Nursing shortages have again caused acute mental health bed closures around the country – this time in the North Shore’s only acute mental health unit – but unions report nurses in other centres working double shifts as vacancies take their toll.
Five beds of the 35-bed He Puna Waiora inpatient unit were closed on Sunday by the Waitemata District Health Board for seven weeks while it recruits and orientates new staff.
In April this year Capital and Coast DHB temporarily closed three beds in its Te Whare o Matairangi acute mental health unit because of staff shortages. This week Radio New Zealand reported that CCDHB was looking to employ unregistered staff to bolster its workforce as the capital’s mental health crisis team had one in four positions vacant. This winter there were also reports of staff working extra shifts at Christchurch’s Hillmorton Hospital because of 45 nursing vacancies.
Erin Polaczuk, the PSA’s national secretary, said the Waitemata bed closures were a last resort by the DHB after 12 unfilled staff positions (nurses and assistants) had lead to remaining staff working double shifts to try and manage a full ward of patients.
“It was just getting to the unsustainable point,” said Polaczuk.
“This isn’t unprecedented – there has been bed closures before [around the country] because the lack of staffing is creating an unsafe environment.”
Grant Brookes, the president of the NZNO, described CCDHB trying to resolve the nursing shortage by filling vacancies in its crisis team with healthcare assistants as “not a robust approach” as to work in a Crisis Resolution Service a nurse needed at least four years’ mental health nursing experience.
Brooke said he understood Wellington’s mental health services were currently around 40 nurses short, with 13 vacancies in the crisis team resulting in nurses doing “thousands of overtime hours and working rostered double shifts”. He said there had been insufficient investment in recruiting senior nurses and high turnover because of the conditions of work.
Polaczuk said concerns about the growing demand for mental health services outstripping the services ability to cope was behind the PSA’s call this year for the incoming government to commit to a mental health inquiry looking at all aspects of mental health from helplines through to acute mental health units.
“There needs to be a structured plan to fix this [staffing crisis] and we need to respond. Particularly in New Zealand where we have such an embarrassingly high suicide rate – we really can’t afford to have any gaps in our mental health service.”
Meanwhile, Polaczuk said while demand kept outstripping mental health services ability to recruit experienced staff, she expected more bed closures could follow around the country. “It’s a recipe for a situation like the one we have right now.”
She said PSA was not pointing their finger at DHBs. “DHBs are trying their best to manage a tricky situation on tight budgets, but there is a risk for people who work in the field of mental health that they can become unwell themselves. So we want to avoid fatigue and overwork that can lead to people becoming ill.”
Brookes said there must be more investment in mental health. “Nurses are doing huge amounts of overtime and are struggling to keep up.”
Waitemata DHB in a statement said the temporary closure of the five inpatient beds was a precautionary measure in the interests of patient and staff safety while it filled vacant roles. It said it had four staff arriving over the next few weeks, with more to follow. The DHB was working with its community-based mental health services, which had a number of community beds available, as well as its other inpatient mental health facilities to ensure alternative care was available for patients.
Pam Lightbown, the DHB’s general manager of specialist mental health and addiction services, said staff and patient safety was its highest priority and it was focused on recruiting suitably qualified health professionals to ensure it continued to deliver best care.