Nurse facing poor performance allegations that he failed to contact emergency services when patient became unwell
A nurse employed at a Wicklow nursing home allegedly failed to contact emergency services when a patient became unwell and told a healthcare assistant he thought he was dying, a fitness to practise inquiry has heard.
Mr Edwin P Lara, who worked as a registered nurse at San Remo Nursing Home in Bray, which has since closed down, appeared before the fitness to practise committee at the Talbot Hotel, in Stillorgan, Dublin yesterday.
He is facing six allegations of poor performance by the Nursing and Midwifery Board of Ireland concerning events which took place during the course of his night shift on February 25 and 26, 2019.
The committee heard how a man, referred to as Patient A, died on the morning of February 26.
He suffered from type 2 diabetes and was recovering from major surgery which was carried out at St Vincent’s Hospital in January 2019.
It is alleged Mr Lara, who qualified as a nurse in 1992, failed to adequately treat Patient A’s hypoglycaemia from 6.20am onwards by not testing his blood sugar levels every 10 to 15 minutes or providing a sufficient amount of “rapidly absorbed carbohydrate”; failed to check his vital signs adequately and failed to provide adequate care to Patient A by not contacting emergency services or the director of nursing.
Mr Lara was the only registered nurse on duty that night but there were also two healthcare assistants and one additional assistant who was responsible for a particular resident.
There were 32 people resident at San Remo at the time, including 12 high-dependency patients.
The committee heard how Patient A, who was 76 and had been staying at the home since 2010, was a “different man” after returning from his surgery. He had gone from a patient of medium dependency to high dependency. He had to wear a bag to collect waste, would often stay in his room and was very down. Prior to the surgery he was independent, could go out to the local shop, loved to read the newspaper and would be in the lounge area entertaining others.
Two of the healthcare assistants on duty said Patient A became unwell during the course of the night and told them he “just wanted to die”.
The inquiry heard how one of the healthcare assistants told Mr Lara she was of the opinion he wasn’t very well as he was sweating, had become pale, was breathing differently and was passing abnormal bowel movements.
She indicated she thought he may need to go to hospital as he said he believed he was dying.
She claimed Mr Lara responded to say he was fine.
The committee heard how Mr Lara, in his affidavit, said Patient A only became unwell in the morning when his blood sugar level was low. The inquiry heard how staff would normally give patients experiencing hypoglycaemia a drink of Lucozade but there was none available at the time, so he was given an Angel Delight dessert and a cup of tea with sugar.
Ms Luzviminda Montejo, director of nursing, said during handover Mr Lara did not indicate anything urgent was wrong but mentioned Patient A’s blood levels were low and he was given some Angel Delight to rectify this. Around 9am, after Mr Lara’s shift had ended, Patient A took a turn and became unresponsive. An ambulance was called but he was pronounced dead at 9.35am.
The committee heard the post-mortem found he died from presumed cardiac arrhythmia due to severe coronary artery disease.
The Nursing and Midwifery Board of Ireland indicated the cause of death does not relate to the allegations Mr Lara faces.
On the same night, another resident, referred to as Patient B, sustained a fractured femur following a fall.
It is alleged Mr Lara failed to provide adequate care by not ensuring she was assisted by two staff members with her evening routine when he should have known this was required, failed to appropriately assess her for injuries following her fall and failed to contact a doctor or emergency services.
Mr Lara chose to have non-legal representation. The inquiry is expected to continue in April for a further two days and will hear evidence from Mr Lara and other witnesses.
The fitness to practise committee will report to the Nursing and Midwifery Board on its findings at a later date.