Health care assistants suffering injuries due to short staffing: Union

The nurses union says health care assistants charged with keeping an eye on at risk patients are being abused and patients are suffering injuries due to short staffing.

In Canterbury, Nurses Organisation delegates will meet with Te Whatu Ora Waitaha on Friday after writing a letter requesting a chance to discuss their concerns with safety for cohort patient watches at the Christchurch Campus.

'Patient watches' are where trained health care assistants monitor patients deemed a threat to themselves or others due to things like confusion, delirium, or dementia symptoms.

"The ongoing shortage of Healthcare Assistants (HCAs) has led to a standard practice where a single HCA is assigned to watch three patients simultaneously," the letter said.

The watches can be in multi-bedded rooms in some areas, but the union said patients were also frequently located in separate rooms, which meant one staff member could not see all the patients they were assigned to at once.

"The practice of 1:3 patient watches is inherently unsafe and places both patients and staff at significant risk.

"When a staff member is tasked with monitoring three patients in three different locations, they cannot physically prevent a patient from falling, removing essential lines, or harming themselves."

The union said the situation was now at a critical point.

"With winter approaching, we anticipate a further increase in patient acuity and occupancy, which will only exacerbate the pressures on our HCAs and heighten the risks associated with this practice."

Health New Zealand said the scheduled meeting aimed to bring people together and find way forward.

Delegate and Christchurch health care assistant Al Dietschin said incidents of patient harm directly resulting from the use of cohort watches had been reported to the union from across the country, including in multi-bedded rooms.

"If you're watching, say, three people and two of them decide they need to get up to go to the toilet or something, you can't be in two places at once and often that's when the falls occur," he said.

He said the union was aware of other cases where patients had suffered falls and other injuries, as well as an attempted suicide and other concerning incidents.

RNZ asked Health New Zealand to verify the injuries identified by the union but they were unable to provide further comment.

Health care assistants say they are afraid

Delegate and Auckland health care assistant Anamei Graham said staff - who could be alone in a room with agitated or aggressive patients - were feeling unsafe and some staff had been physically or sexually assaulted.

"The reason why we are feeling so unsafe is because there's just not enough staff to come and support us," she said.

"I've experienced my hair being pulled, being slapped in the face, my private parts being touched by a patient. I've also had a patient hold a knife to me and tell me to get away when I'm just trying to assist them," Graham said.

Dietschin said some health care assistants he's spoken to reported feeling burnt out, stressed, and scared to do close observations because of the nature of the patient's condition.

"If they've been assaulted previously, they're often traumatised and they're quite frightened to do that work again."

Dietschin said he was aware of healthcare assistants needing time off due to work place injuries and had personally been punched, kicked, spat at and bitten by patients.

More health care assistants needed

Dietschin said a lot more health care assistants needed to be employed and trained, and more staff were needed in the cohort rooms.

He said having a number of people on hand both minimized the risk of patients getting hurt and made the job safer for staff.

Graham said the staffing shortages were "incredibly scary" for staff.

She reckoned having at least two health care assistants in a cohort room would help ensure they were able to provide enough support and attention to each patient.

Health New Zealand says they're taking measure to minimise risk

National Chief Nurse Nadine Gray said the safety and wellbeing of patients and staff was at the heart of everything they did.

"Health care settings can be challenging environments where patients can be impaired due to multiple possible causes, including delirium, pain, medication side effects, and many other conditions, resulting in unpredictable behaviour."

Gray said they could not prevent some issues with patients from occurring but had processes in place to manage them that minimised the risk of harm to staff and prevented further escalation.

"We take violence and aggression seriously and our staff have the right to expect to be safe from violence and abuse at work."

Gray said they had taken measures such as providing staff with personal alarms and training, and having security teams in close proximity to emergency departments to help de-escalate incidents of aggression, if required.

"We are continuing to roll out an intensive violence reduction training to security and clinical staff across our hospitals, as part of the Government's $31 million funding commitment over four years. We expect our wider programme of work to provide safer environments for staff and patients."

Gray said Health New Zealand was always looking at ways to improve its system, and quality and safety was its number one priority.

"Health NZ is committed to strengthening our workforce and continue to actively recruit for vacancies across the country.

"Planning is under way to establish a new national programme of work focused on strengthening how we plan for, manage and assure nursing safe staffing across our organisation."

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