Tuesday 27 January 2015

Let's talk about Mental Health

Let’s Talk about Mental Health:



Yes,…..let’s talk about Mental Health.



1)  Let’s talk about how the Government of Ontario has reduced the number of inpatient beds for geriatric mental health patients – in some places closing units altogether, or un-funding them before they could be opened.

-  Geriatric patients have unique needs - and patients with dementia or Alzheimer’s do not belong with other mental health patients.



2)  Let’s talk about the dearth of mental health services for pediatric (“Child & Adolescent”) patients in Ontario – especially if those patients require admission to an inpatient bed in a hospital.

-  If they are placed on a “Form 1” (involuntary admission due to the threat of harm to themselves or others) – there are even less beds available for them in the province.

-  Some “Child & Adolescent” mental health units have been closed, had the number of beds reduced, or been unfunded prior to opening.

-  The Greater Toronto Area (GTA) has a surprising lack of beds per capita available for child or adolescent mental health patients on a “Form 1”.

-  Most pediatric hospitals in Ontario do not have the capability to admit and care for child or adolescent patients on a “Form 1”.



3)  Let’s talk about how the Government of Ontario has systematically closed all of the psychiatric “Emergency Departments” at dedicated psychiatric hospitals – leading to longer wait times for mental health patients to be assessed by a psychiatrist, and leading to a further strain on Emergency Departments in acute care hospitals.



4)  Let’s talk about how the new psychiatric hospitals being built in Ontario have LESS inpatient beds than the older buildings that they are replacing.



5)  Let’s talk about the inability of patients requiring “Detox” to go directly to a facility with “detox” capabilities – thus adding further strain to Emergency Departments in acute care hospital – and a further strain to the ever-shrinking number of inpatient mental health beds in acute care hospitals.

-  Currently patients requiring “detox” show up at their local ER and are admitted to one of the limited mental health beds – just so they can “detox” and be sent out the door days later.



6)  Let’s talk about how fewer and fewer hospitals are providing crisis intervention training to their Emergency Department, Mental Health, and Security staff.

-  Currently most hospitals in Ontario require their Emergency Department, Mental Health, and Security staff to undergo the two-day “CPI” crisis intervention course – and recertify on a regular basis.

-  Those hospitals usually require all other staff with patient contact to undergo a shorter course – and recertify on a regular basis.

-  Some hospitals have shamefully not made this a priority.





Links:



“CPI – Nonviolent crisis intervention training”:  http://www.crisisprevention.com/Specialties/Nonviolent-Crisis-Intervention


Tuesday 20 January 2015

Excellent article on Hospital-Acquired Infections

FYI.  The National Post published an excellent article on hospital-acquired infections, entitled:

"Infected and undocumented: Thousands of Canadians dying from hospital-acquired bugs"

 http://news.nationalpost.com/2015/01/19/infected-and-undocumented-thousands-of-canadians-dying-from-hospital-acquired-bugs/

Friday 16 January 2015

Is your doctor or nurse a thief?

Is your doctor or nurse a thief?


If you were to steal a narcotic (i.e. morphine, oxycodone, cocaine, codeine, hydromorphone, etc.) or benzodiazepine (i.e. Ativan, Valium, etc.) in Canada you would be arrested and charged with crimes related to possession of a controlled substance and likely theft as well.  You will in all likelihood get a criminal record.

In Canada, the dirty little secret is that if your physician or nurse steals narcotics or benzodiazepines from the hospital that they work in, they will likely never be arrested – and will likely be back to work and maintain their license to practice (albeit with some restrictions) after they have received “treatment” for their  “addiction”.  This will not be court-ordered therapy, but “treatment” arranged either through the hospital’s employee assistance program (EAP) or as required by the physician’s or nurse’s regulatory body.

They will likely never be arrested and rarely, if ever, receive a criminal record - even if they are arrested.

Additionally, many physicians and nurses obtain these substances by withholding them from patients [Criminal Negligence and Assault] and administering a placebo such as sterile water or saline or another drug [Assault].

Nurses who are unionized will likely only receive a suspension while in “therapy” or at least be hired back without prejudice – because their addiction is treated as a disease - and the criminal activity that sustains the addiction is ignored.

Yes, physicians and nurses work long hours, they have stressful jobs, their patients die, etc.

Some of them have chronic pain issues.

Some have sad stories and horrible upbringings.

Well boo hoo….!!!

A lot of professions work long hours, under stressful conditions, and many have to see people die under far worse conditions.

A lot of people have chronic pain issues….and do not have the well paying jobs that are inherent in healthcare.

A lot of people have sad stories and horrible upbringings.

The relative ease of access should mean healthcare professionals should be held to a higher level of accountability –NOT lower.

The fact that healthcare providers are both educated about and exposed to the negative consequences of addiction in patients is also reason to expect a higher level of accountability.

I say this as a healthcare professional, and someone who has suffered chronic pain issues for years.

I have never become addicted.  I have never stolen drugs to satisfy an addiction.

If I do…throw the book at me!

If you want to create efficient deterrence for healthcare providers, the law needs to by fully applied to them.

Do the crime, do the time!

Why are hospitals not automatically calling the police to report these thefts?  It is not up to the hospital to determine if there is sufficient evidence.  That is the role of the police and the justice system.  Just make the call - even if the perpetrator is not known. 

Perhaps we need to require urine drug screens from all employees that had access to the missing controlled substance before they leave for the day if we are unable to determine who stole them - as they do in the United States.



In Canada, the punishment for Theft (because that’s what it is), as prescribed in the Criminal Code is:

334. Except where otherwise provided by law, every one who commits theft

*       (a) is guilty of an indictable offence and liable to imprisonment for a term not exceeding ten years, where the property stolen is a testamentary instrument or the value of what is stolen exceeds five thousand dollars; or

*       (b) is guilty

o    (i) of an indictable offence and is liable to imprisonment for a term not exceeding two years, or

o    (ii) of an offence punishable on summary conviction,

where the value of what is stolen does not exceed five thousand dollars.

[Emphasis added]


In Canada, the punishment for Criminal Negligence as prescribed in the Criminal Code is:

221. Every one who by criminal negligence causes bodily harm to another person is guilty of an indictable offence and liable to imprisonment for a term not exceeding ten years.

[Emphasis added]


In Canada, the punishment for Assault as prescribed in the Criminal Code is:

266. Every one who commits an assault is guilty of

*       (a) an indictable offence and is liable to imprisonment for a term not exceeding five years; or

*       (b) an offence punishable on summary conviction.

*       [Emphasis added]


In Canada, the punishment for Aggravated Assault as prescribed in the Criminal Code is:

*       268. (1) Every one commits an aggravated assault who wounds, maims, disfigures or endangers the life of the complainant.
        

*       Punishment

(2) Every one who commits an aggravated assault is guilty of an indictable offence and liable to imprisonment for a term not exceeding fourteen years.

[Emphasis added]


In Canada, the punishment for Unlawfully Causing Bodily Harm as prescribed in the Criminal Code is:

269. Every one who unlawfully causes bodily harm to any person is guilty of

*       (a) an indictable offence and liable to imprisonment for a term not exceeding ten years; or

*       (b) an offence punishable on summary conviction and liable to imprisonment for a term not exceeding eighteen months.

*       [Emphasis added]


In Canada, the punishment for illegal Possession of Substance (narcotics) as prescribed in the Controlled Drugs and Substances Act is:

*       4. (3) Every person who contravenes subsection (1) where the subject-matter of the offence is a substance included in Schedule I

o    (a) is guilty of an indictable offence and liable to imprisonment for a term not exceeding seven years; or

o    (b) is guilty of an offence punishable on summary conviction and liable

§  (i) for a first offence, to a fine not exceeding one thousand dollars or to imprisonment for a term not exceeding six months, or to both, and

§  (ii) for a subsequent offence, to a fine not exceeding two thousand dollars or to imprisonment for a term not exceeding one year, or to both.

[Emphasis added]


In Canada, the punishment for illegally Obtaining Substance (narcotics or benzodiazepines) as prescribed in the Controlled Drugs and Substances Act is:

*       4. (7) Every person who contravenes subsection (2)

o    (a) is guilty of an indictable offence and liable

§  (i) to imprisonment for a term not exceeding seven years, where the subject-matter of the offence is a substance included in Schedule I,    [narcotics]

§  (ii) to imprisonment for a term not exceeding five years less a day, where the subject-matter of the offence is a substance included in Schedule II,

§  (iii) to imprisonment for a term not exceeding three years, where the subject-matter of the offence is a substance included in Schedule III, or

§  (iv) to imprisonment for a term not exceeding eighteen months, where the subject-matter of the offence is a substance included in Schedule IV; or    [benzodiazepines]

o    (b) is guilty of an offence punishable on summary conviction and liable

§  (i) for a first offence, to a fine not exceeding one thousand dollars or to imprisonment for a term not exceeding six months, or to both, and

§  (ii) for a subsequent offence, to a fine not exceeding two thousand dollars or to imprisonment for a term not exceeding one year, or to both.

[Emphasis added]


How's that for deterrence?!? 


Links:


Controlled Drugs and Substances Act:  http://laws-lois.justice.gc.ca/eng/acts/C-38.8/

Wednesday 7 January 2015

Infections....

Don't forget to check out the first post from November entitled, "Are hospitals in Canada doing enough to reduce infections?"

 http://ontario-canadahealthcarewhistleblower.blogspot.ca/2014_11_01_archive.html


[More posts to come in the near future.  Stay tuned.]