Nine month suspension for nurse who falsified end of life patient's notes

A nurse who admitted deliberately falsifying the notes of an end of life patient who was left in soiled clothing in bed, has been suspended for nine months.

A nurse who admitted deliberately falsifying the notes of an end of life patient who was left in soiled clothing in bed, has been suspended for nine months

 The Royal Cornwall Hospital, also known as Treliske Hospital. Picture: Alamy

Deborah Tracey Crane retrospectively made an entry into the notes of a man referred to as Patient A indicating she had attempted to perform pressure care, despite knowing no such attempt had been made.

A Nursing and Midwifery Council (NMC) fitness to practise panel also heard Ms Crane ordered two healthcare assistants (HCAs) not to attend to Patient A, and refused ‘on one or more occasions’ their requests to turn him to relieve pressure ulcers.

Care responsibility

The incidents happened during a nightshift on 29 December 2015 at the Royal Cornwall Hospital – commonly known as Treliske Hospital – where the Band 5 staff nurse was responsible for Patient A’s care.

Ms Crane claimed she had ‘attempted unsuccessfully’ to turn Patient A by herself at 2am and with the aid of the two HCAs at 4am.

But the panel did not accept this evidence, noting that Ms Crane had failed to provide sufficient detail of the care provided to the patient, their condition or clothing. The panel said the instruction for the HCAs not to attend the patient was 'out of character' for Ms Crane, but determined it was 'even more unlikely' for the HCAs to fabricate such an order.

The panel additionally found proven charges of Ms Crane failing to ensure Patient A was subjected to care rounds, turns, or regular pain assessment, as would have been clinically appropriate.

Her actions were also found to have ‘caused and/or contributed to Patient A being found on 30 December 2015 having soiled himself with urine and vomit, which, at approximately 7.45am, had dried'.

Evidence provided by several witnesses, including nursing colleagues, meant the panel was not able to determine Ms Crane’s actions directly caused Patient A’s pressure sores.

However, the panel concluded the lack of care provided during her shift meant it was ‘more likely than not’.

'Forgotten entry'

Ms Crane claimed she made the retrospective entry because she ‘simply forgotten to do this’ on the night shift in question.

However, the panel decided the entry 'was made to convey patient care had been given when you knew such care had not been given'.

RCN counsel Tom Buxton, representing Ms Crane, told the panel his client had ‘shown considerable insight into the incident, and as a result of this (had) learned from the experience’.

Panel conclusion

The panel concluded Ms Crane’s actions meant her fitness to practise was impaired by reason of misconduct.

She had also breached the trust’s end of life care strategy and the NMC’s record keeping guidance for nurses and midwives, as well as the NMC Code.

The panel's reports adds that it was not satisfied that Ms Crane fully understood how her actions placed Patient A at risk of harm, or the significant effect on his family.

‘In addition, your conduct has impacted negatively on the reputation of the nursing profession and the panel were not satisfied that you understand how you would handle a similar situation differently in the future,' the report says.

Read the NMC report of the case

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