The Nurse Houston incident and hospital security

These are difficult times for the health sector, more particularly, for state-run hospitals. Maternity deaths involving both mothers and babies are attracting hostile attention to the institutions. Irate relatives are openly questioning the competence of medical staff of the hospitals.  Much of that questioning is occurring against a backdrop of grief and anguish and a less than adequate knowledge of medicine and medical procedures. Inevitably, the charges may very well be entirely without foundation, though, to the accusers, that matters little in the heat of the moment.

The frequency with which these incidents occur has created a volatile and potentially dangerous environment. This newspaper recalls at least one recent incident at the GPHC during which a female doctor was threatened by irate relatives in the wake of a patient’s death.  There have been other ugly confrontations involving the medical staff of the GPHC – and other state-run hospitals – and relatives of persons who have died in their care.

You would think that in these circumstances the GPHC would have moved long ago to ramp up security in order to protect staff against the kinds of ugly reprisals that are known to follow some patient deaths.  No effort or cost should be spared to ensure that even as doctors, nurses and other medical staff are busy seeking to save lives and give care and other forms of service, they are not required to continually look over their shoulders out of fear of a frenzied attack by some irrational, grief-stricken person who has gotten it into his or her head that their bereavement is the fault of the institution. The same, of course, should apply to all medical facilities across the country.

Nurse Ursula Houston was entitled to that quality of protection. Never mind the reports which state that the attack on her on the evening of November 14 stemmed from a private matter. The fact is that a person with violent intentions was able to access a nurse on duty and attack and injure her at a time when, frankly, security at the GPHC ought to have been at a higher than usual level of alertness.

The slippage, the GPHC says, occurred at the level of the guard or guards on duty at the time. Part of the problem with that statement, of course, is that it points to the likelihood that the guard or guards on duty at the time may very well have to take the fall in this instance; and the outcome of the eventual report will more likely than not meet with dismissive responses from not a few cynics who generally hold the view that enquiries of this nature do little more than throw up fall guys who must take the rap, while those who should really be in the firing line – invariably the more senior officials – escape responsibility.

In this instance an enquiry ought to be answering some more fundamental questions that go beyond whether or not a security guard might have fallen asleep on duty or temporarily deserted a location.  We need to be provided with information regarding the overall security regime at the GPHC if we are not to be left with the view that what the report has come up with is not just another case of taking the easiest way out.

The question that arises, in the first instance, is whether or not, beyond the security guards who man the gates and internal stations at the GPHC, there is any special security regime in place to protect the doctors, nurses, ancillary staff and patients. Secondly, should the GPHC’s security not have been particularly sharp on the evening of November 14 given everything that had happened there and at other hospitals in the preceding weeks, and given the fact that yet another irrational reprisal by an aggrieved relative could certainly not have been ruled out entirely. After all, there had been at least one very recent case in which a member of the hospital’s medical staff had been threatened in such a circumstance.

One assumes – rightly or wrongly – that setting aside the visible arrangements associated with the manning of gates and strategic positions inside the hospital, there are other specific hospital-related security protocols that are in place, and we are certainly entitled to ask whether those protocols do not extend to specifically ensuring the personal protection of patients and medical staff; and we are certainly entitled to enquire as to whether or not those protocols were in place on the evening of November 14. Shouldn’t Nurse Houston’s assailant have been required to account for his presence at the hospital outside the normal visiting hours and perhaps subjected to a physical search before being allowed to access the area where she was working – armed, as it turned out, with a knife and a quantity of corrosive acid.

The point about all this is that an enquiry into this particular incident has to go beyond the simple exercise of determining which security guard, in the final analysis, may have slipped up and let Nurse Houston’s assailant through. A proper enquiry has to paint with a much broader brush since it may well turn out that the attack on Nurse Houston occurred either because the GPHC, as an institution, failed on the evening of November 14 to apply security measures commensurate with what at the time was, arguably, a higher the usual threat level or that the protocols associated with the direct protection of the medical staff – assuming of course that such protocols exist – may simply not have been in place.

The fact of the matter is that security guards at public institutions tend to operate in a pretty much routine manner and that manner often includes habits – like nodding off or wandering away from their posts – that are decidedly inimical to effective security. That may not have been the case at the GPHC on the evening that Nurse Houston was attacked, but the point must nonetheless be made that given all of the weaknesses which we know are associated with the culture of security guarding, a special and deliberate briefing ought to have been done by the GPHC with the Guard Service in order to make the guards particularly aware that the hospital was in a state of higher than usual alert given the controversy that it had attracted in the preceding period.

If the administration of the GPHC might feel compelled to punish the particular security guard or guards deemed to have been delinquent on the evening of Nurse Houston’s attack, its investigation, if it is to seek to avoid any repetition of the incident, must embrace a broader examination of the entire gamut of security measures with a view to ensuring that corrective measures are not limited to the kinds of cosmetic adjustments that really do no more than seek to create the impression that the gap has been plugged when that is in fact decidedly not the case.