Hong Kong health care and hospitals

Unsupervised procedures by nursing students ‘occurred multiple times’, family of dead Hong Kong patient says as they reject hospital’s apology

Wife of deceased patient slams hospital and says management is involved in a cover-up

PUBLISHED : Wednesday, 29 August, 2018, 8:43pm
UPDATED : Wednesday, 29 August, 2018, 11:06pm

The family of a 61-year-old man who died after a nursing student performed a medical procedure on him without supervision has alleged that the breach in protocol had occurred multiple times, and called for a review of the system.

The man’s wife, surnamed Tong, said dealing with her husband’s death was like “being pierced by knives daily”. She recalled seeing student nurses performing tracheal suction – clearing the patient’s airway of mucus – on him.

The woman and her daughter met members of the media on Wednesday, two days after Tuen Mun Hospital revealed details of the death.

Hospital apologises for patient death after student nurse’s unsupervised procedure

The man, a former crane operator and the family’s breadwinner, was recovering from a tongue cancer operation. He had been in hospital since late July and had a tracheotomy tube inserted after a temporary opening was made in his airway.

On August 4, a nursing student working in the hospital’s surgical ward tried to perform the suction procedure on Tong, as he was feeling uncomfortable because he was retaining sputum.

The student’s attempt was unsuccessful and when a small amount of blood was found in Tong’s vomit, she sought immediate help from a duty nurse.

Despite other nurses and doctors trying to resuscitate him, his condition deteriorated and he died last Saturday.

The hospital apologised on Monday for not adhering to protocol, which requires a nursing student to be supervised and guided for tracheal suction. The man’s wife said students had always been performing the procedure by themselves.

“I have never seen a student and a nurse perform the procedure together,” she said.

She added that the student involved in the incident had done the procedure “many times” for Tong, and in total, three to four student nurses had conducted the same routine on her husband.

The woman said she was told by hospital management after the incident that the student nurse did it “out of desperation”. She said the response was “irresponsible” and showed an attempt at a cover-up on the hospital’s part.

Asked if she would accept the hospital’s apology, she said: “If your family member was killed and [the killer] said sorry 100 times, would you accept it?”

If your family member was killed and [the killer] said sorry 100 times, would you accept it?
Patient’s wife

The woman and her daughter questioned if Tong had received sufficient care. While his tracheotomy tube was found to be displaced during efforts to resuscitate him, Tong’s daughter said the tube had been moved a few days before the incident, according to photos taken.

A nurse in the ward had also noticed this, she claimed.

“Why did no doctors or nurses tend to this issue during their ward rounds in those few days before the incident?” Tong’s daughter asked.

Both women also questioned whether it was appropriate to allow the nursing student, who was in the early stage of training, to care for a patient such as Tong, who was considered to be seriously ill.

“We are not targeting the student, but the entire system ... There are guidelines but the management did not implement them. We feel angry about it,” the daughter said.

Lucia Chiu Po-kam, a member of a concern group that looks into lapses in the city’s medical system, said the Hospital Authority had set many guidelines that frontline staff were not able to carry out.

“There was insufficient manpower to follow and implement those guidelines,” said Chiu, who worked as a nurse in the public sector.

A spokesman for the hospital said on Wednesday that it understood the family’s discontent with the level of care for the patient before his death, and with the system of supervision for nursing students.

“The hospital has already followed-up with the family on their areas of dissatisfaction and made improvements,” he said, adding that the hospital would like to apologise to the family again.

He said the hospital had launched an investigation and would thoroughly review its internship and supervision systems.

The hospital has also reminded ward management staff to strictly follow protocol stating that supervision and guidance should be given to nursing students when special procedures are performed.