A case study showing an example of how stealing controlled drugs led to a nurse being the subject of a Nursing and Midwifery Council fitness-to-practise hearing
While employed at a hospital, Nurse A stole codeine phosphate 30mg tablets on one or more occasions. On 13 August 2015 while being investigated by the hospital she said that she had not been involved in any previous investigation into missing medication when this was not the case. Her conduct was dishonest in that she was seeking to conceal her involvement in such a previous investigation.
Nurse A was employed as a registered nurse at a general hospital, part of the Health and Services Department in Jersey in 2015. The matter was investigated internally by the department following a significant increase in codeine phosphate tablets being ordered for the ward.
In spring 2015, a significant increase in codeine phosphate tablets usage was noted. Stock levels were monitored from the beginning of summer 2015 and it was observed that on 10 separate occasions, a number of codeine phosphate tablets had gone missing. The staff register was checked and it was revealed that the only staff member with access to the drugs who was on duty for all 10 shifts was Nurse A. It is alleged that Nurse A, on one or more occasions, stole varying amounts of 30mg codeine phosphate tablets.
During the course of the investigation at the hospital, she denied she had ever been the subject of any previous investigation into missing drugs – this was not correct.
At the hearing
Following a marked increase in the usage of codeine phosphate 30mg tablets on the ward, the usage of codeine phosphate was monitored. The ward manager told the panel that the checks were initially completed once a day and then twice a day. The monitoring revealed that there were 10 separate occasions when significant amounts of codeine phosphate tablets had gone missing.
It was discovered that Nurse A was the only registered nurse on duty for each of these occasions. There was no evidence that any other member of staff at the relevant times had keys, which allowed access to the locked cupboards or ‘PODS’.
Nurse A admitted all the charges in their entirety. As such the charges were found proved. When determining whether the facts found proved amount to misconduct the panel had regard to the terms of the Code. Nurses occupy a position of privilege and trust in society and are expected at all times to be professional and to maintain professional boundaries. To justify that trust, nurses must be honest and open and act with integrity. They must make sure that their conduct at all times justifies both their patients’ and the public’s trust in the profession.
The panel found there was no harm caused to a patient and the charges did not relate to clinical failings. However, Nurse A breached one of the fundamental tenets of the nursing profession – to act with honesty and integrity at all times. The panel noted that her actions brought the profession into disrepute as members of the public would not expect nurses to behave in this way.
The panel considered that because of Nurse A’s non-engagement with the NMC, it was unable to conclude that she was not liable to repeat similar misconduct. It noted that she had been the subject of a previous investigation into missing drugs. Although, no findings had been made against Nurse A, the panel was of the view that if this previous investigation did not deter her from misappropriating drugs, then it is unlikely that these proceedings will.
Results of the fitness-to-practise panel
The ftp panel can impose four different sanctions:
- Caution: the nurse or midwife is cautioned for their behaviour, but is allowed to practise without restriction
- Conditions of practice: this will prevent a registrant from carrying out certain types of work or working in a particular setting, it may require them to attend occupational health or do retraining. The order can be applied for up to three years and must be reviewed by an FTP panel again before expiry
- Suspension: the nurse or midwife will be suspended from practice for a period of initially not longer than one year, but this can be extended after review by an FTP panel
- Striking off: a nurse or midwife is removed from the register and not allowed to practise in the UK. The nurse or midwife must apply to be readmitted to the register