Decision Report 201301873

Summary

Mrs C said that a family member (Mr A) had been admitted to a community hospital for palliative care (care to prevent or relieve suffering only). She complained to us that a nurse had been very reluctant to ask the out-of-hours doctor to visit, despite Mr A's pain, and that when he did visit, the nurse did not give Mr A the medicines the doctor prescribed.

Our investigation revealed that there had been no clinical reason for the out-of-hours doctor to be contacted and that the medicines he prescribed were strong pain relievers, to be given as and when needed. (Mr A had already been prescribed middle-strength pain relievers and was taking these.) It was clear from the clinical records that there was no reason for Mr A to have the strong ones at the time and that when, a few days later, he was in particular pain, they were given. We took independent advice on the case from our nursing adviser, who said that it is established good practice for medical staff in such a situation to prescribe drugs on a 'just in case' basis, so that nursing staff can assess their patient and administer medicines when required. In conclusion, we considered that the nurse's actions had been reasonable.