Monday 16 December 2019

'Severe understaffing added to unsafe workload put on male nurse who taped mouth of brain damaged patient', court told

Mark O'Regan

A "severely understaffed" hospital added to the "unsafe" workload placed on a male nurse who taped the mouth of a severely brain damaged patient, an inquiry was told.

Bimbo Paden had worked at St John's Community Hospital in Sligo where he has admitted placing surgical tape on 'Patient A', a "vulnerable" man who was resident there for 13 years having suffered a brain haemorrhage.

But his barrister Noel Whelan insisted "circumstances" surrounding the incident must also be taken into account.

On the second day of a Nursing and Midwifery Board of Ireland (NMBI) fitness-to-practice hearing this morning, Mr Whelan argued staffing levels on the morning of the alleged incident in June 26 last year were "insufficient."

He said his 42-year-old client was extremely stressed and overworked at the time of the incident.

He argued the "challenging behaviour" of Patient A, who engaged in periods of "loud" shouting, "had an impact on the nurses' workload.

Clinical Nurse Manager Grainne McHugh agreed that "to a certain extent" such behaviour added to the workload.

She recalled that there were ten maximum dependency patients on the unit.

This comprised of five women and five men.

There were also around seven medium or low dependency patients, which included one who was at home on the day.

But she stressed there are varying degrees of maximum dependency.

Another resident, who was in bed directly across from Patient A, had terminal lung cancer and suffered from “cognitive deterioration” and alcohol-related memory loss.

He became “upset and distressed” by the “continuous” noise Patient A was making.

Ms McHugh also agreed with Mr Whelan's contention that having a terminally ill patient on the ward created its own "challenges" for nurses carrying out their duties.

The hearing heard that some patients "tended to wander" and three posed a risk of leaving the unit.

But she said nurses on the unit are "ultimately responsible" for the safety and care of the residents.

"It would come under the nurses' remit and responsibility to know where the residents are at any given time," she said.

Mr Whelan said the HSE's Trust & Care findings showed the ward was "severely understaffed" and staffing levels were "unsafe."

Asked by Mr Whelan if she agreed that the workload imposed on Nurse Paden was unsafe, she admitted the ward "could have done with more staff on that day."

"Staffing levels were low on that day," she said.

"If any member of staff delivering care and they feel under stress or unsafe, then it is their responsibility for their own health and wellbeing, to stand back from situation and to get assistant, and get help and support.

"No matter what the staffing levels, we have to ensure that we give the best care possible with the staff that we have on at any given time."

It is the first public fitness to practise inquiry by the NMBI, which has replaced An Bord Altranais.

The hearing continues.

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