I was most concerned about the assault on three psychiatric nurses by a patient on 9 July last. It was shocking that three nurses in the course of their work should sustain such terrible injuries. The assault took place while the psychiatric nurses were attempting to return a patient who had been detained for treatment in St. Ita's, Portrane, to the hospital after he had absented himself without leave. I would like to pay tribute in this House to the bravery of the three nurses involved and wish them a full recovery to health.
Following the incident on July 9, I immediately took the following course of action. I requested the assistant inspector of mental hospitals to investigate the circumstances surrounding the assault and to make recommendations in relation to the escort of psychiatric patients. I visited the three injured nurses in Beaumont Hospital, who were making a good recovery from their horrific injuries, and satisfied myself that the Eastern Health Board would provide all necessary support to them pending their return to full health. I met with the unions representing the three nurses — the Psychiatric Nurses Association and SIPTU — and invited them to submit their views for consideration.
The assistant inspector of mental hospitals recently submitted his report on the incident to me. He noted that there was nothing in the previous history of the patient to suspect that a potentially homicidal attack on the three psychiatric nurses would ensue and that the professionalism of the personnel of the various disciplines involved prevented a more tragic outcome. He commended the written procedural policy regarding nursing escorts of St. Ita's, Portrane. He concluded that the assault in question falls into a one in a million category and its extraordinary rarity must in no way be used to put any escort procedure in place that would take from the dignity of patients, increase the unease of the already traumatised relatives, increase the likelihood of danger to escorts or diminish the professionalism of psychiatric nurses.
It was noted by the assistant inspector in his report that the psychiatric nurse was the escort of choice and that violence is not usually associated with psychiatric patients. In fact, the incidence of violence in society in non-psychiatric cases far outweighs the violence associated with the psychiatrically ill.
Discussions have also taken place between the assistant inspector, officials of my Department and the Garda Síochána to discuss the respective legal responsibilities of the Garda and the health services in relation to escorting patients. The constraints of the current legal framework were discussed and it was agreed that legal changes were necessary to provide more suitable arrangements for escorting patients to psychiatric hospitals. New mental health legislation is currently being prepared in my Department and will include new provisions in relation to escorting psychiatric patients.
As a result of the assistant inspector's report and my meetings with the unions involved, my Department wrote to each health board on 12 October requesting that the following steps be taken by health boards in relation to each psychiatric service: guidelines for staff involved in escorting patients to be drafted and agreed. These guidelines should define the respective roles of medical staff and nurses in escorting psychiatric patients; appropriate training programmes to be provided for staff involved in escort duties; that the requirements of the health and safety legislation be met in respect of escort duties and, in particular, that safety statements be drafted and agreed; the staffing levels for escort duty in each service to be reviewed; staff on excort duty to be provided with mobile phones; a formal reporting system to be put in place following each episode of escort duty to be provided with mobile made available for staff on escort duty.
Officials of my Department have scheduled a meeting on 26 October 1993 with the two unions representing psychiatric nurses to tell them of the outcome of the assistant inspector's report and of the steps taken to guarantee the greater safety of nurses on escort duties. I will be meeting the union representatives at a later date. I hope that in the light of the assistant inspector's report and the action that I have taken, the members of the Psychiatric Nurses Association employed by the Eastern Health Board will resume escort duties in co-operation with their colleagues in the nursing and medical professions.
The Dáil adjourned at 9.15 p.m. until 10.30 a.m. on Wednesday, 20 October 1993.
