A former nurse at the Palmerston North Hospital mental health ward says the working environment was chaotic, and it did not improve in the years after two patients died there in 2014.
Palmerston North Hospital. Photo:
The former nurse also said before the deaths of Shaun Gray and Erica Hume that year hospital management was told it was only a matter of time before tragedy would strike.
The nurse, whose name is suppressed on an interim basis, gave evidence on Friday at an inquest into Gray's death.
The 30-year-old father of one died in a suspected suicide after being admitted to the ward, known as ward 21, following an overdose.
The nurse was not involved in Gray's care, but was a New Zealand Nurses Organisation rep for the ward.
In March 2014 he and another union delegate raised concerns about the working environment in a meeting they demanded with hospital management.
The nurse described the ward as chaotic.
"[The other rep] and I made it clear to the meeting that ward 21 was not a safe workplace. It was not a matter of if, but when, a serious or sentinel event occurred."
When that happened anyone was at risk - patients or staff.
"It was the responsibility of the DHB to provide a safe workplace and this was not being done," the nurse said.
In the following months the nurse tried to follow up on the meeting and in August 2014 contacted a senior Health Ministry official.
By then an external review of the ward was under way after Gray and Hume died.
The nurse no longer works on the ward, having recently left. He said in the years after 2014 "superficial changes" were made, but nothing with any depth.
Since 2014 other patients have died by suicide or in suspected suicides.
External reviews found the present ward not fit for purpose and a new one is due to be opened late next year, a year later than expected.
The nurse told the hearing that in the period before Gray's death he had concerns about the high number of ward patients who were aggressive after using legal highs, which were prevalent until a law change.
Police were not always responsive, and that led patients to believe there were no consequences for assaulting staff or having drugs on the ward, as charges were rarely laid, he said.
And staff were not interviewed by management after reporting incidents.
"I became scared of what I would encounter at work each day and from conversations with colleagues I know that others felt the same way...
"The ward was chaotic and I felt the staff were not adequately supported. There appeared to be a lack of leadership in ward 21."
The union delegates conducted a survey of ward staff, and the results showed most felt supported by colleagues but not by management.
"There was very much an attitude of, 'We're going to get through this together'."
Lawyer assisting the inquiry Kate Fitzgibbon asked about evidence another ward nurse gave at the hearing, that people such as Gray, who were admitted with addiction problems, faced stigma from staff.
The nurse said he could not agree with that and such attitudes should have been dealt with as a performance matter.
He said he was lucky to have worked in other mental health units that were run well and where patients were well cared for.
"What we were able to do for people who used the service was exceptional.
"That is what is a very painful thing for me at ward 21 - I know what a good metal health service looks like and I know how it works.
"The people who work at word 21 do not, because they have never had one...
"I was at work to service the patients and I was employed by the hospital. I didn't work for the hospital. I worked for the patients, and I could see that the patients were not getting the service they deserved."
The inquest has finished its second week and is due to wrap up next Friday.