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.
