A North Ayrshire mental health nurse who "abused" his position of trust has had his registration suspended after putting multiple, particularly vulnerable patients "at high risk of suffering harm".
Ross Allan, who was employed as a registered charge nurse within the community services department at the North Ayrshire Drug and Alcohol Recovery Service, was found to have "breached the fundamental tenets of the profession" after fitness to practise hearings held by the Nursing and Midwifery Council (NMC) concluded last month.
As part of five charges against him, the NMC panel found 38 separate incidents proved involving 20 of the 24 patients listed in the allegations.
The charges related to events that occurred between April 2015 and July 2016, when Mr Allan was said to have changed patients’ prescriptions without the agreement of a qualified prescriber, failed to review patients' need for prescription medication, failed to provide initial and or follow-up appointments for one or more patients, failed to refer patients to other clinicians, and failed to adequately document care provided to one or more patients.
Mr Allan did not attend the virtual hearings and a report published this week said there had only been "limited engagement" by him with the NMC in relation to the proceedings.
The panel decided to proceed in his absence, stating there was a "strong public interest in the expeditious disposal" of the case.
Mr Allan was said to have had a caseload of around 66 patients at the time, which was "not considered to be high", according to the report.
It was alleged that the nurse had either failed to see his patients as regularly as was required or had failed to record that he had not seen them when the patients did not attend their appointment.
During interviews as part of a local internal investigation in February 2017, the nurse made several admissions and accepted that he had "let the service and patients down".
After an initial assessment for one patient, referred to as Patient A, Mr Allan did not carry out follow-up reviews before changing her prescription, and he admitted that this "risked both the safety of Patient A’s unborn child and Patient A’s potential for overdose".
Another patient, who was prescribed Suboxone - used to treat opioid dependence - should have been seen every three months as a minimum but Mr Allan did not see him at all over the course of almost a year.
The panel also found that in the case of another patient, Patient J, Mr Allan should have seen him within seven days of being discharged from hospital as he was at high risk of relapse, however the patient "waited seven weeks to be seen, he had no support [from Mr Allan] in this time and then relapsed".
The report said: "The panel could not see an initial appointment or any follow-up appointments on this patient’s records."
Mr Allan also failed to arrange any appointments for a patient who was regarded as high risk because of his substance abuse, despite the patient being on his caseload.
A further patient whose overall risk was categorised as 'red' due to the risk of suicide and self-harm was not provided with a follow-up appointment or a plan for future appointments, and no actions were completed in relation to the patient's care other than a referral to a consultant.
The panel also found that in numerous cases the nurse had provided "inadequate detail" in his patient notes.
It was claimed during the hearing that Mr Allan "has not admitted the charges, not engaged with the NMC and has provided no evidence of remediation or insight", with an NMC representative stating "there is a risk of repetition".
The report read: "He said that there had been quite a lot of change with the role, the service and the amount of patients which he had found ‘quite overwhelming’.
"Mr Allan was asked if he considered himself to be a competent charge nurse and he replied ‘I’m disappointed this has happened and would normally have been able to say yes’.
"He was asked what might have caused the concerns and he responded ‘someone said I might be burnt out. I have been doing this job for 12 years. I think there may be some complacency and maybe I was being a bit cocky. I feel ashamed to have left my colleagues in this situation and I’m disappointed in myself’.
"Mr Allan stated that he was under stress and he did not handle it well although it was 'probably no more stress than anyone else'.
"He said that he understood the severity of the situation that he was in and could not believe that he was in it."
The NMC panel ruled that Mr Allan's actions "did fall significantly short of the standards expected of a registered nurse".
The report said: "The panel considered that Mr Allan was an experienced nurse who was treating extremely vulnerable patients and that this misconduct took place over a significant period of time.
"The panel also noted that some of the patients appeared in more than one charge, which means that they would have been subject to more than one failure as a result of Mr Allan’s conduct.
"The panel also considered that Mr Allan was well aware of what was expected of him in his role."
The report added: "The panel was satisfied that the misconduct in this case is capable of being addressed, but the panel had no evidence before it to show that Mr Allan has taken any steps to strengthen his practice.
"The panel considered that the local investigation interview took place six years ago and that there has been nothing submitted by Mr Allan as he has chosen not to engage with his regulator regarding these substantive proceedings."
Mr Allan's registration was suspended for 12 months but an 18-month suspension order has been imposed in the interim to cover any time for a potential appeal against the decision.
A spokesperson for the North Ayrshire health and social care partnership said they were "unable to comment on individual circumstances" - but did confirm that Mr Allan is "no longer an employee of NHS Ayrshire and Arran".
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