A hospital dismissed a long-serving Clinical Nurse Manager (CNM) after she admitted to forging a medical consultant’s signature and using a patient’s personal data to illegally obtain prescription medication from a pharmacy.
The CNM also admitted to taking two tablets of a prescribed medication from the hospital on January 19th, 2021, and further accepted these were not isolated incidents.
The hospital dismissed the CNM, who had been employed since February 1993, for gross misconduct on June 18th, 2021.
The CNM, who earned €1,106 per week, took an action for unfair dismissal at the Workplace Relations Commission (WRC), but Adjudicator Brian Dolan dismissed the woman’s case.
In his findings, Mr Dolan said the CNM’s admitted actions constitute gross misconduct. He noted she immediately admitted to the misconduct when questioned, apologised for the damage caused and sought to rectify the root cause of the issue that led to the misconduct.
Mr Dolan said a fundamental aspect of the hospital's duty of care is the control of prescribed medicines and patient data and the CNM "by her own admission, misused the trust placed in her in respect of these matters".
Mr Dolan stated the hospital "is naturally entitled, if not obliged, to view any breach of this trust in the most serious of terms".
Mr Dolan concluded that the nature of the CNM's misconduct, coupled with the nature of her role and the hospitality’s duty of care, meant her dismissal was within the bounds of reasonable responses, even after taking mitigation factors into account.
Prescribed medications
Mr Dolan said it is agreed that the CNM illegally removed prescribed medications, intended for patient use, for her own use.
Mr Dolan said it is further agreed that the CNM removed blank prescription scripts for the ward to which she was assigned and thereafter misused patient data and forged a consultant’s signature in order to obtain controlled medication.
The hospital told the WRC hearing that the CNM’s misconduct, in addition to the admitted misuse of the personal data of a patient and a colleague, served to irrevocably breach the bond of trust.
The hospital contended that the actions of the CNM were in breach of the hospital’s own policy on the storage and handling of medicines, the Misuse of Drugs Act, the hospital’s code of conduct, the code of professional conduct for registered nurses and the hospital’s own internal disciplinary policy.
After the CNM made admissions concerning the irregularities, she was suspended from duty. During the investigation process, she disclosed that she had experienced addiction issues.
The CNM was represented by Liz Curran of the Irish Nurses and Midwives Organisation (INMO) in the action.
At hearing, the CNM agreed with the hospital’s narrative of events, including the admission of alleged wrong-doing.
The CNM put forward a number of mitigating factors, including that she accepted responsibility for her actions, she is attending a counsellor, she had completed a treatment programme for alcohol dependence and remains enrolled in a further two-year programme, and she continues to attend her GP for ongoing care.
Mitigation
In addition, the CNM suggested the imposition of a number of conditions on her return to work. These conditions, she said, could include the submission of ongoing evidence of her attendance at an alcohol dependency treatment centre, evidence of her attendance at AA meetings, random drug and alcohol testing, and redeployment to a role where she would not be in contact with prescribed drugs.
The CNM submitted that no evidence of consideration of these mitigating circumstances and conditions was taken by the hospital, with the matter simply being upheld internally on appeal.
The CNM submitted that the mitigating factors provided, in addition to the suggested conditions for her staged return to employment, rendered the sanction of dismissal outside the band of reasonable responses in the circumstances.
The CNM said she always held patient safety in the highest regard and her actions did not serve to endanger the safety of any patients.
Mr Dolan used his discretion to anonymise the parties following an application by the CNM.
The CNM made the application on the basis that the matter concerns sensitive information, including matters relating to misuse of third-party data and certain allegations of fraudulent activity. On the date of the hearing, these matters remained under investigation by third-parties.
The CNM's application was made with the consent and support of the hospital.
