A violent patient who attacked a nurse at the Hillside Psychiatric Centre is back in a forensic facility under heavier staffing.
Dan Murphy, president of the Union of Psychiatric Nurses, said Monday the patient is back in a ward among those who are the hardest patients to deal with.
"Everything I saw about the care plan for him was deviated from immediately" when the man went to Hillside, he said.
"I believe they didn't follow the care plan that was mapped out for him. It said there had to be four staff to go into a seclusion room to treat or deal with him.
"At our unit, at least four staff have to go in, and at least three have to be male."
Instead, the man was on a ward with two staff, and when one went on a break, he attacked the remaining nurse.
The attack occurred last month. The nurse was knocked to the ground, then the patient jumped on her and pinned her. It took eight staff to get him off.
He has since been charged with assault and court has heard he suffers from Huntington's disease, which can cause emotional instability and agitation.
Murphy said there had been several incidents involving the man before the attack and his volatility wasn't under control. Yet staffing was lower than the forensics plan called for.
"If they had measured acuity, they certainly wouldn't have had two staff on that ward when that patient was there," he said.
"You can't predict when you'll need help with mental-health patients."
Sandy da Silva, IHA regional director for tertiary mental health services, said the staffing level is considered appropriate.
She couldn't speak to the man's case directly, but said the internal and WorkSafeBC investigations are continuing.
"We're looking at what occurred based on staffing available," she said.
"We maintain the staffing ratios that we have in place" but also look at how acute patients are and how many are on the ward.
"There is always more than one nurse in the wing at any given time," she said, adding others are close enough to help.
She didn't know when the WorkSafeBC investigation will be done, but she did say they have requested a substantial amount of information from Interior Health.
Murphy said Interior Health's ratio of one nurse per four patients isn't safe, but that's the levels that are still in place at Hillside.
"They're going so bare-minimum staff for the patients they have. I just called up there, they've got two staff for eight patients who are purple dotted for aggression. Nothing's changed."
He's also concerned that WorkSafeBC officials don't fully understand psychiatric care and what's needed to keep staff — and the patients themselves — safe.
"I told WorkSafe there have to be policies in place that say doctors' orders can't be overwritten by a manager's budget needs," he said.
"You're not doing a good job of taking care of the staff if you have 65 code white calls (staff in distress) in one little hospital."