Nurses in Mt Carmel ward 'reaching burn-out point'

The Malta Union of Midwives and Nurses has continued to voice its concern about having a variety of patients - including illegal immigrants, drug addicts and criminals - under the same roof in Mount Carmel's male ward 1 and the effect this is having on nursing staff.

Nurses in male ward 1 at Mount Carmel Hospital claim to be reaching "burn-out" point because they are having to "deal with drug addicts and hardened criminals, even though the ward's mission statement is to cater for patients suffering from mental impairments", a hospital source told The Times.

The union has been harping on the situation for ages, and is meeting the hospital management on Monday to discuss the state of the ward, the union's general secretary, Colin Galea, said.

Those with criminal records, who had psychiatric problems, were prone to aggressive behaviour and even attacked staff, as well as having a detrimental effect on the other patients, he maintained.

Moreover, the drug addicts also abused of treatments and would even steal drugs from others to satisfy their needs, Mr Galea said.

He said the hospital management was aware of the issue and was setting up a dual diagnosis unit, which is, however, not yet operational due to a lack of nurses.

The idea was to divide patients according to their background, he said, adding that the management agreed and everything was in place, barring the human resources.

Mount Carmel Hospital chief executive officer Edward Borg said a temporary dual diagnosis unit, with six beds, was being opened for drug addicts with psychiatric problems and that, eventually, a substance abuse unit would be built.

The hospital had a long-term project in mind, the first phase of which starts this month, with the construction of a new forensic unit.

He said the number and quality of the nurses in the dual diagnosis unit had not yet been agreed on. The management had put forward its proposals, but the union has not yet accepted.

Mr Borg said the unit could be operational if the proposals on how it would be run were accepted by the union and approved by the relevant authorities.

He also insisted that whoever was in male ward 1 was there due to mental problems. Even in the case if those who had a dual diagnosis - alcoholics, or drug addicts, with mental problems - the common denominator was the mental problem and they were there to be treated for that.

Mr Borg insisted that the patients in the ward were "not all mixed up" and that their background was not relevant.

Patients from prison went straight to the forensic unit, which is under the administration of the prison, while those who had a criminal record, but were not serving time, could not be prevented from going to Mount Carmel if they had mental problems. There was no doubt these were more difficult to handle, but police assistance was requested.

Mr Borg said the hospital was working hand in hand with Sedqa experts, who visited the patients. When they were cured from their mental problems, they would go to Sedqa to follow a rehabilitation programme, he said.

But hospital sources complained that male ward 1 "is really an admissions ward and should, therefore, treat mental patients, who are not chronic sufferers - people suffering from depression, for example".

As a result of the situation, the staff was under immense strain and stress and was reaching burn-out, he said.

The nurses also felt they could not dedicate the right amount of attention to those who were meant to be receiving it. The drug addicts were demanding, so the more vulnerable patients, who were meant to be in the ward, did not receive the ideal care, the source said.

People suffering from depression can be lethargic and need constant attention and encouragement even just to get out of bed and get washed, he said.

The source maintained that drug addicts should be set up in their own unit and that it was not right for depressed patients to end up with criminals.

Their presence put pressure on the nursing staff to carry out searches on visitors to see what they were bringing in, "but we are not bouncers. Our role is nursing and patient education, as well as health promotion".

Male ward 1 has a maximum capacity of 20 patients, but is considered to be overcrowded, with more than 25. The ward operates on a skeleton staff, every shift consisting of two nurses and a nursing aide, the source said.

The source maintained that the illegal immigrants should also have a psychiatric unit for themselves at the detention centres.

"If someone is detained for months on end, even years, and is left in the dark as to one's future, it is only obvious and natural that one would fall into a depression. Anyone would," he said.