Nurses working at a Canberra mental health facility are scared of repercussions from management if they report assaults as workers feel they have been blamed for violent incidents.
Staff working at the Dhulwa Mental Health unit reported more than 100 physicals assaults over a six-month period, with one nurse likening work at the facility to being "sent into the killing fields".
The Australian Nursing and Midwifery Federation has called for an inquiry into violence at Dhulwa, with ACT branch secretary Matthew Daniel warning a "catastrophic event" was imminent at the facility.
The assaults took place in the six months to February. Canberra Health Services received 83 reports of assault over the period but the union said the true numbers were higher. Mr Daniel said nurses were keeping statistics themselves.
"Members are keeping the statistics themselves because they're concerned that the true extent of the number of assaults and the seriousness of the assaults won't be recognised," he said.
"There's also a problem with the reporting that there is not a great level of trust in reporting through the proper mechanisms for reporting these things because as evidence has shown there's not a lot of change occurring."
Canberra Health Services executive director of nursing and midwifery Karen Grace said most of these assaults occurred within a short period in February and this was due to "particular circumstances in the unit at the time".
But Mr Daniel said the issues had been ongoing since 2018 and he did not accept the government narrative that this was limited to February.
He said nurses felt there was a lack of action around tackling the assaults and in some instances nurses were being blamed for the level of violence.
Mr Daniel said nurses were afraid to take action to de-escalate situations or respond to situations.
"There are some punitive actions being taken against other staff members for intervening to de-escalate situations or respond to situations," he said.
"They are particularly scared that if they take any action to de-escalate or respond to a situation then they're going to have management come down on them heavy and their experience tells them that's the case."
Nurses were particularly worried about how CCTV footage was used by managers.
"The use of closed circuit television in the unit is being used for punitive purposes of hauling them over the coals for apparently doing the wrong things," Mr Daniel said.
"It's meant to be there to provide a level of safety and possibly even an opportunity to learn what occurs and review what occurs in the unit.
"Our members say that the information is being taken off to some sort of secretive group of higher level managers that then come back, heavy handed in their approach to staff, and the management team seek to put blame on nurses for contributing to the escalation of behaviours, because apparently, management claim that they don't have the necessary skills to deal with the situation."
Ms Grace said CCTV footage was examined in some circumstances to understand why an incident had happened. She said it was part of a formal process for reviews.
"The main aim of that is so we can understand whether the training that is in place is actually being able to be put into practice in high stress situations or whether we need to help staff with additional training, support and education in order to improve the responses or to recognise triggers earlier," she said.
Ms Grace said work was being undertaken to improve issues at the facility but said mental health nursing was difficult.
"Mental health nursing is probably one of the most difficult specialities within nursing and it's quite distinct to other types of nursing," she said.
"With it comes inherent risks because of the nature of the patient cohort that we deal with in the mental health space so it can be quite difficult to navigate that very fine balance between staff safety and patient wellbeing and safety."
Senior staff across Canberra Health Services have been stood down in recent months, when asked whether this should happen at Dhulwa, Mr Daniel said there needed to be consequences.
"Over a long time they've shown their inability, numerous managers over time have been ineffective," he said.
A Canberra mental health nurse, who asked to remain anonymous, said procedures were unclear. The nurse said there was a shared experience about not if you get assaulted but when.
"There are protocols and frameworks to follow after an assault occurs within the mental health system...but they're used as a very basic guideline...it doesn't go into the nitty gritty [details] of what may be needed to best support staff," the nurse said.
"Personally, I've always wanted to be a mental health nurse. But after being assaulted multiple times, I had to really consider ... as to whether my passion was worth the risk."
The nurse has only worked a few shifts at Dhulwa but said it was a scary place to work.
"I've only worked in Dhulwa three times, to be honest, because I found it to be a scary place to work," the nurse said.
"That was to undertake training and do supernumerary days, which is when we do shifts to learn about the unit policies and practices, we're not supposed to be on the floor to do general nursing duties.
"After doing those three days, I was too scared to accept any shifts there, which sucks because there's a lot of shifts available because there's not a whole lot of nurses that want to work there."
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ACT Minister for Mental Health Emma Davidson said the government wanted to work with nurses and their representatives to make sure their concerns were being listened to but stopped short of committing to an inquiry into the facility.
"We want to work with these nurses, and with their representatives, to make sure that their concerns are being listened to, that they are being understood, and that we can work with them to make improvements to their workplace and make a safe environment," she said.
"We've been undertaking a lot of work over the last few years in cultural form and workplace safety across all of our health service services in the ACT, across the entire health system and it's really important that we're able to continue to engage with the unions, professional associations, health services and the universities who are training the next generation of nurses as well."
Ms Davidson also referred to the period in February when violence had escalated. She was unable to provide much detail on the reasons why there was a surge.
Opposition health spokeswoman Leanne Castley backed calls for an urgent inquiry into Dhulwa. She said she had also received reports that nurses were afraid to stand up to management.
"We hear that there's [been] over 100 physical attacks in the last six months, this is unacceptable and nurses deserve better," she said.
"Nurses are afraid to speak up. Not only are they afraid of going to work and being physically attacked, they're afraid of saying to their bosses that [they're] in trouble."
