Nursing Assistant Council and Their Duties

As Young son described it to me and to the inquest, she felt intimidated and outnumbered on the committee. “I felt that my role was to support Ann McNeill,” she told me, referring to the spokesperson for the anesthetists who had withdrawn their services. “I didn’t open my mouth until she spoke and then I jumped in and supported her.”
Every time she tried to intervene, Young son said, she felt she was “practically laughed out of the room” because she was “just a nursing assistant online.” Interestingly, Young son notes, none of the concerns of nurses that she voiced at the meetings were mentioned in chairman Nathan Wiseman’s minutes.
When the committee met, according to witness testimony at the inquest, major issues about Odem’s competence and communication problems with the entire team were left unaddressed. Nevertheless, the committee (many of whose members seem to have felt pressured to go along with the decision) determined that, at least temporarily, Odem should only perform low- and medium-risk surgeries. The program was restarted. Within a short time, however, he was again performing a full range of pediatric open-heart procedures. Again, nursing’s concerns were ignored and unrecorded. And, again, babies started dying (320-324).
By this time, Young son found she could no longer tolerate taking the tiny patients from their parents and bringing them to the operating room. “When I take a patient from a parent, if the patient is old enough to understand, I usually tell the child, ‘You’ll be seeing mommy and daddy soon,’ or I tell the parents, ‘You’ll see your baby in the ICU in six or ten to various hospital bodies, including the Nursing Council, because “while nurses were involved in the program, it was in his opinion a medical and surgical issue, not a nursing issue” (455).
When Judge Murray Sinclair delivered the report and recommendations of his inquest, he succinctly stated the relationship between the hospital and the medical view of nurses helped create this tragedy. In his conclusion, Judge Sinclair’s ire is contained but clear, and his comments are worth quoting in their entirety:
“The evidence suggests that because nursing occupied a subservient position within the HSC structure, issues raised by nurses were not always treated appropriately.
“Throughout 1994, the experience and observations of the nursing staff involved in the program led them to voice serious and legitimate concerns. The nurses, however, were never treated as full and equal members of the surgical program, despite the fact that this was the stated intent of the administrative changes that the program underwent in June 1994. Intensive care unit nurses, for example, were never properly involved in the review team that assessed the program during 1994, and nurses were not properly involved in the Williams and Roy Review [reviews that took place after the program was shut down]. The concerns expressed by some of the cardiac surgical nurses were dismissed as stemming from an inability to deal emotionally with the deaths of some of the patients. As well, any concerns over medical issues that the nurses expressed were rejected as not having any proper basis, clearly stemming from the view that the nurses did not have the proper training and experience to hold or express such a view. In addition, while HSC doctors had a representative on the hospital’s board of directors, nurses did not.
“Historically, the role of nurses has been subordinate to that of doctors in our health-care system. While they are no longer explicitly told to see and be silent, it is clear that legitimate warnings and concerns raised by nurses were not always treated with the same respect or seriousness as those raised by doctors. There are many reasons for this, but the attempted silencing of members of the nursing profession, and the failure to accept the legitimacy of their concerns meant that serious problems in the pediatric cardiac surgery program were not recognized or addressed in a timely manner. As a result, patient care was compromised” (477-478).
Failure to Rescue in Bristol
In what has been called an “eerie parallel” to the Winnipeg case at the turn of the twenty-first century, nurses at a pediatric cardiac surgery program in Bristol, England, also watched patients die unnecessarily.