Nurse denies ill-treating patient at Withybush Hospital

Primrose James, 51, is accused of assaulting the patient after he struck out at her and a colleague when they were changing his bedding.

She denies an offence of ill treatment of a person who lacks capacity.

Healthcare support worker Holly English said she noticed the patient needed his clothes and bedding changed at around 2am on May 31 last year.

“As we were changing his sheets I rolled him towards me,” she said. “That’s when he tried to hit out at me. He missed.

“I told him not to hit me. It’s wrong.

“We went to roll him on to his back. Because he had hit out at me, Primrose had hold of his arm.

“After he was on his back, the arm Primrose didn’t have hold of hit out at her face.

“As soon as he went to hit out at Primrose, Primrose smacked him across the face.

“After she smacked him, she kept tapping his cheek and telling him off.

“She was quite aggressive. Quite confrontational with him. I was completely still.

“She started poking him on his forehead.

“She pressed her finger to the side of his nose to push his face away from her.”

“Why didn’t you intervene?,” asked David Singh, defending.

“It all happened really quickly,” said Ms English. “I was intimidated and shocked.”

Ms English said she reported the incident to one of the registered nurses on the ward, Christine Schofield.

Ms Schofield had been on a break at the time of the alleged incident, and it was reported while James was on her break.

“When Primrose came back from her break, I said ‘Can I have a word?’,” Ms Schofield said. “I said to her what I’d been told and I’d have to inform the site manager. She didn’t say anything.”

Georgia Donohue, prosecuting, asked whether they checked on the patient.

“We went to see him. No injuries were visible," Ms Schofield said.

Giving evidence, James - now of Victoria Road in Southend-on-Sea - described the man as “a difficult patient to manage”, adding that he would “kick out, hit out, [and] spit” at hospital staff.

She said she went to help Ms English change the patient after he had kicked Ms English in the stomach the previous night.

“He tried to hit Holly,” she said, adding that she then held his arm to prevent him doing it again.

“After that we had to turn him to my side to finish the process of changing him.

“This is when he lashed out at me. He went for my face. He slapped me.”

James said her arm moved as an “involuntary reaction” to being hit in the face and connected with and “blocked” the patient’s arm.

“That’s when I held him so he wouldn’t lash out again,” she said.

“It was during the changing process. I said to him ‘Why are you always like this? I am just trying to help you’. I tapped him on the back of his hand. There wasn’t any force at all.”

She was asked if she poked the patient in the forehead or on the nose, to which she replied “No” to both.

James was asked if the patient had “lashed out” at her before.

“A couple of times,” she said, saying she had been hit in the face and kicked in the leg.

“On these previous occasions had you ever reacted?,” asked Mr Singh.

“No,” she replied.

“It’s part of my job. It shouldn’t really happen, but it does.”

Ms Donohue asked James why she didn’t step away after the patient struck out at her.

“We were in the middle of changing him and he was half naked,” she said. “There was only me and Holly on the floor. I couldn’t leave him like that just because he slapped me. I had to continue to provide personal care.”

Nicola Jones, the clinical site nurse, told the court the hospital was busy that night and she had been in A&E at the time of the alleged incident. She said she called the ward at around 5.50am as part of her checks as part of her role, and was informed of the allegations.

Ms Jones said James told her: “I understand you wish to speak to me. I didn’t hit the patient.”

“She was indicating she tapped the patient with her fingers,” she said.

“That is a hit,” Ms Jones said.

“She said to me she did not hit the patient.

“Just after that conversation a member of staff came in having changed the patient and he had hit her in the face. She had tears in her eye and said she had been hit in the face.”

Ms Jones was asked if it was appropriate for James to block an attempt at hitting her, and to tap the patient on the hand and tell him not to do it again.

“At the end of the day, the patient was in bed. It’s not like he was running after her. She could have stepped away,” she said.

Ms Jones was asked about the patient’s condition following the incident.

“When I arrived at the ward I asked how the patient was. They said he was fine,” she said.

“You didn’t feel the need to see [the patient]?,” Mr Singh asked.

“I trusted the nurses looking after him,” she said.

The court heard that the patient had been taken out of his bay for being disruptive to the other patients, and was in the ward corridor near the nurses station.  

When asked to describe the patient, Ms English said: “He could be quite violent and hit out at the nursing staff. He could get quite agitated quite easily when we were trying to provide personal care.”

The jury was told of a further six incidents where the patient had attacked or attempted to attack health care staff between May 21 and June 6.

The trial continues.