Nurse’s registration cancelled over concerns about ability to practice safely

A nurse midwife has had her registration cancelled by the High Court over concerns about her ability to practice safely due to a history of psychosis.

The president of the High Court, Mr Justice Peter Kelly, noted the nurse has a history of psychosis constituting a medical or mental disability and that her regulatory body believes her practising nursing may constitute a risk to herself or patients.

It was considered this was especially so because of her lack of insight, failure to engage with health professionals and to take her medications, he said.

The nurse, he noted, was notified of the recommendations her registration be cancelled and had not appealed those.

On foot of the evidence, there was no good reason for the court to take a different view from her regulator and he would order that the nurse’s name to be cancelled from the general nursing register, the judge directed. He also directed nothing can be published to identify the nurse.

The Nursing and Midwifery Board of Ireland (NMBI), represented by solicitor JP McDowell, had sought the order concerning the nurse, who qualified in nursing in her native non-EU country. She was registered on the general nursing register here in 2003 and worked as an agency nurse.

She was considered in Autumn 2016 to be suffering a psychotic illness with a depressed mood, was treated but was found to have poor insight and to be only partially compliant with medication.

She later came under the care of a consultant psychiatrist who considered she suffered a psychotic illness which was schizophrenic in form. After she relapsed into acute psychosis later in 2016, she was detained under the Mental Health Act for a period.

Inquiry

The psychiatrist wrote to the Preliminary Proceedings Committee (PPC) of the board in early 2017, expressing concerns about her mental health and fitness to practise.

That ultimately lead to a fitness to practise inquiry on the ground of alleged relevant medical disability which was held in private. The nurse did not attend and was not represented despite considerable effort by the PPC to have her engage with the matter, Mr McDowell outlined.

Among those who gave evidence at the FTP inquiry was an independent psychiatrist who also took the view she suffered from a relevant medical disability which may impair her ability to practice as a nurse or midwife.

In early 2019, the FTP committee found it had been established beyond reasonable doubt the nurse suffers from a relevant medical disability, being a history of psychosis, which may impair her ability to practise nursing. It recommended her registration be cancelled.

The NMBI agreed with that recommendation and applied on Monday to the High Court for the cancellation order.

Separately on Monday, Mr Justice Kelly granted Patrick Leonard SC, for the Medical Council, orders to censure a doctor over admitted professional misconduct and place conditions on her registration. The doctor cannot be identified by court order.

The misconduct involved using a false patient name when prescribing benzodiazepine medication for herself and prescribing such medication in excessive quantities when she knew of its addictive potential. She also admitted prescribing benzodiazepine medication for some of her family members. The misconduct all occurred on the same date some four years ago.

Because of the doctor’s background of long-term mental health difficulties; the fact the misconduct occurred on the occasion of a distressing family matter; her otherwise unblemished career and acceptance the conduct was utterly inappropriate and wrong, the Council agreed with its FTP committee’s recommendation to censure her with conditions attached to her registration.

Those include requirements to remain under the supervision of the Council’s health committee until discharged from such supervision, to comply with steps stipulated by that committee, including to provide her medical records, and not to prescribe controlled drugs for herself or family members.

Mr Justice Kelly confirmed the Council’s decision and made the relevant orders.