Staff at a Government nursing home have called on the Health Ministry to carry out an inquiry after 20 workers have left in two years and claims were made that nursing practises were old and out of date.

Four registered nurses will have left Lefroy House in Somerset this month alone, but others warn that the exodus will continue unless action is taken soon.

Five nursing staff spoke out yesterday and demanded intervention by chief medical officer Dr. John Cann. And they said the principal issue was poor management.

Two British nurses told The Royal Gazette they could stand it no more and left after only a matter of a few months on the Island, citing a dictatorial management style and old nursing practises as key reasons.

They claimed residents were unduly restrained every morning after having been woken up at 5 a.m. - regardless of whether they were sleeping or not.

As a result, the overseas nurses, who each have many years experience, said they planned to write to the Nursing Times in Britain to warn other carers not to come to Bermuda to work.

Mother of two Nicola Upcott-Bayes, who came to Bermuda in April with her husband and two children, said she was recommended for dismissal after just two months because, she felt, she had challenged some of the policies in place.

She said: “The quality of the food is generally quite good and the hygiene is good, but some of the handling and care of the residents leaves something to be desired.

“They get the majority of residents up at 5 a.m., put them in wheelchairs, then put them in chairs and restrain them for hours, regardless of whether they need it or not.

“I have lived and worked in a number of other countries, and have never seen anything like it.

“Management says it's for their own safety, but the residents should not need to be restrained if there is staff around to look after them.

“And if some of the residents do want to go for a wander, then the staff should be able to take them. They should not be restrained around the waist for hours on end. If people do need to be restrained then Lefroy's own policy states that it should only be done with a medical order and in consultation with relatives, but this did not seem to be adhered to.”

However, Mrs. Upcott-Bayes said the nurses were also told to write notes about the residents in a book for the doctor to look at during her weekly visits to Lefroy, so she could see who needed medical attention.

However, the disgruntled nurse said on one occasion, she found the notes she had written about one resident ripped completely out of the book by management without reason, and on another occasion, comments about three residents were crossed out.

Only after she persisted with one request was the resident allowed to see a doctor and antibiotics were prescribed.

Nurse Deborah Fazakerley left Lefroy and returned to Britain earlier this month after falsely claiming that her father was ill and she needed to return home at short notice.

In a joint letter with Mrs. Upcott-Bayes, which has been copied to Health Minister Nelson Bascome, Dr. Cann and a host of other people, she also complained that staff were working 16 hour-shifts.

She said: “There are serious concerns about the safety aspect of staff working double shifts, i.e. from 3 p.m. right through until 7.30 a.m. Obviously as almost half the workforce is leaving, this will increase in frequency.

“And on medication, enteric-coated medication (which ensures that medications dissolve gradually in the system) was being crushed. This has been addressed after the matter was raised.

“But medication errors are extremely high - in fact Lefroy's Quality of Care statement for staff actually says it aims to keep errors to five percent. Is this condoning five out of 100 mistakes?”

Mrs. Upcott-Bayes, who has previously managed two nursing homes, said when she asked if a greater number of incontinence pads could be left for every shift because they were running out, she was asked ‘why?' and was later told the larger ones had to be rationed due to cost.

And she said staff were also told to ration medical gloves, due to cost. She also complained that she had been referred to as “white girl' by one member of staff.

To make matters worse, Mrs. Upcott-Bayes said after she was recommended for dismissal, both the health department and personnel services were unable to tell her when her final working day would be, and when she and her family would receive their return air tickets home.

She said: “There was no point in us staying, so we just wanted to know when I could have my final pay, receive our tickets and leave, but no matter who we asked, no one was able to tell us.

“Obviously, we had given everything up to come to Bermuda, so we had to start and arrange for new jobs back in England and somewhere to live. We have children to consider, too.

“We finally got the tickets and are now just desperate to leave. It has been a nightmare from start to finish.”

Three other nursing staff working at Lefroy yesterday said they agreed with the majority of what the two nurses had said, particularly when it came to management style.

And they said they were concerned about a further shortage of staff.

One said: “By the end of this month, four nurses will have left out of a total ten. It will probably take us between six and eight months to replace them.

“In the last two years, we have lost 20 staff, including aids and nursing coordinators.

“I don't understand why the Department of Health is doing nothing about this. The turnover of staff is bad, so it must realise there is a problem. I would say 80 percent of staff are unhappy.”

But the nurse said they did not agree that residents were unduly restrained. The nurse said: “If you have staff working in another area, then you need to restrain the residents for their own safety. I don't think restraining is something Lefroy is really in favour of.”

And the nurse said if all residents were to be up in time for breakfast at 8 a.m., they needed to be woken up at 5 a.m.

Another nurse said the exodus was down to the “dictatorial management”.

The nurse said: “They want you to do what they want without any real policy. It's true, the nursing practises are out of date. If you challenge anything at all, then you are publicly chastised.

“Some nurses crush medications and you are not supposed to, and there has been a lot of restraining of residents, but they have started to put limits to it because of complaints. They are still restraining without doctor's orders, though. I agree that people should be restrained for safety reasons, but not restrained without a reason.”

And the fifth nurse said they planned to leave at the end of the year.

“I totally agree with all of them,” said the nurse.

“Government has not done anything to correct the situation. They seem to change the policies as they go along and people are just unhappy. People are there because they need a job, not because they want to be there.

“And I agree, residents should not need to be restrained if there are enough staff to look after them, but we are always short. There should be 11 people on, including aides, all the time, but sometimes there are just six.”

Carla Zuill, whose late grandmother Marie Burch was at Lefroy prior to her death in May, said she had had no problems with the nursing home.

She said the first time she saw her grandmother restrained, she did question it, but was told it was for her safety.

“She was never tightly restrained and she never complained about being restrained,” said Ms Zuill.

“I went there for two years and never heard any of the patrons complain.

“I always found the manager Ms (Rosheena) Masters, from the first time I went there, to be caring and compassionate and very open. Any questions that we had, she always answered.

“I did notice a high turnover of staff, though, but it appeared to be the aides, not the nurses. I just thought they were transferred or temporary.”