'Psychiatric patients 'fear for their safety': Nurses speak out on overcrowding in 'hazardous' part of KGH
Penticton Herald  December 01, 2006 

KELOWNA -- Young psychiatric patients are forced to stay in smelly hospital beds next to adults with little supervision, say nurses.

Staff are unable to segregate teenagers in the McNair unit at Kelowna General Hospital, which puts them at risk of assault from older patients, said a psychiatric nurse who requested anonymity. One "provocative" young man was beaten recently when he became too annoying.

"Another big patient, who's six feet five (inches), picked him up and threw him through a picture frame and hammered him while he was on the floor," the nurse said.

"We had no means to segregate him. His dad was unimpressed."

A Nov. 18 fire in the psychiatric unit has prompted nurses to speak out against what they say is an overcrowded, neglected and, at times, hazardous part of KGH.

In a suicide attempt, an elderly patient borrowed a lighter and ignited two beds. A male nurse used an extinguisher in choking smoke to douse the flames. Seven patients were evacuated.

"The fire was a wake-up call," the first nurse said. "One girl I work with is resigning. Her husband said 'You don't go to work to get killed.'"

Staff say the unit is more dangerous now that the seven-bed overflow area where the fire broke out is no longer locked. The area used to house patients too ill to possess matches or lighters, another nurse said. Now, those patients are amalgamated with the main, 18-bed unit.

"Since the doors were opened, several patients have urgently requested the doors be locked because they fear for their safety," the nurse said.

The McNair unit is actually safer now that the locks are removed, said Dr. Don Duncan, medical director for mental health and addiction services for the Okanagan. By amalgamating the separate areas, there's a higher staff-to-patient ratio. Interior Health has also hired more commissionaires to provide security, he said.

Duncan believes patients in both areas "have the same needs" and don't need to be segregated. But he admits the unit is "clearly not sufficient" because it features two long hallways with poor line-of-sight for staff. He agrees the unit needs more than the three intensive-care beds it has.

"It's not ideal as a psychiatric unit," he said. "We should have 33-34 beds, by the ministry benchmark, and at least six ICU beds."

One nurse said the current ICU beds often smell of urine. Patients sleep on mattresses on the floor and sometimes "urinate everywhere."

"How long do they have to lie on the floor where it stinks like urine? . . . People are squeezed into a sardine box with less ability to be hygienic."

Duncan appreciates that staff are frustrated with limited resources, but hopes things will improve "sooner than later." IH officials have requested a new unit for psychiatric patients, although Duncan admits the plan could languish for some time.

Compounding the problem is a shortage of nurses across the country. When a patient becomes acutely ill or aggressive, staff are told to supervise him one on one because they can't separate him from the other patients. Sometimes an extra nurse isn't available, said the second nurse.

Even though the McNair unit received $600,000 in new funding over the last year, Duncan is concerned staff could leave if the situation doesn't improve.

"I'm always concerned about the frustrations staff experience trying to care for their patients. It's not just about losing staff, but the potential for lowering staff morale during a difficult time."