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Witnesses recount violence, abuse by nurses at Turku geriatric hospital

Three former nurses who worked at a geriatric hospital in Turku are facing charges ranging from aggravated assault to breach of duty in south-western Finland's District Court this week. A witness on Tuesday recounted an incident of a nurse punching an elderly patient who was strapped down to a bed and sedated.

Kupittaan sairaala
The geriatric psychiatric ward of Turku City Hospital is located in Kupittaa. Image: Dmitri Volgin / Yle

The court case against three former male nurses from the geriatric psychiatric ward of Turku City Hospital has heard testimony from witnesses. During their investigation police interviewed some 80 witnesses about events at the hospital between the years of 2009-2013.

One of the men is facing charges of aggravated assault and breach of official duties. The second former nurse faces a deprivation of liberty charge, one assault charge and four counts of breach of duty charges. The third man is facing two counts of breach of duty charges. All of the men have denied culpability.

The aggravated assault charge stems from an incident in 2009, when the man allegedly punched an 80-year-old man in the chest and stomach with his fists while he was strapped down in a bed. The nurse in question had worked at the geriatric psych ward for some 14 years.

The information gathered during the police's preliminary investigation - which was sparked some time after an article about allegations of abuse appeared in Turku daily Turun Sanomat in early 2016 - found that nurse and witness statements about what had been going on at the ward did not match up.

A witness - who was the nurse's co-worker at the time of the alleged assault - told the court on Tuesday that the two had put a patient to bed for the night around midnight. According to the witness' testimony the patient had been lying quietly on his side as the witness briefly left the room to look for something.

Nurse punched patient several times

When the witness returned to the room, according to the witness' testimony, the other nurse was holding down the patient with his left hand and hitting him with his right fist in the stomach and chest.

The witness said the nurse had punched the patient three to five times, but said the patient had received sedative drugs and did not react to the nurse's punches.

The witness said the topic of that incident was not raised for discussion afterwards, saying that there was an "unwritten rule" at the ward not to document everything that took place there.

However, testimony given by the nurse accused of assault differed from that of his former co-worker. The nurse said he remembered that night very well. However even testimony about the timeline of the events of that night were very different.

The male nurse said that he went to the patient's room at about 8:30 pm, as he started his night shift at the ward.

Nurses' accounts differ

According to statements given during investigation of the incidents at the geriatric psych ward, the nurse said he found a piece of mattress plastic in the patient's mouth and managed to remove it, but said he noticed that the patient began eating more plastic.

Saying that he wanted to prevent the patient from choking, the nurse testified that he dropped the patient down on his side with force onto the bed, began hitting the patient on the back between his shoulder blades and asked the patient to cough in order to clear his airway.

He said that when his co-worker came back into the room the patient was about to choke on the plastic.

The co-worker witness disagreed with that testimony, however. According to earlier statements, the witness said the defendant had indeed removed plastic from the patient's mouth, but a day or two before the night of the alleged assault.

"I am certain that it didn't happen on the same night as the assault took place," the witness testified.

Patients allegedly thrown roughly into chairs, beds

The second defendant, facing two counts of breach of duty charges, was a nurse specialist and had worked for 13 years at the ward.

Testimony was heard that the second defendant had on one occasion been asked to assist a female nurse to lift a female patient into the shower. The nurse specialist asked another male nurse for help - the third defendant in the case, who faces four counts of breach of duty charges.

Preliminary investigation documents show that the two male nurses lifted the woman up by her arms and carelessly tossed her back into her chair. Investigators found that the nurses had acted hastily and unsuitably.

The nurse specialist said he doesn't even remember the shower incident, saying that similar situations often take place in geriatric care facilities.

"Sometimes you can't place a larger patient slowly back into a seated position," the nurse said according to court documents. The defendant said he does not remember a number of other suspected incidents, either.

"I did not notify a doctor as I should have"

The third defendant, who faces charges of deprivation of liberty and assault as well as four counts of breach of duty charges, had worked at the hospital ward for 20 years.

The liberty deprivation charge stems from an incident which the defendant admitted to. During the preliminary investigation, the nurse said he had put a female patient in solitary confinement without notifying a physician about it.

"I admit that this happened to have taken place. I do not remember if it happened several times, but I definitely did not notify a doctor every time it happened, as I should have done," he told the court.

The third nurse also admitted to having lifted patients from their chairs to beds without assistance because he didn't want to wait for help from another caregiver.

In these cases some of the patients may have hit their heads on the edges of the hospital beds, the nurse admitted, but said those were accidents.

All of the defendants denied the charges made against them, in testimony heard on Tuesday.

Nurses independently sedated patients

According to testimony from several witnesses, all three of the defendants had given medication to patients without going through the right procedures.

According to preliminary investigation documents, the nurses said that it was normal protocol. They told investigators that nurses are sometimes obliged to give patients "necessary medication" prescribed by doctors - for example, sedatives.

"Nurses in these cases have the right to decide for themselves when [medication] should be used. The 'necessary medication' handed out should always be documented," the defendant told the court.

However, the nurse admitted that it is possible that protocol was not followed for every medication that was given to patients. He said such circumstances took place when he gave restless patients sedatives to help them fall asleep.

The defendant said he did not consider that the practice amounted to abuse.

Police investigation uncovered more

The preliminary investigation about the geriatric hospital ward involved statements from 80 individuals, and the abuse charges against the three nurses were just a part of even more dysfunction and unprofessionalism at the facility.

One witness, a female nurse, told investigators that she faced retribution from other nurses after she pointed out they weren't following proper hospital protocol. She said other nurses bullied her, demanded that she be fired, put salt in her coffee and lied about her to the facility's head physician.

A former hospital employee told investigators that she had asked hospital management to carry out an internal investigation of the hospital, and later had requested that the hospital contact the health supervisory authority agency Valvira. However, she told investigators, she was forbidden from contacting the agency and an internal investigation was carried out instead.

After the internal investigation took place, the three defendants on trial Tuesday received written warnings about their behaviour.

Despite the large volume of witness testimony and documentation, prosecutor Anja Rantanen-Lahti says the case will be difficult to prosecute because there is only a single plaintiff, and it is now several years since the events took place.

Rantanen-Lahti, who is asking the court to hand all three of the male nurses conditional prison sentences, says that the trial should be completed in about two weeks.

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