Abuse in Victor Valley Community Hospital, Victorville, California
Abuse in Victor Valley Hospital
Victorville, California
December 31, 2003
Introduction of letter to Patients' Rights
It's not easy posting revealing details about being hospitalized. In fact, it takes guts. Especially since it was a psychiatric hospital. The norm for most folks would be to 'let it go' and escape the embarrassment. In other words, it would be easier for most to suffer at the hands of psych staff than to let the world know they were in such a place. Taboo. "What will the neighbors think?" The problem is that, someday, sometime, someone, needs to take a stance and say, 'enough,' or it will continue. I am one individual, with a single candle light to shine in a place of darkness. I offer my candle to share with yours toward a brighter light. Where there is no light, the darkness rules.
I have logged this material on the web to offer as a template if you have been mistreated and want something done about it. Short of suing the hospital, you can usually get Corrective Action if handled correctly. This is useful to offer some sort of closure. It is a matter of 'validation.'
I was so peeved and upset at Victor Valley Hospital that I took the time to write this 9 page letter (below) to the Department of Patient's Rights (DPR) and requested an investigation. As of today, December 31, 2003 that investigation is being carried out. A couple of weeks ago, on the heels of this letter I appeared at the DPR in person for questioning. That interview was taped. The DPR is making a transcript of that tape at this time. Once finished, those transcripts will be uploaded on this section.
I've been upset lately reliving this event. The taped interview with the DPR brought it all to the forefront in detail along with my anger. Yesterday, I called Victor Valley Hospital where the abuse took place. I spoke with the hospital's Risk Management Department and faxed over the 9 page letter for action. Today, I called and was told that a letter was sent out and that the psych manager will be contacting me. Once this letter is received and contact is made, I will logged those details in this section.
One last note. 5 out of 6 complaints were given to the nursing staff while I was THERE. In the header of those complaints I requested that the grievances be handled directly by the DPR and NOT the hospital because of a conflict of interest. Two months later, DPR has still not received those complaints. They just 'disappeared.' DPR has told me that this was an obstruction of justice and they are looking into it.
Table of Contents / Letter to Patient Rights
- Overview
- Problem / Solution /Accountability
- Policy vs. Law
- Proposed Corrective Action
- Complaints [6] Against Victor Valley
Hospital
- Complaint #1 [Logged while inpatient]
- Complaint #2 [Logged while inpatient]
- Complaint #3 [Logged while inpatient]
- Complaint #4 [Logged while inpatient]
- Complaint #5 [Logged while inpatient]
- Complaint #6 [Logged Next Day After Discharge]
- Official Notice to Attending Doctor
START
From
the Desk of Kathi Ann Stringer
Corona, CA 92882 (xxx) xxx-xxxx
November 29, 2003
Pete
Department of Patient’s Rights’
San Bernardino, California
(909) 421-9388 / Fax: 873-4433
VIA Fax and Mail
Reference: Notice of Denial of Rights w/o Good Cause / Abuse
ACTION: CORRECTIVE ACTION
Date of the following events: 11/12/03
Dear Pete,
Per our conversation, this material is provided to assist you in Corrective Action led by your department. A written response regarding this matter and the official stance of the Department would be appreciated. I have listed the six complaints, the sixth being the worst. Below is a brief overview of those complaints.
- The only water available was from a utility sink operated by
foot pedals. A glass or container to hold water is not readily
available. I discovered this after I awoke my first morning there
and staff refused to get me some orange juice. The day before I was
heavily drugged and I needed some sort of liquid that morning with a
more nourishing substance then luke-warm water. After strong
resistance from staff (x5 chit-chatting), i.e.…. reasons given à
tight with budget, not in the building, etc, a staffer finally
retrieved one orange juice on the other side of the main unit exit.
Retrieval of orange juice only took about 30 seconds. This set the
frustrating tone for future engagements from staff.
- After I made many, many verbal requests for juices and/or milk
to be provided during snacks and meals, staff refused or strongly
resisted to provide those items. I was told many reasons for this,
one of which the hospital had funding problems and had to cutback.
Even though I had refused to eat solids, it would appear my desire
to drink nourishment provided at least one avenue toward recovery.
I’ve seen nurses’ offer patients in the past Boost or some other
sort of nourishment when a client is refusing solids. However, the
resistance was so strong from staff that I eventually told Paris in
the evening to keep his juices and I would drink only water. From
that time until discharge I did not take any form of nourishment
from staff due to the resentment I had toward them born out of their
resistance and lack of desire to help.
- I was refused in what I believe a reasonable request for
adequate toilet articles. One staffer refuse to provide extra
diapers so I would not have to continually track down staff every
couple of hours, AND go through a repeated ‘ask, wait, and remind’
procedure. Staff was also inconsistent on this issue since one
staffer later gave me 2 diapers at one request.
- My things were moved from my room without my knowledge into
another room with a single bed. I was NOT invited to be a part of
this process. I was treated as a non-person. I was not having any
problems with my roommate and she told me several times later during
the day that she missed having me in the room. Staff cited “new
admits’ for the room change. This did not make any sense because
another depressed female was given my bed. This appeared to be as
some sort of bias against me since no other logical reason was
offered.
- Access to the Telephone. While I was speaking to my friend
Cristina on the phone, our communication kept being interrupted
because our connection was repeatedly severed. There were times if I
held the metal-coiled phone cable in a certain position, the
short-out happened less. Finally it got to be so frustrating playing
around with the cable that we could no longer speak to each other.
When I notified a staffer, she said they were already aware of the
problem because it happens frequently, and “more often in the wet
weather.” When I asked to have access to a working phone, a staffer
tried to make a connection to my friend by dialing her number on the
same broken phone but according to the staffer, “I can’t make a
connection because the phone is broken.” When I asked for access to
a working phone, staff would not respond with a ‘yes or no’ answer.
Therefore I had ‘no’ access to a working telephone. [I did notice a
position for another patient phone next to the broken one but it was
gone too. I do not know if it is because it was being repaired or
the hospital opted not to replace it. However, with only a single
phone in the unit, they are responsible for a back-up plan if that
‘one’ phone stops working correctly.]
- Alex grabbed my shirt when it was not necessary and jerked me up
from my chair because, according to him, turning on the TV required
mandatory ‘time-out’ (the TV volume was low). When I refused the
time-out, Alex pushed me into seclusion without good cause and later
I was forced/drugged without good cause, and staff refused to tell
me what the drug was.
I can identify all persons by sight if given the opportunity. I am also available for person-to-person interviews if that will strengthen this case.
Problem / Solution /Accountability
I anticipate the short-term solution would be in-service training. The problem is that with staff turnover, fading memories, and lack of acute accountably, there is little, if anything that will amount to long-term gains. In addition, there appears to be a conflict of interest since inpatient supervision/staff are handling the bulk of the problems. The jest I got out of it was supervision wanted to provide a place for venting to smooth things over. The problem is venting is only a short term ‘quick-fix’ and doesn’t change methods and frequency of training, revision of quality control manual, and scoring to reflect staffs’ comprehension of code, law and policies.
This is a problem area since most of the staffers I came into contact with seem to think hospital policy out ranks W&I Code, Title 9, Title 22, or provision for civil rights. One example is this “one-hour rule” that a staffer can place a patient into seclusion without an emergency status is hospital policy but is not a provision in current law. Staffers seem to have a bland lack of concern when it comes to law vs. hospital policy.
- Immediate in-service training
- On requirements for seclusion i.e….ONLY when a patient poses a ‘serious’ risk to self, others or community property.
- On requirements for restraints
- On requirements/regulations regarding involuntary use of drugs.
- “Complete” reporting when asking for a Doctor’s order for a denial of rights. It appears the doctor was as much at fault for not investigating further before granting the Order. It appeared to be ‘business as usual.’
- Sensitivity issues. Awareness can help develop a therapeutic alliance for treatment compliance / or the reverse, from lack of awareness (empathy).
- De-escalation / defusing problem areas to help facilitate a therapeutic environment of ‘least amount of restriction.’
- The right to have access to a telephone in good working condition.
- Provide access to drinking water (fountain, glasses or etc.)
- The right to have immediate access to certain toilet articles without having to go though unnecessary steps (repeatedly) to get those items.
- Empathy, Insight and Respect that will promote a more stable environment. [My possessions were removed from my room without my knowledge and placed at an unknown location known to me. Staff moved me from my room to another without including me in the process and it was apparently an unwarranted move.]
- Increase frequency of training since it appears currently modalities are not effective.
- Issue and mandate a scoring method to reflect staffs’ comprehension of training material.
- Audit Victor Valley Hospitals Quality Control Manual. Request revisions to reflect tighten accountability that will identify a departmental position (person) when policy and law are in conflict. Some ‘person’ needs to be held accountable, rather then putting blame on a network errors, misunderstandings, and omissions.
- Set into motion a method with measurable goals that will identify Victor Valley Hospital’s departmental progress.
- Provide an absolute mechanism that guarantees the County Office of Patient Rights receives a copy of every grievance and complaint AND at every level that is aimed at (mis)treatment from Victory Valley Hospital to identify trends or patterns. The impression I got was staff tried to divert or ignore complaints, rather then to seek corrective action.
The first five complaints listed below were originally given to staff to give to your department. I have typed them and listed them below. However, the sixth complaint was not made while in the hospital because when I asked for the complaint form, Alex shoved me into seclusion. Therefore, complaint #6 and it contents of events were written down on the following day.
I look forward to hearing from you and will assist you or your department in any way possible.
Respectfully,
Kathi Stringer
Kathi’s Mental Health Review
http://www.toddlertime.com
Complaints [6] Against Victor Valley Hospital
#1
TIME: 7:00 AM
Compliant/Concern:
Staff did not treat me with warm personal regard. I asked for orange juice x2 in 30 minutes. Staff denied. Finally I sat by the exit. Staff said I was threatening. Staff distorted my request for orange juice saying I was demanding. Staff clearly was not interested in providing a therapeutic environment.
Desired Resolution:
Inservice training i.e.…building a strong therapeutic alliance and countertransference management.
#2
TIME: 8:45 AM
Compliant/Concern:
I asked the nurse who I needed to talk to when I needed something, because so far all contacts have an “attitude.” She replied, “We have 2 mental health workers (MHW’s) and they are busy, so your needs and wants will have to wait.” I said, “I need a diaper.” (I’m incontinent) She got me one. Then I asked for more then one so I wouldn’t have to bother and wait every time I am wet. She (nurse) refused. Then I asked again who I needed to ask. (A valid question since she was the one who just got that diaper for me). She responded, “I said we have 2 mental health workers. Don’t you understand English?” She said it in a demeaning nature. I replied, “Do you understand countertransference management?” I told her I would not (constantly ask, and wait, ask and wait) ask for any diaper. I will just wear soiled clothing.
Desired Resolution:
Allow patients more then one diaper per request to prompt respectful relationship.
#3
TIME: 12:00 PM
Compliant/Concern:
Staff moved my room without telling me first, because they said, “The doctor told them too.” I had just told the doctor that I had SRS – sex reassignment surgery. This hurts – it feels like “put the freak in her own room.” Staff refused to give a reason – other to say, “New admits.”
Desired Resolution:
In-service on sensitivity issues and honesty.
#4
TIME: 2:00 PM
Compliant/Concern:
“To use the phone.” The phone is not working. I asked staff and they said they already knew about it and added, “it happens worse in the wet weather.” They did NOT offer any solution or remedy to make or get phone calls. 5 minutes later I re-approached staff and asked for a compliant form since they did not seem interested in providing a means for communication of phone. Then, they said repairs is being called. I asked if in the meantime another phone would be available. They said, “you already have a phone.” I said, “Yes, but it doesn’t work.” Then a staffer checked it for herself. She dialed my friend's phone number and could NOT connect. I finally asked, “Are you refusing to let me use a different phone?” Staff would not answer. I asked several more times a “yes or a no” question. I still got no response when I asked to use the staff phone. I said, “Then you are refusing. I will write you are refusing to let me make a call with a phone that works.” Staff said, “Go ahead.” NOTE: This phone problem seemed to be long standing and apparently since I pursue the problem – repair has been called. But staff are still refusing their phone.
Desired Resolution:
In-service training and replace staff as necessary until patient’s rights’ are followed per W&I code.
#5
TIME: 8:55 PM
Compliant/Concern:
I have not eaten any solids last 48 hours and choose not to eat solids while involuntary held. However, I have chosen to drink milk and juice during the stay. All through the day my request for these nourishments have been met with extreme resistance from staff i.e.…(Pete). At this writing Pete has again refused milk and juice, and said, “Choose, you only get one.”
Desired Resolution:
Stop admitting patients if hospital does not have the funds to give an adequate fluid diet if clients refuses to eat solids.
#6
TIME: 10:45 PM
Complaint Against Victor Valley Hospital
Use of Seclusion and Drugs Without Good Cause.
At about 10:45 PM I asked the med nurse for my sleeper – Restoril. It appeared she was taking inventory and she said it would have to wait. I went back and watched some more TV. I returned 15 minutes later and the meds were refused again. Staff cited a shift change was in progress. I returned to watch TV again. Paris turned off the TV. I turned it back on. Paris shut it off again and stood in front of the TV while I watched him from across the room in a chair. After about another 10 minutes I checked with staff again for meds. Again they were refused. I returned to watch the TV and I turned it on after I plugged it back in. A female staffer shut it off. I turned it back on. She said, “If you keep doing that, you are going to end up in seclusion and restraints.” She disappeared around the corner toward the nurses’ station.
While sitting there I was thinking over her threat and it really bugged me that she so easily threatened “seclusion and restraints’ off-the-cuff. I went back to the nurses’ station. The female staffer was standing to my left and leaning against the countertop. I said, “I would like another complaint form please. This staffer just now threatened me with S&R for turning on the TV set, and she can’t do that. I have to pose a serious threat to myself, others, or pose a serious risk of destroying community property.” Then a staffer in a white jacket spoke, “She did not threaten you with seclusion and restraints.” (I found out later his name was Alex). I was wondering how Alex could vouch for what she said since he wasn’t there when she said it. However, she owned up to it and admitted that she said it. I asked again for a complaint and reminded them this was the 6th one for today. Alex’s demeanor totally changed. He looked stiff and defensive. He became visibly angry. It looked as though he was going to become a bully.
He followed up with the female’s staffers response, “You are not in charge of this unit, we are. And, if you touch that TV again, you will go into seclusion!” That came across as a cold, bold threat. I raised my voice to match his and said, “Either the law works or the law doesn’t work. You can’t do that.” I went back to the TV room and it was already on. Alex turned it off and stood there with his eyes narrowed on mine. I wasn’t going to let him bully me. I turned on the TV again and sat back in the chair. Alex tightened his voice more, “You are NOT in charge of this unit.” I was just as tense keeping my frame of voice following his. “Alex,” I said, “You don’t know what I go through around here. All you get is a snapshot of what is going on. I was trying to be nice and wait patiently for my meds after being denied 3 times. I wasn’t pushing for them and instead apt to watch TV to give you guys some time. But no, you don’t appreciate I was watching TV because you continually refused my valid request for meds.” Alex replied, “None of that matters Kathi, you are not going to run the unit!” I quickly responded, “I’m not trying to run the unit. I’m only trying to manage my own life and not be manipulated by you.”
Alex approached me and grabbed a hand-full of shirt above my left shoulder and jerked me up from the chair. “Hey Alex,” I said, “There is no need to get physical and rough. If you want me to walk some place, I can do that myself without you hoisting my shirt way up in the air.” Alex said, “You are wrong Kathi, I’m in charge, not you, and I will escort you my way.” Alex seemed as though he released some tension through his clutching of my shirt. It was as though his hate was getting expelled through me because he was doing something physical against me.
He stopped in front of the seclusion room (behind the nurses’ station). Alex said, “You need to go in there for a ‘time out.” I held my position and answered, “I don’t think so Alex, there is no provision in law for a mandatory ‘time out.’ You may be able to pull that on others but it won’t work on me. Unless you plan on locking that door and making this officially seclusion, there is no way I’m going in that room. I’m not stupid.” Alex placed both of his hands on my shoulder-blades and pushed me in. He shut the door and locked it. That did it. The law keeps getting beat up. I lost it and screamed through the door/window, “You better have a damm good reason. You better get this cleared through the doctor! You better tell him step-by-step what happened here. You so can’t do this!” Alex screamed back, “You are not in charge here Kathi, I am!” I said, “You may be in change now Alex, but taking the law in your own hands will reverse in due time.”
I laid down on the floor and placed the mattress over the top of my body. I certainly did not want them starring at me like I was in some sort of sick zoo. The floor was cold. I was between the door that entered the back of the nurses’ station and the bed. Just then I heard voices from under the crack of the door. I pushed my ear closer. I heard lots of laughter. One female staffer was congratulating Alex, “Wow Alex, I never knew you had it in you.” Then more laughter. About 30 minutes later Alex opened the side door. He sounded irritated that I was on the floor. “Kathi, you are acting like a child. What are you doing on the floor? You are so childish. This is crap.” I said, “Hey Alex, I figured you don’t want to see me and I sure and the hell don’t want to see you. And besides Alex, do you think because you snap your fingers I will become an instant adult to suit you? I’ve already heard doctors explain to a judge in court that I operate at a pre-adolescent level. So you are going to hold that against me too? Did you come in to let me out or to torture me?” Alex said, “No, I don’t have to let you out. There is a one-hour rule. I can hold you in here at my own discretion up to an hour without any need for a doctor’s order.” I answered, “There is no rule, code or law that allows you that. It is flat-out illegal.” It didn’t matter; Alex shut the door and locked it.
I lay back on the floor under the mattress and listened to more laughter. It was maddening to listen to their laughter. I shouted under the door, “You better call this in and explain this to someone that will be accountable. You can’t do this!” Alex said, “Yes I can Kathi, and I am!” “Alex, is this your way of deescalating a situation? Is this how you go about developing a strong therapeutic alliance with clients?” Alex answered through the door, “Kathi, I know under all that badness there is a good person under there somewhere.” More laughter from staff.
After I’d been in there for about an hour, Alex opened the door again. He mumbled something about the hour being up. Then he started cursing and criticizing me. I defended myself verbally to his verbal assaults. It looked as though he escalated his body and voice to put me on the strong defense because I gave back what he dished out. Then he turned around and locked the door again. Then it all became clear to me. He got into it with me to use that as another reason to hold me again according to his apparent arbitrary one-hour rule. I went back to my spot on the floor. I held my resolve and dignity and resisted being manipulated to being on display by lying on that bed.
The phone rang and Alex answered it. “Yes. Oh yes. It’s about that new admit. No. Yes, the bipolar one. Yes, she’s been escalating all day. Yeah. Okay.” Alex hung up the phone.
That sounded to me like he was getting his doctor’s order with very minimal information given to the doctor. I spoke through the crack at the bottom of the door. “Alex, you can’t use ‘escalating all day’ as a justification to put me in here. You are supposed to say exactly what happened, who, when, and where. And, none of that got said. This is sounding like the good-ole-boys-club to me. I get it now. I see what is going on.”
About 15 minutes later Alex opened the side door again. I saw about 10 people standing there including security. I knew what this meant. They wanted to legitimize all their actions by claming they needed to use medications on me. What a deceptive farce. My tone and conduct in verbal exchange was no different than Alex’s. I said, “So you are going to drug me now Alex to back up all your mistakes? Fine. I’m not going to fight you.” I flopped down on the mattress and added, “This is clearly a distortion campaign being leveled against me.” All hands pressed down against me. It felt like hundreds of hands against my back. Staff gave me 2 shots; one in each hip, and refused to answer when I asked them what it was.
Staff left. I went back to my spot on the floor. At that point I just started laughing. It was a feeling of being sane in an insane world. I started to sing Puff the Magic Dragon and Home on the Range. I sang those songs over and over during the next few hours as a sort of coping devise. About 3 or 4 hours later I fell asleep.
I opened my eyes. The door was cracked. I closed my eyes again. Some time went by and then a staffer came in and asked me to drink some juice. How dare they, I thought. Why now? What about before? This felt like some sort of cosmic joke. I refused. I wanted nothing more from their abusive and manipulative ploys. A bit later a staffer said the doctor was waiting to see me.
He was waiting in his office writing. I took a seat. He asked a couple of questions, and then sat there making notes. It was painful just to hold my eyelids open. I had no reserves just to sit there and remain awake. My body was pushing me to lay down and this doctor seemed preoccupied with his writing. The minutes passed by and nothing from him. Finally I said, “Doctor, I don’t see why you need me in here. You are not engaging with me in any meaningful way.” I got up and went to my room to sleep. Later, a staffer woke me up because the doctor wanted to see me again. I stumbled in painfully awake. We went over the self-dangerousness and he said that was a stumbling block to release me. Then I had to go through it all over again with him. I finished with, “…besides doctor, if I was safe, why would I be volunteering to go to the Willows (a psych inpatient unit in Corona) then? What am I supposed to do? Just walk in and say, ‘I’m fine now. Victory Valley Hospital fixed me?’ What would be the point in being a volunteer patient if I did not have a current problem with self-dangerousness? But now, my condition has worsened. I am not better. But again, they way I see the law, you have no choice but to release me from the 5150 after the 72 hours are up if I am agreeing to continue as a voluntary patient.” My eyes burned from the meds trying to push them shut. I didn’t wait for his answer, and just got up and left his office and went back to bed.
Later a staffer woke me and said that my significant other, Cristina was on her way to pick me up. For once it looked like someone caved to straightforward logic.
Cristina arrived. I refused to sign any paperwork. We left without a word.
End compliant #6
Official notice to the doctor below was written in the evening, the day before release and BEFORE seclusion.
Doctor,
Tomorrow night at 12:20 AM (after midnight 0020) the 72-hour hold will be up. To refresh your memory, you threatened me with a 5250 if I was not willing to be treated involuntary. However, W&I code makes a provision that if I DON’T ACCEPT TREATMENT *VOLUNTARY* then, and only then you can hold me involuntary. But, I have made MANY references that I WILL go voluntary to the Corona Willows. So it appears to me your threat to hold me is unfounded. So, if you choose to wait till the last minute to release the hold, I will be without a ride in the middle of the night and will have to start walking. I offer a better and safer way. Release me during the early day or mid-day tomorrow, and Cristina will drive me directly to the Willows. ELSE, IF YOU CHOOSE TO 5250, I WANT A WRIT FILED IMMEDIATELY, AND THEN LET THE JUDGE EXPLAIN HOW 5250 WORKS IN THE REAL WORLD. I DON’T THINK YOU CAN THREATEN A JUDGE LIKE YOU CAN ME. Please let me know your choice ASAP so Cristina will know how to plan her day, pick up or not.
Very Sincerely,
Kathi Stringer