Overcrowding at Hunter psychiatric facilities

An Industrial Commissioner has inspected James Fletcher psychiatric hospital in Newcastle to examine nurses’ concerns that overcrowding poses a risk to patient and staff safety.

Nurses at James Fletcher, along with nurses at the psychiatric in-patient unit at Maitland Hospital, have been in dispute with Hunter New England Mental Health since October last year.

James Fletcher is gazetted for 64 beds but was sometimes 10-14 above that number, with up to 24 patients in a 20-bed ward not being uncommon.

The dispute went to the NSW Industrial Relations Commission after nurses voted to ban patient admissions to already full acute wards.
Commissioner J D Stanton has so far held three hearings into the dispute plus the site inspection.

NSW Nurses’ Association branch secretary Greg Ribbons said Commissioner Stanton was able to see first-hand the impact of overcrowding such as patient lounge areas converted into makeshift bedrooms.

‘We are asking Commissioner Stanton to order management not to go over-census in the interests of safety,’ Greg said.

‘Management say they are coming up with strategies to reduce the incidence of overcrowding, and gave us a written assurance that they wouldn’t go over census except in extraordinary circumstances.

‘They have just introduced a strategy of having some patients assessed by the treating team outside the unit if wards are full.

‘Over census is still occurring on a regular basis, though not at the extreme levels recorded last year.

‘We are working with management as best we can to find solutions, but a resolution to this issue is still some time away, according to our members. However, they all remain committed to a successful outcome.’

The NSWNA carried out its own occupational health and safety inspection at James Fletcher and reported that many design features were not consistent with NSW Department of Health guidelines for acute mental health units.

The union’s OHS coordinator, Trish Butrej, reported: ‘There are no consultation/interview rooms, some units have no seclusion rooms, most bedrooms are shared and, when the unit exceeds 100% capacity, patient lounge/dining space falls far short of recommended levels.

‘The risk of violence in mental health facilities may be increased by crowding. Research suggests that one reason for this is lack of privacy and personal space,’ she noted.

NSWNA General Secretary Brett Holmes said the union had received many complaints from members about workplace safety in Hunter Mental Health.

‘Violence remains a significant issue for mental health nurses,’ Brett wrote in a letter to Hunter New England Mental Health management.

He pointed to one survey finding that over 38% of workers’ compensation claims from mental health nurses were as a result of being hit by a patient and more than 2% were as a result of being bitten by a patient.

‘NSWNA stands by its members’ right to raise any concerns about risk factors for violence and expects that management will act to ensure their safety in accordance with OHS legislation.’