A fitness to practise committee heard distressing evidence during its inquiry, including details of the final hours of a diabetic patient for whom an ambulance or doctor was not called by the nurse caring for him, despite serious concerns.
At the conclusion of an inquiry yesterday, the Nursing and Midwifery Board of Ireland (NMBI) upheld five of six allegations against nurse Edwin P Lara.
They related to his care of two unnamed patients during one night shift at the San Remo Nursing Home in Bray, Co Wicklow, on February 25 and 26, 2019.
Mr Lara was found to have demonstrated poor professional performance and breached the professional code of conduct.
The committee found he failed in his care of Resident A, a 77-year-old man with type-two diabetes, by not testing his blood sugar levels every 10 to 15 minutes and by not providing him with sufficient rapidly absorbable carbohydrates. He also failed to provide adequate care by not contacting emergency services.
The same night, Resident B, an 89-year-old woman, sustained a fractured hip in a fall.
The committee found Mr Lara failed to provide adequate care, by not ensuring she was helped by two staff members going to bed. He also failed to assess her injuries appropriately and failed to contact emergency services.
The committee heard Resident B was "screaming with pain" after the fall, but concerns raised by a healthcare assistant were dismissed.
The committee accepted the evidence of a healthcare assistant who said Mr Lara responded to her fears the woman had broken her hip by saying she was fine and he would give her a painkiller.
In relation to Mr Lara's treatment of Resident A, who had "dangerously low" blood sugar, committee chair Professor Colm O'Herlihy said the registered nurse's "interventions were clearly insufficient".
He said: "You did not dispute evidence that you failed to test blood sugar every 10 to 15 minutes as directed by policy."
Prof O'Herlihy said the evidence established that two readings were taken, one at 6.55am, showing Resident A had a blood sugar level of 1.9, and another at 7.27 am, showing a reading of 2.2.
"Your own account was Patient A was given Angel Delight, half a glass of apple juice and a limited amount of sugary tea," he said.
"The limited blood sugar readings thereafter demonstrated that your interventions were clearly insufficient, as (Patient A's) blood sugar remained well below three.
"These readings reflected a medical emergency, not an upward trajectory as you suggested."
The committee also found it ought to have been obvious to Mr Lara that Resident A was seriously ill, and by not contacting emergency services, he was guilty of poor professional performance.
"The evidence established that you took a dismissive approach towards concerns of staff members and should have sought outside help," Prof O'Herlihy said.
The inquiry had heard that at around 9am on February 26, Resident A became unresponsive. The day staff called an ambulance, but he was pronounced dead at 9.35am.
A post-mortem found he died from presumed cardiac arrhythmia due to severe coronary artery disease. The cause of death does not relate to the allegations faced by Mr Lara.
Mr Lara was also found to have failed to assess Resident B for injuries after a fall in accordance with procedures.
The committee also upheld a complaint he failed to contact emergency services or a doctor afterwards, despite this being suggested by a healthcare assistant, which he dismissed.