A nurse did not contact a doctor or emergency services when a patient in his care became ill and told staff he thought he was going to die, a fitness-to-practice hearing has been told.
At the conclusion of an inquiry on Monday, the Nursing and Midwifery Board of Ireland (NMBI) upheld five of six allegations against nurse Edwin P Lara.
They related to his care of two patients over the course of one night shift at the San Remo Nursing Home in Bray, Co Wicklow in February, 2019.
He was found to have demonstrated poor professional performance and to be in breach of the professional code of conduct.
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The committee was satisfied Mr Lara had failed in his care of Resident A’s hypoglycaemia — a condition where blood sugar levels fall below a normal level — by not testing his levels every 10 to 15 minutes; by not providing him with sufficient rapidly absorbable carbohydrate and by not escalating the matter by contacting emergency services or a doctor.
Committee chair Prof Colm O’Herlihy said in summarising their findings based on previous hearings, that the treatment of Resident A, a type two diabetic, fell short as his condition deteriorated during the night.
His blood sugar levels had become dangerously low and he was passing abnormal bowel movements, but Mr Lara did not contact emergency services, a doctor or senior nursing staff.
Providing him with an Angel Delight desert and some sugary tea was “clearly insufficient”, Mr Tarrant said.
The fact there was no Lucozade available at the time “provides you with no excuse as to other means and mechanisms to ensure that Resident A was provided with sufficient amounts of absorbable carbohydrate”.
“It ought to have become clear to you that this was a medical emergency,” Prof O’Herlihy said.
The Committee heard that despite concerns raised by both Resident A and staff members, Mr Lara had not acted on this. An allegation he failed to check vital signs was not proven, however.
Three of the six allegations, relating to Mr Lara’s care of another patient, were upheld. These related to Resident B who had fallen and fractured her hip.
The hearings had heard the resident should have had the assistance of two staff members when going to bed but had only one. It was “common knowledge” she required this assistance, and Mr Lara was found not to have ensured it was provided.
When she fell, Mr Lara failed to properly assess her injuries in line with policy at the San Remo home. She was subsequently diagnosed with a fractured hip and had been “screaming in pain”.
Mr Lara checked her for bruising but did not inspect the movement of her hip or look for potential fracture signs.
“She appears to have been left in pain before ultimately falling asleep,” Prof O’Herlihy said. The committee also held up a complaint he failed to contact emergency services or a doctor afterwards, despite this being suggested by a healthcare assistant, which was dismissed by him.
Monday’s hearing did not hear from Mr Lara. A full report including recommendations of sanctions against him will now be prepared for the board of the NMBI.
