The President of the Malta Union of Midwives and Nurses (MUMN) Paul Pace came out in defence of nurse Rhys Xuereb who he says was "unjustly suspended" for the disappearance of Carmelo Fino from the St. Vincent De Paul Residence (SVPR).

The MUMN has issued a number of directives and, until its demands are met, said that nurses are not to admit any new patients at SVPR or government elderly homes.

The MUMN called a press conference outside SVPR to discuss the "false" inquiry which led to the suspension of nurse Rhys Xuereb, over the disappearance of Carmel Fino.

Carmelo Fino is an 83-years-old SVPR resident with dementia who went missing on 28 June.

An internal inquiry had found that the disappearance of Karmenu Fino from St Vincent de Paul was the result of shortcomings in the standard of care provided by employees rather than a systematic failure. 

During the press conference on Tuesday, Paul Pace, the president of MUMN, defended nurse Rhys Xuereb, stating that he was suspended without even having the chance to defend himself by seeking help from a union or legal support.

Pace argued that if the system had worked, "Carmelo Fino would still be alive."

Pace said that Xuereb was only a reliever who had graduated a few months ago, however, he was still tasked to take care of an open ward with 34 patients.

"The MUMN declares that its officials have not been interviewed by the judge in the course of this inquiry, as otherwise it would have certainly drawn his attention to the fact that, according to a protocol agreed between the MUMN and the government, the ward in question should have (during the night shift) two nurses and not one nurse. The fact that only one nurse was on duty on the night in question is clearly a system failure, for which responsibility falls totally on the shoulders of the ministry and the administration."

Moreover, Pace said that the report did not even distinguish between the role of a carer and a nurse. The MUMN said that the conclusions of the report place a collective blame for this occurrence on the night shift, without distinguishing between the various personnel and categories of personnel constituting the said night shift.

Pace said that it was not the role of the nurse to remain on constant watch. With Fino, Rhys' responsibility was to give him his pills. Once he did that there was nothing stopping Fino from walking out because he was admitted to an open ward.

Pace argued that the ministry was just using Xuereb as a "scapegoat" even though he was innocent.

This goes back to the many arguments made by the MUMN, that the shortage of nurses had become a ticking time bomb, Pace said.

Pace added that what happened to Rhys could have happened to anyone, "he was just in the wrong place at the wrong time." Pace further added that if something had been done about the state of nurses, then they would not be in this situation. Furthermore, Pace said that at no point in the report did it ever mention that Fino escaped an open ward.

He said that Fino was in an open ward which gives patients the privilege to walk in and out of the ward whenever they please. He further explained how there is not even a door in this ward, just a small gate.

"SVPR residents suffering from dementia, if the system is truly in place and is truly working, should be placed in a Closed Ward specifically designed for residents suffering from dementia, where more stringent measures are in place to avoid wandering from such patients."

Pace brought up what the family had said: "He could not even communicate verbally." If this was the case "was the 'night shift' also to blame for this deficiency, as the judge would appear to conclude? Why did Fino's medical team never transfer such a patient to a closed ward? Why was this omitted from the retired judge's report?"

"This is a decision which clearly does not fall within the remit of the nursing staff to make." Pace added that the Minister cannot say that the system works well, when after this incident they turned SVPR into a prison. He expressed how there is a security team now and patients have coloured tags limiting their freedom.

They are also required to fill in a form every time they leave the elderly home, he said.

Pace's argument is that the minister cannot state that the system works and then follow on to completely change the system. He further said that the police had 11 hours to search for Fino, but all they did was search the hospital.

Pace challenged the minister not to be a "coward" and conduct another inquiry, but he expects that a more "competent judge" will handle it and that Xuereb would have the chance to defend himself this time.

MUMN's directives

The new directives that have been implemented by the MUMN are as follows: Nurses are not to phone any relatives for any reason in SVPR; All top up forms are not to be filled, which includes weekly top up forms needed for the pharmacy, MMMU provisions, stationary and any other items. Only emergency tablets and injections ordered on the day are to be filled since the rest of the items can be delivered to the wards by other personnel; All forms such as SVP69 - which is used for the release of a residence outside hospital grounds - is not to be filled nor endorsed by the nurse.

Nevertheless, Pace made it clear that none of these directives hinder the health of any of the residents inside. However, he said that SVPR will remain closed and not admit any new residents until something is done to improve the system.

The MUMN is asking for all wards to have no more than 30 residents, that every nursing shift in every roster in SVPR have two nurses, that every ward would have two nurses during the night, and that "no replacements are needed to avail on one's vacation leave or study leave."

"Until all the above conditions are reached, SVPR and elderly homes are not to admit any residents," Pace said.

Pace believes that it will remain closed for a while because to meet the MUMN's demands, SVPR must lose 80 patients and gain 100 nurses. He finalised by addressing how the MUMN was a family and they were behind Rhys' back, "because what happened to him could have happened to anybody."

Ministry strongly denies 'frame-up'

In reaction, the Active Ageing Ministry "regretfully" took note of the MUMN's reaction to the internal inquiry led by former Judge Geoffrey Valenzia and the steps taken by the Public Service Commission.

"While the ministry respects and appreciates the work of the MUMN to continue improving the conditions and interests of its members, it reiterates that the case where an elderly man exited St Vincent de Paul at night and did not return could not be ignored, as it seems they are expecting."

"Instead, the obligation was for the facts to be established and recommendations be made in order to reduce the possibility of such cases repeating themselves. For this to have happened an independent inquiry was led by retired Judge Geoffrey Valenzia." The ministry denied that there was a "frame-up", calling it "an allegation that is not only denied with the greatest force, but also does not do any good for the people making it."

"The ministry also said that on the order of the MUMN, directives affecting patients/elderly residents, who don't deserve to be used in this way, have already come into force. In the face of all this the ministry will continue to operate correctly, in a dignified mannet, democratically and transparently. This with respect to patients and the absolute majority of workers who conduct their work with love and dedication, among them being the members of the MUMN. That is why our appeal remains for everyone to act responsibly."