Mental health staff respond to Health Care Complaints Commission findings about Ahlia Raftery's death

About 25 members of the Nurses and Midwives Association met on Friday to discuss the implications of the Health Care Complaints Commissions's findings into the 18-year-old's suicide.

The commission prosecuted a complaint against four nurses who were responsible for caring for Ms Raftery. It alledged their failure to undertake appropriate observations of Ms Raftery in the hours before her death constituted unsatisfactory professional conduct and professional misconduct.

Two of the nurses have been deregistered for 12 months and the other two have been reprimanded as part of the commissions findings delivered last week.

The source told the Newcastle Herald that the tragedy and subsequent investigations had taken a professional and personal toll on staff at the unit.

"The result undermines public trust in our service, putting more lives at risk while unwell people avoid seeking help from our system and fits into a negative narrative about mental health services in general," one staff member who provided a written comment to the meeting said.

"None of us want to see death and tragedy come to any person in our care. None of us. We work so hard to make sure it doesn't. This whole situation is horrible and has negatively impacted on a lot of us and how we now approach our jobs and our team work."

Staff passed several resolutions relating to their work environment that will be presented to Hunter New England Health management on Monday.

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One resolution related to a desire to work with Hunter New England Mental Health management to address the "systemic environmental and practice issues" that contributed to Ms Raftery's death.

"The branch expresses concern at the actions taken by Hunter New England Mental Health in response to the tragic death of Ahlia Raftery have placed further pressure and professional risk onto nursing staff and are impacting negatively on the ability of nurses to provide holistic care...," a resolution says.

"There is a perception growing among nurses that support and visible leadership from executive management for the nurses involved in the recent Administrative Tribunal case and the nursing workforce in general is lacking..."

Other resolutions called for the immediate implementation of the coroner's recommendation of one-to-one nurse to patient ratios in the PICU.

"All patients on observation levels at less than 30 minute intervals must be nursed on a one-to-one basis and that staffing of any unit with patients on these observation levels is adjusted according to the demand," the resolution says.

In addition, the introduction of back to base pulse oximetry monitoring of all patients on observation levels greater than 30 minutes and the conversion of all door knobs in the mental health inpatient areas to a type that cannot be used for self harm.

Staff have also called for the implementation of technology to enable the "safe, confidential and contemporaneous" recording of observations without the need to leave the patient area.

The Raftery family issued a statement in response to the staff resolutions.

"Though it's not an apology, we thank the members of the Nurses and Midwives Association for their thoughts and sympathy," their statement said.

"Whether it is with changes at the hospital or to the practices of individuals we just don't want what happened to Ahlia to happen to anyone else.

"We sat through all of the coronial Inquest and the NSW Civil and Administrative Tribunal hearing and listened to the evidence of the nursing experts. We know the work of a nurse in a PICU setting must be challenging, but knowing everything we do, in no way do we accept propositions that the punishments were harsh or an inference that nursing errors may be explained away by a busy workload.

"A reading of the Coronial and NCAT findings in their entirety makes it clear that there were numerous, systemic, environmental, and nursing failures, and no amount of fairy dust can conceal these realities.

"It also begs the question, that if the ability of nurses to attend to their patients, ensuring that observations were being made and recorded was such a difficult burden that patient safety has been compromised, why have these issues not been strenuously raised by the Nurses and Midwives Association membership and attended to prior to Ahlia's death over four years ago now? We think that there must be a good deal still wrong that must be fixed, not only within the local Hunter New England Health Local Health District and nursing fraternity, but across the nation.

"We appreciate the Nurses and Midwives Association considering positive improvements, and we wholeheartedly support any resolutions to improve patient care, in particular with one-to-one nurse/patient ratios in psychiatric intensive care settings, and for technological innovation to be investigated and introduced.

"Any recommendations made by the Nurses and Midwives Association and subsequently implemented by Hunter New England Health Health will ultimately benefit patients."