A registered nurse has admitted giving dementia patients at a nursing home non-prescription drugs on her day off, after claiming they were violent, including one who bit and hit others.
Elisabeth Buckley has admitted to the professional misconduct charges, including forging another nurse’s signature to prescribe the drug.
Buckley appeared in the Health Practitioners Disciplinary Court on Wednesday after the charges were brought by a New Zealand Nursing Council Professional Conduct Committee.
Buckley worked as a facility manager at an Auckland nursing home for residents with dementia, between January 6, 2020 and March 16, 2020, when she resigned.
She was hired in response to a district health board audit which identified 29 unmet criteria and the need for the facility to be managed by a qualified person.
Buckley was responsible for closing unmet audit criteria, many of which were related to inadequate documentation and systems.
An agreed summary of facts stated on Saturday, January 11, Buckley instructed a health care assistant to give two patients Lorazepam, which was not prescribed.
When the assistant questioned the instructions, Buckley told her “I’m the registered nurse” and that she had already informed the doctor.
Buckley personally administered Lorazepam to a third patient.
She also admitted to forging the signature of the facility’s registered nurse on a patient’s food profile.
The court was convinced that Buckley’s actions constituted professional misconduct.
Buckley testified at a hearing to determine her sentence.
“I want to acknowledge that I take full responsibility for my actions,” she said.
“I acknowledge that my conduct was extremely unprofessional.”
Buckley claimed the drug was given to patients after she saw them show signs of ‘sunset’ behavior, which occurs in people with dementia who may become more confused, agitated or insecure. of them as the day progresses.
She said patients had become verbally and physically abusive towards staff and residents.
A patient was throwing objects at people and hitting and biting staff and other residents, she said.
Buckley, who was not registered for work that day, said the patients had become incredibly anxious and agitated, so she decided to give them the drugs out of concern.
“I recognize that it was not appropriate for me to make this assessment.”
Buckley, who suffers from anxiety and depression as well as ADHD, described her new role as stressful and admitted she may have been too sensitive to what was going on.
“I was really concerned and worried for the residents and felt I had to do something for them.
“I accept that my actions were inappropriate and out of place.”
Buckley admitted to copying the RN’s signature from an old food profile onto a new document, as required by the DHB audit, but continued to deny it was intentional or that she had it falsified.
Matthew McClelland QC, appearing for the CCP, disputed Buckley’s claim, saying she deliberately tried to copy the nurse’s signature.
Buckley responded by saying she didn’t remember signing the form.
“I don’t remember trying to make one signature look like another.”
McClelland argued that Buckley’s conduct was a significant departure from accepted professional standards.
“It is professional misconduct and it is conduct that brings the nursing profession into disrepute.”
He said aggravating factors, including that Buckley was acting outside his scope of practice, had to be taken into account when deciding on a penalty.
Although the conduct did not warrant deregistration or a period of suspension from practice, the CCP wanted Buckley to undertake and successfully complete a Nursing Council of New Zealand course of study relating to the dispensing of drugs.
She must also disclose the court’s decision to any employer before she begins work as a registered nurse for a period of 12 months and a restraining order must be imposed to express the court’s strong disapproval and concern over the conduct. of Buckley.
Belinda Johns, representing Buckley, argued the offense was at the low end and any penalties should be kept to a minimum.
While Buckley’s actions had lowered the standards of the profession and undermined public trust, they came from a place of honesty and good intentions, Johns said.
Buckley was attached to the nursing profession. She felt she still had a lot to offer and was looking for a second chance, Johns said.
It was agreed that conditions would be placed on Buckley’s certificate of practice, which currently held none.
The court retired to consider the sanction to be imposed on Buckley and is expected to conclude later today.
– by Leighton Keith, Open Justice