Nurse who taped patient’s mouth accepts guilt

A nurse who placed tape over a patient’s mouth accepts he is guilty of professional misconduct, an inquiry heard today.

Bimbo Paden, a Filipino nurse at St John’s community hospital in Sligo, faces three charges of professional misconduct in relation to events that took place on June 26th 2013.

His is the first fitness to practise inquiry into a nurse to be heard in public. The hearing opened today at the headquarters of the Nursing and Midwifery Board of Ireland in Blackrock and is expected to last two days.

Mr Paden has already faced criminal charges over the incident; last April in Sligo District Court, he was given the benefit of the Probation Act after pleading guilty to assault of a patient.

He is charged before todays’s fitness to practise inquiry with having placed surgical tape over the mouth of a patient in circumstances where he knew this to be inappropriate.

He is also charged with placing a sling under the patient without the assistance of a colleague in breach of HSE lifting procedures. The third allegation is that he failed to act in the best interests of the patient, and put the health, safety and welfare of the patient at risk.

The hearing is due to hear from eight witnesses called by the nursing board and at least four called by lawyers for Mr Paden.

Outling the board's case against Mr Paden, Neasa Bird, barrister, for its chief executive, said his actions were entirely inappropriate and incredibly upsetting. She said the patient's family were horrified by what had happened.

She said it was the chief executive’s case that what happened was an act of abuse and form of physical restraint for which there was no possible justification. It was not accepted that staffing levels were an issue in the case.

Noel Whelan, barrister, for Mr Paden, said his client accepted that putting the tape over the patient's mouth amounted to professional misconduct. He accepted the placing the sling under the patient was inappropriate and not in accordance with the care plan but did not accept it was professional misconduct.

He said Mr Paden, who came to Ireland in 2000, was a father of three who was the only breadwinner in his household. He worked with the patient for over six years and got on with him very well. Until this incident, his care of the patient was proper and professional.

Counsel said Mr Paden was horrified at what he had done and was ashamed of his actions. It was “a moment of stupidness or silliness” on his part. He also accepted that what he had done amounted to assault and a gross breach of trust on his part.

St John’s has 100 residents, making it the second largest community hospital in the state. The patient in the case, referred to at the hearing as Patient A, was admitted 10 years earlier after suffering a brain haemorrhage. He was a maximum dependency patient requiring full care for all his needs.

Ms Bird said Patient A was unable to talk and communicated by making “verbal noises” to staff. Two staff were required to meet his care needs apart from meals.

Mr Whelan said on the day in question Mr Paden was on his medication round when he visited Patient A and Patient C, who had cancer, in a bay.

Patient A was making a continuous, relatively loud noise, to the distress of Patient C, he said.

Mr Whelan said Mr Paden, motivated by a desire to alleviate Patient C’s stress, decided to move Patient A to the activity room, where the music generally calmed him down.

He put a sling under Patient A, and took a piece of tape from his pocket and put it on the patient’s mouth. It was there “for a matter for seconds”, Mr Whelan said, before another nurse arrived and he removed it.

Mr Whelan said his client accepted what he did was wrong and could not be justified.

But he said Mr Paden was stressed and he had an inequitable distribution of the workload. A subsequent inquiry found his workload was “inequitable, unreasonable and unsafe” for any one staff member.