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HomeMy WebLinkAboutBILLSMAN-1991-13-06-RIVERSIDE HOSPITAL OF OTTAWA __.......-,. .r-n .",c-~ <:t .... ~~(";:'1 Ii:{ECEtVED ~;EP ,) fl 1C~" J ") <__::1' IN THE MArTER Of AN ARBITRArION BETilEEN: THE RIVERSIDE HOS?ITAL Of OTTAwA AND: the Hospital THE ASSOCIATION Of ALLIED HEALTH PROfESSIONALS the Association GRIEVANCE Of S. BH..GS'1Al'" Boa~d of ~bit~ation: Ms. Jane E. Em~ich ,'Ie. Robaet Radfoed .'1r. ?ete~ Seguin Appea~ances: fo~ the Hospital: ,'1~. Gynn H. Hamden Ms. Eleano~ S. Dunn Me. Jim Robeets Ms. Do~othy Gallaghe~ Ms. Janet wilson fo~ the Association: Ms. Dianne Nicholas Ms. Sue McCulloch M~. Sid Billsman Ms. Sue Domina Chai~ Hospital Nominee Association Nominee Counsel Di~ecto~, ?e~sonnel Se~vices Chief Technologist Asst. Chief Technologist Gegal Assistant Counsel A.A.H.?O. LaboU(" Relations Office~ Geievo~ Baegalning Unit Repeesentative Hearings held at Ottawa on Novembee 12th and 13th, 1990, and January 4th, 11th and March 4tn, 1991 The parties placed befo~e the Board a se~ies of g~ievances arising f~om foU(" incidents fo~ which discipline was imposed upon the g~ievo~. The parties ag~eed to consolidate the hearing of these matte~s and are ag~eed that this awa~d should dispose of each of the g~ievances. In ~espect to the'fi~st two incidents, which occu~~ed Saptembe~ 28th and Octobe~ 2nd, 1989 ~espectively, the Association contends that no discipline is wa~~anted at all. In ~espect to tne latte~ two incidents, which occu~~ed on Octobe~ 10th, 1939 and Janua~y 11th, 1:190 ~espectively, the Association acknowledges that conduct occue~ed which may me~it some discipline, but maintainad that the penalty imposed was excessive. The Association asks the Boa~d to modify the penalty in acco~dance with the j~isdiction confee~ed by the collective ag~eemant in ~ticle 8.05. In addition, the g~ievoe g~ieves that A~ticle 22.05 of the collective ageeement was violated when he was called back to the Hospital to meet with membe~s of management in connection with a fact-finding meeting on Octobe~ 4th, 1989 &~d a disciplina~y meeting on Octobe~ 27th, 1989. The g~ievo~ is a regularly sCheduled part-time X-ray technologist and these meetings fell on his days off. The g~ievo~ ~esides in Comwall and boa~ds at a hOuse in Ottawa foe the days that he must wo~k in Otta.a. DUt"ing all the ~elevant times, the g~ievo~ .as regularly scheduled to wO~K two shifts or th~ee shifts pee week. He has always woeked on the night shift f~om 4:00 p.m. to midnight with on-call responsibility feom midnight until the day shift commences at 8:00 a.m.. The eelevant p~ovisions of the collective ag~eement are the following: 1 Article 3 - MANKZE'1ENT RI~HTS 3.01 The Association ~ecognizes that the management of the Hospital and the di~ection of the wO~lCing fo~ces are fixed exclusively in tne Hospital and shall ~emain solely with the Hospital elCcept as specifically limited by the peovisions of this Ageeemant and, without eest~icting the generality of the fo~egoing, it is the exclusive function of the Hospital to: (0) hire, assign, eeti~e, di~ect, p~omote, demote, classify, t~ansfer, layoff, ~ecall, discha~ge o~ otheewise discipline employees, p~ovided that claim of discha~ge o~ discipline without cause may oe the suoject of a g~ievance and dealt with as he~einafte~ provided; ~ticle :3 - GRIEVAi'lCE ?ROCEDURE 8.05 Discha~ge Geievance The discharge of an employee dUt"ing the probationa~y pe~iod shall not be the suoject of a g~ievance o~ arbic~ation. The disc~ge of a tempo~ary employee shall not be the SUbject of a g~ievance o~ arbic~ation. A claim oy &'1 employee, othe~ than a tempo~ary employee, who has completed hee p~obationaey peeiod that she has been unjustly discharged oe suspended shall be treated as a g~ievance if a weitten statement of such gelevance is lodged by the employee, with tne Hospital, at Step No.3 within ten (10) calendar days aftee the effective date of the dischaege oe suspension. Such g~ievance may oe settled undee the Grievance o~ Arbitration ?roceduee by: (a) confirming the Hospital's action in dismissing the employees, or (b) reinstating the employee with or without loss of seniority and with or without full compensation foe the time lost, or (c) any other ar~angement which may be deemed just &~d equitable. 2 The Hospital agrees that it will not suspend, discharge or otherwise discipline an employee who has completed her probationary peeiod, without just cause. 8.13 The Board of Arbitration shall not have any jurisdiction to amend, alter, modify or add to any of the provisions of this agreement oe to sucstltute any ne. provisions foe any exlsting peovisions or to glve any decision inconsistent with the teems and provisions of this ageeemenc. Artlcle 22 - ?R&'1IOM ?A~M&"'T 22.05 Call-Back Wheee an employee has completed he~ regularly scheduled shift and is called in to work outside her regularly scheduled hours, oe where an employee is called baCK feom standby, She shall eeceive time and one-half (1 1/2) times her regular steaight time hou~ly rate for all hours worked with a minimuin of three (3) hoUt"s' pay at time and one half her regular straight time hourly rate except to the extent that such theee (3) hour period overlaps or extends into hee regularly scheduled shift. In such a case, she will receive time and one-half (1 1/2) her regular straight cime hourlr rate for actual hours worlCed up to the commencement of her ~egulae shift. Hours .orked under this article will not be considered hours worked foe the purposes of overtime. 3 1. Tba B... Incident - Sapteotler 23, 1989 In respect to the fiest incident on 8ept.embar 28, 1989, mUCh of the evidence received oy the Board was hearsay. It was alleged that the gri.evor omitted to provide the. patient, B.il., a fourteen yeae old boy, with a hospital gown and that the grie'loe slung the protective lead shield so heavily upon the patient as to caus.e paln. It is fuethee alleged that following X-rays, the grievor eequested tne patient to leave the eOQU to put his shoes on in the hallway. Counsel for the Hospital advised the Board that he had contacted the patient, but h.e did not wlsh to become invol\Ted in the proceeding. The patlent's mother, who instituted the complaint alleglng dlsrespectful treatment of her son, was not pr.esent in the X-ray room when the pictures were taKen. Me. Billsman did not testify, so we do not have any dlrect evidence of what teanspired in ~espect to this incident. However, on October 4, 1939, the grlevor was called ln to the~ospital to meet with the Assistant Chiaf X-Ray Technologist, Mrs. Gallagher, and the Manager of Diagnostic Imaging, Me. Rob:ets, to investigate the facts of this incident. Mrs. Gallagher took notes of this meetlng and testified with the aid of these notes. She said the grievoe admitted that the patient, B.w., had taken off his pants in the X-ray room, to prepare for the X-~ays of his Knee and leg. The paCient was still wearing his underwear, shirt and soc"-s. She noted that the g~ievor could not recall if he had provided the patient with a gown, out the grievor added that since the patient was still wearing his underwear and would have the lead p~otector apron over his 10wee abdomen, he did not think theee was any peoolem. Ms. Gallagher admitted that the X-ray room dooe would be closed when a patient is baing seen by the 4 X-ray technologist. The grievoe denied slinging the lead apron onto the pacient, and explained that he usually allows the patient to place it on themselves. In ceoss-exarnination, Mrs. Gallaghee ..as as'~ed whether she recalled the grlevor telling her that the eeason he aSKed the patient B.w. to remove his shoes in the hall was because he was bringing another pat lent into the X-ray room. Mrs. Gallagher could not ~ecall the grievo~ having said that. She maintained that if that .as the rationale adopted by the grievor, it was discourteous to patient B.w. be~ause it would talCe a very short time to finish tying up his shoes and it is safee for the patient to walK with laced-up shoes rathee than unlaced'shoes. Mr. Rooe~ts was also p~esent ac the meetlng of Octooer 4th with the grlevor. He referred to his notes made at the meeting to eefresh his memory. He testified that the geievor aoknowledged that the patlent was aSKed to remove his jeans in the X-ray room and the gelevoe indicated he probably did not give the patient a gown. In respect to tne lead peotector apron, the grievor indicated he could not remember, but he usually glves the patient the peotector o~ shlelding to put on themselves. A disciplina~y meeting in respect to this inoident was held with the g~ievo~ on October 10th at .nich Mrs. Gallagher was present, but not Mr. Roberts. Mrs. Gallagher testified in Chief and in cross examination that the g~ievor at this meeting admitted that he probably did not give the patient a gown; he denied navlng slung the lead peotectoe apron upon tne patient. In chief, she indicated that the grievor said that it was not t~U9 that the patient was asked to finish dressing in the hall. The Board accepcs that the ElnployeJ:" bears theoughout the bUt"den of establishing just cause for imposing discipline upon the grievoe. This 5 bUt"den extends to proving the existence of the facts of an incident whlch would warrant discipline and to justification of the quantun of penalty imposed. We further accept that in deciding Ylhether that burden has been met, this Board must not malCe ceitical findlngs of fact upon disputed issues by eelying upon evidence which has no cogency in law, such as neaesay evidence. Howe"er, that does not mean that within the context of the evidence as a whole, there <!lay noc be instances where an onus of credible explanation may fall upon the geievor to explain the reasons foe oe the circumstances of hls conduct, paeticularly where such ~easons or ci~cumstances are ~elied upon as a complete defence to discipline or to mitigate the penalty. The oVe~all bUt"den of peoof rests upon the Employer throughout in a discipline case, out where the facts upon which the grlevoe seeks to rely for the pu.rpose of defence to discipline oe mitigation of penalty lie pecullarly withln his knowledge, an onus of crediole explanation pertaining to those facts may aclse within the context of the case. Having said this, the Board concludes that in respect to the,B.w. incident, the cogent evidence of what transpirad in the X-cay room is limited to the evidence of Mr. Billsman's admissions as eelated by Mrs. Gallagher and Mr. Roberts. We therefoee find that the patient B.W. Ylas asked to remove his je&~ in tne X-ray room and that he was not gi"en a hospital gown. We find Chat the allegatlons that the gelevor slung the lead protector ap~on upon the pat:ient so heavily so as to cause pain is not estaolished. We also flnd that it is not establisned that the patient was required to finlsh dressing (ie. by lacing up his shoes) in the hallway. 6 M~s. Gallagher testified that it has been hospital policy since 1933 that all out-patients, such as patient B.W., cnange in the Diagnostic Imaging Department and the peocedure is that hospital gowns ~lll be peovided by the technologist for all patients required 'co remove clothlng. On the day shlft, she sald that hospital volunteers assist in seelng that patients are issued a hospital gown and slippers. It was established that the grlevoe has always work~d tne night shlft when he is the only X-ray teChnologist woeKing in the Department duelng those houes. rne sup:rvisory personnel work only during the daytime houes. At the relevant time of the g~levance, it was established theough Mes. Gallagher chat the hospital policies weee Kept in a manual in Me. Roberts' office. During the hours the grievor woeked, Mr. Roberts' office would be locked. The Association pointed out that the pat lent was at all times clothed except for his jeans and shoes, and the lead protectoe apron would cover his lower abdomen. Therefore, the Association argued thaG theee was no-basis upon which to conclude that the patient was uncomfortable or that his dignlty or modesty were oompromlsed. ~thermore, the Association contended that since the policy concerning the provision of hospltal gowns was Kept in Mr. Roberts' lOCKed office dU("ing the hours the grievor has always worKed and sinoe this policy ~as not provided to the grievor at any time, theee is no proof that the grievor Kn~W or ought to have ~o~n chat patient B.W. should have been given a gown. The Boaed concludes that an employee with t~n yeaes of servioe in the , hospital setting such as the grievoe, ougnt to be a.are that the customary procedure is to provide a go~n to a patient, particulaely when the patient's oute~~ear, such as pants, ace removed. Although the grievor has worKed 7 alone with considerable autonomy on the night shift, we have no explanation proffered from him to explaln why he chose not to provide the patient with a gown, as the grievor chose not to testify. That the policy manual ..as not readily available does not necessarily establish that the grievor did not Know that gowns should be provided. Mrs. Gallagher testified that the gownlng procedure assists ln putting the patient at ease by respecting the patieht's modesty and dignity. The Board concludes that the grievor's failure to provide a gown to the patient B.~. was discourteous and not in compliance with the standard p~ocedure of which the grievoe should have oeen aware. We theeefore turn to tne issue of the propriety of the penalty. Mrs. Gallagher testified that the grlevor .as given a veroal warning in July, 1989 concerning discourteous conduct ln eespect to two patients. The basis for the Hospital imposing a written waenlng on October 10th included allegations concerning dropplng the lead protector apeon on the patient and requiring the patient to put on his shoes in the hall..ay. We have concluded that these allegacions we~e not established upon cogent .evidence at the hearing. Accordingly, the Board finds that a veebal warning in respect to this incident would be more appeopriate. The Board fuether directs that the letter of October 10tn, 19.39, from Mrs. Gallaghee to the grievo~, Mrs. Gallagher's notes of a conve~sation with the patlent's motner, and the letter dated October 1, 1989 from the patient's motner to Mrs. Gallagher, be removed from the grlevor's file. Although the Board was adVised that the grievoe had been issued a veroal warning in July, 19.39 concernlng discourteous conduct co two pacients, since Key allegacions fo~ming the basls for the Hospital's assessment of penalty fo~ the incident 8 on September 28th in ~espect to patient B.w. were not established, a greatee penalty than a veroal waening ought not to be sustained. The grievance ln respect to this incident is therefoee allowed in pact, 2. Grievance Cl~ Call-Back. Pav for Fact-Find.ing Meeting of October 4th, 1939 The g~ievor shares his position with another X-ray Technologist. He works alte~nate weeks of t.o shifts or three shifcs pee week. During the time that he must work his shifts, he stays at a boarding house in Ottawa. His residence is in Cornwall fr~n whlch he comm~tes to Ottawa to work his set of shifts. Mrs. Gallaghe~ aCKno.ledged that a fact-finding meetlng which she arranged with the grievor, hls Association representative, and'Mr. Roberts on OctOber 4th fell on the g~levor's day off. He was not scheduled to .oe~ again until October 10th. Mrs. Gallagner aCknOwledged that she had checKed the grievor's schedule prior to calling the meeting and that she had tried to ,reach him at hls boa~ding house in Ottawa on October 3rd. When pressed in cross-examination about WhY the meeting could not wait until the grievor's next shift, Mrs. Gallagher explained that it was a matter of urgency to conduct the investigatlon concernlng the lncident with pat lent B.W. and the second incid~mt on October 2nd, so the Hospital could respond to the complaint of t3. vi. 's mother, and to the Elneegency Department concernlng patient D.P.. M.rs. Gallagner added that based on past dealings 9 with the grievor, she Kne'. the g~ievor to be forgetful. Therefoe,e she wanted to gather tne infoemation conceening the first two incidents while recollection of the events would be fresh. Mrs. Gallagh:r fuether acknowledged that she could not eecall any other employae who had been called in to the Hospital fo~ a fact-finding oe disclplinaey meetlng on a day off. Tne ~ssociation aegued that the purpose of call-back provisions is to recompense an employee for the inconvenience and cost of being eequired by the employee to return to .or~ at a time that is outside and not contiguous with his o~ her regular wo~king hours. The addltional expense of the peemLwn serves as .ell to detee a'1 employer feom ~equiring such woe~ ~'1less it ls wareantad by the lmpoetance or uegency of the woe,{. In suppoet of h,=r. position, counsel eefereed the Board to several cases which review the jurisp~udence on this point: Re County of Kent and Ontaeio ?uolic Seevice Employees' Union (1932), 8 L.A.C. (3d) 133 (Swinton); Re Hydro-Electr.ic Commlssion of the Town of Mississau~a and I.8.g.N., Gocal 536 (1915), B L.A.C. (2d) 158 (ferguson); R: OntaeLo Hydro and OntarLo Allied ConsteuctLon Trades Council and I.U.a.g., Local 795 (1984), 15 L.A.C. (3d) 207 (O.G.R.8.) and Ke City of Toronto and C.U.P.g., Gocal 79, (1985), 12 G.A.C. (3d) 252 (P.C. Picher). All of the cases arciculate the puepose of the call-bac~ provisions in the mannee argu.ed b'l tn: ~ssocLatiO<1. Howevee none of the cases disposes of the paeticular ql.lestion before us. The issue eaised before us is whethee the call-back. premium applies co a meeting called 0'1 the employer to investigace an incident involvlng an emplo'1ee which illa'1 t:ad to discipline being imposed upon the said employee. In such cirClJ;nst8.!lc,='3, can it be said that the employee has been called bac~ to .wor,,'? Th:ee is no 10 qU2stion on the facts of this case that the maeting ~as at the behest of the HospLtal; otherwise, che grievoe would not have eepoet~d to wor~ until hLs nexc sCheduled shLft on OctOCee 10ch. furtneemore, there ~as consideeable inconvenience entailed for the geievoe i~ having to comuut= the 1.5 houe d~iva to Otcawa fro'n Corn.aLl an.d back.. The quest Lon in chis case is whether the call-oack. premLl.Lu should apply when the grievor does not actually perform work, but is ee~uired to attend at the woe~ place for a fact-finding meeting aeLsing out of alle::;ations of misconduct beought against him. [n none of the cas;as cited to this Board, did the grievor not perforrn duties and responsibilities assoclated ~ith theie posLeion. AetLcla 22.05 includes a minim~n guaca~cee oF. three houes' pay in the avent that the worK required to be done can be perfoemed in less than that tlme. Thus entitlement to call-back preml~u does not depend on the duration of t02 ~oek required to be peefoemed. However, the language of ~ticle 22.05 stLpulates that the employee is "called in to .or,,- outside rer regulat"lf scheduled noues ... she shall eeceive tine and one-half ... foe all houes worKed ~ith a inini'num guaeantee of three houes' pay". Tne ~ticle goes on to provide that the miniJli.Lll guarant,ee does not apply if the theee hour peeiod overlaps or excends into hee regularly sCheduled shift. The Baaed concludes that the languag:e chosen bf ene paceLe" ,nanifest.5 an Lntentlon to have call-baCK premi~n apply in circ~nstances ~hen the employee is called into work and perfoems ~ork outsLde hee regulae .0eKLng' hours. Thus, where the emploY.'le is called-in to attend a ineeting, W'n,~eeLn work-r,elated matt-ees ae,'l oeLng investigatied, out woe" is not perfoemed, the prernlum would not apply. rhat Ls not to say t:~ac employees, such as the 11 p~ofessionals in this case, are not resp~~siDl~ foe the quality of the wor~ they perfoem. Indeed, it .as cleae from th,e evidence ln tnis case that the Hospital expects Radiation Technologists to monltor the quality and accuea~y of theie '.ork. Ho.ever, ln tne classic call-bacil: sicuacion, the decision to requir.:.oeil: to De peefor!ned outside regulaely sCheduled hours, is the employer's. rhe pr-e;nium s,er,r.es to discoueage the employee from puteing an employee to the inconvenienc," of c-3.ll-ba;i{ 'iithO'le Crle eX:C:"3 cost beL~g justified by ehe urgency oe the importance of Che woe~. In the instant case, the employer's lnvestigacion is teiggered by the occueeence of an incident in which the employ:ee is alleged to ha!Je oeeached the policLes a'1d proceduees applicable to the perfoe;nance of his joo e<esponsibilities. It is in eveeyone I s interest that Che peet inant informat ion conceming such allegations be gatnered expeditiously, whilst recollections are still feesn. On the facts of chis case, the paeticulae disincentive of the Call-baCk pt'erniu,m would be counteepeod\l!cti",e to peompt and thoeough in!Jestigation oy the Hospital of matters reL3.ting to ,misconduct a'ld ehe lmposition of discipline. In 8eown and Beatty, Canadian Labour ~oitration, 3rd ed. (1990) para 3:3410 at p.8-81, the following ob3er!Jations at':e made as the applicaoilicy of call-baCK p~emiLlrn to -:::iec:rlmstanc,es .here peioe ,niscondu:::t disentitl",s the employee from wor~ing: Depending upon tn.: language of tn", call-in provlsion, &~ employe.: may also be eequieed to satisfy ceetain other oondicioo'5 in addieiCYl to ha!Jing been incon"enlenced by an addicional trip to .ori{ in oeder to claim the oenefit ... There is also a consensus among aroit,atoes thae &'1 employee who eeports foe .0eK and is ai"Lsed thac he is being suspended at the start of his shift for some pase 12 misconduct would not oe entitled to call-in pay. Assuuing this to have been the first reasonaole opportunity for the employer to so advise the employee, arbitrators have stated 'that such persons could not be said to have reported foe worlC where none is availaole. 'These aroitrators reasoned that, in SUCh circuust&~ces, wor~ is availaole and that it ls simply by vietuc of some peioe misconduct that the employee is not entitled to do it. Cited in support of tnat statement of principle are the cases Re Sunrvpe Products Gtd. :19:33) 4 L.A.C. (4th) 62 (Chert~o~), Steel Co. of Canada Ltd. (1971) 25 L.A.C. 525 (JOhnston), cited with appeoval in TnQnas Built Buses of Canada Gcd. (1930) 27 L.A.C. :2d) 4J9 (Weatheeill). 'rhese cases address a situation Where call-in is claimed for reporting to worlC for a snlft Which is not .orked oy eeason of the imposition of a suspension. In the lnstant case, call-oack premium is claimed for reportlng to the ~orkplace to attend an invescigative meeting pertainlng to allegatlons of misconduct against the clai,nant. Parity of reasonin!5 dictates that the sane resulc should flow. The facts indicate' that the ihvestigacive meeting was called in oeder to Z,:,L'JW Che Hospital to respond promptly to the complaint concerning patient S.W. and the incidehc respecting pat lent D.P. of Occooe~ 2, 1939. The investigative meeting would not have been required oy the Hospital out foe allegacions of misconduct aeising ln respect to the grievor. As noted at p.351 of the case, Re U.S.W., Local 5250, and Steel Co. of Canada Ltd. (1971) 23 G.A.C. 325 (Johnston) the standa~d of just cause for discipline imposed upon the Hospital by Articles 3.01(0) and 3.05 requires the Hospital to ascertain the facts underlylng allegations of misconducc and to levy a sanction, if war~anted, in a reasonaoly expeditious manner. The Board theeefoee concludes that the call-baCK p~emiuu is not appliCable to the grievo~'s 13 attendance at th-a disciplinaey inHstigat iv~ :na,:tin:; held on OocO:)ee 4th, 1939. As fu~thee suppoet for this conclusion, the Boa~d notes that ln Articles 7.06 &~d 7.09 the pa~ti~s have sp~cifically addeessej thos~ sicuations in 'Ilhlch ti,na sp~nc on ;natt~rs whi'~h pertain to th'e administeatlon of th~ Goll'ect1ve agee<e;n=nt is compensaole foe duly s.el~,~t;ed emplof~'e r'epeesencaciv~s. [n the aos~nce of SUCh a peovision speak~ng to attendance ac a discipl1naey investigativ: m~'eting, a~d given tn: puepose of th: call-bac~ premi~n, to~ Boaed finds tnat such an att~ndanc? ought not to be chaeacterized as .oe& for th~ purpos"s of tn~ application of the peemi~n. Considering the obj:ctive s~ev~d oy th: peovision, togetoee with toe language sel:oted by the pa~ti?s in ~ticle 22.05, the Boaed finds that the call-bac~ premium is inapplicable to th? fact-finding m?eting of Octooee 4, 1939. Thus, the grievoe's clalm to call-back premium in eespect to hls attenda.'1c: at th? Hospital for tn: fact-finding meeting on OctOb~r 4th 1s denied. 3. The D.P. Incident - October 2, _1909 The grlevor was suspended for on: daf 00 Octobee 11th foe having moved a patlent froin an 'I.-cay str~t;;'1"e to tIP- X-Cd! table at appeoxinately 5:00 p.m. and again at 7:00 p.m. to i;~e X-cays of the pacient's feactueed eight f~mur, s&ull, chest, and cervi<Cal spin: eesp=ctiv>=Ly. rh'e lett?~ of discipllne states as fOllo.s: 14 rhe Hospital has co;npletad its iov,;stigatior'l of the incident whlch occurred on October 2, 1939 iovolving a patient, Me. P. You ,noved trlis paCi,enc, .ho had iOuLtiple injllries including ar'l oOvious feactured femur, twice feo~ a x-ray stretchee to the x-ray table. As you kno. the steatchee is designed to facilitate the t8^ing of eadiographs .ichout moving the patient. Given the natllr,; of tile patlent's injueies, SLJ;;h a mov,e is dan3;eous and pllts tne patient at unr'lecessaey eis~. Moving,a patient .ith such a feacture runs con teary to basic x-ray tecnnology principles and is a beeach of YOllr peofessionaL responsioilities and standards. 'lOll have been disclpLLned in th,,, past foe your actions with patients. In July you received a verbal warning and in Octooee a weitten warning eelat;;d to youe conduct to.ards patients a~d your level of peof;ssionalisn. In vlew of this most recent incident a disciplinaey action of a one day slls;>ension on October 11, '1939 '.ill be issued. Should any further incidents arise in the fUCllre, strongee discipllnary action will be ta~en. (Letcer expurgaced as to full nacne ot pacient to peotect pacient confidenciaLity) Blll Davis is a eegistered nurse .ho woe~ed the evening snifc in the Emarg;ncy Departillent on Octobi;!r 2nd and who attend,;d llpon thi;! patient D.P.. rIe testified that the patient was teanspoete1 int:o t:he E,neegencf D<"paet:,nent feo:n the amoulanci;! on a bac~board, with a cervical collar applied, nis le3s steapped togethee and a yellow plastic splint: applied to the rignt leg. Under the supervisi01 of Dr. Stewart, Me. Davis said that the patienc was moved from che feactllre board onto the X-cay steetchee &~d the splint steaps were cut so that the feactured eigne leg cOllld oe exanlned and abduct"d to align the 'oones. The eecord of teeat,nent completed in th:e Energency Depaetm:ent indicated that the patient had suffeead multiple injllries to his 15 s~ull, chest and eight femur. X-rays ware oeder~d for these areas. rha pat;ient had been teansf.~rred to an X-ray "te,~t:)iP-e whLch Ls glass-topped and spe:)ially designed to acco'll'nodac~ ;{-ray ~assett;es so that the X-rays c&~ b~ tak~n .Lcnout tran"feeeing the pati~nt to the X-~ay taole. ,'Ie. Davis tra~"pocl;~d the patient to th~ X-ray depart;:n,enc on tne X-ray stretchae. He described the patLant as ,no&~ing a~d sceeaning "ita pain tht"Oughout the e;{alJlina~ Lo.:1. L'l ti1a Eln:ergen:)y D.apaetl~.:1.t and dueing tt:ansit to X-cay. He stated that the ~atL~nt had not been sedated although a tranquillizing gas .as oedered, but 'the pat;i~nt had reject;~d Lt;. ~r. Davls explained chat the rignc leg still lay in the yellOW splint, but since the feaccue.a .as high up on the leg in the upp~r ~nd of tr1e fernue, and si'l:),e tn.e steeps to the splint had be~n cut ln ti1e E::neegen~y Depart,nent, the l,eg .as essentially U!lsuppoet.~j. 1hlS, the poetion of the Leg belo. the fea,;ture site could flop aOOUG .ithill the splint, 1,1'1le,ss it ..eee held durlng any teansfer. Mr. Davis said that when h~ beought t~ patient to the X-cay depaetrnent, ne told the grievoe that X-cay" of the nead, :)hest and rLghc leg .ere eequie.ad. H.e 8.dd.ad that h,~ suggesti~d to the geievoe that the patient not; be moved. ilhe!l the geL,vor a~ed Me. Davis to help him teansfee Cne paCient to the X-ray cable, ~e. Davis eefus.ad s8.ying Chat he did~'t thinK Ch2 patient shOuld be mO'l,ed, &1d that he would not h~lp tne grLevoe to mOve the patient. Me. Davis th.en retum~d to the X-ray depart,neat. Throughout his testimony, i1r. Davis iadi~ated that it is part of basi~ nursing teaLaLng to know that a teauna vi~i;in with a fractuee of a loag bone like the fenue, shOuld not oe ,nov,ed lest fatty emooLL oe olood clots 02 eeleased, oe arl arc.ary s2veeed. He aCKno..le.:lged ho..ever that at Che ti'ne he 15 suggested to th~ geievoe Chae patient D.P. not be moved, it was con~~en about the pain of the pai;ient thai; was upp::ernosi; Ln his ,nir1d. He explaLr181 that if a fatty emoolus oe blood clot is eeleased a~d lodges in a patient's lungs, eespieacory dLsceess can ensue oe pneLlnonLa. Mes. Gallaghee added in hee testimony that if a fati;y e'noolus lodges in t:~e ocain, iC causes a stroi{e; Lf it lodg.es ir1 the heart, it can lead to a facal neart attac,{. The nursing notes feon the evening of Octoo2r 2nd peetaLnLr1g tQ paeL8r1C D.P. weee filed in evidence as ",ell. The chaeg.e nues,e, ',{"ndy Peatt, "ho signed the notes, was not calLed to.Cestif/. rhe notes indicate that the patient D.P. was sent twice to X-rayon that evening. He .ent to the X-cay Depaetment fLrst ac appeoxirnateLy 5:80 p.m. foe the first s~t of X-rays of hls rLght fe,nue, S{'lll and ch.est a~d then at approxLnately 7:00 p.m. foe X- cays of his cervical spine. rhe pai;ient Jlas assessed at 6:25 p.'n. by Dr. Gitcens and Ms. Peact indicates ther.e is "no n,,;ncion of LnnooiLLzaclon of the leg, so mor,:: enan LL~::Ly o'lOC done". ,'1r. Davis "as sufficLencl/ conceened .hen he learned thai; pat Lent D.P. had been moved in the X-raf department by the grievoe, thac he '.eoCe a note on Octooee ,::Cnd to :4". Peace. That note was idenCified a'1d filed; ic reads as follows: This is to as" YO'l to loo" into .ny ,sid Bi L Ls,u3f1 the XRaf t.eci1nL~ian 0(1 ,'1onday evening at appeoxLuately 1180 had to 'nOve a paC Lane wLth an 0t3VDU3 oeo"en fe:uue, unstaole. [cefused to help him move Che paci~nC wno .as ceyLng "itn pain and Sha{ing NLth shOCK. 30 he' rnoved hiin off Che Xeaf si;reConee on co tneie macnine. when Lisa L. went co CheCK on tne patient at approximately 1720 She helped pull the inatteess baCK onto tne Xray str,,;echee. [n cross-examinatLon, Me. DavLs admitted tnaC upon eh"; patient's eetuen co the Emeegencf DepaeC,nent fcom X-raf the patient was noc ln any woese 17 condiclon, noc in any moe.:! pain, nor in a different positlon. He ac~owledged that the pacienc .as conscious a~d neith.:!r th~ patient; noe any membee of his family >loiced a~y co,apLain~ about; o~Lng mO>l,ed Ln en,," X-ray Department. At the sam~ ~eet;Lng on ac~ooee 4t;h that; she Ln>lestLgated the incident on Septe~bee 23th, 1339 .itn patlent a.J., Mes. Gallagher ~uestioned tr1~ gri.ellor about; .hat teanspieed ",ita patient D.?. .'1rs. JaLLagn,er ,nadc not.~,'5 of this inteNie", and of the grievoe' 5 eespons'~s &~d sne eeferred to those notes to e.:!feesh hee me~oey. \ih",n as;ced '.hethee he mOiled the patierlt witn a fractueed unsupported femur onto the X-ray taole, th.e geLevoe eeplled "'{~s". ,{hen as>c,ej wh.:!t;nee he had assista~c,e Ln 'nolling the patient back to tne X-cay stret'cher, the grielloe eeplied "Yes - Go craine f1eaghee and t;h,~ ~atLent's fathee". 'Nhen as<ced wnecher h~ mOll,~d eh,e pat Lent feo;n the X-ray str,ec:)rl:ee to the X-cay tabLe approxL,nateLy two hOllrs lat",r to do the cervical spine X-rays, the gri.e'lOr eespoaded "fes". ,\ks. GaLLaghae then as,ced woetnee he had assi.stance co effd::;t tnLs .nOV(~, th:; g("i:~ljo(' C'~:3po(),d~j f1'{,~s, Paulall. rhis is in refeeence to Paula B('o.n, anot;he(' X-('af TecnnologLst .ho was wo('~Lr1g on thl~ sana shift: that; :~v~nir1g dOirl,g lnammograffis. rha g~i~vo::" ...;as then aSr<2:d .hethee he had assLsca~ce to transfee Che pat Lent baCK to the X-raf stratchac th\:;: s2co~d cLUe; th2 g("L~\loC' r.~pliej "fas .- r...,oC'rain..:: M2agh~(" and. the patient's father". ,ihen as,c.?d .hy he 'nolled the pacient, the geV~Ilor eesponded tnat hLs procedure .as faster, entailed less radiaclon foc the patient, and less mOllemenc for cne patient and fe",ee eepeats, because ene radiograph eesults weee moee accu('ate. 13 :1rs. Gallaghee aCkno.le.:lga.:l ti1at it Ls ;uoe~ tLn,"'-'~O,1.Sll;ai!13 for the X- eaf technologLst to t~e X-eafS llsLng the cassett2s a~d X-cay steetch3r t>~caus~ ch,~c.; is no GenCl~('i(lg Light, and moC'~ car~ Inl.lst b~ tal('~n to pO.5L1;Lot1 the cassettes properly. l'1rs. 3allagh,~e also a(:K.'1o.L"dged that th" [J8.i;La!1l; could be e)(pos~j to moe" eaJlatlon usin3 the (:ass,~tt~s with the X-ray stret(:hee than with the X-raf t3.ol" whL::h ls ,~~llLppej .ith a geid to s;::att~e the radiation. In respecc to th,:> gei~voe's ;::o,nfrent chat trre qU'3.1itJ of the fil;us is bettee using the X-eaf t'3.o1e, Mes. Gallagh"r indi(:'lted tnat verf aG:::ueate, high eillsolutLo!1 pV::t1lres aCe l,ess celtiC'll co sha. an obviolB fea(:ture of the femur, such as that sclffee.ed Of th~ p'lti~nc.rhis .ould b,~ a moee ilnpoetant factor if th,e suoj.ecc :natt,ee .ee':> a dlseas,e peocess, eathiee than tra~na. In eespect the gelevoe's connanc chat there would be no movement for the patient because the transfer .as so s,nooth, Mes. '}'lLLagner opposed that view, saying that th.ere would o,e less mOve'l8nt for the pat i.e!1C If no teansfers h3.d be,en .eff.eGt,,:>d. !1es. G'3.Llag!1.er questLO!1ed I'Iheth,ee the leg was unsuppoeted a~j th.e gri.evoe eesponded "Yes, out it had a yello. SpUrlt feom the amoulance aeol.lnd it". On Octooee 10th, 1939, Mes. Gallagnillr m.et .itn the geLillvor agaln, witn Mr. Roberts in atterldance, '3.3 ,.,ell as th" Asso.:::lation r.epresentacive. Th.e grievoe was advis.ed that a on,,-day sU:3p'e!1:;lon '.ouLd be l'npo3ed and seend Of the grievoe on Octooer 11th. The geiillvoe protested thdC it should b.e 0!1 Octobee 12th, which would be the last of a the2e day stine, rathee Chan in the middle. Th.e geLevor asked ,'1es. Gallaghee I'Ihf there \faS sucn a prool.e,n, sincill any transfee of tne pat ierlt had b,e~n s'no:)i;il and \fitho'lt 'Ilov,,:n.ent co the patienc. Mrs. Gallagh.ee aSKed him if he ~'1d.erstood the eanifL:::aclons of trarlsf.eering a trauma patLerlt .ich a long bone fra(:tllr.e. rhe grL.evoe 19 eespond~d "Yes". :-Ies. Gallagh,~r th~n as<C8d wh3.t ace tho? eaaifi,;aeiO'1s, and tho? grie\loe eepLLed ".{haC you saiJ - fatty emooL i". Tho? grievor then seated "Dc. rad~os said en" fiL'Ils :,[~r,~ ceally good". Mrs. Gallaghee cou~tee,~d "That ls not the issue". Mrs. Gallaghee tesCHi"d that sno? .as l,=ft .Lth the iiUpe',~ssion fro,a th,= la~"cing Chat Che ge-ielOe did not really a[J[Jee,:;iat,~ the seriousness of his misconduct. Latae on Octoo~e- 10th, 'Irs. GaLlaghee '!lat .ith 23.uLa Brown who confLe:aad thae she had assist,~d t:'le geievoe in teansfae-~ing pacient D.2. feom tha X-ray cable foe- X-rays of tne cervical- spine. Ms. 8eo.n dLd not testify at the nearing to desceib" tha ,aethod used Oy Che gria\loe- co effact tna teansfee. rhus we ace left with a nota weitt;~n by ?3.ula BrOwn to Mrs. Gallaghee conceenlng hac pae-t;i;)ipation in ch,~ ceansfee a'1d :'1rs. ~aLlaghee's notes of hee conv'ersatLons with 'Is. aro.n on October 4th and O:::tooee- 10th, 1939. Mrs. Gallaghee issued a veebal waening to Ms. 8e-o.n. ~aongst Qcnee assurances, :\1('s. Jall3.3h~e '1:)\;'=:i t;i'B.t "-Is. Beo.'1 eeql.l~st,~d tnat X-,.3.y staff be educati!d aoout th,~ peo()"(' peoc,"duea COfl,;,'l!ming X-cats of teauma \lictlms. :-Ie. Rooercs, who .as pe"d,~nt as '.eLl at tne fact-fLnding me,~t;ing of Octobee 4th, indicated thae t;h~ 1uestlofls po:;,';(j, arlJ a.nsw=es peo\lLdaJ. ;)f the gC"ielJot" ia raLal;ion to pa1;L8:rJ.i; O.p. A'~ra as .'1::"5. 3aLL3.gh=C' C',~Lac:=d In a3'C' testLnony. ,-Ir. Rob'l!ct5 cotllln~ntad that he did not acc-:pt che g,L:l\loe's rationale foc transfeceLng che patient to thi! X-ray table feon tha X-eal stretcher. Although the diagnoscic :[uality of X-cats is bett,~e [eo,n the X- ray tabli!, th'e natu(":~ of tn'l! fcactllee .as so O;)v'LO'lS that che 3.ccueacy and eesolution of tn,~ eadiogeaphilas not; as ceuciaL. fue the ernore , ,'1:'. Rol:J.~('ts disage,=,"d that tne pat Lent .ould b'e exposed to less eadiacion using th" X- eaf table v~rsus the X-ray steacchee. Mr. Robe('cs indLcat~i, as did Mes. 20 Gallagner, that the nu~o~r of eapaats eaquie2d depended upon the s~ill of the radiology teChnologist rath~c than upon .hethee th~ images weee talCen on tha stretchee oc tha taele. firJ.ally, ,'1r. Rocert.., dLsage~~d tiMt Ch~ tearJ.sfac of tha patLerJ.t entailed l,~ssno'le,n,~nt. 'E'lan .itn the assLsta.rJ.c~ of two othee p2C"SOrJ.S, ch:~ Hospii:al's concern was that Ch~ Leg .as LItlsuppoeted and theee foe'e if the move was effected, the flatiant's leg .ould ha;;,e to b., h;eLd as '''ell as-tha st~~tCt1~(" to d:f1S11Cc Ct1d.C Ll; s:;~f'~d in pl3.G:~ dllC'Ln.~ :;h,~ cC"aflsfar. rha persons used by the geLe'lor, aside from Paula crown, weee untrairJ.ed to a..,sist with such a InO'le or to undeesta~d the peofler allg~ment of the leg. ~~. Roberts emphasized tnat it .as pact of the oasi~ tcaLrJ.LrJ.g of a c~iiologf technologist to mo. that trau,na 'lictLllS should be eadiographed on the X- cay Stretcher, eathee tha'1 teansfeered to the K-eay table. ~r. Roberts identified an exceept feo,n a eecogrJ.ized standad c~x:t on anaton:rNhLco. supports this view. ~rs. 3allag~ee had ~efeered to this text and basic ceaining mat::!eial fro,n the san.~ school that the grie'loe had att,ended, ale,eii: many yaars prlor. rhe conceerJ. ex:pc2ssed by both ~es. 3allagner a~d ~r. Rooerts .as that the teansfers were unrl<ecessary A.rJ.d ,~rJ.cailed ge,~atee cis,;: of seeLous complications to tha patient and that tne grie;;oe had utilLz:~d uClteaLrJ.,ed oc insufficient numoers of personnel to assLst hlll. Foe Lnscance, on the secorJ.d transfee aeo~~d 7:CO p.m., the grievoe was assisted Oy &'1othee teained technologist, but ti1er.e .ould need to ce so'n.eone to help co stabilize Che leg, parcicularly gi'len the possU)Llitf of sflas.n, a~d anothee peeson to hold the steetchee in place. On other ceans[ers, th::! seceataef 1.0eraLne ~eagner and tne patienc's father assisted. Thase paople ..0uU rJ.ot 21 oa teained to do so, altnough . - Ls claar thac not a lot of trainlng is L~ t"equLred to hold th: 5GC"8:tch,~c tL:?;htly against eh: X-raf table. rhe grie\loe did not tastiff, noe did anyone eLs~ '.no'.as pC'\~;:5~~(ll; ir1 th.:= X-cay room when tha patient was teansferrad, sucn a3 Loreaine Maagh8e oe tn~ patient's fach8r. Mes. ~allaghee dLd not spea~ co th~ patient oe his fathae, although the patLant was stLll in hospLtal on Octooer 4th and 10th. Instead, Mrs. Gallagher ealied on the infoe~atLon she ootaLned feo~ the nurslng notes, Bill Davis, Paula Beo.n and the gei8voe. The Asso~iation invited the Board to vie~ a video of the grLevoe effa~ting the teansfee of a peeson feo~ &n X-ray stretchee to the X-ray table. rhe person ln the role of patient l'Ias not inj'leed Ln any .ay and the video does not show any peesonnel assLscLng the geiavoe Ln effecting cna transfer. In the lnt8eests of claeLtf &nd fairneSS, sinca tha video did not recreate exactly .hat occueeed .hen tn.e geLavor a[f.eccad tn,e teansfees- of patient D.P. on Octooae 2nd, '19:.39, counsel agce=d that cne vid'8o dLd poeteay accurately tne foLlo.ing: 1. the method of transfer Ln\lolving pull Lng sh.e8l;s <.n,i:=e the mattress .heee th~ pat Lent is eescing so as to cause the ~atceess to slide feon the X-eaf sc::",ecchee to the X- raf caoLe; 2. the X-raf steet~het" and X-ray taole we::"e on the sane plane on the nLght of O<;l;ooi:le 2n:i, 19:.39 and in th.e video; 3. the grievor .as posLcLon.=d in che fnLddle of l;he X-ea! taola and geaobed each cornae of the Sheat a~d pulled it to,.;ards him to ~ause trP. ,nattee,3s to ,nO\l~ to.ard hi:n feom the X-eaf steetchee to the X-eaf table. Next the geie\lor pulled the Upp,er end of the ,nateress usLng the sheet and then the lo.~e end usLng the sheet to be suee the ~atteess Has full! transfereed onto the X-cay taole. 22 In tne '11deo, tne pati~nt a:?p,~ae,~d to O~ teansf~ee,~d s;noothlf and without any appreciaola ,novement. Ho.e'lee, the person playing tne cola of pat Lent .as C.1nlnjue,ed and theca fore would not repr~senc the ,novem,ant oe cont~ol which a teau~a victim, su~h as patient D.P., wLCh a lon~ bone fractuee .ould 2xpeeLence oe exact. ~es. Galla~nee ac~noHledged that tne method of transfer~Lng patients using S~~dCS und~~ the matteess was Kno.n to hac as suLtable for the teansfee of patients Ln aoJo,ninal ;)aLn oe feaLl: pa~L~~Cs. She r8~ainej sCaadfasc in h~c vi?w, ~v~n wn2~ p~8ssad ia c~oss- examination, that this method was unaccaptabl-e to teansfer a teau~a victLn such as D.P. with a long oone fracture, pat"Gi,;:.1l3.rl/.he(l tna attandin~ nUt"se had recommended that the pat ient not oe ,nov",d and t(l3. pat Lent had been placed upon an K-raf stretchee in the &n;rgency Depaet,nent. 'Ie. Robeets .as of the sane vie'N, and steessed as well the peoblems of effecting such a transfer using unteained pe~sonneL to assist. r~e steetch~e should be~ld in place againsc the X-cay table and the beo~en leg should be suppoeted and kept aligned. Me. Robeets ~otified the Medical Dieectoe of the HospicaL of the incident and eeceLved the folLo.ing eesponse dat,ed Octooee .5, 1339: Significant fractuees of laege ma~eo.-~ontaLning oonas can lead to fat ernooLLsm e5p~ciaLLy if tne patL:ent is excessi'lely moved. rhat is a majoe conside("ation in S9Li(ltin~ B. r:C'a;i;:l(,~ or .-3. lar~.= oond. R-;ln~ln.J..~(,,: I?IRSr: do no har,n. Having conducted a thoeough ee'lie. of the evidence in connection Nith this incident the Boat"d .ould make the folloHin~ findings: 1) It is pact of tne basic teaining for eadLation tec~1010gLsts to ~no. that pacients .ith feactures of long bones such as the femur should 0': X-eay,d on the X- ~af steetchee and not be teansfeeeed. 2) The geievor ought co have known tnat the transf,e of pacient D.P. .as noc ad'lisable, on the follo.ing 23 ~eounds: th: natue~ of Gh: X-ray r~~uLsLtL<Y1 a~d injury \ia. fCaCGut'2 VdC'SUS dL52as8 ?CO'::>~S3); th2 eecom:nendatLo~ of 'Ie. D"lllis, tn~ ai:;t.~nding nues,:, :10t to ~ove tha patient and Mr. DavLs' e=fusaL to help tha gri.='l'oc .,.;h~n t;h~ g=-La'Jor Sllggd5l:..=d th.: tra!'ls.Ear; the patLenc had aleeaiy Qaen placed upon an X-ray steeGcher, aIld 'I..-rals sULi:;:~,)l,~ in quaiitf ~"lJ1 oe ta,,'~n. [nd~=d, !1es. GallagMe t=,stLELad that technologLsi:;s h-3:J,~ in3isi;~d that GCallUa \fici;L,:ns b; (,,'2cuC'rlc:d co Ene:C'g.=n~i foe tesns[=e to a~ X-raf steetchee so that they dO~'C halle to te:~nsf;ee tile pati:ent to th= X-cay table. ~inally, on tneee occasions, the ;!;rievor utiliz,:d assLsCanCs who ~ere ullteaL~ed to nelp in ceansferrLng ti'1e paCie~t D.P. oac~ and foech [rom the 'I..-eaf steatcnar co th= X-ray taole - nanely the patL~nt's [athae and ~oeeaine Meagner, a seceatary. 5) The patlant D.P. fortunacely did 'not suffer any haem [roln Cha tea~sf=es to and [com tn~ 'I..-eay streCchae foe the X-rays at 5:00 p.n. a~d ac 7:00 p.m. on Octooer 2, 1339. 4) There ar'~ seeLoils eLS'l:S a::lsocLac~d W'ith the 'llov,<uent of a teau>na paGient with a long bone feactura including th., nl.ease of fatty e'llOoU oe oLood clots oe che ::lelleeance of an artery, that; ca~ ::lerLouslf cOillpr~nise a patlenc's C'd:~O"':~C"Y. F\lrthcrmoc-::, th-:ra is a C'i:3'< enat ch.~ patLetlt 'nay go i~Co ::lpasn, .hi;)h ca.n cause difficulties in affactLng a smooth tr~~sfcr~ 5) The policies co~C~e~Lr1g t:1,e .nooLl L7.e~"lJ1J not bloG~ing hips foC' X-r:afs .ol~C'.~ put; in pLa~~.-= aEi;:-;C' Ch,~ Lr'l;)Ld~rl::; of" Octooer 2, 1939. NaLChee polLcy estaolish,s thac it was not pact of the oa::lic train Lng of an X-eal technologist to >moW' Ghac a Ge3.ulla victLn with a lo~::; oo~e fracGuee such as patienc D. P. should not be ,nollel feom tha X-cay sceet:;hee a",p,)',; La III .{'lo>11 ehe attending nue::le put tne gei.evoe on notic.e chat fueth.ee 'llO'l.ernenc of cha patL.ent 'Jlas not ad'lisabh. rfla e)(a:nLna~i()~ and aLL3;nment: of tna paGient ':3 injured l~g conducted ln tne Eineegency Dilpaet,n,"~c .as ;:>=rfoened by a pilysbLa'1 or u'~dee the supaevisioll of a ph{sLcian, teaineJ to deal \'lith SLl:;)h an injLtr'y and a.aee of the riso:s asso:::Lated W'ith such Inove,nant. rha ma~Lp<.llaG ion of the patient in the ~na~ge~;y 0,parener1G does not reliell= tha geiavor feon rasponsLoL Uti of a'loLdi~g furth.a~ .noven,=nG in tha X-ray Oapac l';~r1i; . 5) rn.ese rLs:~s ShOLlld have b,een knOJlCl by t:1e gei.,'.{oe and ...raighed ltlll;n th:= a.j\fi-:>~ of tn.~ at:i~~r1di(l~ l'luC'5,~ 1 L'"L...... Davis, not to 100lle t:1a patient. rne e,aqLlLsition foe X- cays to the S.\:ull, ch2:3G a~J eight lag of paGient D.P. 24 contained no insteuction from Dr. Stewaet oe &~f of the oth~e att~nding PhfsLci~~s, namely Dc. Gitt~ns and Dr. radeos, not to mo~~ the patient. Notwithstanding Chis, a e,~:3ponsio l,~ ,nat1l0.:le of 'th~ health cae~ t,ean att,anding upon paciant D.P. e~eecising due care in tne cLe<;'lnsc:3.'1ces,.;o'lld not hav.e mo~ad th~ patient. 'N" find tne gei,,,~oe made an .eeroe in jlldge'nent in deciding to :no".e til" patienc and that su;h ~eeoe oeeached the scandards of caee .hich a peop"rly teained X-cay technologist would ha"e pro~ided in the circunstanc.:ls. The geie~oe did not GesCiff and theeefoee .;.:l have no ceason to Joui)t; 1;f1~C th:::: gcL.~lJo(, ("-=caLI/ad t.h~ sa:n.3 basL~ tralning that oC:'1Cle 'f..-eaf tecnnologi3CS eeceive. rh~ justifications pro~ided Of th" gei""oe foe his actions wee-e eefuted bf the e~ldClnc,~ of his sUGl=Ni soes .3I1d ace found to be inad'equac,~. 7) rne grievoe o,~aes peinaey r,esponsiaility for deciding to transfee the paGient D.P. feom the X-raf stretchClr foe tne X-rafs to his s~ull, chest and eight leg as wClll as foe the X-rafS to the patient's cer."ical spine. The paeticlpation of Paula 8eown in assLsting on one occasion was noc as exc.:lnsiv" and .;as ac~owl.edgad Of nee to oe .rong in the circ<.1ustances. ThUS, tM Board finds that the fiospi~al .as not '3.:;cing L,npeOfl.erlf Ln distinguishLng ctle disciplinary p:~nalci,.e, L:npos,~d upoo. the grieJor a'1d'1s. Beo.n. 3) Although it '.;o'lld hav, been peef.erable to ha~e th~ dLeect .e'Jide:'!,c.e of .h3.C teansoir.2d 0,'1 the Geansf:.ee3 fro.n Ms. Brown or som,.e of the ocners .ho aasLst=d ti1,~ 3('1.8:voc, Ch:-;: .~vid~nc~ of ,VIe-s. Gallag(l,-=~) t;n.~ ai.nLssi.or1s of the geieJoe made to i1ee descrLoi:'!g the teansfee, and the evidence of Bill Davis ace suffLcient foe th.:l Boaed to piece togeth.:le whc3.G o,;cller.ed. r<1e video pe'~Glae,ed Of the griCl~or .as self-ser.~Lng a'1d did not accue3.tely r~..::c.~aG,~ what; OC":;llr'C',.:J on th2 ~"-~:'1L:13 of J:~C6)~c 2nd in all the salLent detalls. Th.e Boaed finds that the 8.npLo'fcC" 0(1 t.~'1d ~vLd~r1;~ .-3.jd:l,;~d -~.>tq'.)LL:3h::d gtOUr1ds for- dLscLpline. [f Ghe geie~or wisned the Boaed to fL~j chat th,.e CO\leS,~ of .eJ,~nts d,.esceLbad was factually inaccueat,e or thac ti1.'~ee wee,.e otheenlti8;atlng factoes pertainin5 to the teaining of th~ gei,.eJoe oe the polici.es of the fiospital, ch=ee was an onus of ~xpl@"~tion .;hich fell upon th~ 6eLeJoe o~ suCh mattees, althougn the fiospital ~.:lr.caLnlf aeaes che oJ.erall ourden to =stablLs:~ mLs--;onduct and just iff the penaltf imposed of a on'~ da.f sllSp:ension. ;,- --:I Based on th~ for~~olng flndings, we conclud~ tnat th~ Hospital has estaolished .s;eounds foe the i,aposition of di,5.~ipLLne ill eesp,ect to che gei~I/or's te3flsfer" of patiellt; D.? from th~ X-r:af scret;~:~er on the u~nillg of October: 2, 1339. The Association submicc,ed that since tne penaLci,es foe the 3.ept,e,ao,ee 23Ch, 1989 incid~nt wiCh patient B.w. and foe Ch,e OctoO-~r 2nd, 1939 incident .iti1 pacient D.? wer'e impos,ed OIl tile sarna dat.e, Oe::tooer 1,Oth, the . disoipline could noc be peo::;r:,essil/.e arl.i "ee'n its eeil';l.Oilitacil/e puepo"e oecause the griel/or had no oppor'tullitf to leam fro,a til~ penaltf i,m[)osed. with eespect to t;~e B:il. incident. \{,e reje-ct tha,t argLlin~nt. rne ti:nln.s; of che irnpo'3itio~ of tne penalti,e5 .as an ar:tefa~t of th~ peoximity of the two instances of miscolldue::c in the context of the gelel/oe's unusual sciledule of worh::ing hours. The nature of tne miscondll:,;c.8.'5 '~'lic.e di ffer:ent in each episode. 'ilhLle peogr:essil/e discipline should s~rve co ooerect ,aiS<"<9llduGt, it also seeves c'1e purposes of pl.l(llsh:nent 'l.nd detereence. [ndeed, from tile e"id~n~~ of Mes. GaLlagner:, ic .as app'l.e~nc that lest tn,~r-= be any furt;h~c lnisapp('~~h.='1sLO(l .::XU0r15SC X-tay t;:-=Ch.doLogL:5ts a:5 to Ci1.::: peopee peocedl.lee foe nandlin.s; paci~nts .iCh long bone feactue:es, an in- s,et"\Ti~,e was latee held. on till" copL,; and the poLLcL.e;5 concemLng the rnooiliz~r and tne bloc:~i'lg of hLps .er:e [,lr'o,a'lL.:;aced 011 November 7, 1990. "tie t~e thes~ actions as an illdicatLOIl of now seeiously the HospitaL vLe,~d tne nacuee of the grievoe' s misco,~dl.lct on J<)tober 2, 1.139. 'tie heaed no HLd.enc~ fro,a och=(' X-ca.! tachn0LogLst.:3 4'oc;,c,i.ng in t:1-= grLeJocf s d~p8.C't:n::nc to suggest that the griel/oe's d?-clsion to teansf~r' O.? ill tile circumstances he did was acceptaole and appeol/ed or condoned Of tne Hospic'l.L. ?' ,0 ~~th~r, tQ~ed is a su~estiQl in the ~videnca of Me. Rooeets that the grievoe .as not accustoilled to attendin:?; Hospical in-s~Ni~~ peogramrnes foe 'f.-raf technologists. 8-ivan that the gelcHor has .or",d Vl e,~laCiv, isolation on the nighc shift ovee en; pr:~vious tan y,=ae,s, \'1e can onll sp:~ctllai;= th~t he had Losi; tou'~~ wiCh current sta'1daeds of care and uSllal peocedue,es in h,andling CeaU1l3. "L,~t i'n:3 sucrl as O.? i:l cne X:-ray Dep,3.et,nenc. In anf ennt, we do not find thac th8 t Ln in~ 0 r i;r],~ i'npos it ion 0 f t.~; p,en'3.lI:ies on the facts of this cas,~ sonehow consteain.3 the HospLcal from te;:3,ti:1@; th,e 'llatc.er as culpa()l,~ or chat it C:3,n:1ot cO:1sLdee tnis incid,ent in conj~ction with t~e 8.;. i:1cid=nt in assessing penalty. The Association r~feeeed us to a serl~s of cas~s wnLch aetlculaCe C~; tests to which an employer .ilL be put on aebiteal r~vL=w or the dLs~har5; of an ernploY'8:~ co;:- nOf'l-")1l1.9abl~ d2Eici..~(l~Y' Ln j00 p:=('fo(":nan.c~: R~ Ejic:" Cowell P~ivaCe Hbspica~..2'2:f f!s>..'?QiC:3,L 8nolof==S' (hLo:1, LocaL 180, (1932) .5 L.A.C. (jd) 229 (Hop~) at pp.2jj; Re HeaLth ~bou(" Rel:3,Cions Association of British Colurnbia_ (')3.'2':!-!.:~.2",i1:3.'!...tloS,)~_~:..L:~'2L~,?~,?_I;("ll:~tLon '" GeneeaL 'iloeo<:ees' Union, GOC:3,L 502, (1939) .5 G.A.C. (4th) 119 )lcPhiLLLps) at p.12:5-121; Re western Maeind Gt<1. and rearnst.=t"3 Unlon, [..OC3.l 551, (1933) 12 G. A.C. (3d) 250 (Albertini); Re North '{or,^- G=neeaL c!ospical and C.O.?~. , (1913) :5 L.A.C. (2d) 45 (Shiill~) ac p.40-49; Re 3elCish Columbia Hydeo :3,r1d OffLce a:1d Technlcal P.Jnplofees' Onion, l~o::al 513, (1934) '14 L.A.C. (3d) 59 (Ma:::Inc/re) at p.77; Re McK2LLar '}en~e?.U:io'2.il;aL 3/1d_C.U.p.~., (1;1.36) 24 L.A.C. (3d) 69 (Joyce) at p.1j-14. In tile inst:3,r1t cas~, th~ Emplo/,ee dLJ not treat C~~ geie'Joe's conduct as non-culpable, nor.as the penalty of discharge i1npo,sed in conscquenc~ of any of the inc idents put b~foe~ us for r~vie.. :}=neeallf Cnese cases ,haL 21 i'V ""' '0 '1 o r" (\, (f. Ol ..... ~ r- 'v X 'U IV '1 (T ..... l/I 'V ~ >:.. ~Q ..... ~ ,,, ~ (T & (T (T ;:i " '1 ," '" ;ll if< ~ () ~' '" '1 P " ;ll s:- o. 'v ;:.. (T o (T ;:; '" <..J. '" &' IV S l1> ~ (T <T o S o <; ((i '0 '" Co' r' IV ~ (I o '0 ~ ;ll (f, r' ;J ,. '1 '1 o , ..... (T ....', '" ..... r- ~ ..... (T ;0' ..... ~ n ..,' ,,, '1 ,,, ;ll ...... S o ,.., ;:; ..... (f. rj ",' (j" ;po l/I U, 8 ..... ;ll ,-,- ..... g '" '1 00 'v P- ~ '0 '-' ;J IC (f, (T ",' ,. <; ..... 'v .. to fir IT Cv <; IV ;J ..... ...., (T ;:; l1> lJtl '1 ..... ev <; o , (f, ::> o n '0 o 8 <; ro to ;J' ,,, '0 III (T ..... 'v ~ n ~ "" ~. ~ '1 ,. "'l ~ tv P. <1 o ;S tv ...... '0 ;:J ..... s 8 <; Iv n ~' cv '0 III (T ..... 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CD Cv ..... ;J o o " '" (ti .:> n' ..... ;:> ~ (v III ..., r- r' il< " g '1 (\, '0 o ") n 'v p. 51> 0>, Sl> " p. "' (T '0 -" ~ (T ;:;' ll> (T ?5 lD .g r- o '<; fv .., ..... (f. C" ;:; (T ..... \:{ r- 'v p. -" <>> !'-' (T ;S IV o ~' ill ..... '1 o r? (T ..,' ev ~ o ..... n .., l1> <T ..... o ;J o o ll> .. "" ;3i; .., o Ell iv Sl> o ..... (T iv Po ~ ,.,. (T ;J ll> '0 '0 .., o <. P> r- ;:; ..... IJJ (T ;S IV o IV IJJ (\) 1/, o ,.,. (T iv P. (T o s:- UJ ~ o (fJ ;:; P> .. I~J IV ;J I(Li h I: I;J IE I~ r-. ~ ill "'" 01 ~ -" j\) l~ ;p- O r-. f" P. ~ o o ;:; UJ ..... .,. IV " III o r- (v (i o p '0 r- ev X ..... (T '<< (T o o e- n III ..... ::> ;:; ,.,. IJJ '0 '1 o N, '" U, IJJ ....' 8 ll> ..... () ..., IV iJ, '" ::> n ..... ll> r- (f, ,..., ;J o ;J 'v o ~, IV X '0 'c ,l n P> (T ..... o ::> IJJ o 1-<. ll> ;:> <j<: .., ill '<, <T ,1< (, ;J' ;:> o r- () 1<4 ..... IJJ " .. ;> o ;y P> (f, .., ev (j fv ..... <. 'C I-L rv X " IV ;:> (f, ..... <; 'v (T " III ..... ~ ..... ;J ~- o ,.., ;0; o .. '" <; '" ..., ..... P " P' CO ..... ;J (fj " !!5 ~t " il> (j. ;v .. ". ill '1 ,,, p. ,. IV ...... ..... ;:, 0_ 0>, r" cr ;J (T ;J' 'v ~ '1 0' '1 P ~ (, '" o ~ fv l/I ll> .., (T ..... () s:- r- ill CT W Po ..... ;J n ;:; '" v' 'v !2 if, '" iv', il> ..14 cr ;S 'v "<. III ..., to P> '0 '0 r- ..... 'v iJ, (T o CT ;:> ,], ..... ill "' '" '" IJJ '1 III ..... l/I fv P. ..... ;J (T ;:>' o IJJ (\) '1 \l) r- ill n ,... o ;:> (f. P' ..... '0 o gs U to " ev ., p ..... ~ IT 'v "" ... I], 8- ;J o n p. ,... IJJ tG .., Hi ill '" ..... (T ~' (T ;:; l{; 'D ..., ..... ;J (, ..... "0 ,.... 'v v. IJJ (T ~ it .., p. (f, .. ..... <T ;:; (lJ p. '" .0 '" Sl> (T 'Ii ..... ;J l/I (T '1 '" o (T ..... 8 ~ Po 01) s:- ..... "" f'i ~ (j ,. G 'v r? o " IV ~ fv P '0 ,.... o '<, p 'v ;J <T (l ~ !5 ..... (l ill (T fv .. ,.,. (T ;:; <1 ;s I. '1 11< .g ..... '1 Cv "' .1< P Co. (T ;J' o v. fv UJ n ~ iJ, ill .., P. u, (T o S' '1 P s:- r- il' n ,. ..., IV (U l/I o ;J ll> 0- ..... 'v ~ "" (T '0 P> ,.., ,.., o 2. ~ o '0 '0 o '1 (T !5 ,... (T '<; '0 'v '1 0' '1 Q ~ (, fo (T o S \l) ,c (T " P' o IJJ ,v IJJ (T ~ Po P> .., p. (f, - (T o patient, chis erroe ought not to be teeaced as culpaole oe suoject to discipline. In suppoet of its pO?itlon, th~ Association e~feeeed us to the cases Re Sudouey-ilide Co.1lJm.l11L.::aGi.oB and U.S.W., (1333),33 L.A.C. (3d) .;!.23 (franks), a~d Re Boaed of School Trustees Di.sCri.ct No.. 57 (Prince Geoe~e) and United Brotheehood of Caepencees & Jolnees, Lo~al 2105, (1933) 54 G.A.C. (3d) 223 (DoeS2Y). In the Sudouey-'w_id,e ~~IJJlicati.o'ls case, the ooaed of arbLceaGion found that the geieJoe, an opeeatoe .ho nonltored se~u~ity alarms, follow.ed a standaed t"Llle for distlnguishi'lg false fC'o.u eeal alae,us, although it turned out that ~11~ alaem .as ee~l. Tne boaed concluded that despit,e the outco.n?, thee.e .as no. culpable miSC0nduct oe neglig,enGe on th? pare of the grievoe. In the Prince Geoege School Boaed case, the grieJor .as discipli'led for two accidents he had within two days of each othee caused by bac~ing hls truck into. a school OJ.eei1ang and inco. "1~ upeight Gern,enC cul'lert. Subsequently, the .nieeoes on the t~uc~s weee ch&~ed to impeo'le visibility and the culveet was mOJed. [n the past, the employer had imposed discipline only for culpaole misconduct and not foe the OGcueeen~e of da.uage to propeety. Even where fault oe caeelessness .as adnLtted, the boaed fO~1d that tne employee had normally issued a J.eroal admonition to pay Glosee attencLo'l. A.t. p.255, r'1r. Dot'sey cOrlHlents: DeiJees rnust continually exercise judge~nt responding to the cas" at h~d, the eMieoruent, .eath'ee conditions, chaea~teristics of the vehlcle and so forth. rher-e do O:~CL1(" L!'1 chis O.')cllpal;Lon, as in mas!:;, rnisadJe'ltuees that eesult fro<n eeeoes of jud:;e'u.ent that ace non-cuLpa,);.e an.d de no.t anount to neglig.e!lc.e ... Judge,ni'!ht inhee,ently has the eisk of erroe ..hich is not cae,eLe'5S, negligent oe otheNise culpaole and '.hich can eesult in rnisadventuee that may sometimes have seeious ~Or1S~::qL1..;l1C':::3. 'J/h~n such (~("C"OCd o~(;uc, t;h.e .fa~t; of tho:: conse~uence do~s not in itself giJe cause for Z;) discipLLn~ unless th~ea is a cleaely establLsned employer rula to that effect. This Board do:~s not disagr~~'..rith theS? stat:~mants in peinciple, out finds that tha [acts of the incid8nt o[ Octobee 2nd, 1939 ace distL~guishable as cuLpaole misconduct. In fact, the standard peoceduee WhiCh the gri8vor ought to haife ~nown feQu basic training and ought to haife followed given th~ nuesa's ad'lic,~, was to aifoU fu;:othae ,UOifa,lEnt to pat Lent D.? because of the medical eis.<s assoclated ..rlth movarn=nt of a f8,noeal feaccure. Thus, th~ natue~ o[ the eeeoe bf the grievor .as culpaole and distinguishaol8 frolu the soet adde~ssed in th.; cas,;s e,;Lied upon of the Assoclation. [ndeed, Me. Harnden eeferead us to th.~ cases St. ,'lacy's Hospital and G.D.S.W.G. (Borshell geievance), dated Maf 21, 19.36, unrepoeted, (Devlin) a~d Otta.;a Gan~ral Hospital a~d O.P.S.E.U., (MOhd Za&L grieifance) , dated FeOrll3.ef 1:5, 193,:3, uneepoet~d, (Devlin), in ""hich .,eroes in judgement .ere found to o.~ culpable and subject to di,scipLLne. - The Board thceeroe~ remains of the Vi8. chat the grlevor's conduct on the eifening of Oct~)er 2nd, 1939 in ceansfeeeing pacient D.? back and forth feom the X-ray stretcher to th~ X-eaf table foe t.o sets of X-cays at 5:00 p.m. and 7:00 p.m. vias culpable &~d affoeded to the Hospital grounds for discipline. fuethermore, the Board concludes that glifen the peioe incLde~t of Septemoee 23th &~d the v~eoal warnings eeceived Of the geieifoe in July, 19:39 conc,erning his bedside lUannee .ith p8.i:i~nts, 9.t'ld given the seeiousness of the nature of tne grieifor's mlscondw)t on Occooer 2nd, 1333, the Hospit8.l was not 8.cting unreasonably in imposing a one-daf suspension upon th.; grievor as a incatl:3 or ilnpC'~5SLr1g upon hiln the gca'lU::r wi.th ,.,hieh ch-= 30 Hospltal viewed his ,:;ondLlct. ThLlS the geie'I9..'1:.:e in nsp~:.:t to t!1is incident both as to cause foe disciplin.e and quantum of discipLLne is denied. 4. Incident 'illth patient C.S. on OctoOer 10, 1939 On Octob,ec 15th, 1939, an eighi:<een y,ea~ oU 'aale, ..ho ls a peofessional hoc"ey player, '.as admitted theoLlgh the Ea,eegency Department pees.ent ing with injLlries to his right shoLlldee and right eloo.. The ee.::;oed of teeae,aent indi,:;ates that X-rays weee eeqLlLsitio.~ed of 'these areas. The geievoe cadiogeaphed the patient's right eloo. a'ld left shoulder. The geievor maeked the X-ray of the left shoLlldee as being the eight shoLlldee. rhe letter of discipline in respe.::;t to this inCident eeads as follows: The HospLi;al h3.s cQ;npl,eted Lts Ln'I,~stL$ation of the incident which 00cueeed on Octobee 15, 1939 involving a - patient, Me. C.S. You weee to x-cay the right shoLlldeea~d eloo. of this oatient. Ho.avee, YOLl peo,:;eeded to taKe radiographs of his left ,side and ta:en place the in,:;oeeect anato:ni.~al ,naekees on the film. rhese are seriouS eeeors .hlch eun ,:;onteary to basi:.: ~-cay te,:;hnoiogy pelnciples. On July :5, 1'939 you e'ec.eiI8d a v,aebal waming relating to youe conduct towards Hospical patients a'1d on OctOber 10th a wrLtten .aening. You also eeceived on October 10th, a one day sLlspension for faillng to follow oasic x-ray technology peinciples. [n viaw of this most eec:ent incident, a discipLLnaey a,:;tion of a thee,e day suspenslon on Octooee 50, 31, and NOvembec 7 is issued. Should any further in,:;idencs arise in the fLlture, strongee disciplLnary a.::;tion will be ta~en. (Letter e;:puegat'ed as co patient's full na,ne to protect confidentiality) 51 when Mrs. Galla~hee i~vestLgated the matter .ith tne grievor, she as~ed hlm to write down his veesion of ~vents, whLch he did o~ Occobee 25ed. His ~esponse is as follows: On Oct. 15, 1339 a patient C.S. c~~e LnCo ou~ Department foe a X-~ay of his ~ighC elbO. and right shoulder. .tlhen the pat ie~C C3.n,~ L~Co th,~ roo,n [ as,\>ed him to place his sore elbow on the X-ray plate. He put his righc elbOw on the plaCe &~d I proceeded to X-cay it. [ th,~n as'l:ed hi,n .hich shouldee was soee and he said it W"~s his eLght shoul,l~e. [Chen p~o:;,e~ded to put the right shouldee maeo:,ee o~ tn,~ film and s'~c up the X-ray ,nachi~e foe the peopee e~posuee. [chen aso:ed him to put his soee snouldee on the X-raf plate. [then aSKed him to turn his shouldee inteenally and then centeeed the light ov.ee Ch2 should.ee h2 had given rne. [tooo: 3 l-rays of his Shouldee in different oositions. EaCh tLne I ;{-eaf2d hlm he gave me hLs L:ft snouldee foe posltioning and finally X-raying. COOking oac,," [ can not Ur1d,~esCand .hy the patient gave me his left shouldee to X-ray and saying nothing to ,ne about X-eaying the W"~ong shouldee on theee diffeeent occasions. After developin~ the films [ Ch2C:.ced to se.e if t~'1e eequisitlon eequest macched the films [ had ta'l:en. The "R." mark.ers on C:18 film coeeespond.ed to the re'lllest on the requisLtion foe a right elbow and right shouldee. Th2 ne~t moening you phoned ,ne and stated that there was a ~ix-up on Chis case. [cane into the Hospital eight away on lny day off to sceaighten out the matter. The requisitlon as~ed roc a right aloow and eighc shoulder. The films indicated I dld a right aloo. and eight shoulder. So,n,~one had pici(ed IIp a haart shado. on on2 of the rlght shoulder films indicating the left shouldee was x-rayed instead of the eLght snoulde~. I phoned the patient's coac~ and he seated that he couldn't rernembee '.hich shoulder was so~e. ne tnought C.S. was having teouble with botn shouldars. I then phoned C.S. 's eoo.ning hOuse and his landlady couldn't recall whi:;h shouldee .as soe,e but she W"ould 52 call C.S. at s~hool sad find out. When I called her ba~k she infoe,ned me Lt .as hLs eLght shouldee and that he was golng to Dr. Jltten's offLce cnat afternoon to gel: it ch,'~i<.ej Qll\;. I phon,ed Dc. Jitcens' office and informed him of the ;nLSCaKe. Dc. Jitt,,~ns said Chat Lf th,e shoulder had to be X-~ayed it would oe done at his clLni~. I phoned latee to confiem that C.S. did have his right shoulder X-~ayed ~t the Smyth Rd. clinic. Thac aftet"noon I pnon.ed ttH RLveesLde Hospital and spoi{e to Norill. I as"ed him to put a note Lnto the X-eaf fil,e of C.S. whi~h you had left out foe him. Tne noce stated that the left shoulder .as incoeeectly X-rayed and that che patlent had gone to Or. Gittens office and if need be th,e right shouldee .O'lU 0e X-eafed at his clinL~. Conclusion: To this day I can not understand why the patient gave me the wrong shouldee to X-ray. '''hf, aftee positLoning the left should tnree tLm,es, cenl;eeLng the posLtionil1g light ovee the left shouldee three ti,nes, a~d having the patient; internally ~otate his left shoulder c.Lce the [)atient; didn't say anfthing about me X-eaying the uninjlleed shoulder. This is the first tlone in approximately ten yeaes at the Riveeside thac it has happened to me and [ nope it '.ill oa the last. C'.\e:no expuegat;ed as to pat Lent's name to peotect confidentlalLty) The eeroe ~ame to light .hen a Phfsician reviewing the radiographs noticed a heart-shadow which .ould i~dLcate that it was not the eight shoulder as indLcated Of the arlatonL~al lIlar~er, but the left shoulder. Mt's. Gall~~er testified that if a eadiation technolo~Lst is faced with a discrepancy between the eequisition and the p~esenting proolem as desceibed Of the patient, the technologLst should fiest make enquiries of the Emergency Department physiclan to claeify the eequest .hila the patient is present befoee X-rays are taKen. If such cLaeificatLon cannot be oocained, Mrs. Gallaghet' testifLed that the radiologist Should X-ray the pact ordet'ed 33 in the requisil;ion and the area of con;:;~m and then fla,s th~ radiog~aphs with a note to h8e actention conceening the discrepancy. The X-rays taken should be revie.ed by the technologist oefore the pacient lea~2s. This tescLnony is substantially in accordance wieh tne Hospital policy conceming veeification of X-~ay requests: X-RAt' R8QUESTS ?Jl.LCi rhe tecnnologisc is responsible for ensueing that the aeea eequested to oe X-Rayed is eelat,2d to th2 hiscory and the atlatoni';al sid,e. If Chare is a disceepancy, tn2 technologisc will chaclC wlth a Radiologisc oe cne ffinaegancf physlcian. If no one ls avaiLaole to ;:;larify the anatomical area, ie: weise instead of hand X-Ray the part oedered, plus the aeea of conC2cn. rhe teChnologist is eesponsloLe for doubLe- chec~ing eequisitions to ensure Chat the infoemacion is coeeect and all anatonical aeeas to 02 X-Rayed ace included. Anf discrepancies are to oe ~eturned to the front office foe coeeection. Mes. Gallagner indicated thac this policy was ln effecc throughoue the relevant tiffie period and was reviewed, DUe not re~ised, in December, 1939. The Association conceded that the conduct of the grievor was culpable ln respect to thls incident out contends that a tht"ee day suspension on Octooer 30, 31, and November 7th was excesslve. Tht"ough cross-examination of Mrs. Gallagher, it is apparent that ereors such as this do occ~ with some regularity by X-ray technologists working on the day shift. If the error is not piCKed up and coreected by the technologist, lt is usuallf dlscoveeed d~ing the shift oy ~rs. Gallaghee, whose ~esponsioilities 54 include the quality assurance of radiographs t&~en each shift. Geneeally speaking, the error is brought to the attention of the technologist by ~rs. Gallagher and some counselling occu("s concerning the peoper procedure of verifylng requlsltlons and the accUt"acy of Che anatomical markers on the films talCen. This veebal counselling ls then confiemed L'1 writing. Naturally, if no further incident occurs, no further disciplinary action is taken. Mrs. Gallaghee dld not KnOW of an7 oCher radiation teChnologist who had received a suspension for X-raying an lncoreect bod7 part. Tne only other incident that came to light with eespect to the grievor X-raying an lncorrect oody part was the x-ray of the incorrect hip which occurred on January 21, 19:37. On that occasion, no disciplinary action was talCen other than a counselling letter. The only reason we allude to thls lncident is tnat the grievor suggests L~ hls wrltten response dated October 23rd that this is the first time he has committed such an erroe ln ten years. The evidence sho.s that the grlevor gave his full cooperatlon-to co~rectlng this error as soon as he .as made a'.are of it. In fact, the patient saw the sports medlcine specialist, Dr. Gittens, the next" day and had his right shoulde~ X-rayed at that clinic. Thus, the grievor's eeroes entailed no serious medlcal consequence for the patient. The grievor has been worKlng in relative isolation fo~ some time on the night shift and ooviously was not keeping current with the policies and standa~ds expected. That the Hospital was of the same view is confirmed oy the action taken subsequent17 of placing the grievoe on tile day shifc commencing his next see of Shifts after the suspension on November OCh. He was eequired to review the policy and procedures manual, the safety manual and to Submit his films foe review by Mrs. Gallagner each day for tne 35 following six weeKS. During this time frame, Mrs. Gallagher put ce~tain performance goals ih writing for the g~ievor whicn are as follows: to i~prove communication sKllls with pacients, staff and supervisor to improve ~owledge of policies and procedures withln the Department of Diagnostic I~aging to impeove ~o.ledge of safety standards wlthin the Department to eeview patient care as per the Department policies and the cole of the technologist In lignt of the short time feame that elapsed bet.een the incidents, the Hospital ooviously bec&~e alarmed as to the reliability of the grievo~'s work. rhe Hospltal apparently tOOK a s~newhat mechanical view thac since the g~levo~ had already received a one day suspension, the next step should be the imposition of a three day suspension. rlowever, given that this soet of error is of relatively com~on occurrence and is gene~ally teeated with greater lenlence, and glven the long seevice of the grievor who had been left to wor~ In relative isolation on the night shift, the Board ls of the view that a more just and equltable response to thls incident .ould have been the imposition of a one-day suspension, in the context of the p~ior record. The grievance on this matter is accordingly allowed in part through substitution of a one day suspension on Octooer 30th. The grievoe is accordingly entitled to be compensated for his losses occasioned on Octooee 31 and November " 1939. ~ 5. Call-BacK Pay Claimed for Octooer 27, 1989 DisciplinarV Meeting Mrs. Gallagher testified that she spolCe to the grlevor before he left for Corn~all on October 25th to arrange the dlsciplinary meeting in respeGt to the incident with patient C.S.. The g~ievoe indicated that he agreed to come in the next day at 11:00 a.m., although thls '.as to be a day of rest for hlm. This agreement is indicated oy the grievor's note on the ~eeting notice filed as Exhibit #30. Mes. Gallagher indicated that the meetlng could have been arranged at another time more convenient to the grie'Jor. Thus the meeting occurred at a time which was not at the sole behest of the employe~, but was mutually arranged. In any event, our reasoning on this issue concerning the language and p~oper application of Article 22.05 as outlined ln eespect to the claim for October 4th, applies to thls claim as well. The griev&'1ce in respect to call-back pay for the disciplinary meeting on Octobe~ 27th is dismissed accordingly. ~ o. Incident of January 11, 1990 Concernin2; Patient O.K. rhe grounds for discipline are set forth in the disciplinary letter dated Feb~uacy 3, 1990: I am writing to confirm our meeting held on thls date at 1300 hours to discuss an incidenc occuering on January 11, 1990 regarding a patient Ms. D.K.. The Hospltal's lnvescigation of this lncident has revealed that you x-rayed the sore shoulder (right-side shoulder) of a patient named Ms. D.K. and marked the 37 film anatomically correct. Aftee Ms. K. had left, you changed the marker on the film to indicate that the left-side shoulder had been x-rayed in ordec to coreespond with the requisicion, which had incor~ectly called for an x-ray of the left-side shoulder. It is a clear policy of the department and a basic SKill of x- ray technology training, that x-~ay technologists must verlfy information peovided on the requisltions with each patlent'before beginnlng their x-ray and to take the app~opriate action lf there is a discrepancy. You failed to complete such verification. rhis verification must be completad in ordee to ensure that the informatlon on the requisition is correct and to ensure the safety of the patient. In additlon, you compounded the erroe by changing the initial correct marKer (right- side shoulder) to the incorrect marKee (left-Side shoulder), not realizing whlch shoulder had in fact been x-rayed. These actions are totally unacceptable. On July 5, 1983 you ~eceived a verbal waening relatlng to yoUt" conduct towards patients and your level of professionalism, and on Octooer 10, 1989 a written warning. On October 10, 19:39 you were also given a one day suspension foe moving a patlent with an obvious fractUt"ed femUt" - an action cunning cont~ary to basic x-ray technology principles and in oreach of your professional responsibilities and standards. On October 27, 1939 you recelved a three day suspension for taking ~adiographs of the wrong side Shoulder and elow of a patient and then placing the incoerect anatomlcal marKer on the film. These are serlous eeroes whlch run contrary to basic x-ray technology peinciples. In vlew of the most recent incident, a disciplinary actlon of a three day suspension on February 12, 13 and 14, 1930 will be issued. Should any fQether incidents arise in the future, stronger disciplinary action will be taken. (Letter expurgated as to full name of patient to protect patient confidentiality) Mrs. Gallagner aSlCed the grievoe to write hee a memorandum setting forth his version of events and any explanation. Thls memo was filed before us: 30 On January 11, 1990 D.K. was brought to the x-ray depaetmenc on a steatcher along with an x-ray requisition that indicated that a left shoulder was inju~ed and that a left shoulder should be x-~ayed. When I x-rayed the patient I x-rayed the injured shoulde~ which happened to be the right shoulder and I placed a "right" marKee on my film. In sent the patient baclC to emeegency and the doc toe came over to read the films. ' ~t the end of my shift I .ent over my films of that evening and noticed that this paeticular ~equisition had aSKed fo~ a left shoulder to oe x-rayed and I had a right marker on my film indicating I had x-rayed the right shoulder. Since the patient had left and the doctor had gone home [ did not have a chance to cheCK it out .ith them. I ass~ned that I had made a mlstake with my marKee and changed it to colncida with the requisition which had the left shoulder balng injured. The raquisition had this er~oneous infornation on it three times. [t is attached. Eight days later I ~eceived your let tee lnfoemlng me that there is some questions about the anatomical martcers on the film. 'while looKing at D. K. 's x-rays I noticed that she was again x-eayed today and that hee eight shouldee was the one injured. [have compared the x-rays taKen today .ith the onas I tOOK eight days ago and they are identical. [had indeed x-rayed the right injueed shoulde~ eight days ago. ,[ should have stUctc to my martcer and not changed it ,to coincide ,wlth the mlstakes made ln the emergency department by Dr. Watt and the admittlng secretary. Had the casualty officer or the admittlng secretary not made a mistalCe ln ma~klng the left shouldee on the ~equlsition my original anatomical martcer would have remained untouched. I quite often find requisitions that coma from emergency with mistakes on them. [usually cor~ect them. ' (l'1emo expUt"gated as to patient's na.rna to protect confidentiallty) 3) This incident occurred wnlle the grievoe's films were still being reviewed on the day shift by M~s. Gallaghe~ followlng the night shift worked by the grievor. Only one month before, the gelevor had completed a stint of approximately slx weelCS of worlClng undee closer supervision on the day shift and with performance expectations clearly set and communlcated to hlm. The grievor had been required to review the policy and procedure manual and the safety manual. FUt"theemoee, this incident is similae to that <liCh respect to the patient C.S. and lnvolves a oreach of the policy on ve~ification of X-ray requisitions. Undoubtedly the errors made in the &nergency Departmenc on the requisition in this case would have been detected by the grievor if he had clarified the discrepancy between the patient's complaint and the requisition when the patient was present and before the X-rays weee taKen. Once the radiographs .ere taKen, the grlevoe would have detected the problem if he had checked the radiog~aph while the pat lent was still peesen~, rather than dolng so ac the end of the shift. In any event, the grie'lOe should have Known tnat it was incorrect to change the anatomical marker at the end of shift when the doc toe and patient had bocn left. In llght of the grievor's previous record, the steps talCen by the Hospital after the incident with patient C.S. to impeove the grievor's familiarity with performance expectations, and given the short lapse of time between the C.S. and D.K. incidents, which we find to be of a similar nature, we conclude that the Hospital was not acting unreasonably in imposlng a suspension of three days. Accordingly, the grievance in respect to this incident is denied. 40 Dated at Kingston, Jntaeio on the 'l.OrT\.l- day of August, 1991. ~: .J C.?::_j-----.J Elnrich Chair 'D I~<:'/=^\"\' A-PP~l1J Dt'lr'\'\ Robert Redford Hospital Nominee ~ /{ ~- -' Peter Seguin Ass icn Nominee 41 " , , PARTIAL DISSENTING OPINION OF P.R. SEGUIN IN THE MATTER OF AN ARBITRATION HEARING BETWEEN THE RIVERSIDE HOSPITAL OF OTTAWA AND THE ASSOCIATION OF ALLIED HEALTH PROFESSIONALS OF ONTARIO RE GRIEVANCES OF SID BILLSMAN --------------------------------------------------- ------------------------------------------------------ After reviewing the entirety of the award, I find that ! must partially dissent with respect to the Board's decision concerning the two grievances regarding Article 22.0p - Call-Back. On two separate occasions the Grievor was required by the hospital to attend a meeting to review the method and results of his work. Both of these meetings occurred "outside his regularly scheduled hours". The Board has arrived at the'conclusion that the Grievor's attendance at these meetings does not constitute a Call-Back. In reviewing the evidence and argument, it was clearly determined that these two situations fell within the normally accepted principles of "inconvenience" and "an extra trip to and from work". However, the Board examined the language of Clause of 22.05 and concluded that these meetings did not fall within the normally accepted definition of "work". In addition, the Board reviewed these situations in the context of the Collective Agreement language and arrived at the conclusion that the lack of express Page two (2) language qualifying these "investigative and review" meetings as a Call-Back, should then necessarily disqualify them from such consideration. It is both of these conclusions that I cannot accept. Authors Earl Edward Palmer and Bruce Murdoch Palmer, in their third edition of "Collective Agreement' Arbitration in Canada" review the jurisprudence on the issue of "work which qualifies for Call-Back Pay" at page 631 of their text. They have concluded as follows: "It has also been held that in order to qualify for Call- Back Pay, it is not necessary that the employee actually work after reporting; however, it may be necessary that an order to wo~k be given. Similarly, the type of work done does not affect payment. Thus, persons may be recalled for overtime work or for special work, such as participation in a mock disaster by the hospital/employer, and validly demand such pay. However, it must be kept in mind that the rational for Call-Back pay is "work". And consequently Call-Backs that are not directly related to work may not be compensable under these clauses." Page three (3) In keeping with these principles, the Grievor in this case was clearly "called-in" to the workplace to deal with issues concerning the methods which he employed in obtaining x-rays. In addition, the hospital had concerns regarding the quality and correctness of some of the x-rays which the Grievor produced. There is absolutely no doubt that these Call-Back situations resulted from matters which were "directly related to work". As such, any conclusion that these situations did not meet the specific requirements of Clause 22.05 of the instant Collective Agreement can only be concluded to be unreasonable. This is further supported by a review of the generally accepted principles of labour relations as they apply to the "investigation and processing of grievances". It has lO!1g been accepted that any meetings called by the parties to deal with matters of discipline fall within the definition of "work". The instant Collective Agreement clearly establishes that the parties recognize labour relations meetings between them as constituting "work". The hospital decided that they could not wait for the Grievor's next scheduled day of work to deal with their concerns, and made a proper management decision to request the Grievor to attend meetings in the workplace. Page four (4) In my view, the Board's conclusion that the Call-Back premium is inapplicable, is contrary to the express language of the Collective Agreement, and the recent jurisprudence concerning the "directly related work", which qualifies for Call-Back. I would, therefore, have allowed both of the Grievor's requests for .Call- Back Pay. &- /(' ~" Peter R. Seguin August 20, 1991 ,,' PARTIAL DISSENTING OPINION OF R. W. REDFORD IN THE MATTER OF AN ARBITRATION BETWEEN RIVERSIDE HOSPITAL OF OTTAWA AND AAHPO - GRIEVANCE OF BILLSMAN Having had an opportunity to review the award, I find that I must ., partially dissent. The portion of the award that I cannot acc~pt is the portion dealing with the second suspension for having X-rayed the wrong shoulder. The incident occurred October 16, 1989 just a few days after the grievor had served a one day suspension for a similar offense. The first issue is the criteria that a Boaed of Arbitration should apply in changing a penalty. In supporti,ng the first one day suspension which the Hospital had app l j,,,,d relative to the October 2nd incident, the Board concludes that the Hospital's penalty was "not unreasonable".. This suggests that the stanaard which is being applied is one which would allow a latitude of reasonableness and was not simply a reassessment and the application of the Board I s judgement over t.'nat of the Hospital. I can agree with this standard. However, in the second application of discipline, in my submission, the test was narrowed and the Chairperson has simply imposed her own conclusion over that of the Hospital without having established it to be "unreasonable". Indeed the chairperson agrees'that discipline was \']<l1.Tar,ted, but differs -2- only slightly from the Hospital in the quantum that should be applied. Even the type of discipline appropriate to the October 16th incident is not at issue. Both the Hospital and the chairperson agree a suspension is warranted. The only difference is the chairperson's assessment of the number of days which should apply versus that of the Hospital. Where the differenc~s are so narrow and where it has not been found that the Hospital's action was "unreasonable", it would have been my view that the discipline should have stood. What the chairperson has done is impose her own assessment on the Hospital's and second guessed the matter. This is not, or should not be the standard applied through arbitration. Where a penalty is deemed to be "unreasonable" in all of the circumstances, It should be changed, but the arbitration process should not be used as an "armchair quarterback" to impose their "superior" interpretation. On the facts, I also dis~gree with the c0DclusloD of the chairperson on this issue. The mistake that was made on October 16th was a second mistake similar to the one which had just been investigated and where discipline had been applied. It was a failure to follow accepted procedure in un area where he knew or should have known how to proceed. While his actions after being told of the error were different than the October 2nd incident, -3- it remains that he did not follow procedure in a very critical area for the second time in less than three weeks. Surely it is not "unreasonable" for the Hospital to impose progressive discipline. The infraction was similar and the timeframe was frighteningly short. Three days, after a one day suspension was not "unreasonable". Therefore, I would have found that the Hospital's actions were well within the bounds of reasonableness, and would not have felt it appropriate to reassess the penalty. In my view, the Board should not interfere with a decision on discipline unless the employer's position was clearly unreasonable. In this case, the employer's position was not unreasonable, given the facts of the October 16th incident. I would have dismissed this grievance and t:l1e Hospital's three day suspension would have stood. 1(?(iiK( - R. W. Redford June 13, 1991 ,. ADDElIDOM 1'0 AWARD I have had an opportunlty to review the partial dissent of Mr. Seguin on the issue of the geievoe's claims to call-back premlum pursuant to ~ticle 22.05. At p.2, he makes eeference to an excerpt at p.531 of the text Collective Agreement ~oitration in Canada, 3rd edition, oy th~ authors Earl Ed'.ard Palmer and Bruce .'1U("doch Palmer, to the effect that "the type of wor~ done does not affect payment. Thus, persons may oe recalled for overtime WO~K or foe special work, such as paeticipation in a mock dlsastee by the hospital/employer, and validly demand such pay. However it must be kept in mind that the rationale for call-baCK pay is "work'! and consequently call-oaCKS that are not dieectly related to worlC may not be compensable under these clauses". Indeed, I would subscribe to the principles artlculated oy the authoes, and would not have hesltated to allow the g~levor's claims to call-baCK if he had been summoned by the Hospital to participate in a mock disaster, or to attend an In-service educational meeting, or to pee form some other ove~time duties that are not regularly scheduled. However, the eeason the grievor .as required to commute co the wor~place was to attend meetings at which allegations of misconduct against hlm were being investigated and from which discipline could and did ensue. Had the grievor noc engaged in misconduct, tne Hospital would not have eequLeed any such meetings to lnvestigate the allegations. Thus, in the absence of language clearly entitling the grlevor to the peemium, the majority has concluded that the call-baclC premlum oughc not to attacn to attendance at such meetings. The 'C majority reasons that the extea cost of the peemium payment should not be visited upon the Hospital where the ciecumstances giving rise to the need for the meeting are instigated oy miscondLlct of the grievor rather than by the worK-related requi~ements of the Hospital. ~ . E. Emrlch E'-E~