A nurse with “numeracy difficulties” who made errors giving drugs to patients at Ninewells Hospital has been sanctioned by her professional body.
Janice Walker demonstrated “a sustained lack of skill … in basic areas of nursing practice,” and on a number of occasions “did not administer drugs safely,” according to the competency and conduct panel of the Nursing and Midwifery Council.
They have now imposed an 18-month conditions of practice order, restricting her ability to work as a nurse, following a hearing in Edinburgh last week.
If she applies for a nursing post, she must work under supervision and must not administer drugs independently until she has been assessed competent.
Ms Walker worked as a senior staff nurse at Ninewells but was suspended after she made a number of mistakes.
More errors followed after a period of mentoring and she was dismissed in January 2008.
She has not worked as a nurse since then, but continues to work at the hospital as a healthcare assistant.
Ms Walker qualified as a nurse 20 years ago and spent 14 years caring for elderly people at the Royal Victoria Hospital in Dundee before choosing to challenge herself with a move to working in Tayside’s largest acute hospital and was quickly “overwhelmed” by the change.
Within a short time of her arrival, she made a drug administration error which was followed by further such errors. In her own evidence at the hearing she “made no secret of her numeracy difficulties and their impact on her ability to do drug calculations.”
She worked on different wards in the hospital, with periods of mentoring and formal supervised practice and assessment, prior to her eventual dismissal.
The panel did not think she went to Ninewells suffering from a basic lack of skill and ability that she had managed to conceal.
“Rather, she was initially overwhelmed by the move to a larger hospital, the pace of the ward to which she was assigned, a greater level of responsibility than she anticipated and the impact of a different shift pattern,” said the panel.
“At the same time, senior staff on the ward had understandable expectations about a new colleague who, as the panel was told in evidence, had been the best candidate for the job.”
The situation, together with the first drug error, started a process of loss of confidence which “steadily spiralled” as time went on.
When Ms Walker was placed under supervision by hospital management, that made her more anxious and worried about her ability to perform competently.
“As her confidence left her, so her performance deteriorated to the point where, finally, she was failing to meet required standards in a number of basic respects,” stated the panel.
It was on that basis it found the nurse’s fitness to practise to be currently impaired.
She made errors in administering drugs and the NMC panel found that on a number of occasions did not administer drugs safely. Her work was below the standard to be expected of a nurse of her experience and amounted to lack of competence.
The panel was “in no doubt” her fitness to practice is currently impaired, and concluded her lack of competence could be attributed to “the circumstances of her working at Ninewells Hospital and not to any deep-seated lack of skill and ability.”
In evidence, Ms Walker said she wanted to pursue a nursing career if she was able to do so.
She said her confidence has been much restored, not just because she has not been under pressure at work, but also because some stress factors apart from work have now gone away.
Working at the hospital as a healthcare assistant, observing nurses at work, she has been able to learn how they go about prioritising and managing their work. She told the panel she would apply this learning to her own practice in any future nursing position.
The panel did not doubt her sincerity and accepted she would respond positively to the re-training and supervision that would be necessary in the event of her returning to work as nurse.
A spokeswoman for NHS Tayside said, “We can confirm, as stated in the report, that Janice Walker was dismissed as a registered nurse in January 2008 and that she now works as a healthcare assistant.”