Union defends nurse's performance in Jasher's death

Jasher Francois -

THE TT National Nursing Association (TTNNA) says it stands behind the general-trained nurse involved in the death of six-year-old Jasher Francois, as based on its preliminary fact-finding exercise, her performance during the incident was up to standard given systemic constraints.

In a statement on August 12, the association said out of respect for the grieving family and in the interest of accuracy, it had purposely withheld public comment at the time of the incident, choosing instead to conduct its own preliminary fact-finding exercise before making any statements.

It said its comments were limited only to nursing involvement and not the actions of the doctors or any other health practitioners.

“The involved general-trained nurse followed all professional instructions and performed all duties to an appropriate standard given the systemic constraints in our healthcare environment. The nurse's professionalism, composure, and adherence to protocol are to be commended, and we stand firmly in her defence.”

The association said it was important for the public to understand that magnesium sulphate administration typically occurred in patients who were critically ill.

“This drug requires strict dosing protocols, careful dilution, slow intravenous administration, and constant patient monitoring for potential side effects such as respiratory depression, hypotension, and loss of reflexes.

"These requirements are particularly demanding, and nearly impossible, in environments where nurses are tasked with multiple high-acuity patients at the same time.”

The association also reminded all nursing personnel that they should follow certain professional safeguards.

“If a nurse has any clinical concern about a medication order whether related to dose, suitability, or monitoring capacity, they must escalate that concern immediately to a supervisor or physician before proceeding.

“They should continue to keep family members informed of the patient's condition and the sequence of clinical interventions to ensure they have a full appreciation of the care being provided.”

It said while the South-West Regional Health Authority (SWRHA) and the government had launched their own investigations into the incident, it must warn the public against expecting any fundamentally new information or recommendations.

“History has shown, through numerous commissions of enquiry, independent reports, and best-practice advisories issued by TTNNA, that the systemic issues at the heart of such tragedies have long been identified.

“This includes the findings of the April 2024 Pan American Health Organization (PAHO) investigation into the multiple infant deaths at the Neonatal Intensive Care Unit (NICU) of the Port of Spain General Hospital, which echoed concerns we have raised repeatedly over the years. The real challenge has been implementing these known solutions with urgency and consistency.”

The association said the circumstances surrounding Jasher's death again validated its repeated calls to improve patient-to-staff ratios, a concern it had raised in multiple forums over the past decade.

It said the shortage of specialised nurses, including paediatric nurses, was at a crisis level in TT as none of the nursing schools delivered specialised paediatric training.

The association said in order to reduce the risk of future tragedies, it called on the government to urgently implement safe patient-to-nurse staffing ratios in all clinical settings.

“We are encouraged that the current Minister of Health, Dr Lackram Bodoe, has only last week committed to addressing these ratios by filling 1,800 vacancies-a reform that is urgently needed to ensure safe and sustainable nursing care.”

It said the Tertiary Education Ministry should immediately award scholarships for nurses to access specialised nursing programmes regionally and internationally, until local nursing schools commence training.

The association said the SWRHA should review and strengthen critical care protocols, ensuring adequate staffing and resources for continuous patient monitoring during high-risk medication administration.

The association extended its heartfelt condolences to Jasher’s family, loved ones and community.

“The loss of a child is immeasurable, and we grieve alongside his family during this profoundly difficult time.

“The TTNNA reaffirms our commitment to both protecting the integrity of our nursing professionals and advocating for systemic reforms that safeguard patient lives. We stand ready to work alongside all stakeholders to ensure that the lesson from this heartbreaking loss leads to meaningful, lasting change in the delivery of healthcare in TT.”