Butner, N.C. — Poor training, understaffing and confusing work policies were to blame for an incident in which a patient was improperly restrained at the state's newest psychiatric hospital in Butner, workers said Monday.

Several workers spoke about the incident in which a 24-year-old male patient at Central Regional Hospital was strapped face down for nearly an hour last Wednesday.

One worker was fired and six others were placed on investigatory paid leave for up to 30 days, according to the North Carolina Public Worker's Union.

The workers said a doctor ordered them to do a forced blood draw on an aggressive and combative patient and that although they did not want to, they felt obligated to follow orders.

"He wasn't in any danger at any time," said Patricia Swann, a nursing supervisor involved in the incident. "We had staff sitting with him at all times."

Employees admitted the action was not part of training.

"We're not trained to put anyone facedown, but in the real world, things happened," said Bernice Lunsford, a hospital worker who also serves as the union representative for Central Regional employees.

Lunsford and the employees involved charged that management is making scapegoats of the employees.

"Nothing ever comes around until something goes wrong," Lunsford said. "It seems like, to me, around here, you're damned if you do and damned if you don't."

Tom Lawrence, a spokesman for the Department of Health and Human Services, said Friday that there were no injuries and that the incident occurred as it was described.

He declined further comment Monday, saying there would be no more response on the matter until an investigation is complete.

"Once the investigation in complete, any disciplinary actions will be taken," he said.

Some lawmakers and mental health advocates have voiced concerns similar to those of the Central Regional employees, saying there is lack of training and appropriate personnel and that pay is inadequate to attract top candidates.

The state's mental health hospitals have been under state and federal scrutiny for the past two years, and three of the four have either lost or been in jeopardy of losing federal Medicare and Medicaid reimbursements.

Cherry Hospital in Goldsboro lost its funding last month following the April 29 death of Steven H. Sabock, a 50-year-old patient whom workers neglected for 22 hours prior to his death.

Surveillance video released last week shows workers playing cards, socializing and dancing over four work shifts while a lethargic Sabock sat in a chair in the same room with little attention from the staff and no food.

Three employees were ultimately fired, two resigned and 10 others were disciplined.

As federal regulators investigated the hospital in August following Sabock's death, two hospital health-care technicians, a full-time nurse and a part-time nurse were also fired in connection with accusations related to a patient beating.

And Broughton Hospital in Morganton lost federal funding for more than a year after a patient died there in 2007.

Dr. James Osberg, chief of State Operated Services, which oversees mental health services, said last week that most of the patient abuse and neglect cases surfacing are the result of a culture that tolerates such behavior in the hospital system.

Health and Human Services Secretary Dempsey Benton has taken steps over the past year to overhaul the system, including more worker accountability.

Following the investigation into Sabock's death, he ordered further disciplinary review of the workers involved with that incident and closed the ward where Sabock stayed.

Wednesday's incident came as federal regulators were at Central Regional conducting an extensive review of the hospital's operations. It's unclear if or how, federal fundings will be affected.

The hospital, however, was in jeopardy of losing federal funding for not being in compliance with operational procedures. Those violations stemmed from the delayed merger with Dorothea Dix Hospital in Raleigh, now considered to be Central Regional's Raleigh campus.

After several delays, that move has been postponed indefinitely because of ongoing concerns about patient and employee safety and staffing concerns.