Touching a nerve
The vexed issues of violence in Mental Health Inpatient Units – and responses to it – have been in the spotlight this month. An NZNO media release, requested by the Mental Health Nurses Section to highlight the ongoing problem of assaults on Nurses, attracted widespread attention – with coverage by RNZ (here and here) which also appeared on Newshub and in the NZ Herald. We were pleased that these news outlets reported the link which we made between violence and unsafe staffing levels.
Our media release followed a report, first published in the Otago Daily Times, about a Mental Health Nurse in Invercargill who was punched in the eye by a health consumer, and repeatedly in the side of her head. The consumer then bit the Nurse’s arm so hard it pierced her skin through her clothes. In convicting the offender, Judge Catriona Doyle handed her a suspended sentence “to protect her mana and her dignity.”
Our media release touched a nerve because appalling stories like these are all too common. The MHNS Committee has obtained a response to an Official Information Act request showing that there were 197 recorded assaults on Mental Health Nurses and Support Workers in the Auckland Metropolitan District alone in the year to 27 November 2022. 192 of them occurred in inpatient settings.
In an environment like this, it’s easy to feel that the future of Mental Health Nursing is dim. But working in collaboration with Te Ao Māramatanga NZ College of Mental Health Nurses and the Mental Health Directors of Nursing, MHNS is also boldly charting a positive vision for our profession’s future.
Over the last two years, this collaborative has been at work revising and updating the 2006 document Mental Health Nursing and its Future: A Discussion Framework. The resulting Destination 2030 – Future of Mental Health, Addiction and Disability Nursing in Aotearoa consists of nine papers, covering Standards of Practice, Māori Mental Health, Addiction and Disability Nursing, Leadership, Education and workforce development for Registered Nurses, Professional/clinical supervision and cultural and/or kaupapa Māori supervision, Recruitment, Retention, Skill mix and the role of Nurse Practitioners. We are excited to be almost at the point of sharing Destination 2030 with the sector and seeking your feedback.
Finally, in place of our regular feature article, this issue of the MHNS Newsletter contains the feedback which MHNS provided to the Ministry of Health Manatū Hauora on their draft Guidelines for Reducing and Eliminating Seclusion and Restraint. We commented on perspectives which were missing from the draft Guidelines, including an acknowledgement that sometimes seclusion is used to help maintain the dignity and mana of a service user who may be engaging in behaviour which, later, they may wholly regret. We recommended that the guidelines include greater consideration of the needs of whānau, staff and peers and a more balanced approach to safety versus therapeutic value.
Although we are disappointed that our feedback was ignored by the Ministry in their final document, published in April, we are determined to continue advocating for practising Mental Health Nurses and the people we care for – whether in the media, in Ministry consultations or in other available forums.
We hope you find something of value in the following pages. If so, do feel free to forward it on, and maybe add a suggestion that your NZNO Mental Health Nursing colleagues join the Section as well.
Introducing Committee members Joy Neilson & Debbie Watson
Ko Takitimu te waka
Ko Tararua nga maunga
Ko Raumahanga te awa
Ko Wairarapa te moana
Ko Ngati Kahungunu ki Wairarapa te iwi Ko Ngati Moe te hapu
Ko Papawai toku marae
Ko Rangitakiwaho toku tipuna
Ko Alex toku papa
Ko Kuia toku mama.
I was born and live in South Auckland. I am mother to five adult tamariki and nana to seven mokopuna. I have worked in mental health for 29 years, either in acute inpatient or in the crisis team in the community. I have held several leadership roles within those services. I am a PSA delegate in my work place. But I am also a member of the NZNO and look forward to serving as a NZNO member on the Mental Health Committee.
I have seven years experience as a RN across various settings in acute and community general nursing, including three years as CAMHS Nurse. From 2009 until now, I have been a Nurse Educator at SIT in Invercargill. During this time, I also maintained my practice as a RN Casual Inpatient MH and Casual CAFS Nurse for a period of time (but not currently). For three years as a Programme Manager at the School of Nursing at SIT I was part of committees as such:
• SDHB Future Nursing Workforce Strategic Planning Committee
• SIT Nursing Advisory Committee
• SIT Teaching & Learning Board of Studies committee
The MHNS Committee is thrilled to welcome our two new members and can now report that we have a full Committee, which comprises in addition Helen Garrick (Chairperson), Jennie Rae (Treasurer), Grant Brookes (Secretary), Fiona McNair (Facebook Administrator) and Anne Brinkman (Professional Nurse Advisor).
Committee news
The MHNS Committee has met twice since our last newsletter in December. At our March meeting, the focus was very much on our imminent educational Forum and Biennial General Meeting to be held the following day (see separate news item, below).
The MHNS Committee meeting this month discussed at length the troubling issue of workplace violence. As well as deciding to request the NZNO media release, mentioned above, the Committee also agreed to write to the Chief Victims Advisor at the Ministry of Justice to highlight the issue of victims’ rights for Mental Health Nurses who are assaulted at work and to write to the NZNO Board and CEO about the need to continue whole-of- organisation work on this issue.
The Committee also heard that NZNO Professional Nurse Advisors are finding a new willingness by employers to acknowledge staffing shortages. These shortages are not being resolved through the Care Capacity Demand Management Programme. The large amount of time being spent on CCDM work, with little benefit to show, is leading to a re- evaluation of NZNO’s engagement in the Programme.
The current review of the NZNO Constitution also received attention at our June meeting. This review was initiated in 2020, after a remit from MHNS and the NZNO Cancer Nurses College was passed by members, calling for a full, independent review. An NZNO member consultation opened on 2 June, asking members for their views about the key functions of NZNO and about whether our current member structures give effect to Te Tiriti o Waitangi and embed democratic processes for members that can work in a bicultural environment. The Committee encourages all of our MHNS members to respond before the closing date of 7 July. For more information, a copy of CEO Paul Goulter’s recent email on the Constitutional Review is available here.
MHNS Forum a success!
After years of frustrating postponements due to Covid-19, the long-awaited MHNS Forum and BGM finally went ahead in March. Gathering in person in Wellington and online via Zoom, Forum participants heard from:
• Professor John Dawson – Otago University. “The reasons why capacity principles might be included in mental health law and the potential implications for nurses”
• Erika Butters – Protecting Vulnerable Adults Trust. “Principles of supported decision making and the rights-based approach”
• Teresa O’Connor, Past Editor Kaitiaki, Nursing New Zealand. “Political action: A necessity for the survival of mental health nursing”
Feedback about the Forum has been overwhelmingly positive. In a post-event survey completed by half of Forum participants, 90 percent of respondents rated the Forum as “Good” or better, with 85 percent saying it was “Very Good” or “Excellent”. There were also very useful suggestions on how we can make the next one even better, including some interesting topic suggestions.
Changes to the MHNS Newsletter
After a couple of years as editor of the MHNS Newsletter, it’s time for Grant Brookes to move on. His responsibilities on the Board of Directors and in his new roles as MHNS Secretary and Chair of NZNO Greater Wellington Regional Council sadly leave too little time to continue. The MHNS Committee has plans in place to keep up communication with MHNS members, however. Look out for a new format in your inboxes this year.
MHNS feedback on draft Guidelines for Reducing and Eliminating Seclusion and Restraint
Click on the image below to read our feedback to the Ministry of Health Manatū Hauora on their draft Guidelines for Reducing and Eliminating Seclusion and Restraint.
Grant Brookes | Nurse & Trade Unionist 