Te Whatu Ora’s attempt to cut costs by requiring health care assistants to carry out cohort patient watches is harming vulnerable patients and staff, NZNO says.
Patient watches involve trained and experienced health care assistants monitoring patients deemed a threat to themselves or others. They often have confusion, delirium or dementia.
Tōpūtanga Tapuhi Kaitiaki o Aotearoa NZNO delegate and Christchurch health care assistant Al Dietschin says cohort patient watches are occurring throughout the country.
“In Christchurch, health care assistants have written to local Te Whatu Ora leadership to raise our concerns that short-staffing and cohort patient watches are inherently unsafe and places both patients and staff at considerable risk.
“There have already been documented incidents of patient harm directly resulting from the use of these cohort watches. With winter approaching, the situation is now at a critical point. The letter warns: ‘the NZNO members are extremely concerned that without immediate and substantive change, further patient harm is not just possible, but inevitable’.
“The patients we watch are often highly agitated, have dementia or deliriums and can have mental health issues. They often have intravenous lines, drains, nasogastric tubes and catheters in which they can pull out, causing them further distress and trauma. They can hurt themselves in falls if they are not constantly watched.
“There has already been a warning from the Coroner about the link between short staffing and falls. Despite 18 months of raising concerns with Te Whatu Ora in bargaining about understaffing, the situation is getting worse,” Al Dietschin says.
NZNO delegate and Auckland health care assistant Anamei Graham says understaffing means health care assistants are constantly forced to prioritise their tasks.
“It is very difficult to watch several such patients at once if they are put into a cohort, especially if they are in different rooms. It is not safe for them, and it is not safe for the kaiāwhina watching them,” she says.
“A lot of us are feeling unsafe. Whānau are asked to help but they are not trained to provide patient supervision and monitor changes in behaviour. Often it is a spouse caregiver who really needs some respite from 24/7 care themselves.
“We are pulled in all sorts of directions at once and we are stressed out and burnt out. There’s not enough HCAs on the wards and patients and whānau can feel it,” Anamei Graham says.