Liverpool nurse suspended after falsifying records and failing to give vital medicine

A Liverpool nurse has been suspended after failing to administer vital medicines and falsely filling out paperwork indicating she had done so.

While working as a registered nurse at Cressington Court Care Home in May 2020, Stefania-Mimi Iordache did not correctly give two separate people their required water tablets. Both residents’ medication administration records had been signed by Mrs Iordache to say they had been handed out as expected.

A Nursing and Midwifery Council (NMC) fitness to practise committee was told how Mrs Iordache failed to establish the condition of a resident transferred to the home from the Royal Liverpool Hospital who died 10 days later relating to urinary sepsis.

It was said the resident was no longer in the care of Mrs lordache at the time of death. A committee report into Mrs lordache’s conduct said she had been handed a three month suspension.

The document set out how across two days in May 2020, Mrs Iordache – who was employed at Cressington Court on an agency basis – did not correctly hand out diuretics to two residents. Records for both individuals would show the nurse filled out forms to say she had completed the task correctly.

A panel hearing was told Mrs Iordache admitted to this during evidence. However, the trained nurse and midwife disputes claims around her treatment of a third person, known as Resident C.

The woman was transferred to Cressington Court on May 7, in which Mrs Iordache claims she attempted to contact the Royal Liverpool Hospital but was unable to speak to anyone and was informed she would have to wait for at least 30 minutes as the hospital was busy due to COVID-19. Owing to the needs of the residents at the home, Mrs Iordache said she was unable to hold the line and await a response.

She did not, however, call back at a later time. In a written statement and oral evidence, Mrs Iordache had set out to establish why Resident C had been transferred from the Royal without a catheter.

The nurse was also found to have not provided a healthcare assistant colleague with adequate instruction on how to insert a urine collection pad onto Resident C. A woman referred to as Witness 3 said Mrs Iordache had said to her: “Just open it up and put it in” and used hand gestures to explain how to apply them.

On May 7, 2020, it was recommended a urine sample be taken from Resident C to establish any reversible causes of her state of confusion. Mrs Iordache said in oral evidence she could not do so as she had only been contacted by a colleague at 10am and best practice was to do so first thing in the morning.

The nurse said a sample could also not be taken between May 8-10 as it was a bank holiday weekend and no laboratory provision was available. Given Resident C’s history of urinary tract infections, it was pertinent to undertake a test of some kind, with urine dipsticks available at the home.

Mrs Iordache said she could not find the sticks and it was her “understanding that it was not appropriate to undertake a dipstick test as it would be illegal for a doctor to prescribe antibiotics on the basis of such a test.” The panel determined there was no documented record of the steps Mrs Iordache had taken, but accepted she had intended to ensure the sample was obtained.

The report said on May 11, the agency worker had been the only nurse on duty at the time. She got into a “heated” argument with the care home manager and complained of being tired and burned out.

Mrs Iordache claimed the manager would not listen to her concerns and tried to make her point. After this, the nurse left the home, 30 minutes into her eight hour shift and did not return.

It was said Resident C’s condition deteriorated, leading to her death on May 17, caused by urinary sepsis. Mrs Iordache had no further part in caring for her after leaving abruptly days earlier.

However, the panel said by failing to contact the hospital, offering correct pad application instructions and ensuring a follow up urine sample was taken, she had placed Resident C at “unwarranted risk of harm.” In submission to the panel, Mrs Iordache said she had an eight year unblemished record and felt she had no support from management or senior care staff.

Her mental wellbeing had been impacted by the additional workload she faced and expressed sorrow at what had occurred. She said if she had not been working under the conditions she found herself “none of this would have happened.”

Despite this, the NMC panel deemed Mrs Iordache’s actions amounted to serious misconduct and handed down a suspension of three months, with an 18 month interim order subject to an appeal.