Bundaberg Hospital nurse Nancy Williams fails at appeal bid

A court has heard shredding a hospital handover sheet and giving too-high drug doses were among the actions of a nurse, still employed by Queensland Health, that could have proven fatal.

Bundaberg Hospital.

A court of appeal has found a Bundaberg Hospital nurse had “no reasonable excuse” that could explain why she failed to follow hospital protocol on dosing patients with drugs.

Nancy Williams lodged an appeal with the Queensland Industrial Relations Commission which had found that three out of four claims against her were substantiated by the court.

The claims were that on June 20, 2021, Williams failed to comply with hospital documentation standards, that she had given a patient a 5mg wafer of the antipsychotic drug Olanzapine instead of the prescribed 2.5mg and a 5mg Olanzapine wafer to a patient without need.

The fourth and unsubstantiated allegation against Williams claimed that she had given a 5mg Olanzapine wafer to a patient to “ensure the patient remained calm throughout her shift”.

Court documents reveal Williams had received a letter from Wide Bay Hospital and Health Service chief executive Debbie Carroll outlining disciplinary action to be taken in the wake of the findings.

However, in March this year, Williams sought to appeal the decisions around the three substantiated claims.

She argued that while she had failed to document the giving of medication, she “did so with reasonable excuse”.

Industrial commissioner John Dwyer said this allegation was “no trivial breach of policy”.

A Bundaberg nurse remains registered but is no longer allowed to administer medication.

“A failure to record what medication has been administered to a patient, either immediately or without reasonable delay, creates an enormous risk to the health and safety of a patient,” he said.

Williams had offered up “mitigating circumstances”, claiming that the patient’s chart had gone missing after she administered the medication, and that it was “common” practice for staff to administer medication with a delay in writing it up.

But the court heard the medication was given between 2.10-2.30pm that day, and as of the end of Williams’ shift at 5pm the patient’s chart had still not been updated.

A supervising nurse stated she had seen a handover sheet in Williams’ hands at the time of discussing an intervention and that Williams was seen shredding this document as she was escorted from the premises.

Of further concern, was that the patient had not been among those being treated by Williams, leading to the possibility that the patient could have been administered more medication by other unaware nursing staff.

“It does not take any imagination at all to see how Ms Williams’ failure to document the medication in a timely manner could have had serious or even fatal consequences for the patient,” Mr Dwyer noted.

Williams claimed the second allegation had been wrong, arguing she had given the 2.5mg dose and not the 5mg amount noted in the findings.

However, the court had made a “judgment call” in accepting a witness’s version of the event, that the witness did not see Williams break a wafer in half and that the entire portion was given to the patient.

In the third allegation, where Williams was accused of giving a 5mg Olanzapine wafer to a patient without need, she argued that she had relied on the observations of herself and another nurse to make the decision to administer the drug.

Mr Dwyer said the patient had no clinical history and no need to be given the antipsychotic medication and that, in any case, the nurses had not adequately conducted observation of the patient that could safely inform them of the need to administer medication of this type.

The decisions against Williams, in all three substantiated allegations, were confirmed.

The Bundaberg NewsMail understands Williams remains registered, but is prevented from administering medications.