Caution for nurse who grabbed and swore at dementia patient

A fitness to practice panel also heard Tina Lawlor grabbed and/or shook the patient’s wrist in the incident at Bro Ddyfi Community Hospital in Machynlleth, Powys.

Ms Lawlor was handed a three-year caution by the Nursing and Midwifery Council (NMC) after the eight-day hearing, meaning she can continue to practise with no conditions on her registration.

A report on the hearing says Ms Lawlor was suspended from her role as a band five nurse at the hospital’s inpatient Twymyn Ward following the incident in March 2021, and resigned two months later.

It says Ms Lawlor accepted shouting at the woman, named as Patient B, but denied swearing at her or shaking her wrist.

However, the panel heard live evidence from three former colleagues who all witnessed the incident, whose version of events did not align with Ms Lawlor’s.

They told the panel that on the day in question they heard what one described as “high pitched shouting and screaming” and rushed towards it, believing there to be an emergency – but found it was Ms Lawlor shouting at a patient.

The report says: “Witness Four recalls going into the room and seeing you hold Patient B’s left wrist in your hand tightly and shaking it.

“Witness Four alleges that you said words to the effect of, ‘I’ve not got time for your s***’ and, in a shout, told her to take a tablet.

“Witness Three recalls that when she asked you what was wrong, you replied, ‘she won’t take her f****** tablets’.”

The report says the panel did not accept Ms Lawlor’s claims that the witnesses were “colluding” against her.

It says: “The panel further noted that three witnesses heard the scream at the same time, and all described it as being particularly loud.

“There were some minor variations in their accounts but fundamentally the core of their evidence was that they all observed something which caused them concern.”

The panel found the two charges relating to swearing and grabbing the patient’s wrist proved on the balance of probabilities, and the charge relating to shouting at the patient was found proved by admission.

A separate charge, that Ms Lawlor had failed to inform colleagues that a different patient had soiled themselves several weeks previously, was found not proved.

The panel also ruled that Ms Lawlor had no case to answer in respect of three further charges, including one that she had shouted at a colleague that she was the nurse in charge and that another colleague – who had been knocked unconscious after hitting her head on a hoist – should have stayed on shift.

The other two charges Ms Lawlor had no case to answer for related to allegations she shouted at another patient to “take your tablets” and slammed her hand down on a table.

Dan Santos-Costa, presenting the case for the NMC, submitted that the three charges found proved amounted to misconduct.

He said they demonstrated behaviour which was “unprofessional, unkind, and put the patient at an unwarranted risk of harm”.

Zahra Ahmed, representing Ms Lawlor, said her client had demonstrated remorse for shouting and also accepted holding the patient’s wrist, but not in an aggressive manner.

The report says: “You have been apologetic, learned from your mistakes and have continued to work in your role since the incident happened two and a half years ago in March 2021.”

Ms Ahmed also told the panel that Ms Lawlor had attended courses and now works in a nursing home, where some patients have dementia, and a statement from her current manager was “excellent evidence of remediation”.

The panel concluded that Ms Lawlor’s actions did amount to misconduct and ruled that her fitness to practise was currently impaired on public interest grounds.

A caution order was imposed, meaning future employers will be notified of the outcome of the proceedings for the next three years.

The report says the panel felt this would mark “not only the importance of maintaining public confidence in the profession, but also send the public and the profession a clear message about the standards required of a registered nurse”.