A hospital orderly who was captured on video criticizing Joyce Echaquan shortly before her death testified today that she meant no harm with her comments.
The orderly, whose identity is protected by a publication ban, was fired from the Centre hospitalier régional de Lanaudière in Joliette, Que., after the incident and testified about what happened at a coroner's inquest Wednesday in Trois-Rivières.
Coroner Géhane Kamel is investigating the death of Echaquan, a 37-year-old Atikamekw mother of seven who filmed herself being insulted and mocked by female staff not long before she died at the hospital northeast of Montreal last September.
In the video Echaquan recorded, the orderly is heard saying: "What would your children think, seeing you like this?" And later: "You made bad choices."
At that moment, Echaquan was in a private room where she had just been transferred, because she had been screaming and scaring other patients in the hallway, according to testimony heard on Wednesday.
Based on the timeline given by witnesses, Echaquan was sitting on the ground in the bathroom when the orderly walked in.
She told the inquest she just wanted to motivate her patient to get up and thought that talking about her children would "bring her back to reality."
The orderly insisted there was no racism or bias against Echaquan, although she acknowledged she assumed Echaquan "had made bad choices" because a nurse told her that Echaquan was in withdrawal.
The orderly's testimony, and the fact that the video Echaquan recorded was played in the courtroom for the first time, set off a wave of emotions Wednesday, with Echaquan's family weeping as they watched the footage and heard her crying out in pain.
Several people had to leave the room.
The witness said she was doing the best she could under the circumstances that day, with very little personnel on hand.
"There was no malice," she said.
The other nurse featured in the video is expected to testify Thursday morning.
The Grand Chief of the Atikamekw First Nation, Constant Awashish, said the orderly's comments were hard to swallow.
"I'm going to give her the benefit of the doubt, but it's kind of hard to believe given the way it was said," said Awashish, outside the courthouse.
Paul-Émile Ottawa, the chief of Echaquan's community of Manawan, said it was extremely painful for her husband and mother to watch the video but said they wanted to stay in the courtroom to see the process through until the end.
Ottawa said Thursday's testimonies showed there isn't "a single health care worker" responsible for her death but rather "the administration who think they can manage such a huge hospital with a reduced workforce."
Inquest hears Echaquan was restrained, left alone
Staffing shortages and lack of resources were central to the testimony heard earlier in the day.
Two other hospital staff members, whose names are also protected under the publication ban, said that was one of the reasons why Echaquan was restrained and left alone in her hospital room for 40 minutes after a nurse gave her a sedative shortly before she died last September.
A patient attendant told the inquest that leaving a restrained patient unsupervised went against protocol at the Joliette hospital.
"There was no one with Joyce," said the attendant, who had to pause several times during her testimony Wednesday to catch her breath as she teared up.
WATCH | Staff at hospital where Joyce Echaquan died testify at inquest:
The patient attendant provided more insight Wednesday into what happened the morning of Echaquan's death on Sept. 28, 2020. She testified that Echaquan was calm and chatting on the phone when she first saw her at around 8 a.m.
But when the patient attendant came back from her break at around 10:15 a.m., Echaquan was kneeling on her hospital bed, banging her head against the wall and screaming.
The attendant tried to calm her down. "But I couldn't even catch her eye — it was empty, like she wasn't there," she said.
Echaquan was taken to a private room and given a sedative by a nurse, at which point she had calmed down. The attendant was the only one on the floor that day, had 38 people to care for, and went back on the floor.
"It was chaotic."
At 11 a.m., things went from bad to worse, she testified. Her colleague called her into Echaquan's room again.
She saw Echaquan had restraints on her feet and hands and said she was asked to add a waist belt, which is used to properly secure patients. She told the inquest that such restraints are used when patients are a threat to themselves or others.
The patient attendant said she didn't know what had happened before that.
"They just told me she was lying on the bathroom floor," she told the coroner.
Nurse stopped Facebook Live video
During that time, she said the nurse told her in a panic that Echaquan "was filming us. She filmed everything. I deleted it."
The Facebook Live video that Echaquan shared that day showed a nurse and another patient attendant who was in the room calling Echaquan stupid and saying she'd be better off dead.
Phone records disclosed to the inquest as evidence last week showed no video was actually deleted from Echaquan's phone, however the Facebook Live was stopped.
Following hospital protocol for whenever a person is filmed, the patient attendant testified she went to inform her superior about the video and then returned to her other patients.
Student nurse, attendant testify about transfer
During this time, a student nurse in charge of Echaquan's floor was trying to locate someone to supervise Echaquan.
The student nurse testified she had never dealt with a patient in restraints before that day, and wasn't exactly sure how to handle the situation. She said a doctor approved her request to find somebody to watch Echaquan while she was restrained, but seeing as there was no one available, she was told to "figure it out."
Several staff members were on lunch break, and the student nurse said she had several other patients in serious condition to monitor.
Forty minutes later, with the student nurse still unable to find anyone to watch Echaquan, a resident gastroenterologist who wanted to talk to Echaquan about her treatment, told the student nurse she was "acting out." The student nurse testified that this was an expression used to describe a patient who is pretending to be asleep to avoid questions.
The student nurse checked Echaquan's vital signs. "When I saw her, I knew right away she wasn't doing well."
Seeing her pulse was weak, she asked that Echaquan be transferred to a resuscitation room, but again, she had to wait and was told they were all full.
"I don't think I was taken seriously," the student nurse said, noting that she decided to check herself. She found a bed was available, but had to wait ten more minutes before the transfer.
The patient attendant testified that she was called to Echaquan's room. When she arrived, she said Echaquan's daughter was there, but no other staff members were present.
The patient attendant testified that she knew right away something was wrong.
"I thought 'Oh my God, we have a problem.' "
She called for help, told her colleagues "she isn't breathing" and quickly brought Echaquan to a resuscitation room.
Two patient attendants tried to resuscitate her for 45 minutes, but it was in vain.
Divide between hospital staff, Atikamekw community
During her testimony, the patient attendant apologized to the family, and said she hoped reconciliation could happen between the hospital and the Atikamekw community.
She said the language barrier had always been an obstacle to properly interacting with Atikamekw patients.
But since Echaquan's death, she said there's a divide that's been created.
"There's this fear — we don't know what to say, and they seem to fear us."
She said a lot needs to change to improve relations, including more resources to translate Atikamekw at the ER and more training, something that should have been done long before.
"No one ever listened, and someone had to die for things to get moving."