Woman (91) woken and forced to have unprescribed enema in nursing home

A 91-year-old woman patient in a north Dublin nursing home who was in good mental health was woken early in the morning and forced to have an enema against her will which had not been prescribed for her, a Nursing and Midwifery Board fitness to practise inquiry has been told.

The inquiry on Friday was told the patient, referred to only as Ms A, had protested that she did not want or need it.

She said she had been hurt by it, her nightdress had been pulled up, and during the procedure she was crying and asking for help and begging nurse Maribel Balagot Adame Ynso to stop, the hearing was told.

Ms A, who has since died due to unrelated issues, was a patient at the CareChoice Nursing Home in Malahide when the incident happened on June 6th, 2018.

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The inquiry heard that following the incident Ms A told the home's then director of nursing, Frances Murphy, that she had tried to explain to Ms Ynso she had had a bowel movement the previous day. She had been so upset she did not want to see Ms Ynso again.

In a witness statement Ms Murphy told the inquiry she had spoken to Ms A and Ms Ynso among others, as well as checking patient records and CCTV cameras and had then made a complaint to the Nursing and Midwifery Board of Ireland.

Counsel for the chief executive of the Nursing and Midwifery Board Ailbhe O’Neill outlined a number of allegations against Ms Ynso including that she had not gained consent and had administered a procedure which had not been requested by a prescription. It was also alleged that Ms Ynso had failed to record an enema, properly consult a cardex system identifying patients and failed to report an error in procedure.

Ms O’Neill pointed out these actions were in breach of patients’ rights including rights under the CareChoice charter for patient care as well as the Nursing and Midwifery Board’s code of practice.

Apology

At a hearing on Friday Ms Ynso accepted she was guilty of all allegations and apologised for her actions. She told her representative, David Miskell, a professional and regulatory officer with the Irish Nurses and Midwives Organisation, that she accepted she had breached standards expected of a nurse and was guilty of poor professional performance and misconduct.

Ms Ynso said she had been working on night duty and, after considering electronic records of patient activity, had concluded that three patients had not had a bowel movement in three days and were in need of enemas. She said she now accepted she had no right to make this determination as it had not been prescribed.

She had been embarrassed by her behaviour and had taken some months off work to come to terms with what had happened. She had since undertaken courses in safeguarding procedures. She apologised to the board and the patient’s family for her actions.

The inquiry found the allegations were proven as to fact, in line with the admissions that had been made.

However, its recommended sanction would not restrict her practice as a nurse. The Nursing and Midwifery Board will decide on a sanction at a future date.