MLA lashes out at minister over security at StantonHospital 'philosophy' of non-intervention remains in place; 'working group' convened
Northern News Services
Published Friday, January 23, 2015
Health Minister Glen Abernethy is under fire from Weledeh MLA Bob Bromley for what Bromley sees as dangerous and unreasonable delay in dealing with security at Stanton Territorial Hospital.
A locked door secured by a magnetic swipe card reader at Stanton Territorial Hospital. Minister Glen Abernethy has convened a working group to consider security at the hospital in light of a Nov. 20 violent event. - Walter Strong/NNSL photo
Stanton e-mails end in fury
Editor's note: The following e-mail exchange between Weledeh MLA Bob Bromley and Health Minister Glen Abernethy was sent to Yellowknifer by Bromley on Wednesday. They have been reprinted here in their entirety.
Subject: Stanton Security
I know this issue of Stanton security is a concern you are aware of. I am hearing from constituents who work there and who were involved in the serious incident before Christmas. They are aware of the short- and long-term actions being taken, and they know it takes time, but nothing that is happening is making them feel safer.
It is clear that what is needed is a security presence that can physically intervene when necessary, and this requires legislation. That is to say, it requires immediate legislation to finally deal with this very long-standing problem. I am sure you would agree that we have been very lucky so far. In particular, we were very lucky the night of the incident that the RCMP were nearby - something that has not typically been the case.
We know what needs to be done. What are you doing to make sure this legislative amendment is introduced immediately? I am copying (Inuvik-Boot Lake MLA Alfred Moses, chair of the Standing Committee on Social Programs) so they are aware of these concerns and the need for support to get this remedied pronto.
Thanks much for your commitment to quick action. You can imagine what working under such conditions of fear can do.
Response from Health Minister Glen Abernethy, dated Jan. 20
Stanton Territorial Health Authority and the Department of Health and Social Services are reviewing the incident to determine the steps that can be taken to improve and enhance security of staff and patients. We recognize that staff in all of our sites throughout the NWT may face risks to their personal security because of the nature of the services we provide.
In response to your request for immediate amendment of legislation, this is not the most appropriate course of action to take at this time.
After the incident at Stanton, there were incorrect media reports that suggested there is territorial legislation prohibiting security guards from intervening in violent incidents. There is no such legislation prohibiting this in the Northwest Territories.
There is also no legislation in the Northwest Territories currently that allows security guards to intervene in such incidents either.
Instead, the Department of Health and Social Services is setting up a working group to determine a territorial approach to staff and patient safety and security in health care facilities. We are committed to considering this issue beyond the immediate concerns that have been raised related to the recent incident at Stanton.
Solutions proposed as a result of the work of this group may include identification of legislative options. We are respectful of the past recommendations for increasing security of staff and patients, and will incorporate consideration of those recommendations in this work. The Department of Justice has agreed to work with the Department of Health and Social Services on this issue.
Minister of Health and Social Services
Bob Bromley response, Jan. 21
A working group is ridiculous. Your procrastination is costing the loss of medical staff when we can clearly not afford it, and it is putting staff and patients at risk in the busiest medical facility in the NWT. Change the damn legislation to authorize our staff and patients to be protected from violence, and do it now. I am not basing this on media coverage, but on contact from my constituents, including staff in the ER.
I am copying media to make sure they get this right.
"Change the damn legislation to authorize our staff and patients to be protected from violence, and do it now," Bromley said in an e-mail to Abernethy on Wednesday.
This follows a Dec. 3 Yellowknifer story that first brought to light a violent event in the hospital emergency room. On Nov. 20, an irate patient flew into a rage, destroyed medical equipment and forced nurses and staff to flee for protection behind locked doors.
Hospital security was unable - and as it turns out "philosophically" unauthorized - to intervene physically to contain the situation. It was only upon the arrival of the RCMP that the incident was safely resolved.
In the days following the incident public statements were made by the head of the nurses union and a hospital spokesperson suggesting there may be a legislative reason why hospital security staff are not allowed to physically intervene in a crisis situation.
According to Abernethy, no such legislation exists nor is it needed.
"The legislation isn't the problem," Abernethy said.
"We don't believe, based on a legal review of the legislation, that any legislation needs to be changed."
Whatever that status of legislation, Bromley said immediate changes are needed, not the new working group Abernethy has convened that involves the departments of Health and Social Services and Justice.
"We need staff at the emergency medical room - it's the busiest medical office in the Northwest Territories - qualified and able to physically intervene in a crisis situation," Bromley told Yellowknifer.
But authorizing security to physically intervene in a crisis is in opposition to what Abernethy described as the hospital's "philosophy."
"One of the challenges is (at) Stanton, they actually have an operating philosophy of non-crisis intervention," Abernethy said yesterday.
"The bottom line is that Stanton has (made) a philosophical decision to emphasize non-crisis intervention as opposed to physical restraint when dealing with violent or potentially violent clients within the facility.
"It's not going to take new legislation to address this problem," Abernethy added.
"It may require a philosophical change in the way they approach safety within the institution."
This philosophy of non-physical intervention is reflected in security and general staff training.
"When a situation does evolve into a potentially dangerous one like last November, staff - as well as security guards - are trained ... to remove themselves from the situation, get into a safe place and call the RCMP."
Abernethy said the working group, which will convene officially for the first time next week, will re-examine this policy in light of the November incident.
Abernethy said hospital administration has already made physical improvements at the hospital to improve security, and has been actively engaged with the RCMP to improve response protocols.
If this sounds familiar, it's because it is. Improved police response protocols were one of the outcomes of the 2011 Leisham report. The report followed from a tragic Nov. 4, 2009 incident when then 35-year old Allisdair Leishman plunged a knife into his own chest twice while under care at the hospital. One of those thrusts pierced his heart, cutting off blood flow to his brain and leaving him severely brain damaged and cognitively impaired. He remains under long-term care at the hospital to this day.
The primary recommendation of that original review - that a special constabulary be formed capable and authorized to intervene in dangerous situations at the hospital - was ultimately rejected in favour of renewed RCMP protocols.
Abernethy, as a regular MLA in 2011, supported the establishment of a special constabulary at the hospital, saying, "That seems like a good thing to me."
The renewed RCMP protocols did not prevent the November incident, so the working group will consider new protocols, as well as possibly reintroduce the idea of a trained special constabulary to protect staff and visitors.
"It's on the list of options and things we need to review," Abernethy said.
"I'm not saying it will happen for sure because we may find other ways to do it. We also have to recognize our fiscal realities as well."
But police protocols are not the issue, Bromley said.
"Everybody appreciates that the RCMP is doing what they can," Bromley said.
"It's just that ... these things are often related to a bad mix of drugs and alcohol (or) mental health situations. They are not predictable and they (the RCMP) cannot plan on being within two blocks to respond immediately."
For Bromley, the Leishman recommendation of trained special constables on staff at the hospital was a good one. He said renewed RCMP protocols - and another working group - do not address immediate staff concerns.
"A working group?" Bromley asked.
"What does that tell our staff? What does it tell the public who has to be there for an emergency medical need?"
Abernethy said since the November incident improvements to security have been made to make staff safer. These improvements include more locks on doors, better safe-rooms and security escorts for staff to their vehicles at night if desired.
"I believe changes made... will improve the situation," Abernethy said.
Beyond physical improvements to the building, Abernethy said hospital administration has taken steps with staff to avoid a possible repeat of what happened in November.
"Staff are more aware of the protocols and procedures and understand the need to go into a lockdown immediately," Abernethy said.
As for the philosophical reluctance of the hospital to allow physical intervention in a crisis situation, that policy remains in place.
"Until we do the additional work, there's room for improvement," said Abernethy.