Collene Hicks, the Director of Nursing Services (Matron) at the Georgetown Public Hospital who was dismissed last Monday by CEO Michael Khan is still on the job.
While Hicks is claiming that she has not been terminated, since she has not been served with a letter of dismissal, Chief Executive Officer (CEO) Michael Khan is adamant that Hicks who was not confirmed in the post has been terminated.
Khan had previously stated that Hicks had been terminated for gross insubordination. The termination followed a memo requesting that Hicks state why disciplinary action should not be taken against her for failing to respond to a letter from Khan. Hicks was supposed to give a response in 48 hours but “fifteen days has passed and she still hasn’t responded to me. It’s gross insubordination,” he said.
Stabroek News learned that Khan had sent Hicks a letter pertaining to several issues that needed to be addressed, chief among these were several staffing decisions including the relocation of nurses in various departments such as the Accident and Emergency Department without consulting or in some cases informing the CEO and board. After Hicks refused to comply with his instructions, the memo was sent to her.
The letter terminating Hicks’ services does not however mention any of this. It says only that her “contract of employment in the position of Director, Nursing services…has concluded on 15th, June 2015”.
Yesterday, Hick addressed the claims of insubordination. In the presence of the institution’s nursing supervisors. She told Stabroek News that the charges of insubordination stemmed from her attempts to return professionalism and autonomy to the nursing service.
Nursing, she stressed “falls under the purview of the Director of Nursing, it is separate from Administration or Doctoring. The CEO therefore cannot dictate that staffing at the Accident and Emergency (A&E) Department be left as it is. The nursing assignments at GPHC must reflect patient needs.”
She explained that A&E which has 17 beds and 17 chairs has 25 staff (registered) nurses while the female medical surgical ward which has 105 beds has 20 staff nurses and the male medical surgical ward has 95 beds and 20 staff nurses. “The patient to nurse ratio is simply not appropriate for affording the best patient care.” Hicks asserted.
As a result of this, decisions were made by the director (Hicks) and the supervisors to investigate instituting a system of rotation which would allow the nurses to gain the necessary experience in various areas of patient care and thus make them better capable of providing quality patient care.
She stressed that this and other decisions which affect the nursing service “do not sit with one person.” “There is no way I as matron can transfer a nurse without consulting with the nursing supervisor. Together we agree on decisions.”
Hicks contends that the previous administration allowed non-nursing personnel to operate nursing, which led to several irregularities.
“Nurses are being robbed of experience by being made to work in the same department without rotation for 3-5 years. Junior nurses are managing shifts at the A&E while senior nurses are present. Ward managers are being appointed who are not qualified; 38% of the present ward managers are not qualified. We have situations where 20 patients who require level four care are being served by four staff nurses while patients who require level one care have no staff nurses to provide them with the needed care”, she shared.
“We need to be able to provide staff to areas based on the care necessary on a shift by shift basis. Since Guyana does not offer specialized nursing training, nurses cannot be operating in only one department. If one area has light traffic then we should be able to relocate staff to an area which has heavier traffic.”
She explained what transpired in the specific case referenced in the media; that of the removal of a ward manager from A&E. The A&E, she explained, had two ward managers, one of whom had considerable years of experience in the department. This ward manager was removed and tasked with documenting the permanent staffing needs of the department, while she was performing this task she was replaced by two other ward managers to compensate for her absence. “This could never be considered leaving a skeleton staff,” Hicks proclaimed.
She further noted that “the board has apparently agreed to have the A&E operate as an autonomous department with its nurses having a different job description than other nurses, this means that a nurse in that department has two job descriptions.” Stabroek News was able to see the document which established the A&E department. In it the Senior Departmental Nurse (a position which does not exist) is tasked with reporting to the CEO on general matters and the matron on nursing matters. There is no clarification on which matters constitute nursing and which constitute general.
Nurses, according to Hicks are being “abused, misused and confused. The autonomy of nursing services must be returned to the hand of nurses so that there can be an end to the suppression, oppression and depression.”
Meanwhile, the Guyana Public Service Union which is representing Hicks continues to call for a withdrawal of the termination letter which it deems null and void and the nurses of the GPHC continue to stage their lunchtime protest against her dismissal.