A nurse who falsified medication records and gave incorrect doses of medicines to residents of a nursing home in Cork City six years ago has been found guilty of professional misconduct.
A fitness-to-practise inquiry by the Nursing and Midwifery Board of Ireland has found a series of allegations proven about the care provided by Carmelita Bacani to patients at the CareChoice centre on Upper Glanmire Road in Montenotte during 2017.
The chairperson of the NMBI’s fitness-to-practise committee, Dr Conan McKenna, said such behaviour also constituted poor professional performance.
Dr McKenna said the committee was satisfied her behaviour represented a serious falling short of the expected standard of conduct of nurses and of the standard of competence of knowledge and skill expected of members of the nursing profession.
As such Dr McKenna said Ms Bacani’s actions constituted a breach of the Code of Professional Conduct and Ethics for registered nurses.
The FTP did not disclose its recommended sanction on the nurse which will be decided by the full NMBI board.
Ms Bacani – a 52-year-old mother of one who comes originally from the Philippines – did not attend the hearing on Thursday due to work commitments.
She had previously told the inquiry that she had halved the recommended dose of the painkiller, Oramorph, to one resident of the CareChoice centre on May 16th, 2018 because he had appeared comfortable, relaxed and sleepy.
Dr McKenna said such evidence was rejected as “not credible” because Ms Bacani had failed to register the change in dosage in the patient’s medical records.
A total of 18 of 21 allegations against the nurse relating to the care of five patients were found proven beyond reasonable doubt based on the evidence of other staff from the nursing home, medical records, an expert witness as well as some admissions by Ms Bacani.
She had also given an amount below the required dose of a treatment for diabetes, NovoRapid, to another individual, Resident B on May 31st, 2017.
Ms Bacani was accused of failing to administer prescribed medication including sleeping tablets and a treatment for Parkinson’s disease to Resident B and three other residents on July 8th, 2017 while signing medication administration records to indicate that she had given them the drugs.
Dr McKenna said no reasonable excuse for pre-recording the administration of drugs had been provided by Ms Bacani.
The inquiry heard the nurse had also inserted false initials on the nursing home’s controlled drugs register on 22 different dates in 2017 to indicate that she had administered a painkiller to Resident E in the presence of another registered nurse as required under CareChoice’s controlled drugs policy.
Dr McKenna said such repeated action over a six-month period was “profoundly serious” and represented “disgraceful and dishonourable” behaviour which brought dishonour on the nursing profession.
He made similar comments in relation to the finding that the nurse had forged the initials of other nurses on the same register on 10 dates in 2017 in relation to the provision of the painkiller, OxyContin, to Resident F.
However, Ms Bacani was cleared of three charges relating to the administration of a drug for improving muscle stiffness to a sixth resident, Resident D.
The inquiry arose following a complaint by the nursing home’s then director of nursing, Joanne Williams, to the NMBI in September 2017.
The FTC committee heard that the complaints about Ms Bacani had also been referred to gardaí at the time but the DPP had subsequently taken a decision that no criminal prosecution should arise from the case.
The inquiry heard that Ms Bacani did not dispute the fact that she had forged signatures about the use of controlled drugs on medical records.
Three former nurses at the centre gave evidence that their initials on the controlled drugs register were not signed by them.
Ms Bacani was suspended by the nursing home who reported the matter to gardaí as the incidents involved the use of controlled drugs.
In a letter to the NMBI at the start of the inquiry in February 2022, Ms Bacani claimed she had acted out of sympathy for the residents because of the pain she had felt herself after undergoing a hysterectomy in October 2016.