It’s nurses who get the chop, not system – Paul Pace

The death of a patient in Karin Grech Hospital in 2012 was not the fault of a nurse but a fault of the system. Paul Pace, President of the Malta Union for Nurses and Midwives (MUMN) said this in comments made to Newsbook.com.mt.

Pace explained that when a patient is placed under supervision, this would generally require absolute attention from a carer or nurse. He said that although the hospitals would be notified about this, many times they still do not employ enough carers to match up with the demand.

The specific case referred to by Pace goes back to a Court case decided last March when a nurse and his assistant were found guilty of involuntary murder of a patient in Karin Grech Hospital in 2012. The patient choked to death while he was eating. The Court had decided that although their intentions were benevolent, they still did not manage to carry out their duty.

Pace maintained that, at the moment, the nurse is appealing to this sentence. He further remarked that through the years going to and fro in Court, the nurse, who is a family man, ended up spending around €70,000 in fees for lawyers and court proceedings. He explained that if the Court of Appeal does not acknowledge that it is the system’s fault and not his own, he is very likely to lose his warrant, apart from running the risk of a civil case. He maintained that there is a great risk that this nurse’s life as well as that of his family, will be completely ruined, all due to faults within the system itself which are not being recognised or rectified.

Steward’s fault or the Government’s”

Pace insisted that a nurse cannot do miracles and that he must manage his time with each patient as required. He said that it is impossible to have one nurse with a group which includes more than one patient who would need one-to-one attention. He went on to say that the actual negligence is not a result of the nurses but rather of  Steward Health Care or the Government. The reason being that they are loath to fork out for more carers. He explained that the institutions are employing extra carers for those patients who are ordered special attention by doctors. He also said that the same patients who would be ordered the same thing but from a physiotherapist or any other professional who is not a doctor, are being left without a carer. He claimed that the law makes it clear that these two orders have equal clout.

What was the 2012 case all about?

The victim was 64 years, suffering from dementia and who, for this reason, used to always be accompanied during meal times. He was recovering in hospital when he choked on a chicken and he was found facing down in a bathroom after he was nowhere to be seen in the ward he was in.

Given that the victim had a problem in chewing, he was prescribed a diet consisting of soft food. He was given the chicken a few minutes before he choked, at a time when the hospital rules used to classify chicken under soft food. The Court heard that chicken is good for the patient as long as it is mashed and under the circumstances that the patient would be accompanied while s/he is eating.

The two nurses had six patients to take care of, and the victim was one of them. This meant that it was impossible to have a nurse giving individual attention to a patient. In spite of this, the Court considered the fact that the patient was left to eat alone, as a case of negligence. The Court said that the nurse was negligent because he did not make sure that the patient had eaten and if he did, that he took the plate away for him. The nurse admitted that he had not verified that the patient had actually eaten and that in fact, he only assumed that the patient had eaten. The Court called him careless, negligent and irresponsible because his actions, or the lack thereof, had caused the death of a patient.

Meanwhile, the Court said that the Head Nurse had carried out her roles perfectly in the Court’s eyes and that she had ensured that each patient was allocated a nurse as well as an assistant nurse. The Court found the two men guilty of involuntary murder and recorded the reasons for their mishandling. The nurse was attending to a student nurse when the victim died and that the assistant nurse was feeding a patient who was in a more vulnerable position than the nurse.

The Magistrate said that nothing could make up for the damage done to both the victim and his family. Therefore, the punishment should reflect the guilty parties’ negligence, which, according to her, did not merit a prison sentence.

While the Head Nurse was exempt from any fault, the nurses where fined. The assistant nurse was fined a sum of €4,000 and the nurse, the sum of €7,000. They had to also pay the fees for the court to appoint experts, which added up to the sum of €1,644.