When I ran the clinic I was pretty wet behind the ears. I knew enough to know good work by the staff when I saw it and I knew how to account for the money provided by the government, but I was a bit naive about crime and all that people were capable of. That changed pretty quickly.
We had twelve street nurses. They were not registered nurses in the professionally accredited sense. They were ex-addicts, idealists, and Eastside types who were comfortable in the area and assorted characters who wanted to do good work and were willing to work for peanuts. Some were good. Some were great and some were saints. But I saw them all, initially, as idealists doing good work. I was wrong.
My first bad worker was a guy called John. Pleasant. Smart. Engaging. A bit older than most of the others but still young in his early thirties. He was a bit burnt out but that hollow, haunted look was not uncommon among our mostly fallen-but-redeemed non-professional staff. The clinic had a policy of trying to hire locally for obvious reasons, but also to give people a second chance.
I heard a rumour that John was dealing heroin while doing his rounds.
That posed a challenge. How do you fire someone for committing a crime so severe that criminal charges would have to be laid and a proper investigation would have to be conducted and all sorts of interruptions to patient care would ensue? How could you NOT fire someone who did that sort of thing? How could you prove it without duplicating the processes that were required by the entire justice system. How could you put any more patients at risk? And addicts faced greater risks from their suppliers than from most other people so, if true, John was worse than the average dealer, he was a dealer who was in a position of authority over his clients.
“John, come down to my office, would you. We need to talk.”
He came down, smiled, cracked a few jokes, made nice. I liked John.
“John, I am thinking of firing you. If I do, I have to do it right now. This minute. You can’t even go back upstairs to the nurses department. I will walk you off the premises.”
He went nuts. Called me names. I calmed him. He sat down.
“John, I have no right to fire you. I know that. I have only heard a weak rumour. That is all. It is NOT fair. So, if you want to, all you have to do is say that you want a suspension instead and you want to appeal to the board. I will not only understand, I hope you choose that route and I will fill out the forms for you. But, you see, if you do choose that way to respond, I have no choice but to chase down the rumour. And, in the process of doing my own investigation, I will have to ask others to get involved because the rumour is serious. I will have to involve the police. That kind of thing. Nothing behind your back, though. I will introduce you to everyone involved in the investigation. If there is nothing to hide, you will be back in a flash and I’ll apologize. I’m sorry. But I have no choice. What would you prefer I do?”
John thought it over, (taking way too long to do that), looked at me as asked me if he should resign instead. I agreed that he should, but I still walked him out of the clinic.
The other nurse gone bad was a tough, young, single mother with a bad attitude and a nasty mouth. But that pretty much made her normal in that group. It was almost a requirement to be that way sometimes down there. She was, however, smart and sneaky as well. One day she came to work and asked if she could take her holidays in a week or so. I said yes and simply asked that she notify the department coordinator. And off she went.
She spent ten days in Hawaii.
She’d been back a few weeks when I got a call from a social worker who had a caseload in the Downtown Eastside.
“Hey, Dave, did you know Joe Smith died last month? He was one of the guys under your team’s care?”
“No. I didn’t know. But, then again, a lot of patients die down here and I don’t personally keep track of them. Why? Something amiss?”
“Don’t know. I just know that Janie was administering his accounts and, when he died, I had to do the paperwork and there was not a penny in the bank. Doesn’t mean much but administered patients have bank accounts and I have never had a situation that had a person at zero unless they died virtually at the end of the month. Joe died on the 7th.”
I thanked the worker, checked the dates and realized that things looked odd. I called the bank and asked them about Joe’s account, told them why and, as this was a time when things weren’t so rigid, they told me. I got the answer I needed. In the monthly statement they issued the month before Joe died, there had been $1,400.00. For a guy on welfare, so sick that he was restricted to his room and mostly his bed, that was a huge sum. The records showed that his balance in the years prior was usually low. But in the last year (for as long as he had been in our care) he had somehow managed to save $120 a month. At the time, his living allowance was just a bit under $500. It seemed impossible for him to save anything. Unless he was not being fed properly or not receiving other needed items or services.
I inquired with Janie. She was angry from the start. Then she said, “He was gonna die anyway. I just took what he wanted to give me.”
I fired her.
And then the story got really ugly.
She grieved the termination. The Board of Directors agreed with me. Janie contended that I was singling her out because she was an ex-addict, a single mother and I didn’t like her. The last part was, by then, true. But then she got some support from the other nurses. I was stunned.
“How could any of you support her for doing what she obviously did?”
The answer made my blood run cold, “Hey, none of us are perfect! We’ve all taken some money from some old guy’s account. Now and then. Not that much but there’s no harm if he’s dying, is there? And when he’s dead, the money just goes back to welfare. And that’s stupid!”
I said, “That has to stop. I will be checking. If there is even a nickel missing from now on, you will be fired. I am inclined to fire you (the department head who had given me the answer) right now for simply having knowledge of this, let alone participating. I won’t because too many people need the care you give, but I swear this will not be overlooked ever again.”
The sad part was that it was mostly a bluff on my part. There was a reason there were twelve street nurses. They had almost two hundred patients. It was a revolving roster. Some patients were short term and were not vulnerable. Some were NOT administered by us (meaning they controlled their own money) and others were pretty smart old geezers. But there would always be at least a dozen who could be taken for small sums and no one would ever know.
It was ugly down there. And not all the ugly came from the client side.