A NURSE who worked at care homes including one in Chester has been struck off the register after mixing up medication given to patients and entering into a sexual relationship with another patient.

Susan Elizabeth Greene admitted three charges of misconduct before the Nursing and Midwifery Council's (NMC) fitness to practise committee hearing was held earlier this month.

They relate to when she was a registered nurse for Lloyds Pharmacy Clinical Homecare (LPC) in 2018, where she had a relationship lasting at least nine months with a man referred to in the hearing as 'Patient A', and was later working as an agency nurse by Hamilton Cross when she gave the wrong medication to patients.

The first happened on September 9, 2018, when at Whittle Hall Nursing Home, Great Sankey Warrington, when Greene administered a resident 500mg of Metformin and 1mg of Risperidone that should have gone to a different patient.

The second happened at Oak Grange Care Home, Mollington, on February 10 and 11, 2019, when Greene failed to give a resident their 6pm Tinzaparin injections on both days.

The panel of John Weeden, Diane Gow and Michael Glickman ruled Greene – who did not attend the hearing and was not represented, but had admitted the charges – should be struck off the register and an interim suspension order was imposed pending any potential appeal application.

The hearing heard Greene first came on to the NMC register in November 2008 and between February 2011 and mid-2018 she worked for LPC, which provides nursing care to patients in their own homes.

It was a qualified nurse who became aware of Greene's relationship with Patient A in June 2018. She contacted Greene and alleged Greene denied having seen Patient A. The nurse then contacted Greene's line manager who found photos of Greene and Patient A together on Facebook.

Greene was suspended the following day, and it was alleged Greene then removed all the posts from her Facebook account.

In her reflective piece in July 2018, Greene admitted being in a relationship with Patient A, which had breached professional boundaries.

She explained she was directly responsible for his care, which involved parenteral nutrition.

Evidence suggested Patient A initiated the relationship via a social media post, but Greene confirmed she had invited him to live in her home with her three children and became directly responsible for his care, and did not alert the relevant trust that this was the case.

The hearing heard Patient A fell out with his family because of his relationship with Greene, which had become a sexual one. They had since ended the relationship.

The panel ruled Greene's actions fell "seriously short" of the conduct and standards expected of a nurse and amounted to misconduct.

Subsequently, when Greene worked as an agency nurse, she administered medication to the wrong patient at Whittle Hall Nursing Home.

She had apologised and said a carer had misidentified the patient who she should give the medication to.

The panel accepted this was a genuine mistake and she had dealt with it appropriately by notifying the relevant clinician and completing the correct paperwork. The patient had not been harmed by the medication error. Consequently, the panel ruled this charge did not amount to misconduct.

However, the medication error at Oak Grange Care Home had happened over two days.

Greene wrote in her reflection there were several interruptions by carers and family members during the drugs round and became reliant on the colour coding used on a chart rather than reading the chart in detail, accepting this was an error.

The panel noted that, additionally, it took a week and a half for the drug administration error to be investigated by the home and for the home to notify Greene, who by this time was unable to recall what happened.

The panel added while there was no actual patient harm, there had been the potential for patient harm if a patient does not receive Tinzaparin medication on two consecutive days.

Noting that Greene was the only registered nurse on duty for those two days at the home, and that this had come five months after the previous medication error, the panel ruled this charge did amount to misconduct.

The panel ruled Greene's actions "brought the nursing profession into disrepute by adversely affecting the public’s view of how a registered nurse should conduct herself, and the panel has concluded that nothing short of striking-off would be sufficient in this case".