Blackburn nurse suspended over medicine mishaps

Ghazala Adman's fitness to practise was found to be impaired and she was given a substantive conditions of practice order in November 2019.

This was over alleged medication mistakes, and failing to maintain the dignity of a patient while he was using the toilet in incidents dating back to 2017.

She was told, among other conditions, she must inform the Nursing and Midwifery Council when taking up any other post, and these conditions were extended twice, most recently until May 2022.

This was after she failed to show fully developed insight into her actions and could not prove she had been complying with the current conditions of practice order in place.

A third review into her fitness to practise was heard by the Nursing and Midwifery Council panel last week, where they deemed Adman's fitness to still be impaired.

It also came to light she had breached the conditions of practice and was subject to a separate investigation whereby an interim suspension order had been issued. 

The substantive conditions of practice order was originally imposed for a period of 12 months by a Fitness to Practise Committee panel on November 8, 2019.

The order was reviewed on November 2, 2020, and the panel decided to impose a conditions of practice order for a further period of six months.

This was reviewed again on May 4, 2021, and the panel decided to impose a conditions of practice order for a further period of 12 months.

On December 4, 2017, whilst working as an agency nurse at Alistre Lodge Nursing Home in Lytham, she:

• Signed MAR (medication administration) charts confirming the administration of medication prior to administering any medication to seven patients;
• Attempted to administer medication without being possession of the MAR charts;
• Renamed and/or relabelled medication pods;
• And did not follow the home protocol for administering covert medication and crushed a tablet and/or tablets when there was no covert medication policy in place.

Four months later, on April 26, 2018, whilst working as an agency nurse at Royal Blackburn Hospital she:

• Failed to provide a patient with adequate personal care when accompanying him to the toilet;
• Failed to adequately maintain his dignity when accompanying him to the toilet;
• And failed to maintain infection control in relation to her actions.

She also administered him 1mg of Lorazepam when it was not necessary and/or required, and then administered omeprazole to another patient at the incorrect infusion rate.

Alistre Lodge Nursing Home

The original panel noted she expressed remorse and showed insight to what she had done but also found she had resumed practising as a registered nurse in July 2019 after a period of one year out of a clinical setting and deemed her fitness to practice impaired.

A conditions of practice order was put in place for 12 months and at a review hearing in November 2020 another conditions of practice order was put in place, this time for six months as the panel still deemed her fitness to practice as impaired.

At the second review hearing in May 2021 the panel decided to continue considering her fitness to practise impaired as they had no evidence as to whether Mrs Adman’s insight had fully developed or whether she had been complying with the current conditions of practice order in place, and extended the conditions of practice order for a further 12 months.

During the misconduct hearing at the beginning of this month, which was the third review into her impairment, the panel discovered that Mrs Adman had been subject of a separate NMC referral for which she is currently subject to an interim suspension order which was imposed on January 8.

It was found that Mrs Adman had breached the current conditions of practice order, and there was also an allegation of dishonesty found which related to Mrs Adman working as a registered nurse during the period December 2019 to July 2020.

It was outlined that the new NMC referral relates to an alleged breach of the conditions of practise order in that Mrs Adman was working and took a number of shifts at a home via an agency that she appeared to be the sole director of.

Mrs Adman also allegedly failed to alert her employer of the conditions of practise order against her, administered medication whilst not being signed off and provided her employer with a falsely attained competency of medicines management certificate on June 3, 2020.

Mrs Adman was confronted about this breach on June 9 2020 and denied knowledge of it and the conditions of practice order.

The panel report stated:"Mrs Adman has been subject to a conditions of practice order for two and a half years without providing any evidence in relation to strengthening her practice or remedying any of the concerns raised.

"The last reviewing panel determined that Mrs Adman was liable to repeat matters of the kind found proved.

"Today’s panel has heard no information that undermines the previous panel’s decision.

"Additionally, it heard about a second referral which suggested that Mrs Adman had breached the conditions of practice order in place shortly after it was imposed in November 2019.

"In light of this, this panel determined that Mrs Adman is liable to repeat matters of the kind found proved.

"The panel therefore decided that a finding of continuing impairment is necessary on the grounds of public protection.

“The panel noted that Mrs Adman has made no effort to remediate the concerns and has only engaged with the NMC to advise of her non-attendance at previous hearings as well as at today’s hearing.

“It is the panel’s view that Mrs Adman appears to have undermined any previous insight and dismissed the concerns identified as technicalities.

“The panel is of the view that Mrs Adman has been made aware of what has been required of her at each stage, but has not taken the steps identified to demonstrate strengthened practice.

“On this basis, the panel concluded that a conditions of practice order is no longer practicable in this case.

“The panel determined therefore that a suspension order is the appropriate sanction which would both protect the public and satisfy the wider public interest.

“Accordingly, the panel determined to impose a suspension order for the period of 12 months which would provide Mrs Adman with an opportunity to engage with the NMC and attempt to demonstrate insight and some form of remediation.”