Nurse feels ‘partly responsible’ for death

Nurses at Christchurch’s Hillmorton mental health hospital say the facility had been grossly underresourced long before the alleged murder of Laisa Waka by a patient.

Waka’s death has triggered an inspection of services at Hillmorton by director of mental health Dr John Crawshaw, in addition to other investigations into the care of the patient and the decision to grant him leave.

Two nurses, who spoke to The Press on condition of anonymity, said Hillmorton staff felt partly responsible for Waka’s death and many made donations to a fundraising page set up to support her family.

They say ‘‘years and years’’ of staffing shortages had been ignored by management, left patients uncared for and staff ‘‘defenceless’’ to respond to incidents of violence.

A young registered nurse at the facility says they chose to specialise in mental health because the field required strong relationship-building skills, which appealed to them.

‘‘. . . you get to know someone on a much deeper level in regard to relationship-building, communication – you’re privileged to understand their life, really.’’

Although not far into their career, they say the work is deeply rewarding on the ‘‘good days’’.

Despite this they often don’t feel prepared to respond to patients who ‘‘kick off’’ and become violent.

They have experienced several violent incidents on the job, and going in to each shift their main thought is ‘‘are we going to be safe?’’.

The nurse is still processing the alleged murder of Waka.

‘‘I just take it one day at a time when it comes to that and just do the best I can every single day.’’

They wanted people to know how hard staff worked to give the ‘‘best possible care to patients’’, and that some things were beyond their control. ‘‘Everyone brings a huge amount of mahi to the table and everyone does exactly what they can at the time, and sometimes it’s just out of our control.’’

They hoped the inspection by the director of mental health would bring extreme staff shortages to light and meaningful reform, including more funding for staff.

They said understaffed shifts were their ‘‘normal’’.

‘‘I can’t tell you what it’s like when it’s good, it’s just what I’m used to.’’

In response to an Official Information Act request, Te Whatu Ora Canterbury (formerly Canterbury District Health Board) said there were 79.45 full-time equivalent (FTE) nursing, 28.9 FTE allied health, and 2.11 medical vacancies across the Hillmorton service as at the end of May 2022.

In addition to staffing shortages, staff safety was a major and unaddressed issue, the nurse said.

A week-long training course in effective communication, de-escalation and safe restraint techniques was helpful, but could not prepare them – or other staff – for every situation, the nurse said.

A senior registered nurse said she felt Waka’s murder could and would have been avoided if there had been more staff rostered on because he would have been given the option to go to a de-escalation area, rather than being granted leave to go for a walk.

‘‘I’m convinced that had we been better staffed that plan would have never been put in place for him.’’

The nurse, who was not working in the unit at the time, said she felt a sense of responsibility for Waka’s death.

‘‘I felt partly responsible. I know that sounds strange, but it was true, I kind of feel that mental health has failed that family.’’

Staffing was so poor that new graduate nurses were sometimes rostered on to manage a shift in secure units. ‘‘That’s scary. I’ve been around a long time and there’s no way I would go and work in that unit at the moment.’’

Nurses were regularly having to do double shifts of 16 hours, and the consequences for patients were ‘‘a travesty’’.

‘‘If you’re a depressed person don’t be admitted to mental health care in Christchurch because you will be sitting in your room on your own, because it’s the most unwell and high-profile people who absorb the resources.’’

A minority of patients, especially when suffering from psychosis or detoxing from drug addiction, became agitated and violent, she said. She said this was far more likely to happen when there was not enough staff to provide the necessary care.

The senior nurse said the specialist mental health service in Christchurch had been poorly managed for many years, and had become ‘‘a problem that’s too difficult to solve’’.

‘‘People just keep putting their heads in the sand ... rather than acknowledging the problem.’’

She wanted to see a return to hospital-based training, more funding to subsidise nurse trainees, an increase in pay through resolution of the pay-equity claim and more Ma¯ ori and Pacific nurses.

‘‘If you’re a depressed person don’t be admitted to mental health care in Christchurch. . .’’