Anger after nurse is strangled by patient in mental health unit

Readers' comments (19)

• Anonymous | 26-Nov-2009 2:40 pm

  As with most things I am totally not suprised by this. It's the same story with a medium secure unit I've worked for. The alarm system has many non-working alarms. And wards are suppose to have 4-5 in a team so you can C&R/PMVA. However they are often left on 2's, and 1's at night. What chance does a nurse or NA have?
  
  I was once nearly attacked, left on a sex offender ward with a new female nurse. The two of us were locked on the ward with 18 male patients. One was particularly violent, and if it was not for the office door, I feel I would have been worse off. All because they had booked 3 bank NA's who did not turn up for shift.
  
  Trusts should stop spending the budget on rubbish and staff up like they are suppose to!

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  Mertha Nyamande RMN | 26-Nov-2009 6:31 pm

  Mental health services remain volatile in that incidents occur when least expected, despite thorough risk management. Due to the nature of the illnesses/conditions in psychiatry and varied understanding /perspectives, patients' behaviour/presentation remain unpredictable. Having said that, i think it is poor practice to run any secure or general psychiatric ward with less than a PMVA team as a minimum requirement at any given time (day or night). Most cuts are justified by the fact that nearby wards will provide support when needed, which may prove ineffective in an emergency situation. by the time help arrives, it may be too late; jeopardising the safety of both patients and staff. Regrettably, the regulatory bodies do not clarify such issues, leaving interpretation open to each individual trust/service. clear guidance is required on a national level to minimise such and other incidents from recurring.
  

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• Anonymous | 26-Nov-2009 6:38 pm

  I wonder how far things have to go before trusts take seriously the high level of staff needed on these types of wards. i work on an assessment ward for elderly patients with mental health and physical illness. We have had many times of only two staff on a night because it is thought the acute medical wards needs are greater, we seem to be the first ward to drop patient staff ration when there is staff shortages elsewhere, they seem to forget we take the patients who have behaviour that is too challenging for the other wards or their mental health support too high for them to be able to provide. They find it difficult to manage one challenging patient yet we have several on our ward plus some patients who are physically very poorly, and not able to make their needs known to cognitive impairment. We have to use agency staff to provide 1:1 care, which is not beneficial to the patients assessment. Only tuesday night did a patient attempt to strangle me, i am very tender arround the area but no external bruising is apparent, i feel so lucky that i was eventually able to break free. Two visitors were hit and we are not provided with alarms because the trust does not appear to recognise the risks .
  

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• Anonymous | 27-Nov-2009 0:27 am

  This attack does not surprise me how about the attacks on staff that are not reported. Also reducing staff at night there is this assumption that everyone is in bed at 10.0 pm not considering someone who is severely unwell and a danger to themselves as well as others do not become well at night and then unwell in the daytime. There is a culture of cutting staff to save money strange it is always the frontline staff not the many unecessary managers/directors

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• Anonymous | 27-Nov-2009 7:34 am

  this is yet another example of the NHS being managed by countless 'managers' who have no idea what they are doing and worse couldn't care less. It is long overdue that all the ex-Tesco/other ex commercial 'managers' were sacked (NO tribunals either as they are not doing their jobs) and replaced by healthcare professionals who care about the staff and not endless targets/cost-cutting and any other sychophantic moves to impress others.

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• Anonymous | 28-Nov-2009 5:45 pm

  Here we go again. Cost cutting measures gripping all nhs service in place of safety. Yes, many other serious attacks have happened on mental health wards unreported and sometimes unrecognised as a serious incident and so brushed under the carpet. Can somebody tell me why mental health services are the first to be affected in any cost cutting measure, given the nature of the service, one would think safety would be considered first.

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• Anonymous | 28-Nov-2009 11:47 pm

  I tend to think that the Government must be realistic about the situation in the sevice. How could you give £50.00 to someone to do a £100.00 worth of shopping for you and still return some change. The strategic health Authority must make funds available for trusts to provide good service and i also think the legislators should intervene and put a statutory minimum on staff patient ratio. This might force trusts to concur.

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• Anonymous | 29-Nov-2009 12:44 pm

  Just to clarify; two staff and twenty-four patients on the ward where this incident occurred. The patient has confirmed that the voices were telling him to kill; this member of staff was first...... who knows what could have happened had someone OUTSIDE the building had not heard the cries for help.
  

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• Anonymous | 1-Dec-2009 9:20 am

  I work on an elderly ward for patients with challenging behaviour and numerous other illnesses. we have 15 patients with only two staff members on a night duty when one staff goes on their break it leaves the other staff alone. We have a call system to alert other wards but what if you can't reach it? the other wards have the same staffing levels so how can they leave their clients to come and help? The NHS needs to wake up and stop their staff being left to cope in these situations.

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• Anonymous | 1-Dec-2009 11:32 am

  I trained as a psychiatric nurse but would never return into that area of nursing again its way too dangerous.Patients who should be locked up are now walking around the hospital openly abusing and threatening staff.Why are incidents like this not in the daily tabloids highlighting such unsafe conditions that nurses are suppose to work under

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• Anonymous | 1-Dec-2009 11:37 am

  I have worked at the same Trust s' other borough which is Tower Hamlets. The conditions are even worse there especially at night where you have 2 nurses on the open ward. It makes me wonder what do they do at night when someone who is very aggressive or even suicidal is admitted at night to the ward? I think there is a serious accident waiting to happen there already one has happened at Hackney. Also the staff are frightened to say anything for fear of being suspended as I have heard that there is actually one ward where all the regular staff have been suspended recently. In my veiw I think the NHS commission should investigate this trust not only for the staff but also to safeguard patients welfare. I would not want to be a patient there knowing that there is not enough staff to protect me agiants other patients would you?

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• Anonymous | 1-Dec-2009 2:07 pm

  It's certainly not just the NHS. I work in a private sector EMI nursing home with up to 20 patients. Two members of staff, one nurse one HCA, is standard for nights. We are told they cannot justify getting another member of staff because of the costs. As some of the residents are being charged close on £1000 a week, god knows how much they'd have to pay to be able to justify the employment of another £6.50 an hour HCA).

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• Anonymous | 1-Dec-2009 9:32 pm

  I work in a large London Mental health unit recently investigated by the CQC and criticised heavily. Sometimes I believe its who is in favour and who is not. Clearly our trust is not and yet doesnt deserve the crtiticism or the major action plans. We are by no means perfect and have a lot of work to do to improve patient care. No person comes to work to be strangled, the government needs to start hearing the voice of the nurse on the ward and the patients whose care is being compromised to save money. As nurses we need to unite, stand up for better care and ask for the finance and the resources to do so.

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• Anonymous | 1-Dec-2009 9:55 pm

  I trained as a mental health nurse, what I saw on the wards made me never want to work on an acute psychiatric ward. I now work in a residential unit for people with learning disabilities, in the private sector. I sometimes get assaulted, one patient's CPN advised us to get the police if resident acted up our manager told us we couldn't under no circumstances - what are we supposed to do, take whatever?
  

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• Anonymous | 2-Dec-2009 7:02 pm

  Within the same Trust where this member of staff was strangled, the following week a female patient (under the age of 50) died in her sleep whilst under "close observation". This Trust seriously needs to be investigated, senior management need to be held accountable and immediate action is required to ensure the safety of both patients and staff.

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• Anonymous | 3-Dec-2009 7:52 am

  Adequate stuffing is mostly necessary to enable staff to introduce all varieties of nursing intervention that are therepeutic to address ones voices hearing,making sense to one of such situation, instead of using nurse's pseudo-sense-of controlling power over resident to'stop'all expressions, or just use of various sedatives and neuroleptic meds of which scanty evidence of its efficacy(mostly on assumptive theory of its use), and leave residents having ones symptom controlled but not issues dealt with(need more staff guided to be able to deal those area,need special interpersonal skill). It is not wise to do away with all the above on daily basis leaving for one occasion for psychologist to deal with , as trying to reduce incidences going beyond control or even trying to reduce probabilities happening would be the basis of all policies. Alarm system and neuroleptics are no solutions for controlling and management of incidences. Ofcourse we need arrangement for emergencies and that adequately. I am thiking of the issues much more proactively as to what happens daily in most wards on activity level for quality and standard of daily life and opportunity of expressions for residents, due to unimaginable inadequate stuffing level. It unwise to depend on emergency measures only to deal with issues as well as one needs to be awaken of issues of adverse and psedueffects of neuroleptics on human being more closely and not follow the ageold system anymore, medical treatment should not be dominant leavig all other avenues closed.
  How does a resident feel to be treated in such wards when ones MIND is able to understand well everything around ones living are\a, regardless one is hearing voices, or other depressive issues causing one quiet or agitated. One do not forget to comprehend kindness from control, empathy from bullie, or empathy from reluctance, after all residents in ward are human being like us. HCAs are working almost all the hours,minutes very close to all emotions of clients and they need support,training,let alone be paid,need supervision to be praised, need permission to attend national and international conferences and workshops, organisers must reduce oneday seminars from £300-400 fees to £40 and then Govt would surely provide all support as then these would prove effective planning for all, especially for patients/residents of wards.

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• Anonymous | 4-Dec-2009 10:34 pm

  We as nurses must be willing to say what is wrong on the wards not waiting until something happens. I know this is difficult to do at the moment, there is too much of managers of wards employing friends or employing people who will alway say yes even when things are going wrong. Staff that are willing to speakout/do speak out about safety issues etc are seen as being difficult. Patient and staff safety is a must on psychiatic units it seems everytime money is short the front line staff or cut but yet all these unecessary managers are still around. Maybe the NHS may have to take over running the hospitals again if things carry on like this because the various Trusts seems to be not doing things very well at the moment. The other alternative would be to have each large teaching hospital to have and manage their own psychiatric unit on site. I wonder what other people think about this idea

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• Doug Langdon | 7-Dec-2009 1:28 pm

  Reading the comments on this subject, does in a way explain why Mental health is still the Cinderella service that it was when l trained in the mid 60's.
  
  Apart from the brave Mertha Nyamande, all the other people who commented have chosen anonymity, not because they are cowardly, but l strongly suspect that they would fear for their jobs if they were identified as someone who was prepared to speak out.
  
  Assaults on staff are a fact of life when you are dealing with people who at times are not responsible for their actions, but it is true that whereas in the 60's and 70's the services were managed by people who understood the dangers of psychiatric patients and the unpredictability of there behaviour, since the introduction of general management, that degree of understanding is no longer available to the foot soldiers who have to content with the clinical situation.
  
  Could l suggest that each Chief Executive be required to spend three months working in an acute medium or secure environment, maybe then they will take the action that needs to be taken to safeguard not only the staff, but the other patients who are also exposed to these dangers.
  
  At one time the major trade union for psychiatric staff was the Confederation of Health Service Employee's, and they did speak out regularly on behalf of members, however l am not so sure that this is still the case with any of the trade unions these days.
  
  In this instance Unison has alerted the trust to the dangers in advance, l now hope that the member of staff pursue's a claim against the employer for negligence.
  
  Could l also suggest that MP's require that in all cases of proven negligence within the NHS that it is a requirement that the Chief executive's are formally disciplined.

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• Anonymous | 26-Dec-2010 3:36 am

  Everyone is aware of the shortages of staff in mental health settings. I am used to say that some patients don't kill us because they don't want. It is a common place people being attacked in the Trust, staff being punched. I think this is all a shameful situation because this is a very bad practice. There is lots of problems and so bad practice, things that people cannot imagine could be possible. I think the management does not take any responsability for any problem that can happen to the staff in the frontline. And worst: they can actually blame us if the things go wrong. They take decisions totally unreasonably and they structure the things in a way that alienate everyone. Also, the control of costs is more important than safety. In general the situation gets forgotten after an incident. Staff is not trained as they should and there are no clear safety or clear instructions about personal safety for the staff

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