Michelle Beets was the Nursing Unit Manager of Emergency Department of Royal North Shore Hospital. On Tuesday 4 May 2010 she was violently and horribly murdered on the doorstep of her Chatswood home by a former employee, Walter Ciarin Marsh. He told his wife — who testified against him in court — that he murdered Beets because she had been instrumental in his employment being terminated at the hospital and because her poor references were preventing him from getting another job.
Marsh was found guilty by a jury last week. He will not like jail. A man who wanted control of his life such that he would kill in such a horrible way, a man who would terrorise his wife and her brother such that they were initially terrified to tell the police what they knew, this man is not going to like jail at all.
Having spent 34 years in the NSW health system, I have seen many changes in the way health services are managed. This have mostly involved the flattening of management structures, and the devolution of senior management tasks and responsibilities down the remaining administrative line to Nursing Unit Managers. These changes open many questions in my mind about the murder of Michelle Beets.
Why was Beets seen by Marsh as the person who was solely responsible for his employment? Why did he see her as the sole person who was blocking him getting future employment?
In times past, these employment tasks were managed by the Human Resources Departments of Area Health Services. The restructuring of health services and management roles means that these employment roles have been devolved to busy Nursing Unit Managers.
I can only imagine how busy and stressful Michelle’s life as a Nursing Unit Manager must have been. There would not have been a lot of spare time to manage all the details of employing new staff, and ending their employment when they left, or were dismissed — all without much needed support from the Human Resources Department. When Beets wanted Walter Marsh dismissed, why wasn’t his case handed over to Human Resources?
When police were finalising evidence against Marsh, reports emerged about problems with his registration as a nurse in the United States. A Nursing Unit Manager can look up a nurse’s registration status in Australia online easily. If there are problems with a nurse’s registration overseas, however, surely that responsibility should remain with the registering authorities? A busy Nursing Unit Manager should not be expected to contact the United States to follow up on the registration status of a job applicant.
If Marsh was a threat to Beets, and she knew it, and she had raised this with the hospital, what had been done by security services at the hospital to protect her? I have heard evidence from Michelle’s close friends that she had expressed concern for her safety. A nursing colleague who attended the interview with Beets in which she advised Marsh of his dismissal told the court that Beets was nervous about how he would take the news — but relieved after the interview was over because he was now out of the hospital.
No one could have anticipated what happened. But for a Nursing Unit Manager carrying such a heavy responsibility on behalf of the Area Health Service to be exposed to such risks, raises real questions about the the allocation of that responsibility.
All sorts of clever ideas have been introduced into the health system over the last 30 years to downsize departments, and to make them more cost efficient. Very rarely it seems, are questions raised about the occupational health and safety implications of these measures.
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