Nurse who forged drug orders to feed addiction suspended

Judge expresses concern over number of similar cases coming before the courts

Mr Justice Peter Kelly approved a recommendation  that, on appropriate certification by a psychiatrist, the nurse may resume work after the suspension period on conditions.
Mr Justice Peter Kelly approved a recommendation that, on appropriate certification by a psychiatrist, the nurse may resume work after the suspension period on conditions.

A nurse who forged orders for drugs and altered prescriptions in the medical centre where she worked to feed her addiction to controlled drugs has been suspended for a year by the president of the High Court.

For reasons including the nurse has undergone various rehabilitation measures, Mr Justice Peter Kelly approved a recommendation by the Nursing and Midwifery Board that, on appropriate certification by a psychiatrist, she may resume work after the suspension period on conditions.

Those include undergoing urinary analysis and continuing to engage with a mental health team.

He was satisfied that would address the need to maintain trust and confidence in the nursing profession.

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The judge observed this was not the first case of a nurse with addiction issues to come before him. He expressed concern such cases are increasing while appreciating the overall number of nurses who are subject of regulatory applications before the court is “tiny”.

He was told by Ursula Byrne, director of regulation with the board, the number of such cases is “miniscule” but had been rising in the past couple of years. The board shared the court’s concern and has taken steps to address the situation and to alert nurses to the consequences of such actions, Ms Byrne said. Such addictions often arose in circumstances where a nurse had self-administered drugs to address a health problem instead of attending a doctor, she added.

Earlier, JP McDowell, solicitor for the board, sought the suspension order arising from findings of professional misconduct by a Fitness to Practice Committee last December concerning the nurse’s use of controlled drugs.

Among the findings were the nurse had, around June 2015 and/or September 23rd 2016, written or caused to have written one or more prescriptions for stock medication of pethidine and/or Cyclimorph when she knew, or should have known, that was not required for stock.

She was also found to have added one or both of those drugs to prescriptions already signed by a medical doctor in the centre and to have self-administered the drugs issued on foot of the prescriptions.

The committee found, and the nurse admitted she suffered from a history of dependence on Cyclimorph and from depression and anxiety which might impair her ability to practise nursing.

The committee recommended she be suspended for 18 months and allowed resume practise after on conditions.

The board agreed recommended the suspension period be reduced to 12 months.

In his ruling, Mr Justice Kelly said the nurse had worked in the centre for 15 years and he was sure it came as a “great shock” when the misconduct came to light because a doctor was standing beside a fax machine when a fax came through for tablets for the nurse which was purportedly signed by him but which he knew he had not signed.

This case involved claims of fraud and dishonesty regarding this nurse’s conduct which were at the most serious end of the scale, he said. Were it not for the findings concerning her addiction, shame about her conduct, her love for her profession and her attempts to rehabilitate, a strike off order would have been sought.

The proposed conditions appear to anticipate the nurse will be given a clean bill of health on review by a psychiatrist before the end of her suspension period and did not anticipate any finding she would not be fit to return.

Given evidence the relevant addiction is a chronic and recurring one, the conditions on registration should have addressed that but the relevant law provided that is a matter for the board, not the court, he said.

He was satisfied public trust in the nursing profession was protected because, during the suspension period, the nurse cannot return to practice and cannot return after suspension unless she has favourable reports.

Mary Carolan

Mary Carolan

Mary Carolan is the Legal Affairs Correspondent of the Irish Times