Head-butts, punches and threats: nursing at the frontline
Snap, grumble and pop as the sealife speaks up on ‘radio Hauraki’
The longest and most comprehensive acoustic study mounted in New Zealand has revealed an underwater orchestra of snapping shrimp, popping fish and moaning whales in the Hauraki Gulf.
University of Auckland researcher Rosalyn Putland has just completed a pioneering PhD study, which collected half a million minutes of sound from six listening posts set up around the gulf.
The study yielded a rich soundscape showing that our underwater environment is anything but a still, silent world, with the seafloor-fixed hydrophones picking up everything from the clicking of dolphins to the slow rumble of far-off earthquakes.
“The fundamental question we wanted to answer is, what is the soundscape of the Hauraki Gulf?” she said.
“It’s a very quiet embayment relative to a lot of places around the world, and we wanted to establish a baseline of what is actually happening naturally, prior to any human impacts in the future.
“Very little sound data has been collected in New Zealand, and it’s been in short-term studies, so it was nice to get this long-term view, with seasonal and annual variations.”
Over the three-year period, Putland recorded two minutes of every 20 — “if I listened to all of it I’d still be here 10 years Medical staff around the country have been abused and attacked by patients almost 14,000 times since 2012.
Staff at district health boards (DHBs) have been head-butted in the face, had urine poured on them, faced death threats and the threat of gang attacks, had knifes, razors and other home-made weapons pulled on them, been spat on, punched in the head or face and strangled.
Those are just some of the more than 3800 recorded attacks on staff by patients and visitors. More than 5300 cases of verbal abuse and threatening behaviour have also been reported.
Sixteen of the country’s 20 district health boards released figures to the Herald under the Official Information Act.
MidCentral District Health Board recorded 2792 incidents since 2012 — the highest number of the DHBs which responded — although there were very few physical assaults.
A MidCentral DHB spokesperson said staff were trained to report all incidents regardless whether they physically harmed. Sometimes staff were involved in a number of incidents with the same patient and later playing it back” — and used computer models to process the enormous amount of data.
Among the sounds captured were the moans of the critically endangered Bryde’s whale, which, despite being one of the third most common mammals found in the gulf, had been rarely recorded.
“The whales were a great sound to hear — that’s a really low moaning sound and they appeared very frequently, and probably more than we first thought they were going to.”
She was able to tease out a colourful range of other specific biological sounds.
“We have urchins, which make these kind of crackling, crunchy sounds as they feed on rocks, and that’s actually quite a fundamental sound here in New Zealand, and we have snapping shrimp, which is found all over the world and pretty much constantly throughout the day and night.”
The din of rain and wind above the surface could be heard on the seafloor, as could earthquakes from as far as 750km away — something Putland was able to confirm using GeoNet data.
“We thought, ‘ Wow, that’s a pretty awesome sound’, and potentially the whales and fish might actually be used to that sound on a natural basis.”
The project’s ultimate finding was a positive one, with each biological sound filling its own “niche” in the gulf’s soundscape.
“It’s been shown in the past that it’s quite a healthy environment if all of the niches are filled.”
New acoustic studies like Putland’s have been allowing scientists to gain remarkable insights into our marine environment.
Devices deployed in the Cook Strait over each was recorded separately.
Capital and Coast District Health Board recorded the second highest number of incidents overall (2569) and by far the highest number of physical assaults (1617).
In one case a patient stabbed a nurse just below his eye with a plastic knife. In another, a cup of boiling water was poured over a nurse.
In a 2015 analysis on the issue, employees reported a lack of staff and the removal of mental-health safe rooms as barriers to safety. The report also recorded concern there was faeces in gaps in the walls, doors were rotting because they were soaked in urine, and security staff were issued with slash-proof gloves.
Capital and Coast general manager of corporate services Thomas Davis said most assaults occurred in the mental-health, addiction and intellectual disability services.
“We have some of the most complex clients in the country. We also experience a high number of assaults on staff in our emergency department,” he said.
“We encourage staff not to tolerate threatening physical or verbal behaviour, and they are trained in deescalation techniques.”
One nurse, off work with serious neck issues for more than a year after six months last year captured vocalisations from Antarctic blue whales, Antarctic minke whales and several different beaked whale species that were rarely seen due to their extensive diving.
These were likely to be the first recordings of Gray’s and strap-toothed beaked whales in New Zealand.
Research into the long-term survival and abundance of the gulf’s Bryde’s whale population has used photographs of their fins to aid efforts in improving the management of the small population.
Bryde’s whales are classified as nationally critical in New Zealand and appear only on the northeastern coast of the North Island. In the Hauraki Gulf, Bryde’s whales appear District Health Board (2016–2017) (2012–2016) being karate chopped, described the attack: “The patient just went berserk in the dining room. The nursing staff restrained him like they are meant to do. I rushed in as well and the nurse that was looking after him said, ‘let year-round, usually in waters deeper than 40 metres.
The study, led by Massey University’s Dr Gabriela Tezanos-Pinto, collated an extensive database of photographs showing distinctive fin features of individual whales over eight years to obtain missing demographic information about the local population. The study catalogued 72 whales over eight years, of which 20 returned to the gulf year after year.
Overall, the study estimated that less than 50 whales visit the gulf each season.
“Our analysis indicates that the local population of Bryde’s whales could not sustain the death of more than one whale per year,” Tezanos-Pinto said.
“This highlights the fragility of the local population, particularly when we know that ship strikes have been previously estimated to cause an average mortality of two whales per year in the gulf.”
An adjunct researcher of the Massey’s Coastal-Marine Research Group, TezanosPinto said that before the study detailed demographic information of this population was unknown.
“While we cannot yet make assumptions about the trajectory of the local population over time, our results can now provide baseline information that can be used to monitor trends in the future and improve the management of the local population.”
Using photo identification allowed researchers to focus on the individual whales and show whether they were returning to the gulf.
The research, published in Endangered Species Research, was funded by the Hauraki Gulf Research Fund administered by the Department of Conservation and Auckland Whale and Dolphin Safaris. him go’, so they let him go and he went berserk.
“I turned my back to get away and he karate chopped me on the left side of the neck.”
Erin Polaczuk, national secretary for the Public Service Association which represents 26,000 health workers and is the country’s mentalhealth union, blamed current models of care and $2.3 billion in government underfunding for the problem.
“It’s easy to point fingers at a mental-health service user assaulting a staff member,” she said. “But we have to remember we are talking about people who are incredibly unwell.”
Staff were tired from 16-hour shifts, needed to cover vacancies, and could not be expected to provide the level of support needed. Polaczuk said some staff had been assaulted so badly they had brain injuries and could no longer work.
Labour’s health spokesman Dr David Clark said the number of assaults on hospital staff was unacceptable and symptomatic of growing problems with mental health and addictions.
“Underfunding in our health system is contributing to a rise in assaults as over-worked and isolated staff and patients have no-one they can call on as conflict presents and escalates.”
Health Minister Dr Jonathan Coleman said: “As employers, I expect DHBs and the Ministry of Health to . . . take any concerns around staff safety seriously.”