A Renfrewshire nurse has been struck off after giving a care home resident higher doses of diamorphine than they were prescribed and lied about the quantity given.
Robyn Connelly was employed at Ranfurly Care Home in Johnstone when the incidents occurred in October 2019.
She was also found to have administered diamorphine or midazolam to a patient without a witness, asked a colleague to sign out drugs when they had not witnessed them being prepared and asked a colleague to amend the entries made for the patient in the care home's drugs book.
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Ms Connelly also left the syringes out until she was told to get rid of them.
A hearing by the Nursing and Midwifery Council (NMC) concluded that her fitness to practice was impaired, with a striking off order issued and 18-month interim suspension order.
A witness statement by a colleague confirmed that Ms Connelly had filled the syringe with more than the prescribed amounts of diamorphine and/or midazolam for the patient.
The colleague said: “She put the needle into the diamorphine ampule to dilute it. It was quite small so it didn’t take all the water. I’m not sure what the dosage should have been to be honest but she drew the whole ampule into the syringe. It could have been 5ml or 10ml, I can’t remember, but I’m pretty sure it was 10ml because I compared needle and syringe sizes with my manager the following day. She used a 10ml syringe to draw up the midazolam. It was a 10ml dosage, the amount that was in the ampule. She drew up the whole ampule.
"I remember questioning why she’d drawn up the whole of both ampules. The nurses I’d worked with previously and since have only drawn up the amount required. They would do a calculation to work out how much was needed. I should have questioned it but I didn't feel comfortable questioning the senior nurse. Although I did say, almost in a joking manner 'oh God you’re not going to give all of that are you?' Robyn said 'oh no, not a chance. I’m only going to give the two nodules'…"
The same colleague also provided a statement claiming that Ms Connelly left the syringes containing the residual drugs unattended until prompted to dispose of them.
They said: “The syringes with the needles attached with the medication we’d, Robyn and I, drawn up previously were lying on the work surface. It looked like some of the medication had been administered and the leftovers had been left in the syringes which were lying on the work surface, which should never ever happen.…Robyn came looking like she’d been crying and was panicky. She said 'I shouldn’t have left the syringes but when I worked in the hospital we were able to leave them and reused them…'"
A second colleague also confirmed that the same day, Ms Connelly asked them to sign out controlled drugs that they had not witnessed being prepared.
They said: "Robyn had asked me to sign out Controlled Drugs but I told her I was not comfortable to do this as she had already drew the medication into the syringe without this being witnessed. This would have gone against the Home’s Controlled Drug policy and process which is why I said no."
The NMC found all the charges against proven, condemning her action for as potentially causing "significant harm" and involving "dishonesty and a lack of candour on more than one occasion".
The decision reads: "Although no harm was caused to any patient, her actions (which appeared to involve estimating how much medication was to be given) could have caused significant harm. Not only did her actions involve dishonesty and a lack of candour on more than one occasion, there was an attempt to cover up what she had done.
"Finally, Ms Connelly has displayed a persistent lack of insight into the seriousness of her actions. Accordingly, all of the factors listed above are present. The panel was also of the view that the findings in this particular case demonstrate that Ms Connelly’s actions were serious and to allow her to continue practising would undermine public confidence in the profession and in the NMC as a regulatory body."
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