Oversight body introduced after bullying complaints at Middlemore neonatal unit

A health board says it has introduced an oversight group at a neonatal unit in South Auckland plagued by managers bullying nurses.

The oversight group had been in place since investigations began behind closed doors last year at Middlemore Hospital, and was still in place, Counties Manukau Health said.

A group of specialist nurses told an independent investigator they had complained for years about a toxic environment, but the DHB only took action 18 months ago to begin addressing this.

The unit's nurses spoke about being under extreme pressure, and first raised concerns with the union early last year about the rostering of shifts "causing fatigue and health and safety risks", an investigator's report said.

Workload had increased as bed numbers went up, but the investigator found only two new senior staff had been appointed over the past three years in the 70-strong unit.

CM Health said that it had now added a large number of new staff, "separate to any investigation", and these were mostly registered nurses but also specialist nurses, charge nurse managers, lactation consultants, a registrar as well as an additional neonatologist.

The number of cots in the unit has increased from 28 to 34 since 2017-18.

In a unit where up to four babies died a week, nurses told an investigator they were left "without any opportunity for debrief or any sense of genuine support from their manager".

"It was a significant concern to hear [neonatal intensive care staff] were not offered any structured professional debriefing programme after an infant death," the investigation report said, and recommended formal support systems.

CM Health said it was developing formal staff support and pastoral care, as well as more education, supervision and reviews.

Nurses expressed concern that exit interviews had not been carried out or retained by the unit for many years, which "suppressed" evidence of the bad environment.

CM Health said the investigation was over and it was confident the primary causes of the concerns had been addressed, with the oversight group of managers, staff and union representatives carrying on overseeing changes.

The Nursing Council is now investigating.

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