did not work, infestations of rats, mice and ants and urine-soaked carpet and stairs.

Facilities were dangerously run down, and conditions in the adult inpatient unit where she worked were appalling, Perkin said.

“It’s quite confronting for youth that come from the new child and youth wing – they come from a brand new facility into this really disgusting one. There’s no amount of air freshener to cover up the smell.”

She noted the ongoing work to replace and expand some buildings on the Hillmorton campus, but given workforce shortages, struggled to see how they would be staffed.

The pressure for beds was unrelenting, and left her fearing some patients were discharged too soon.

“We do push patients out quicker than we should due to bed pressures – the beds don’t stay empty for very long, there’s a very high turnover.”

Many of her peers leave for Australia or elsewhere, leaving an unbalanced workforce primarily made up of junior staff.

Sometimes the pressure became too much.

“I’ve done it myself – called in sick to a shift, taken a mental health day because it just takes a toll. The job eats away at you if you don’t watch it.”

Nurses had a professional duty to immediately raise and escalate concerns about patient safety or compromised care, but around half of the workers surveyed felt they could not raise concerns without fear of blame or retaliation, Perkin said.

Health NZ needed to set up an anonymous reporting system, and listen to and engage with the concerns of front-line staff, she said.

The union also wanted to see safe staffing levels, an end to redeployment to plug gaps, workforce planning to help with retention and immediate fixes for the equipment and facility issues.

Association of Salaried Medical Specialists director Dr Sarah Dalton said the senior doctors’ union shared the concerns raised by the NZNO, and had sent staff down to Christchurch to meet with members in recent weeks.

The issues raised were not new, nor were they restricted to Hillmorton, she said.

“We really need a long, hard look at the way we’re treating mental health services, the way we staff and resource them and the way we’re basically rationing access to care for people who need it.”

Dalton wanted to see more accountability from Health NZ’s board and the Minister of Mental Health.

“These are known issues – it’s not the first time these problems have been highlighted, and it’s about time Health NZ leadership and the government step up, because people are being harmed.”

Health NZ national director mental health and addiction services Phil Grady said he had been in touch with union leadership to offer to “work through” the concerns highlighted in the survey, and would also make a visit to Hillmorton this week to meet staff and discuss the issue in person.

While healthcare settings could be challenging environments, staff safety was a top priority, he said.

Health NZ actively encouraged staff to report incidents of violence and aggression, and was working on ensuring “robust processes” were in place so staff could do so safely and without fear, he said.

Work also continued on recruitment and retention and improving baseline rostering.

“There is more work to do, and we are committed to ongoing improvements at Hillmorton to support our kaimahi and the people in our care,” Grady said.

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– Published by EveningReport.nz and AsiaPacificReport.nz, see: MIL OSI in partnership with Radio New Zealand