Hospital staff concerned at combined cleaner-security officer roles

Key points

Combining the roles of cleaners and security guards into one job at two rural Waikato hospitals has left staff worried about their own safety and that of patients.

And the scheme's cost savings haven't been as much as predicted.

These are among findings in a report obtained by RNZ about the introduction of the scheme – which Health New Zealand calls integrated cleaning, attendant and security services – at Te Kuiti and Tokoroa hospitals.

It was previously introduced in Thames and Taumarunui hospitals.

As RNZ revealed last month, the combined roles began a year ago and Health NZ did a post-implementation review in April.

It found while the cleaning side of the arrangement is going well, hospital staff say they're not getting the level of security services required and they hold safety concerns.

Staff said security officers-cleaners from a cleaning background weren't trained for the job, and that the two jobs conflicted, meaning pre-emptive action during an escalating situation was impossible if a worker was away cleaning.

A rural Waikato nurse, who RNZ has agreed not to name, said she wanted the jobs to separate again.

"I'd like for them to listen to us and hear our cries for help," she said.

"We've put in complaints and concerns about our security issues and how we feel the security guards are actually unfit to proceed with the job they're meant to be doing, or they aren't doing their job."

Although some were reliable, she said staff held concerns about others.

RNZ has previously reported that at Te Kuiti Hospital one cleaner-security officer is on duty overnight, with two nurses.

The Waikato nurse said it was impossible to expect the cleaner-security officers to be in two places at once.

"I don't think [cleaning] should be a role integrated with security. It literally makes no sense. They've got nothing to do with each other. It just baffles my mind.

"It's like making someone who works at a gas station pump gas but also pack your groceries all at the same time. Why would you do that?"

The Health NZ report said the move was partly about cost efficiency. It was expected to save $207,300 in its first year, but only shaved $137,300.

The reports cited some benefits, such as flexibility of work roles, lower costs and consistency among the rural Waikato hospitals, but recommended improving security after deficits were identified.

Among the "lessons learned" was the definition and responsibilities of the new roles weren't clearly stated or understood.

It also recommended consideration of a future review, which the nurse hoped would be more thorough.

"Pretty much every nurse that I work with does not like it. It doesn't function as well as they think it might," she said.

"Reading the report, I feel like there were actually quite a few issues that weren't mentioned that I remember writing as a response to the questions [when staff were surveyed]."

That included the preference to break up the jobs.

The report said there was a perception there wasn't enough communication and consultation before the change.

The nurse agreed.

"It's pretty much someone sitting at a desk and saying: 'We can do this.' They talk about how they should have gone to us and given us more information beforehand instead of just springing it on us.

"Yes, we definitely agree [this] needed to be done. There needed to be more notice, but also I think there should have been: 'This is the job we're thinking of putting in. Do you think it's going to work?'"

Now, if the security officer-cleaner wasn't around when an incident unfolded, medical staff had to try to make it to a phone to call for help, leaving a potentially unsafe situation.

The report said staff were issued with personal duress alarms, although it noted there was limited staff understanding of this, and the devices weren't maintained or used.

There were also security improvements made to the hospitals, such as clearing vegetation.

The E Tū union represents hospital workers such as security officers and cleaners.

Its director responsible for health, Mat Danaher, said not having enough staff, and inadequate facilities, due to a lack of funding meant the combined roles didn't have a chance.

"What happens if you've got one operative who's supposed to be doing an urgent clean to make something safe and in the meantime a fight's breaking out and you need two people to go and help deal with that?

"It can't be done and I think that's what we're seeing the effect of here."

No one was happy with the current arrangement, he said.

"It's a matter of time before someone dies – we have a death that could be prevented. That's literally what we're talking about.

"It is a life and death matter."

Health NZ senior manager Stephanie Doe said it was committed to providing an environment where staff and visitors felt safe, and it received advice from its national chief security adviser on improvements to the rural Waikato arrangement.

The review was of the scheme's implementation, not the model itself, and its roll out had achieved its objectives, she said.

There hadn't been any recent significant security incidents at Waikato hospitals.

"At Te Kuiti and Tokoroa, security staff are onsite 24-7, including within the vicinity of ED [the emergency department] and ward at night. We encourage staff faced with a hostile situation to call police."

rnz.co.nz