Dealing With Patient Abuse

Things did not occur overnight. I was diagnosed with Multiple Sclerosis in 2003 and until 2009, my symptoms were manageable. In March of 2009 I had a relapse. Upon my neurologist's suggestion I headed for the ER to hopefully get started on a steroid treatment. By the time I got there, I could barely walk and within 48 hours, I was not able to walk at all. Transverse myelitis, secondary to the MS, caused lesions to appear on my spinal cord. You can read more of my story and TM here.

Fast-forward a year and a half later. Another relapse hits while I'm at home. I am unable to roll in bed or sit up, let alone transfer into my wheelchair. Homecare decides that I need to be sent to the hospital - I've lost much of my upper body function and they don't feel able to help me. Decision is made that it's no longer safe for me to live alone at home and I'm referred to the continuing care program - Alberta's fancy word for a nursing home.

I got along well with most of the staff...that is, until I met Fay. An Indian lady with shoulder-length hair and multiple piercings on her face. I thought they were kinda cool until I started subconsciously equating them with the incidents that would happen and that now trigger panic attacks whenever I see someone with similar features and piercings.

It was tension at first sight. There was an air about her that quickly put me on my guard. The room quickly filled with tension; I had no idea why. That first evening, she was making fun of me for not having remembered to ask the nurses for a certain piece of equipment that would have made their job easier-it would not have affected me either way. Later on that same night, she spent her time mocking me along with the nurse because I didn't thank her quickly enough to satisfy her.

I started getting anxious and stressed out after this and while I had been having anxiety and panic attacks beforehand due to my health situation, this incident triggered an increase in severity and frequency that I had never encountered before. I started outright avoiding certain situations, including turning back midway going to my own home because I was too freaked out to deal see my own children.

Two more incidents would occur where she would fail to care for me during the night as was indicated on my care plan. At other times, I'd be made to wait for help because they didn't want to put off their low-priority tasks to take care of my then-higher needs.

The following letter was written and submitted to the government authority responsible for handling abuse allegations in Alberta. It contains a detailed description of what happened the night she assaulted me.

This is the letter I had faxed to the people responsible for enforcing the Protection for People in Care Act, here in Alberta. While I documented this event immediately after it occurred, I had it faxed this past Wednesday (June 22, 2011) after thinking long and hard whether I really wanted to pursue this I decided that it was in my best interest to do so.

Protection for Persons in Care
Station M, Box 476
Edmonton, AB T5J 2K1

Tuesday, April 12 2011
On the evening of April 11, contrary to my usual routine, I requested that I get up back in my chair because I was uncomfortable and in pain. At 9 PM, the LPN in charge came in with my suppository asking if I wanted to have it now. Since I had only just been put in my chair, she suggested that we do it at ten thirty. I agreed and continued reading my book.

Ten thirty came and went with nobody coming to offer to place me into bed and give me my suppository. I was caught up in my book so I continued reading. After the 11 PM staff changeover, rounds were made and despite the nursing attendants and various nurses passing by my door at least 10 times, not a single one bothered to ask me if I wanted to return to bed or if anything else was needed.

Around 12:15, I finally caught the attention of an employee (whom I later discovered was the charge nurse, Laverne) who was walking by, I told her I was waiting to get into bed and asked why the people from the previous shift had not done what they said they would do - which was get me at 1030 for my suppository. She grumbled that they had been by on rounds and asked why I hadn't asked them to get me into bed then. Not being able to easily express myself verbally, I mumbled something about being too absorbed in my book. She said I'd have to wait till they finished their rounds.

Patients should not have to wait 30 to 60 min. for an attendant to assist them "just because they're doing rounds." Time needs to be divided on a priority basis, such as numerous times I would be in extreme pain and they refused to help me until they finished the so-called rounds.
When they finally came back at about a 12:45, I verbally confronted them asking why nobody had bothered to come until now. The LPN told me that she had come by at 1030 but I was sleeping. A blatant lie since I was reading and there was no possible appearance of being asleep.
Further into the discussion, she changed her story to say that since I didn't seek her out, she didn't come. So was I sleeping? Or was she waiting for me to call on her? Either way, as the nurse, it is her responsibility to make sure medicine and doctors orders are administered.
By this time they were getting ready to lift me out of my chair and put me in bed. Fay, the Indian nursing attendant, was being verbally forceful and insisting that I was at fault since I didn't go seek them out first. By that point I was flustered and needed time to recompose myself so I asked them to leave me alone in my chair for the time being and I would be fine.

Fay refused to comply. I explicitly told her to let me go and that she did NOT have my consent to move me. She began forcing the sling straps onto the lift in a very dangerous and unsafe way. I told her she was doing it wrong and her response was why I didn't show her how. I told her that she was the attendant and it's her job to know how to do it. She answered that because she worked nights she didn't have to do it before and therefore didn't know how. How can someone who works in a hospital be permitted to use equipment that they do not know how to use? Either they should learn how to use it competently or find someone who does. I would have literally slid out the top part of the sling and fallen head first if I had not said anything. She was using equipment that she was not trained and therefore not supposed to use.

Again, I told her to stop touching me and the sling and that if she continued, it was against my will and I would consider it physical assault.

Despite this, she forcefully continued to strap on the sling leads. I continued to tell her to let me go and leave me in my chair. I tried to physically fight her, off but being perpetual quad, I was unable to do much in my defence. By this time she (Fay) was calling the proverbial shots and everyone else was either just following her lead are watching in astonishment. There were four people in the room: Fay, my LPN, LaVerne (the charge nurse) and a larger lady wearing makeup and had Asian features.

I kept insisting that she was assaulting me and she said that if I resisted she would call security. If I was a person that was able bodied and able to walk, and I wanted to sit in a chair in my room as opposed to sitting in bed, there would be no problem. Now since I'm in a wheelchair and physically unable to defend myself, I consider this to be a physical act of aggression against me.

I was hoisted into bed against my will and when they undid the sling and wanted to turn me over to remove it, I told them that if they try to touch me I would fight back.

My sense of dignity and freedom was violated%u2026 I was being physically moved and handled against my will and against my expressly telling them that I did not consent to these actions. By then I was demanding that they give me my cell phone and computer - I wanted to document this incident.

The next day, the unit manager assured me that she would no longer enter my room, but she failed to pass this message on to Fay. She came into my room around midnight (night of April 12) under the pretence that she needed to "tidy up." At the time, I felt that she was doing this to torture me and, along with a panic attack, I started to become frantic, shouting at her to leave my room. Midnight is a time when most people are asleep and "tidying up" is not done at that time. Since March 2009, I had spent 32 weeks (eight months) in the hospital and never has anyone entered my room to "clean" at night. I felt that my only safe place was violated and that she was pushing herself on me further to mentally torture me.

This is not the first time I've had a problem with Fay. On three other (previous) occasions she has either outright mocked me or failed to care for me in a proper way - such as not turning me in bed during the night when it was indicated that this needed to be done every two hours%u2026 I woke up one morning in the exact same position I was placed around 9 PM the night before, including the plate balanced on my legs. With the paralysis that I am dealing with in my own inability to move in bed, this action is vital in order to avoid pressure sores and blood clots.

To this day, I suffer from anxiety and panic attacks that were largely exacerbated from this incident. While she was eventually forbidden to enter my room, she was not removed from the unit and I would have a panic attack every time I saw her. She is an Indian lady with several facial piercings and again, panic attacks are triggered when I see other Indian ladies with similar piercings.

After speaking with many of her coworkers, I get the understanding that other patients have had trouble with her. If this is an established track record, should someone like that he working in the healthcare field?

On Friday, June 24, a lady by the name of Charlotte called me from the PPCA office with questions regarding my complaint. After about 15 min. of going over my statement, she determined that there were two incidences of abuse under Alberta's PPCA law.

The first one, being the incident where she verbally mocked me for not making decisions that she would have made which caused an instant mistrust of her and the subsequent fear of asking her for anything else.

The second incident, being the night she forcefully transferred me to bed which is caused outright panic attacks and exaggerated fear of her since that time.

About one hour later, I was contacted by Francine who told me that my file was assigned to Terry Davis for investigation. She would be in touch with me the following week in regards to setting up an appointment to discuss the matter in person.

The one or two bad eggs I have encountered over the years are just that: bad eggs. It should have never happened and could almost be considered negligible in comparison to the wonderful care I have received through Alberta Health Services.

The vast majority of health-care providers are there to help and when displeased, are ready to work with you to reach a working compromise.

Patient and elder neglect are very real. Numerous patients fall victim to their caregivers every year. Having said that, I've also observed that many complaints are actually a question of miscommunication rather than actual abuse.

For example, I once had a roommate at the hospital tell me how a nurse had dumped water on her when she was being cleaned. She made it sound like she took a basin of water and dumped it on her. What had actually happened was that the nurse had squeezed some water from the face clots onto her private area in order to help clean it - a normal nursing practice.

On another occasion, a family member lamented that the nursing staff was rough in turning their family member over in bed. They explained that this family member was grabbed by the wrist and pulled over in order to be turned. When someone is turned in bed, it's normal to use the arm as leverage. While one nurse is at the back using a sheet to roll them back over, the other nurse pulls the arm and leg towards her. This is an accepted practice and as someone who has to also be turned in bed, I can say that it is not rough, painful or dangerous in any way.