A fine levied to an Ontario mental health-care centre after a nurse was critically stabbed by a patient in 2014 has drawn sharp criticism from unions representing health-care providers.
The Royal Ottawa Health Care Group was ordered to pay $75,000, plus a 25 per cent victim surcharge that will be put in a government fund to assist crime victims, for violating the provincial Occupational Health and Safety Act (OHS). The sentence was handed down on Aug. 16.
Justice Richard T. Knott of the Ontario Court of Justice found that the Royal Ottawa did not properly reassess the risk of workplace violence as often as needed to protect workers from violence in the workplace, as required by the OHS. The Royal Ottawa faced five charges under the OHS, but was acquitted of the other four in April.
The charges relate to an Oct. 10, 2014 incident at Brockville Mental Health Centre, a specialized mental-health facility. Patient Marlene Carter stabbed a nurse with a pen after the nurse took her to the bathroom. The nurse was sent to hospital with critical injuries. She recovered and returned to work. She has recently retired.
Carter had assaulted many nurses since she'd arrived at the centre from a Saskatoon federal correctional facility in August 2014. She returned to Saskatoon in April 2016, and is again in a correctional facility, a statement the Royal Ottawa issued about the incident says.
The employer needed to do more to protect workers' safety, said Vicki McKenna, vice-president of the Ontario Nurses’ Association. It was "ridiculous" that the employer chose to spend thousands of dollars fighting the case in the courts instead of putting in place proper safety procedures, she said.
McKenna said employers need to provide better safety training to staff, and make sure there are enough staff to care for patients.
But the Centre says the fault lies with society's failure to care for inmates, especially women who have mental illnesses.
A.G. Ahmed, the forensic psychiatrist responsible for Carter's treatment, was not available for an interview before deadline. But in a statement released on Aug. 21, he defended the Centre. Carter came to Brockville in poor health, after spending two-and-a-half years in constraints, the statement says. The restraints, combined with time in solitary confinement, only compounded her complex mental illnesses, already worsened by a brain injury.
The statement describes Carter as a woman prone to violence and severe delusions that would cause her to hit her head against concrete until she bled. According to the statement, she believed seeing blood was the only way she could guarantee her children's safety.
Despite this, Carter was improving at the centre, the statement says. Carter was part of a pilot project where two beds would be dedicated to federal inmates. (The project has ended, news reports say.) Carter was being helped, despite inadequate funding and no unit dedicated to female inmates. Now that she’s not at the centre, Ahmed expressed concern that she won’t get the care she needs.
"We sent her back to the environment she came from," he said in the statement. "Every good thing she had here, the hope we had for her recovery, was taken away."
In January, Justice Knott said the centre had adequate safety procedures. According to the Brockville Recorder, staff were well-aware of Carter's history of violence behaviour, and that the centre’s policies were enough to protect workers, if they were used properly. But the judge said staff could have revisited Carter’s care plan more often.
No one can deny many of the centre’s patients have complex health needs, said McKenna, who said the justice system’s problems need to be fixed. But the centre and other employers need to take responsibility for their duties to protect their staff, and patients.
“At the end of the day, this organization is where this individual was at this point,” McKenna said.
"I agree that people need to be in appropriate settings, but if you do have an individual that is placed in your institution, then you do need to ensure the safety of your patients and the staff. That’s what didn’t happen."
The ONA was not the only union expressing disappointment with the decision. The Ontario Public Service Employees’ Union (OPSEU) called the fine "a slap on the wrist." In a statement released shortly after the sentencing, union president Smokey Thomas said the province needs to do more to protect workers in mental health-care facilities, warning that a lack of mandatory safety requirements in these centres puts workers at risk for injury, and possible death. Thomas is a member of the government’s Workplace Violence Prevention in Health Care Leadership Table.
Meagan Gillmore is rabble.ca’s labour reporter.
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