The High Court confirmed a Nursing and Midwifery Board of Ireland decision suspending a nurse for 12 months, subject to conditions governing a possible return to practice. The court warned that the conditions did not address what should happen if an independent psychiatrist’s report was unfavourable, but said it could not rewrite them under the limited role given to it by section 74 of the Nurses and Midwives Act 2011.
The Board applied for confirmation after the nurse did not appeal the sanction within the time allowed. Mr Justice Kelly, President of the High Court, said the court was not hearing an appeal on the merits. It could refuse confirmation only if there was good reason, such as a wholly unreasonable decision or a serious legal flaw.
The judgment recounts findings by the Board’s Fitness to Practise Committee that the nurse committed professional misconduct. The findings included writing or arranging prescriptions for controlled drugs on a stated stock purpose when the drugs were intended for her own use, altering prescriptions, presenting prescriptions for dispensing, and self-administering medication. The committee also found misconduct relating to prescriptions for other medication signed in the name of a doctor without his knowledge or permission. The judgment says many of the findings were based on the nurse’s admissions and evidence from doctors. The committee found that she had a history of Cyclimorph dependence and depression and/or anxiety, described as chronic recurring conditions, though it considered her not then impaired.
The committee recommended an 18-month suspension, with conditions, including a phased supervised return. The Board later reduced the suspension to 12 months and adjusted the conditions. Justice Kelly said the Board hearing transcript contained no discussion of the reduction and the Board had not explained its reasons. He said it was highly desirable for the Board to give reasons when departing from a considered committee decision.
Under the confirmed conditions, the nurse must continue engaging with her clinician and mental health team during suspension. Between nine and 11 months into the suspension, an independent Board-approved psychiatrist must assess her fitness to return and report to the Board. Before returning to paid or voluntary nursing, she must complete an approved return-to-practice course at her own expense. Further conditions include ongoing clinical engagement, at least three random urine tests with results sent to the Board, and notifying any nursing employer of the fitness-to-practise process and registration conditions.
The judge said the conditions assumed a favourable psychiatric report but did not address an unfavourable one. He said the Board would be responsible for protecting the public if the report was unfavourable, and urged it to provide for that possibility in future cases. Despite the omission, he confirmed the Board’s decision under section 74(3), saying the court was obliged to do so and could not alter the conditions.