Registered nurse ‘did not display knowledge or understanding of care procedures’

A Nursing and Midwifery Board of Ireland (NMBI) fitness to practise inquiry has heard a Co Cavan-based registered nurse failed to demonstrate a clear understanding of the care and administration skills required to support patients in nursing homes.

A complaint against Daniel Ioan, relating to his performance in Fairlawns Nursing Home in Bailieborough, Co Cavan, was made by the nursing home, alleging he failed to display competency in standard patient assessments, keeping of patient records and patient care.

At the inquiry on Tuesday Mr Ioan was accused of a number of errors including an attempt “to feed an unidentified resident when the resident was not appropriately positioned for feeding”. Other allegations included that he had been unable to complete admission assessments; had been unable to demonstrate an understanding of the grading of pressure sores; was unable to use a formula to calculate a patient’s nutrition; was unable to calculate a patient’s body mass index and failed to act appropriately when a woman patient was experiencing chest pains.

Mr Ioan’s supervisor, Heather Clarke, gave evidence she had observed Mr Ioan in several situations where his knowledge of procedures, including what to do when a patient was experiencing chest pains, was lacking. She said she knew Mr Ioan had received training on how to lift a patient and part of that training would have been not to lift under the arms. But she said the next day she had observed Mr Ioan attempting to lift a patient in that way. *

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“It is just he wasn’t safe to work as a nurse,” Ms Clarke said. “I felt he needed further training.” She confirmed she had asked Mr Ioan to contact the NMBI about a return-to-work course or further training. She said that at about 11pm on September 24th, 2019, she emailed the NMBI to express her concerns without mentioning Mr Ioan by name.

She told Eoghan O’Sullivan BL for the NMBI, she “would normally be in bed” at that time of the evening but had been troubled and did not see how she could leave patients in Mr Ioan’s care.

Ms Clarke said she was aware Mr Ioan and his partner had come to see the care home operator, formally the care provider Susan O’Reilly, the following day, September 25th. Her understanding of that conversation was that Mr Ioan had said he and his partner were getting legal advice over aspects of his treatment, she said.

Ms Clarke said she did not see how this visit could be related to her email to the NMBI as she had sent it the night before, and it hadn’t identified Mr Ioan.

Mr O’Sullivan, instructed by solicitor Yvanne Kennedy of Mason Hayes and Curran, said Mr Ioan had responded by indicating he had initially been given a contract as a healthcare assistant and was so busy working in that role that he had not been given time to read up on patient healthcare plans. Mr O’Sullivan said Mr Ioan had alleged “there was no intention to have me working as a nurse”.

The hearing also heard Mr Ioan had completed HSE courses in hand hygiene, breaking the chain of infection, manual handling and people handling and dignity at work, among others.

The hearing is due to continue at a later date.

* This article was amended on Thursday, September 1st, 2022. An earlier version incorrectly attributed Heather Clarke’s evidence to Loyola Clarke