[nursebedlam]

Safety row after attack on nurses

By Carol Nader
September 6, 2004

Traumatised staff at a Melbourne hospital have accused management of creating an unsafe environment for workers, after a psychotic patient assaulted five nurses in one morning.

The staff at Box Hill Hospital's psychiatric unit, Upton House, want to know why the hospital allowed the man, a past patient with a history of violence and assault, to be admitted.

Sources said that during the incident about a week ago the patient also trashed the unit's seclusion room and tore up aluminium and perspex to use as weapons. It took the intervention of the police special operations group to defuse the situation.

Police later took the man to a higher security facility, Thomas Embling in Fairfield.

The man had been admitted as an involuntary patient two weeks before the incident, and had been in and out of seclusion.

Upset psychiatric nurses, one of whom briefly went on WorkCover, want to know why he was not first taken to Thomas Embling. They also claim inadequate security at the hospital.

One source said the patient had been admitted "despite the wishes of the inpatient unit manager". But Chris Watson, manager for adult mental health services for central east, part of Eastern Health, said it was "quite appropriate that he was admitted", despite his violent history.

Ms Watson denied the unit was unsafe for staff. "We manage violent incidents on a frequent basis very competently without injury, and this was an exceptional circumstance. There was no reason for him to go anywhere else at the time. He has a history with us and we wanted to continue his care," she said.

Victoria's chief psychiatrist was involved in arranging the patient's move to Thomas Embling. But staff said the incident would happen again unless the procedure was changed.

Other patients became agitated by the man's outburst, but staff said the unit had only one seclusion room.

The incident has highlighted the lack of resources available to this special group of violent mentally ill patients. Thomas Embling is the only facility in the state able to deal with the most aggressive mentally ill patients and those in the prison system.

It has 100 beds and 20 rehabilitation beds. But the hospital's clinical director, Paul Mullen, said a violent history was not enough to secure a place and, even after the incident, it was difficult to find room for the man.

"There's very limited capacity for us to help people because we're always full," he said. "If every patient who was at risk of doing that was transferred to our hospital we couldn't cope. We took this man at the point he couldn't be managed any longer at the unit he was in."

Professor Mullen said no patient entered the hospital "without someone having to go out, and usually the people who get shuffled out are the people who go back to prison".

A spokesman for Health Minister Bronwyn Pike said the minister had met Professor Mullen to discuss the matter. Health and Community Services Union state secretary Lloyd Williams said hospitals did not provide adequate support for staff.

"New graduates come into the system and we end up with a situation where the most inexperienced nurses are working with the most acutely ill patients," he said.

http://www.theage.com.au/articles/20...?oneclick=true