A nurse is facing allegations of professional misconduct and poor professional performance after reportedly creating and signing prescriptions for herself and patients while working at a GP practice in northeast Ireland. The case was heard before a Nursing and Midwifery Board of Ireland (NMBI) fitness-to-practise committee on Friday.
The allegations remain unproven. The nurse’s identity, the witnesses and the medical practice have been anonymised by the committee, which is due to reconvene at a later date to hear further evidence from the nurse.
What happened in the case?
The NMBI committee is considering five factual allegations, along with claims that the nurse breached the professional code of conduct and ethics for registered nurses.
The allegations concern prescriptions reportedly issued between November and December 2023. Three doctors connected with the GP practice told the committee that they did not sign any of the prescriptions referred to in the case.
According to evidence presented to the hearing, an administrative staff member raised concerns with one of the practice’s partner doctors on December 29th, 2023. Two prescriptions issued that day were among those examined by the committee.
- One prescription was allegedly created and signed for a patient receiving a Prolia prefilled syringe, a medicine used in the treatment of osteoporosis.
- A second prescription was allegedly created and signed for another patient for a Saxenda prefilled pen, used for chronic weight management.
- The prescriptions were alleged to have used the stamp of one of the practice doctors.
Allegations involving prescriptions for patients and the nurse
The hearing was told that the nurse also allegedly created prescriptions for herself. One prescription, dated December 11th, 2023, was said to include soluble Solpadeine tablets and esomeprazole, a medicine that reduces stomach acid.
A second alleged self-prescription, dated December 21st, involved further soluble Solpadeine tablets and reportedly used the stamp of another doctor at the practice.
The committee also heard that a prescription had allegedly been created for a patient in November 2023. It was said to include Deltacortril, a steroid, and Nexium, which is used to treat acid reflux. The prescription allegedly carried the stamp of another GP.
The case centres on whether the nurse created and signed the prescriptions, and whether that conduct amounted to professional misconduct or poor professional performance under the standards expected of a registered nurse.
- The hearing is before an NMBI fitness-to-practise committee.
- The allegations concern prescriptions issued in 2023.
- The nurse accepts signing some prescriptions but disputes parts of the allegations.
- No final finding has been made.
What did the practice doctors tell the hearing?
One of the doctors said she and another partner spoke with the nurse after becoming aware of the prescriptions dated December 29th. The nurse was reportedly told that the conduct represented a serious breach of the practice’s policies.
The committee heard that the nurse described signing the two prescriptions as happening “on autopilot” during what she said had been an exceptionally busy day. The phrase was presented as part of the evidence given about the conversation at the practice.
The doctors also told the committee that none of them had signed the prescriptions identified in the allegations, despite their stamps allegedly appearing on some of the documents.
Different accounts of the nurse’s departure
A further meeting took place at the practice on January 3rd, 2024. Counsel representing the NMBI chief executive said the nurse admitted signing the prescriptions dated December 29th and resigned during that meeting.
The committee was shown a resignation letter. The NMBI’s barrister said the nurse indicated that she wanted to move on with her life.
However, the nurse’s barrister read a document in which she claimed she had been dismissed rather than having resigned. Her legal representative also told the committee that she accepted responsibility for the Solpadeine prescriptions and recognised that this fell seriously short of the conduct expected of nurses.
In relation to the December 29th prescriptions, the nurse accepts that she signed them but does not accept that she created them, the committee was told.
Why the NMBI hearing matters
The NMBI is responsible for regulating nurses and midwives in Ireland. Its fitness-to-practise process examines whether a registered professional’s conduct, performance or health raises concerns about their ability to practise safely and in line with professional standards.
Prescription governance is particularly important in a GP setting because medicines must be authorised, recorded and issued through appropriate clinical procedures. The alleged use of doctors’ prescription stamps is therefore central to the concerns being examined by the committee.
The case also highlights the distinction between a professional disciplinary hearing and a criminal prosecution. The NMBI committee is considering regulatory allegations under the nursing profession’s standards. Its eventual decision will depend on the evidence heard and the legal submissions made by both sides.
What happens next?
The committee will reconvene to hear evidence from the nurse. A future hearing date has not yet been announced. The nurse was first registered in 2002 and worked at the GP practice from September 2023 until January 2024.
Until the committee completes its consideration, the allegations remain unresolved. Any outcome would be determined through the NMBI’s statutory fitness-to-practise process.
Frequently asked questions
What is the nurse accused of?
The nurse faces allegations of creating and signing prescriptions for herself and patients, allegedly using the stamps of doctors at a GP practice. She also faces allegations of professional misconduct and poor professional performance.
Has the nurse admitted the allegations?
Her barrister told the committee that she accepts signing certain prescriptions, including the Solpadeine prescriptions. She disputes part of the allegation concerning the December 29th prescriptions, including the claim that she created them.
Has a final decision been made?
No. The committee is due to hear further evidence from the nurse before reaching any conclusion.
Why have the names been withheld?
The committee directed that the nurse, witnesses and GP practice remain anonymous during the proceedings.
Conclusion
This Breaking News Ireland case remains before the NMBI and no final finding has been made. The next stage will be the nurse’s evidence, after which the committee will assess the competing accounts and determine whether any professional standards were breached.