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Final Panel decision and reasons: 'What penalty should a nurse face for having a lack of knowledge about common medicines?'


The panel considered the provisional CPD agreement between Nurse A and the NMC.

The panel found the facts of the case proved by way of admission as contained within the CPD. It considered that Nurse A’s full admissions and acceptance of the CPD agreement demonstrated insight into the charges.

Nurse A had shown a lack of basic knowledge of medications and medication management. It considered that this lack of knowledge and understanding could have had serious consequences for those in her care. As such it considered her lack of competence as a serious breach of the duty of care a nurse owes to her patients.The panel was satisfied that her lack of basic knowledge and understanding in the area of medications did amount to a lack of competence.

The panel then went on to consider the fact that Nurse A had been asked to undertake an International English Language Testing System assessment. It noted that Nurse A had scored below the requirement set, by scoring a band score of 5 when a minimum band score of 7 has been set to show the necessary knowledge of English to practise safely and effectively as a registered nurse. As such, the panel was satisfied that Nurse A had not shown the required knowledge of English to practise safely and effectively.

The panel considered that Nurse A had accepted her failings and therefore her lack of skill, knowledge and judgement to practise safely as a nurse. She also accepted that she was lacking in the required knowledge of English to allow her to practise safely and effectively. In addition, the panel noted her own reflective piece together with the certificate in relation to attendance on a ‘Medications Training’ course together with a reference provided on her behalf from a care assistant at another care home.

In the panel’s judgement, the risk to the public had not been remediated and as such the risk of repetition remains. They also felt the need to uphold proper professional standards and that public confidence in the profession would be undermined if a finding of impairment was not made.

On the basis of the facts found proved by admission of the charges, the panel found Nurse A’s fitness to practice to be impaired by reason of her lack of competence and her lack of knowledge of English.


The panel considered that taking no action would be wholly inappropriate in this case as this would not address the lack of competence and impairment found proved. Nor would it protect the public or indeed uphold the reputation of the profession and safeguard the public interest. The panel next considered whether a conditions of practice order would be appropriate. It did not consider that such an order would be practical or workable given that the registrant has not fully remediated her practice and does not possess the required level of English to practise safely or effectively.

It then went on to consider the suggested suspension order. It considered this to be an appropriate and measured sanction in that it would offer time to develop her knowledge and skills in relation to medication and medication management and raise her standard of English in order for her to practise safely and effectively as a nurse.

The panel considered that a striking off order would be disproportionate in this case.

The panel therefore makes a suspension order for a period of 12 months. The panel imposes an interim order for 18 months, necessary for the protection of the public and otherwise in the public interest.



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Readers' comments (6)

  • This appears to be a clear cut case. It is easy to measure competence with drug administration.

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  • Conditions of practice for 3 years would have been a better option. In this time she could have attended English classes to improve her English to an acceptable level
    Training by the home seems to have been very lax as medicine management would have been included in the induction programme.
    Medicine do have different names but Ive found that if the chemical name is given, the Romanian nurses usually understand.
    Another problem I found when dealing with foreign nurses, even those who spoke English as mother tongue, was accents & dialects. Great problems arise.
    The fact that the panel didnt even know that there is no danger with cranberry & warfarin is disgusting
    Therefor I feel that the panel came to the wrong decision

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  • Should her lack of English been picked up before being allowed to work.
    This in some was was the fault of the employer or registration procedure ?

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  • I agree with anonymous 11:16pm who did nurse A's medicines assessment? Surely they should of pick this up earlier.

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  • The NMC are wholly inconsistent with what they consider to be worthy of sanction. According to a case published on their website, a nurse can lie through their teeth to avoid taking responsibility for their own actions, can attempt to destroy the credibility of colleagues in trying to blame them, coerce and intimidate and get off with caution, despite (according to the hearing outcome) working with vulnerable clients. So I think this was probably very harsh, given the home had culpability in allowing her to administer medications in the first place.

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  • This is why all Clinical NHS staff who come from overseas should have to have mandatory language skills testing and be required to meet a set standard of this. I am a foreign nurse myself and would expect nothing less

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