East Kent Hospitals nurse slept during shifts and ignored patient warning alarms
Published: 05:00, 09 August 2024
Updated: 21:02, 11 August 2024
A nurse who slept during shifts and repeatedly failed to respond to patient alarms has avoided being struck off.
Member Iorhom was caught napping multiple times by colleagues at East Kent Hospitals (EKH) and even bedded down for the night in a ward while it was shut.
She also failed to spot that the condition of an extremely ill patient was deteriorating, instead telling a doctor they were “thriving”.
But despite her alarming behaviour, the Nursing and Midwifery Council (NMC) has ruled Mrs Iorhom can continue working in the profession.
A misconduct panel heard how concerns had been raised about her competence across a five-month period between October 2021 and March 2022.
At the time she was working for EKH, covering the William Harvey in Ashford and QEQM in Margate.
A damning report told how she secured a job on the William Harvey’s intensive care unit (ICU) in September 2021, despite previous bosses at Kent and Canterbury Hospital raising “concern about her competence and clinical practice”.
It revealed how on multiple occasions while on the ICU – which treats the most critically ill patients – Mrs Iorhom ignored, silenced or failed to respond to warning alarms.
On October 28, 2021, one such alarm sounded to indicated a patient’s blood pressure was too high.
Instead of escalating the issue to a doctor or adjusting his medication to bring it down, Mrs Iorhom turned the alarm off.
On another occasion she did not react to an alarm showing a patient’s oxygen levels had dropped.
The NMC report states: “Not responding to alarms is dangerous and places patients at risk of harm. Certain alarms alert staff to changes in patients’ health and that medication potentially needs to be adjusted.”
The panel was told that on November 29, Mrs Iorhom failed to identify that a patient was seriously ill at the same hospital.
“He was on lots of support and his condition was deteriorating,” the report states.
“However, when asked by the surgeon how the patient was doing, Mrs Iorhom told them the patient was ‘thriving’.
“She did not appreciate the seriousness of the patient’s condition.”
On other occasions Mrs Iorhom failed to recognise a patient was a sepsis risk and failed to deliver vital epilepsy medication to another.
Three times while on duty at the QEQM Hospital in January 2022, she was found asleep at a computer table and woken by a colleague.
“Sleeping on duty compromises the safety of patients and undermines the public’s confidence in the professionalism of registrants,” the report states.
Just five days after being caught napping for a third time, Mrs Iorhom was found asleep on a bed in the treatment room of the hospital’s surgical emergency assessment unit (SEAU).
She had gone to the ward, which was shut at the time, following her shift and was discovered by another staff member the next morning.
“Mrs Iorhom first told a colleague she had done this because she had missed her bus,” the report states.
“She then said it was because no buses were running on Sunday mornings and she would have been late for her shift.
“Mrs Iorhom had not raised her transport issues with a colleague to explore the possibility of her shifts being adjusted to accommodate this.
“SEAU is a closed ward and if, for example, there had been a fire, no one would have known of her presence. It was therefore a fire safety risk.
“It also presented an infection/hygiene control issue as Mrs Iorhom did not have any clean clothes to change into for her shift and could not shower on the ward.”
Mrs Iorhom left EKH in March and shortly after started working as a staff nurse at Castlegreen Care Home in Edinburgh.
The NMC was told an internal investigation was launched in April of that year due to concerns raised about her conduct and practice.
The panel was of the view that to impose a suspension order or a striking-off order would be wholly disproportionate...
But following last month’s misconduct hearing, the panel decided not to suspend Mrs Iorhom.
“The panel was of the view that to impose a suspension order or a striking-off order would be wholly disproportionate,” the report states.
“It would not be a reasonable response in the circumstances of your case because the charges could be addressed by a more proportionate sanction such as conditions of practice order.
“The panel carefully considered whether a suspension order may be more appropriate.
“But it was determined that the risk to patient safety would be addressed by conditions of practice and, therefore, a suspension order is not appropriate.
“Having regard to the matters it has identified, the panel has concluded that the conditions of practice order will mark the importance of maintaining public confidence in the profession and will send to the public and the profession a clear message about the standards of practice required of a registered nurse.”
The order will be in place for 18 months and imposes a number of conditions on Mrs Iorhom, including that she be supervised by a registered nurse, only work for one employer and not dispense medication unless under supervision.
Mrs Iorhom qualified as a nurse overseas in 2000 and started working for EKH in 2021.
The Trust says newly qualified staff are supported with training and guidance and are supervised by more experienced staff.
When issues are identified, extra support is put in place, it added.
It would not comment on the NMC’s ruling on Mrs Iorhom, who it no longer employs.
The NMC concluded Mrs Iorhom’s conduct amounted “to a lack of competence which impairs her fitness to practise”.
“Mrs Iorhom was provided with dedicated support over a several months, yet the concerns continued, and she failed to successfully pass PIP assessments or work independently for a consistent period,” the panel report states.
“The concerns relate to basic nursing knowledge. By failing to demonstrate the standards of knowledge expected of a registered nurse, Mrs Iorhom placed patients at risk of harm and consequently undermined the public’s confidence in the profession.”
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Brad Harper