Edgemoor Employee Rated ‘Outstanding’ : Nurse Fights Suspension Over Patient’s Death

A supervising nurse suspended by the county after a patient in one of her wards drowned in a bathtub at the Edgemoor Geriatric Hospital is an “outstanding” employee who knows state regulations well and follows them strictly, her boss testified Friday at a San Diego County Civil Service Commission hearing.

Gertrude Shaw, who is fighting the eight-week suspension handed down by Health Services Department Director James Forde, received the highest possible mark when she was evaluated by her immediate supervisor only three weeks before the drowning, according to evidence presented Friday.

But Deputy County Counsel Susan Boyle, pressing the department’s case against Shaw, said the nurse’s performance record is not relevant to her actions on Dec. 10, when 66-year-old Josephine Noonan was left unattended by a nurses’ assistant and drowned in the bathtub.

In the hearing, which began Thursday and will continue through next week, Boyle has tried to prove that Shaw attempted to conceal the fact that a nurse under her supervision left Noonan alone in the tub for as long as four minutes.

“I won’t argue with the fact that Nurse Shaw is probably an excellent nurse,” Boyle said in an interview after Friday’s session of the hearing. “This is not a termination. This is not to say she’s a bad nurse. It’s simply a suspension because of the mistakes that were made and the gravity of the situation.

“There has to be someone responsible if the patients (at Edgemoor) are not getting the care that they should.”

Shaw’s labor union representative, however, maintains that the Health Services Department is using Shaw as a scapegoat for Edgemoor’s many problems. Some of the problems have prompted the federal government to threaten to cut off Medicare funds for the hospital’s patients, an action that would close the facility.

“I agree with Ms. Boyle,” said Pat Vetere of the County Employees Assn. “Someone has to be responsible. And in this case, as in many cases at Edgemoor, the ones who should be held responsible are the management, in particular Mr. James Forde.”

Vetere said he plans to call Forde to testify at the hearing, along with the former Edgemoor administrator, the hospital’s medical director, the deputy director of the Department of Health Services and eight others.

Vetere contends that their testimony will show that Shaw should not be held accountable for the county’s failure to maintain proper conditions and adequate staffing at the 323-bed hospital in Santee.

The problems at Edgemoor have combined with other health department woes to place in jeopardy the job of Clifford W. Graves, the county’s chief administrative officer, who will be evaluated by the Board of Supervisors at a closed-door session Wednesday.

If the department is ordered by the Civil Service Commission to repay Shaw for her 40-day suspension, which she served this spring, the decision would be another major blemish on the department’s already tarnished management record.

Shaw was the supervising nurse in the ward when Noonan, paralyzed from the chest down, was placed in a bath by nurses’ assistant Alverta (Pearl) Martin on the morning of Dec. 10.

Martin, who resigned in February, testified Thursday that she left Noonan alone in the tub to look for a comb in another room. When she returned, she said, Noonan’s head was face down in the water, her eyes were “quivering” and she was generally unresponsive.

Martin also testified that she was told by Shaw not to include in a written report of the incident that she had left the patient unattended in the bathtub.

Under Boyle’s questioning, Martin gave this description of her encounter with Shaw:

Shaw “asked me what happened. I said, ‘I left her.’ And she stamped her feet at me . . . and I said, ‘Only for a little while. I wasn’t gone long.’ And I asked her ‘What do you want me to do?’ She said, ‘Don’t say you left her.’ ”

So, Martin testified, when she filled out a hospital “incident report,” she wrote only that Noonan “became unresponsive” and that “her face went underwater.”

But on the same report, beneath Martin’s notes, Shaw made reference to the error, a fact her representative said demonstrates that no cover-up existed.

Patients “should not be left in tub unattended,” Shaw wrote on the form.

Beneath Shaw’s words, her immediate supervisor, Jackie Webster, the next day wrote: “Mrs. Martin reported to me that she had left the pt. a few minutes to get a comb.”

Webster, who was Edgemoor’s acting chief nurse at the time of the death and has since been made permanent, testified Friday that she has always found Shaw to be an excellent employee.

Webster said the “outstanding” grade she gave Shaw on her Nov. 19 annual evaluation was the only such mark she has given in four years at the county.

Shaw, Webster wrote, “takes the responsibility of monitoring patient care plans . . . and instructs the staff nurses concerning timely pertinent updating of these records . . . her instructions are clear and concise, her manner courteous and professional and her reactions to emergencies are appropriate and immediate.”

Webster, who said she was not consulted before the department disciplined Shaw, also testified that the department erred when it charged that Shaw had knowingly allowed Noonan to go 11 days without a bath.

Actually, she said, the two “bed baths” Noonan received the week before she drowned were satisfactory equivalents to a full, tub bath.

But after Webster, who was called to testify by Boyle, complimented Shaw, the deputy county counsel attempted to discredit her. Boyle revealed that Webster was reprimanded--for rating Shaw too highly--by Forde on Dec. 12, two days after Shaw had allegedly tried to cover up the details of the drowning.

Copies of Shaw’s evaluation, however, show that, although it was signed by Shaw on Dec. 12, Webster made her remarks on Nov. 19, after which the form was approved by Francoise Euliss, then Edgemoor administrator, and by Paul Simms, deputy director of the health department.