Psych Nurse Fired After Reporting Patients ‘Blowing Each Other’ and Hitting Staff

In the afternoon of July 28 at the Temple Episcopal Hospital in Philadelphia, chaos reigned. 

Patients in a psychiatric ward at the hospital were fighting each other, more patients were being admitted, another was attempting to escape, and other patients—including people whose ability to give consent was questionable—were engaging in sexual intercourse with each other. 

“Things were getting to the point of no return,” Mallory, a nurse who was hit in the face during what she described as a “melee,” told VICE News. “There were only a couple of us. We needed help.”

Frustrated, Mallory called a supervisor and pleaded for help. 

“It's absolutely nuts up here,” Mallory, whose last name has been omitted to protect her privacy, recalled telling the supervisor. “I got patients blowing each other. They’re fighting, they’re hitting me. I need help right now.” 

What happened after this conversation was, according to Mallory, “laughable.” By the end of the following week, she’d be out of a job. 

Eventually that day, the nurses got the situation under control. But Mallory was later told she’d been reported for using “profane language” in her conversation with the supervisor, as unbeknownst to her, a manager had been listening in on the conversation. 

“The fact that [the manager] is more concerned with the way I spoke, instead of my actual message, that we were in dire need of assistance and perilously close to multiple reportable incidents, speaks volumes on her priorities,” Mallory told the director of nursing in a July 28 email which was shared with VICE News.

Mallory also reported the manager for allegedly ordering her and other nurses and mental health technicians to keep the patient who’d hit Mallory “in restraints until morning, no matter what,” as Mallory recounted in a letter to the hospital’s director of nursing. 

Reached by phone, the manager told VICE News Mallory was not in her unit, though Mallory complained about orders the manager had given her in her statements following her suspension, including to restrain the patient, which Mallory called a “violation of basic human rights.” The manager said she otherwise couldn’t comment and referred VICE News’ questions to the hospital’s risk management department.

“As mental health professionals and nurses who are interested in keeping our licenses, we did not follow this directive,” Mallory said in the letter. “[The patient] was let out of restraints the moment she demonstrated safe behavior, as is the standard.”

Do you have information or tips about patient and/or work conditions at psychiatric facilities? You can contact Paul Blest by email at paul.blest@vice.com or at (919) 330-0761.

Restraints of the nature and time frame allegedly given in the order from the nursing manager are a violation of Temple Health guidelines: “Restraint will be discontinued as early as possible when the patient meets the criteria for discontinuation,” according to hospital policies. Pennsylvania law also restricts restraint use to “control acute or episodic aggressive behavior.”  

Ultimately, Mallory was suspended on July 29, and then fired on Friday, Aug. 5. In her termination letter, the hospital accused her of using “profane language” and of taking too long of a break, which the hospital said constituted "gross neglect of duty,” while her language was considered “behavior unbecoming a [Temple University Health] employee.”

“You took a 1hr 25 min meal period which exceeds that amount of time authorized for your meal break,” stated her termination letter from Temple, which was obtained by VICE News. “Upon returning to the unit, you called the nursing supervisor, and you were heard using profane language in describing the current state of the unit.”

The nurses’ union contract mandates that workers on 12 hour shifts are supposed to be given 75 minutes of breaks total, and the hospital had accused her of being gone for 85 minutes, 10 minutes too long. Mallory also says she was performing work duties during that break, including making sure patients had food trays and proper clothing. “I was 10 minutes late, and I wasn’t really late because I was doing patient things,” Mallory said. 

She also said she’d never been written up in the year she’s worked at the Philadelphia hospital, and her termination letter obtained by VICE News noted no record of discipline prior to her firing.

“If something I did negatively impacted a patient, I could almost understand this,” Mallory said of her firing. “But if anything, it helped multiple patients and maybe saved somebody from getting sexually assaulted or escaping.”

In a series of statements about her situation to VICE News and Temple Health, she said that the focus on her language shows the hospital misplacing its priorities.

“Not once has anyone from management asked me if I was OK after I was struck in the face,” Mallory said in a July 31 statement to the director of nursing after she’d been suspended that was obtained by VICE News. “Not once did anyone ask me about the unmitigated chaos on the unit and how to prevent future episodes like this from happening again. Instead, I have been questioned about my choice of words.”

Mallory believes, however, that it wasn’t actually this incident that caused her firing. 

Weeks before, Mallory says, she told the hospital’s director of nursing that they needed to report an alleged sexual assault of an elderly patient to the city, because of a Pennsylvania law that mandates the reporting of elder abuse. Mallory said that the director of nursing said the hospital’s risk management department would handle it internally. Not trusting the hospital leadership to do that, Mallory said she reported the alleged abuse anyway. (The director of nursing did not respond to emails, a phone call, or text message from VICE News.) 

Temple Health did not respond to multiple requests for comment from VICE News made via email or phone, or a detailed list of questions. The Health Professionals and Allied Employees, Mallory’s union, said in an email that it was “not in a position to comment at the moment.”

The hospital has already come under scrutiny from Pennsylvania regulators and was the subject of a December investigation by the Philadelphia Inquirer, after three patients at the hospital died by suicide and another patient set a fire. Temple Episcopal is located in Philadelphia’s Kensington neighborhood, and, in recent years, Temple Episcopal has been on the front lines of  the opioid epidemic in Philadelphia.

State investigations after the fires and two suicides implicated hospital policies, a lack of adequate staffing, and poor facilities, according to the Inquirer. Two families of Episcopal patients who died by suicide have brought lawsuits against Temple Health, the paper reported in December. (The firm representing the families declined comment as litigation is ongoing.)

Mallory described the turnover at the hospital as “insane” and said “staff are getting attacked daily” there. 

“It's not a safe environment for patients or staff,” Mallory said. “They just need people to change the culture of it, make it a place where people want to work, and then maybe it'll attract good employees that will take better care of these patients, but they just need oversight.”

And still, Mallory maintains that referring to patients “blowing each other” was her way of communicating the urgency of the situation, and told her nursing director in a Jul 31 statement: “If Temple University Hospital begins suspending everyone for using 'colorful' language on the phone in what they think is a private conversation, I am quite sure there would be no one left to staff the hospital."

“First of all, it's a psych ward under the El [train] in Philly. You hear a lot of stuff,” she told VICE News. “That's probably the tamest thing somebody heard that day.”

Mallory told VICE News that she believes her firing is a warning to other employees who challenge the hospital leadership. 

“If this firing actually stands, it sets a precedent that you can just get rid of people that challenge you,” Mallory said. “If you challenge our ideas, and try to do your job to the best of your ability, we can just get rid of you on a technicality, because you're too much of a headache… What kind of fascist dictatorship is that?”