Health watchdog raps Lancashire surgery after newly qualified nurse with lack of training carried out inadequate diabetic checks

A newly-qualified nurse has been found incompetent, after carrying out inadequate diabetic checks on patients or failing to do them at all.
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Hannah Killeen, who was employed by the Fernbank Surgery, which has branches in Freckleton and Lytham has been given a conditions of practice order for 18 months following a hearing by the Nursing and Midwifery Council (NMC).

A panel found that between February 26 and March 16, 2018, she did not conduct diabetic food foot checks adequately or at all for 16 patients.

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Between February 14 and March 16, 2018, she did not conduct the specified elements of patient assessment at all or adequately for 18 patients, including weight checks, full blood count test and urine dip checks.

They also found that she had made inaccurate entries in the records of one or more of the patients, indicating she had conducted a diabetic foot check and/or blood pressure check when she had not.

The NMC panel found that patients were put at potential risk of harm as a result of Ms Killeen's lack of competence, and that it had "breached the fundamental tenets of the nursing profession and therefore brought its reputation into disrepute".

However, they noted that Ms Killeen had apologised "profusely" for her actions, and was willing to undertake retraining to re-enter nursing, which she has not worked in since resigning from Fernbank in April 2018

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The panel did not find Ms Kileen dishonest, accepting that she was " an inexperienced nurse trying to do your best".

The report slammed the practice for "wholly inadequate" training, noting that Ms Killeen's mentor retired in December 2017 and was not replaced, that despite sending emails of concerns to management these were not followed up because of the management culture being "resistant to challenge", and one witness told the panel that the session observations that were carried out were '29 million miles away from training’.

A report addressed to Ms Killeen says: "You admitted to the panel that you should not have carried out these checks without appropriate training but that at the time you were doing your best, oblivious to the fact that you were getting things wrong.

"In the panel’s view, the Practice failed in its responsibility to train you properly in this field before booking you in to undertake appointments. With regard to yourself, the panel considered that at the time ‘you did not know what you did not know’ and were simply doing your best."

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Ms Killeen has indicated she would like to return to nursing, and the judgement was, that if this is the case, she would be subject to certain conditions, including:

- Direct supervision at anytime taking diabetic assessments and foot checks

- Work with a senior nurse on a personal development plan

- Keep the NMC informed of where she is working

- Give a copy of the conditions to any employer.

The report states her failings "related to a very narrow area of nursing practice and considered that you should be given the opportunity to remediate these failings while under supervision."

Partners at Fernbank Surgery issued a statement following the hearing.

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It says: "We take the training of all our staff very seriously. All preceptor nurses receive direct support and mentorship from very experienced practice nurses throughout their time at the practice. We constantly review and update our processes in line with national guidance and recommendations."

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