NEWS-HR

A nurse has denied claims she administered “heavy-hitting” sedatives to children without them being prescribed. Ms H, who has interim name suppression, appeared before the Health Practitioners Disciplinary Tribunal facing a professional misconduct charge. On Tuesday, the panel heard Ms H reportedly administered sedatives she was either not allowed to give without supervision, or which were not prescribed, to two patients while working as an intern clinical nurse specialist at an Auckland hospital emergency department in 2017. While Ms H accepted she failed to document the names of doctors who gave verbal prescribing orders for the medicines, or those who supervised, she denied administering them without prescriptions or supervision. The Professional Conduct Committee (PCC) alleged Ms H gave a patient propofol, fentanyl and ketamine when they were not prescribed or documented in his chart. Propofol has strict guidelines for use, and Ms H was not qualified to give it without supervision. She also allegedly gave ketamine and propofol to a second child with a fracture, when neither drugs were prescribed or documented. On Wednesday, Ms H denied the PCC’s submission that she compromised patient safety. Giving procedural sedation was a “very large part” of her role in the emergency department, she told the tribunal. As an intern, Ms H managed her own patients under the supervision of a senior medical officer (SMO). She would discuss each patient with a supervising doctor, who would then decide whether they wanted to see the child directly. If they were happy with her assessment and plan, the SMO would give Ms H verbal orders to continue with the discussed treatment, she told the tribunal. She said this was done with both patients in this case, who were given medicines under verbal orders. No concerns were raised at the time about the medicines used in either case, she told the tribunal. Ms H said she had administered propofol or fentanyl many times during resuscitation situations directed by an SMO, as was “usual practice” for any ED or ICU nurse. Ms H told the tribunal her orientation to the DHB and the CNS intern role was “poor”, and maintains she was never told clinical nurse specialists could not give propofol. Ms H said she “mistakenly” believed she was able to administer propofol and fentanyl having attended procedural sedation courses, but always did so with supervision. “If I was told to never give propofol, I would have never given propofol,” she said. On reflection, Ms H said she was “really concerned” she could have made this “mistake”. Asked by her lawyer what she would do if a doctor told her to administer the medicines today under verbal order, Ms H said: “Absolutely not, I wouldn’t go there.” A five-person panel, led by barrister Alison Douglass, will decide on Thursday whether the allegation against her are established.

A s.185 (Enterprise agreement) application from St Vincent’s Private Hospitals Limited T/A St Vincent’s Private Community Hospital Griffith & Mater Hospital Sydney for its St Vincent’s Health Australia (NSW Private Hospitals) Support Services Enterprise Agreement 2018 has been approved by Fair Work Deputy President Young in Melbourne on 12 August 2019.

A s.185 (Enterprise agreement) application from the Australian Red Cross Society T/A Australian Red Cross Blood Service for the Australian Red Cross Blood Service Western Australian Donor Centre and Nurses Enterprise Agreement 2018 has been ratified by Fair Work Deputy President Kovacic in Canberra on 13 August 2019.

A nurse who allegedly gave children propofol, fentanyl and ketamine when she wasn’t allowed to and without prescriptions faces disciplinary action. Ms H, who has interim name suppression, appeared before the Health Practitioners Disciplinary Tribunal facing a professional misconduct charge. On Tuesday, the panel heard Ms H administered sedatives she was either not allowed to give without supervision, or which were not prescribed, to two patients while working as an intern clinical nurse specialist at an Auckland hospital emergency department in 2017. The issue reportedly came to light after staff heard Ms H talking about giving propofol to a patient at a “social event”. The panel heard that while undergoing training, Ms H gave propofol, fentanyl and ketamine to Patient A, who had a fractured ankle. None of the drugs were prescribed or documented in the patient’s medication chart. Propofol – which caused the death of Michael Jackson – is an anaesthetic. It is rarely used on its own because it can cause difficulty breathing. There are strict guidelines for its use and it is always administered in a resuscitation room with a “dedicated airway doctor” present, and under the guidance of an ED senior medical officer (SMO), the tribunal heard. However, it’s alleged Ms H did not do this. An emergency medicine specialist told the tribunal she would not expect propofol to be given without a very senior doctor or consultant present, and she would not allow a junior doctor to administer it to a patient on their own. Another witness, a clinical nurse specialist, said she had never given a child propofol in her eight years working in the emergency department. Lawyer for the Professional Conduct Committee, Matthew McClelland, said the nurses actions compromised patient safety. The panel heard Ms H also gave Patient A fentanyl and ketamine without a prescription, or failed to properly document if she received a verbal order to give the drug. Ms H understood she was able to administer propofol to patients because she attended a procedural sedation workshop, but this was not the case, the tribunal heard. McClelland said Ms H also falsely represented herself by signing Patient A’s clinical assessment form as a clinical nurse specialist when she was an intern. She also failed to complete “full and accurate” clinical notes, compromising Patient A’s safety, McClelland said. Ms H also gave ketamine and propofol to Patient B, who fractured her leg. Neither drugs were prescribed or documented. The propofol was either given without the supervision of a senior doctor, or Ms H failed to document the name of the doctor present, the tribunal heard. Ms H was qualified to give patients ketamine, but not without a prescription. A panel of five, led by barrister Alison Douglass, must decide whether the charge against the nurse has been established and, if so, what penalty should be imposed.

The Australian Nursing and Midwifery Federation-New South Wales Branch and The Frank Whiddon Masonic Homes NSW are at s.739 (Application to deal with a dispute) loggerheads before Deputy President Boyce in chambers (by telephone) in Sydney.

Villa Maria Catholic Homes has a s.394 (Application for unfair dismissal remedy) on its hands in front of Fair Work Deputy President Masson in the Fair Work Commission 11 Exhibition Street Melbuorne (Oyeniyi).

A s.185 (Enterprise agreement) application from St Vincent’s Private Hospitals Limited T/A St Vincent’s Private Community Hospital Griffith & Mater Hospital Sydney for the St Vincent’s Health Australia (NSW Private Hospitals) Support Services Enterprise Agreement 2018 (Health and welfare services) has been ratified by Fair Work Deputy President Young in Melbourne on 12 August 2019.

Ambulance Employees Association of WA and St John Ambulance Western Australia Ltd have a contretemps (s.739 – Application to deal with a dispute) on foot before Fair Work Commissioner Williams in Conference Room in Perth at 2.30pm.