Saturday, 28 March 2015

nurse practice training, monitoring, evaluation @nhsfife: what evidence of improvement Stratheden Hospital since Feb12?

old IPCU Stratheden Hospital
It's now been over 3 years since my son was subject to dehumanising treatment in the Stratheden psychiatric Hospital IPCU, Fife, in February 2012, and 6 months since I had my complaint against NHS Fife upheld by the Scottish Public Services Ombudman, in respect of "unreasonable treatment", in September 2014.  

There were also issues in Lomond Ward, Stratheden, on 1 February 2012 which led to the IPCU incarceration, and in March 2012 I had to raise further complaints about the nursing staff in Lomond, many of whom did not seem to care for patients as human beings.  I saw that the patients were at risk and had to keep a close eye on my son until he was discharged.  The staff appeared entrenched and clinical management defensive.

A catalogue of poor and bad practice that I was a witness to, and also subject to, when bullied by nurses and badmouthed in clinical notes written by nurses in the IPCU.  They even tried to put the blame on me in an Adult Protection Investigation, headed up by Fife Council Social Work staff.  When the real culprit was a failed system, poor monitoring and evaluation of nursing practice and patient safety.  A building "unfit for purpose" and staff who were in the habit of using dehumanising practices over a long period of time, unchecked.  A locked seclusion room, no toilet, water to drink, light switch outside, patients unobserved for hours at a time overnight.  Bullying and abusive behaviours.  And a cover-up by management who I hold to be ultimately responsible for the culture at Stratheden Hospital.

[I want to say, as a counterpoint, that I have experienced the psychiatric nursing at Carseview Centre, Dundee, from the carer perspective in 2012/13, and had no complaints.  The NHS Tayside mental health nurses, in the hospital and community, have behaved professionally and compassionately.]

In 2010 I had raised a number of concerns about the nurse practices and behaviours in Lomond Ward, Stratheden, to both NHS Fife and Scottish Government, not taking them to a complaint.  (at that point I had no experience of the IPCU)  I met with clinical nurse managers and with managers from OT and clinical psychology, in Stratheden, in both 2010 and 2011, to discuss my concerns.  But they didn't seem to listen properly to the issues I raised, to my suggestions for improvement, or to act upon them.  The OT head said she wasn't into "micromanagement" and the psychology head said she had no authority in Stratheden Hospital.

In 2011 I was asked by the Mental Welfare Commission CEO Donny Lyons to
speak at their Zero Tolerance Consultation event in Cosla, Edinburgh, from the "lived experience" perspective, having been a mental patient myself.  Here is Dr Lyons Email invitation from August 2011, after I had asked about travel expenses:


I told Dr Lyons that I had no experience of patients assaulting nurses but had experience of being assaulted by nurses, forcibly injected with psychiatric drugs, against my will.  To which psychiatrist Dr Lyons said:

"Just to point out – this is not about patients allegations of being assaulted by staff. I made that clear before. If I experienced that as a patient, I would have the right to make a complaint to the hospital and the police. There is a whole other issue about use of force under mental health legislation that the act and code of practice are not particularly helpful with and we have this issue or our radar too."

However he did say "Feel free to be forthright and even controversial!" and so I spoke out from personal experiences on the day, at which NHS Fife clinical nursing staff were present.

On 1 February 2012 when my son was face-down restrained, got a broken hand, was forcibly injected with Midazolam and transported in his underpants and bare feet to the Stratheden Intensive Psychiatric Care Unit (IPCU) I phoned the Mental Welfare Commission to ask for feedback on the IPCU and was told there was no negative feedback from patients or carers.  However I was soon to find out that this meant nothing in terms of patient safety and the MWC being an efficient watchdog.  It didn't mean that no news was good news.  It meant that they hadn't uncovered the human rights abuse of mental patients going on behind the closed doors of the locked ward at Stratheden.

It was left up to my son and I to both speak out about the abuse and to survive the experience.  Which we are still doing.  Picking up the pieces. 

I had to raise complaints continuously throughout the February and March of 2012, to NHS Fife, copied in to Scottish Government mental health division, to the Mental Welfare Commission, to my MSP and others.  These complaints of mine continued until eventually I had to take them to the Scottish Public Services Ombudsman, in September 2013.  A year later my complaint was upheld.  I had to singlehandedly mount a campaign for justice while also supporting my son after the systemic abuse.  The only medical professional contact was occasional appointments with psychiatrist Dr Reid, who supported us in the tapering of Haloperidol which had been forcibly injected into my son by IPCU nurses in the locked seclusion room, Feb12.

Here we are in March 2015.  What evidence is there of improvement in the psychiatric nursing practices at Stratheden Hospital?  What evidence of ongoing nurse training, monitoring and evaluation of nurse practice, of patient and carer experience, of patient safety?  I don't know.  I haven't heard.  But last Sunday I did experience being accosted and accused by a Stratheden nurse in the Ceres Centre shop, the former Named Nurse of my son when he was a Stratheden IPCU patient in February 2012 when the abuse was going on in the locked seclusion room.  And which resulted in two nurses contacting the police, giving my name, in connection with allegations to do with my behaviour.  No evidence to back up their claims.  A friend called it a "vendetta".  I would describe it as harassment. (see post 'misuse of power')

The fact that my son's Named Nurse from the Stratheden IPCU, February 2012, when he was being subject to "unreasonable treatment" and human rights abuse, has accused me of unprofessional behaviour and reported me to the police, 3 years later, is a matter of concern.  NHS Fife clinical nurse management should have been working with the IPCU staff from 2012, those who were unaware of the abusive treatment.  The locked seclusion room was being used overnight by staff, one shift in particular who left my son for hours on end unobserved then subjected him to abusive treatment after coming upon my son's dirty protest.  Other patients were also locked in and left.

I should not be subject to more bullying and harassment because I had to do the MWC's work for them.  Similarly with NHS Fife clinical management who should have been aware of what their nurses were doing in the IPCU after hours, overnight, with the locked seclusion room.  Ignorance is no excuse.  Blaming a mother for psychiatric abuse makes no sense at all and compounds the issue.  NHS Fife have a responsibility to protect patients, carers and staff.  Their management systems should be robust.  Similarly with their ongoing practice training, the monitoring and evaluation of nursing practice at Stratheden Hospital.

I contend that NHS Fife should have involved my son and I in the plans for the new IPCU, in talks with clinical staff and in discussing ways of improving conditions at Stratheden Hospital for patients and carers.  Rather than ostracising us and creating divisions.  That isn't good practice or good business sense.  The health board should have owned up to the failings and worked with us to create a collaborative relationship, rather than shoring up the divisions. 

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Herald Scotland screenshot 7 Feb 14
I will have more to say about my relationship with the former CEO of the Mental Welfare Commission, Dr Donny Lyons. About how we were in regular contact until the dehumanising treatment was exposed in Stratheden Hospital and a year later, when I complained about the polypharmacy, the multiple drug prescribing at Carseview, Dundee, it resulted in "talk to the hand" and no more communications with Dr Lyons.  Who retired in early 2014.

See "World looks to Scotland after mental health care improved" - are you serious?, my blog post about the Herald Scotland article, 7 February 2014, on Dr Donny Lyons' retirement.


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