Lost patients: an “incident” or “incidents”?

There is a troubling news article about a patient being discharged from the Valley Regional Hospital’s mental health unit without notification to his family and without shoes.

http://herald.ca/novascotia/1290585-discharged-mental-health-patient-walks-15-km-in-sock-feet

The patient was discharged at 7 am. This suggests he could have been lost in the shift change. Unless there are staff shortages or storms, which stretch into 12-hour shifts, the normal night shift operates from 11 pm to 7 am. So it’s possible that one shift thought they were handing this patient off to the incoming shift and the incoming shift thinking the outgoing shift had made the contacts and completed his discharge process.

This could serve as a lesson for both Valley Regional and other hospitals across the province. Valley Regional isn’t the first to lose a patient or let one go without proper notifications. But this is not the first curious event at Valley Regional.

I arrived at Valley Regional one cold morning to see a man in his sneakers, jacket and Johnny shirt tucked into the back of his underwear marching down the sidewalk by the main drive leading to the hospital. He was not wearing pants. A group of staff members stood inside the front doors laughing at his appearance and shrugging, ‘If he wants to go, let him go’. The conversation said he didn’t have money for a taxi and was going to hitchhike home. He may have been angry, but his appearance suggests he was not in full control of himself.

Another time I arrived at Valley Regional to see a man lying on the pavement in front of a parked RV. It was the middle of a sunny afternoon. I didn’t know if he was well or hurt, so ran into the lobby and reported him to staff. I have no idea what happened to him, but I found it surprising that someone could lie on the ground within sight of the front doors, executive offices and a number of treatment rooms and no one would notice or act.

In the days when I spent a lot of time at Valley Regional I encountered a young man who frightened me freely wandering the halls and property. One evening he was in an area near a room housing an elderly female relative. That concerned me. I mentioned it to staff and told not to worry. But I did.

On another visit to Valley Regional I asked why the upper atrium had been enclosed in glass. For 20 years it has been open, enclosed with a railing. It provided a place for patients and visitors to break up the boredom of hospitalization with a little people watching without the patient being on display. A staff member told me the upper level was glassed in for patient safety. The scuttlebutt was that a patient tried to jump.

My point is that while this one patient made the front page thanks to his local MLA, how many stories don’t? How many incidents are hidden either by family shame or, more likely, the convenience of the excuse of privacy?

If failings aren’t recorded, executives can convince themselves they don’t exist or are merely a ‘one-off’ or have what in other situations are called “deniability”. The real question is: is this an example of systemic failings in the care of those in mental health units?

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4 Responses to Lost patients: an “incident” or “incidents”?

  1. woof says:

    I think a lot of finger pointing should be directed at the lame security whose job it is to monitor the grounds and building for situations like this…..they’re actually quite an impotent bunch. But you get what you pay for and they’re getting exactly minimum wage. But as always, sure makes for good optics and excuses for the brass,

    • I take it that you mean security isn’t a priority for management whose main concern is having a body in place and that the individual is not empowered to act.

      • woof says:

        Exactly … they have 0% authority and act only to administration concerns and for good optics … and also ignore many legitimate concerns and violations (fire, safety, theft, etc) by order of admins.

      • You would think that the unions would monitor violations and failings to enforce them since these would put union members at risk, either physically or legally.

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