Canadian Labour Reporter

be on blood thinners — lying in his bed "incontinent of urine and bowel movement," with feces smeared around the room. A couple of hours later, a clean- er asked Posada to come to TS' room to help. TS was still lying on his bed, not talking or moving. Posada decided to try to "redi- rect" TS to get up for a shower or have a bed bath. A personal care assistant (PCA) arrived to help, but they were unsuccessful. A second PCA arrived and re- trieved a shower chair while Posa- da continued to undress TS, and they stood TS up and put him in the shower chair. TS became agitated and, ac- cording to the second PCA, began "hitting out, kicking out, spitting out," while yelling and scream- ing. Upon arriving in the shower room, TS tried to slide out of the chair. Posada and the first PCA were on either side of the chair and secured TS' arms, moving him back into a seating position every time he tried to slide out. Once the shower was com- plete, TS calmed down and he was shaved and helped to his feet. However, he couldn't stand and appeared to be exhausted. Posada noticed TS had a cut on the small toe of his right foot, skin tears on his left arm and middle finger, redness on both arms, his torso and the back of his head. Posada treated the toe with a solu- tion and a bandage. TS was taken to the dining room in a wheelchair for lunch and Posada gave him his medi- cations. TS' mood seemed to be good and they wheeled TS back to his room and helped him into bed. Less than two hours later, the night shift RPN found TS on the floor beside his bed. TS was able to speak but couldn't stand. The RPN assessed him and, in addition to the injuries from be- fore, found more weakness on TS' left side, bruising on his forearms and upper back, and observed the toe was still bleeding and the ban- dage was not there. TS' son-in-law was called and TS was sent to the hospital, where he was diagnosed with a hemor- rhage in his head. Bendale Acres reported the in- juries to the police and the Min- istry of Health and Long-Term Care. The police interviewed Posada but no charges were laid. Bendale Acres conducted an internal investigation. Several em- ployees, including Posada, were interviewed. In an investigative interview, Posada didn't acknowledge that TS was resisting or refusing care. Instead, he said TS engaged in "resistive behaviours" that didn't start until he was in the shower chair. He also didn't identify the fact that TS was on blood thin- ners and what the care plan for him was. Posada also provided a written statement that acknowledged TS was "highly agitated and resistive to care." He said he didn't com- plete an incident report because he felt the injuries were minor and not a threat to TS' health status. Bendale Acres determined that Posada's actions constituted resi- dent abuse, as TS didn't want as- sistance and Posada forced him to have a shower. This was a violation of the resi- dents' bill of rights under the Long Term Care Homes Act, 2007, and the resident care manual, both of which stipulated a zero tolerance for resident abuse. The home also found Posada should have com- pleted an incident report outlin- ing TS' injuries so the next shift would be able to follow up on his condition. The city terminated Posada's employment on Sept. 19, 2014. The Canadian Union of Public Employees (CUPE) grieved the dismissal. Arbitrator Russell Goodfellow found that TS was "a frail and el- derly resident" in a vulnerable position. Posada undressed him against his will, got him out of bed and took him to have a shower, even though he was protesting. As a result, TS received minor injuries and suffered from exhaus- tion, which contributed to more serious injuries. It didn't matter that Posada characterized TS' actions as "re- sistive" rather than actually refus- ing, said Goodfellow. There was no malice in Posada's behaviour and he legitimately wanted to help, said the arbitra- tor, but Posada made the wrong decision. It was clear TS was say- ing "no," but Posada forced care on him that left him exhausted, un- able to stand, bruised and bleed- ing. This was contrary to city poli- cies of which Posada was aware, and constituted abuse. Goodfellow noted that it was city policy to complete an incident report "whenever a resident is in- volved in a harmful or potentially harmful incident," especially when there was "an appearance of any break in the skin, such as pressure sores, scratches, cuts, abrasions, skin tears, etc." Posada's explanation that he didn't think it was necessary was contrary to the policy, and one of the PCAs who was interviewed agreed the circumstances called for such a report. Goodfellow determined that Posada's forcing of care on a pro- testing resident and his failure to file an incident report was serious enough to warrant dismissal. Posada was properly trained on procedures and policies and should have known how to ap- proach the situation, the arbitra- tor said in dismissing the CUPE grievance. For more information see: • Toronto (City) and CUPE, Lo- cal 79 (Posada), Re, 2016 Car- swell Ont 12702 (Ont. Arb.). 7 Canadian HR Reporter, a Thomson Reuters business 2016 CANADIAN LABOUR REPORTER NEWS < Nurse pg. 1 Next shift staff weren't prepared for resident's injuries Photo: upixa (Shutterstock) There was no malice in the nurse's behaviour and he legitimately wanted to help, but he made the wrong decision, said the arbitrator.

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