1 Charge Against Nurse Unfair, Health Chief Says

San Diego County’s director of health services conceded Tuesday that at least one of the charges against a supervising nurse suspended from her job at Edgemoor Geriatric Hospital was probably unwarranted.

James Forde, director of the county Department of Health Services, said that he would not have charged nurse Gertrude Shaw with failing to ensure the proper bathing of patients under her control had he known more about the regulations governing baths at the hospital.

But in testimony in Shaw’s continuing Civil Service Commission disciplinary hearing, Forde maintained that he still believes Shaw is guilty of more serious violations in connection with the Dec. 10 drowning of a woman left unattended in a bathtub.

Shaw’s representative from the County Employees Assn. contends that she is being used as a scapegoat for the county’s numerous problems at Edgemoor. The Santee hospital has been the subject of intense scrutiny and criticism since January. It won a reprieve Tuesday from a threatened cutoff of state and federal funds after state investigators determined that sufficient improvements had been made.

Forde, who suspended Shaw for eight weeks after the drowning, said Shaw should have told paramedics that Josephine Noonan, 66, had been left unattended for several minutes. He also said Shaw should have done more to correct a nurse assistant’s written remarks on the drowning, which failed to mention that Noonan had been left alone.

Forde, who testified for more than three hours Tuesday, at times appeared confused about what actually happened the day Noonan died and about how he came to suspend Shaw but not employees above and below her in the chain of command.

Shaw was the supervising nurse on duty in ward B-2 on the morning of Dec. 10, when nurses’ assistant Alverta (Pearl) Martin placed Noonan, who was paralyzed from the chest down, into a special bathtub. According to testimony earlier in the hearing, Martin then left Noonan to look for a comb. When she returned, Noonan’s head was under the water and she had stopped breathing.

Attempts by hospital employees and paramedics to revive Noonan were unsuccessful, and she was pronounced dead at Grossmont Hospital later that morning.

Since then, Martin has quit her job and Jackie Webster, the chief nurse at Edgemoor, has received a letter of reprimand from Forde. But Shaw, who supervised Martin and reported to Webster, was given a 40-day suspension, which she served under protest and is now appealing.

One of five charges against Shaw is that she had allowed Edgemoor patients, including Noonan, to go for extended periods without tub baths, in violation of state regulations and hospital rules. In a letter to Shaw dated Feb. 20, Forde said Shaw had known or should have known that Noonan had gone 11 days without a proper bath.

But under questioning from union repesentative Pat Vetere, Forde testified Tuesday that he did not fully understand the rules on bathing. Told that Edgemoor’s chief nurse and former chief nurse had both testified that “bed baths”--of which Noonan had two in the week before her death--were equivalent to “tub baths,” Forde seemed surprised.

“The policy as I understand it is that there should be a tub bath twice a week,” Forde said.

Vetere asked him whether he would have charged Shaw with that violation had he known the rules. “I’d say not,” Forde replied.

Forde also admitted under questioning that he had not seen the completed “incident report” on Noonan’s death before he decided to suspend Shaw. He said he had not known before the hearing Tuesday that chief nurse Webster had written on the report that “Mrs. Martin reported to me that she had left the (patient) a few minutes to get a comb.”

Forde conceded that Webster’s comment and another by Shaw that patients “should not be left in tub unattended” muddled his theory that Shaw was trying to cover up the fact that the patient died by drowning. But he said he believed Martin when she said Shaw told her not to say she had left Noonan unattended in the tub.

In other testimony, Forde revealed that the health services department had tried to settle Shaw’s case without a hearing.

He said the department offered to reduce Shaw’s suspension from 40 to 10 days if Shaw would agree to forfeit her right to a hearing. Forde also said that the department asked Shaw not to publicize the agreement.

“I was interested in having as little public flak as possible,” Forde said. “Any publicity at this point is more than we need to have. I believe Edgemoor deserves a rest from the glare of publicity at this point in time.”