Nurse faces professional misconduct charge over allegedly creating, signing prescriptions

A nurse is facing allegations of professional misconduct and poor professional performance for allegedly creating and signing prescriptions for herself and patients at a GP practice in the northeast.

The nurse appeared before a fitness-to-practise committee of the Nursing and Midwifery Board of Ireland (NMBI) on Friday regarding five factual allegations and allegations of breaches of the code of professional conduct and ethics for registered nurses.

Eoghan O’Sullivan, barrister for NMBI chief executive Carolyn Donohoe, said concerns were raised at the practice by an administrative staff member to one of the two partner doctors, witness B, on December 29th, 2023, regarding two prescriptions issued that day.

It was alleged that on this date the nurse created and signed a prescription for patient B for a Prolia prefilled syringe, which is used for osteoporosis, a brittle bone condition, using the stamp of witness B.

It was also alleged that on the same day the nurse created and signed a prescription for patient C for a Saxenda prefilled pen, used for chronic weight management of people including diabetics, and used the stamp of the same doctor.

Witness A, the other partner doctor at the practice, said that after becoming aware of the December 29th prescriptions, she and witness B spoke with the nurse, with A telling the nurse that this was “a really serious breach of our policies”.

Witness A said that the nurse said during this conversation that she signed these two prescriptions “on autopilot” as it had been a very busy day.

It was also alleged that the nurse created and signed a prescription for herself on December 11th, 2023, for 28 soluble tablets of Solpadeine, a painkiller, and for esomeprazole, which reduces stomach acid.

It was further alleged that on December 21st, 2023, she created and signed a prescription for herself for 64 soluble Solpadeine tablets and used the stamp of another doctor at the practice, witness C.

Witness B said that she had a consultation with patient A in 2024 and when she reviewed this patient’s file she discovered that the nurse had created on November 24th, the previous year, a prescription for this patient for Deltacortril, a steroid, and Nexium, which is used for acid reflux, using witness A’s stamp.

The three doctors at the practice gave evidence that they did not sign any of the prescriptions mentioned in the allegations against the nurse.

O’Sullivan said that a meeting was also held on January 3rd, 2024, where the nurse admitted to signing the December 29th prescriptions.

O’Sullivan said the nurse resigned at this meeting, that she said she wanted “to get on with life” and he submitted to the committee a letter of resignation from the nurse.

Brendan Savage, barrister for the nurse, read to the committee a document from the nurse regarding this meeting where she claimed that she was dismissed.

Savage told the committee on Friday that the nurse admitted to “the Solpadeine prescriptions” and that this was a serious falling short of the conduct expected of nurses.

Savage said that regarding the December 29th prescriptions the nurse accepts that she signed them, that this was poor professional performance but does not accept that she created these prescriptions.

O’Sullivan said that in the nurse’s first observations to the NMBI she said she had no idea why she signed the two December 29th prescriptions, that she had 25 years’ experience, that she knew GP practise “like the back of her hand”, that she apologised and “that she was so ashamed of herself”.

The nurse was first registered in 2002 and worked at the GP practice from September 2023 to January 2024.

The committee, who directed that the identity of the nurse, the witnesses and the GP practice be anonymised, will reconvene to hear evidence from the nurse at a future date to be announced.