‘I can get u more Valium if u need em.’

SMS exchanges led to a nurse being found guilty of professional misconduct for supplying prescription drugs to patients in exchange for money, and borrowing thousands of dollars from them

A Sydney nurse with over a decade of experience was employed in the drug and alcohol unit at a mental health clinic when she commenced a personal friendship with an inpatient.

Patient A had a number of admissions to the clinic from May 2016 for alcohol withdrawal management. It was in November 2016 that the nurse struck up a friendship with Patient A, and they continued to be friends “outside of work”.

Patient A was again admitted to the clinic from August to September 2017, and it was around the time the patient were discharged that the practitioner borrowed $7,500 from them for personal reasons.

While she signed a statutory declaration setting out the terms of the loan, the nurse was found to have failed to honour the terms of the loan and only made one repayment to Patient A in the amount of $1,500.

The next month, the clinic’s CEO found out about the loan from Patient A and submitted a mandatory notification to Ahpra about the nurse’s conduct. A few days later, the nurse self-notified a complaint concerning her conduct to Ahpra. Her registration was suspended on 30 October 2017.

In a meeting with the CEO, the respondent conceded that she had borrowed monies from Patient A because she was “desperate”, but did not acknowledge that she had breached professional boundaries in doing so because the loan arrangement had been documented by her.

A number of text messages sent by the practitioner to Patient A during September and October 2017 were characterised as “inappropriate” by the Health Care Complaints Commission (HCCC):

 “I desperately need $6,500 if possible if not I could maybe manage with minimum of $5,000 happy to repay with interest [emoji] soo worried” (sic)

“Also hon could I ask if theres any possibility of borrowing an extra 500 n again I can repay it on Wed just so I can pick up my medications tomorrow??” (sic)

“Please give me this time and please don’t put me back on the streets by your family now reporting this” (sic) including an attachment of a photograph of the practitioner’s baby granddaughter in hospital

 “theres No f****n lies. Your drunk!!!!”

 “Also wanted to know if you would consider helping me one last time [name suppressed] only this time is urgent n life or death for me…”(sic)

 “Like I said I hope your not drinking cos thats why your now sending me threatening msgs or reporting me to [the clinic] again…” (sic);

 “I dunno who your talking too or where your getting your information from but its all wrong nd your breaching all of the legalities within the Statutory Declaration so Get yourself your own lawyer your going to need it. Your shooting your mouth off and you need to stop” (sic)

The HCCC also brought a second complaint about the nurse regarding her conduct with a second patient, Patient B, who was admitted to the clinic in January to February 2017 with a 10-month history of opioid use disorder.

During this time, it was found the practitioner provided additional benzodiazepines to Patient B during their stay as a clinic in-patient in exchange for money, where the patient had not been prescribed the drugs and for which where was no clinical indication.

The nurse also provided benzodiazepines, namely, diazepam, oxazepam and lorazepam to Patient B between May and July 2017, having obtained the medications from the clinic. She again provided them to Patient B in exchange for money.

Around July 2017, the practitioner was found to have borrowed approximately $6,000 from Patient B in circumstances where they were a former in-patient at the clinic. The nurse did not repay the entire amount.

Additionally, in October 2017, the practitioner sent a text message to Patient B advising that she had two sheets of 20 tablets of Endone 5mg, a Schedule 8 drug of addiction that she needed to sell as she was not working.

SMS messages sent to Patient B between May and July 2017 revealed the conduct:

 “Huni listen Im in strife and theres gunna be further delay… sooo I have to get it reimbursed and I cant f****n beliebe this…. So what I will do is I will pay you back almost 3x yr money nd gv you $6000 if that’s ok its just we need to wait a further 10days. Im sorry” (sic)

 “Honey seriously Ive sat down nd done my sums nd to save my ass nd my house I only need 2.5k by Tues latest. I can get u more Valium if u need em and ativans and I will cover your holiday nd pay your debts with no hesitation…” (sic)

 “…Ive got a bottle of Valium as an emergency… I will drive it out to you at anytime u need some…” (sic)

 “NO u cant get 4 bottles of valium n 2 of Ativans we don’t stock Xanax u need to go to yr doctor for those. The maxiumum amount to dispense without signing out is 2x valium 100 tabs n 1x Ativan 50…. thats it sorry.” (sic)

“Hey lovely I couldnt get u Diazepam cos like I told u the supply is low but I did an alternative which is the same as valium nd got u 50 Oxazepam 30mg tabs” (sic)

 “Hey darlin sorry for my late note….Ive managed to sort out 2boxs so u let me know what u wanna do to get them (wink emoji)” (sic)

 “Hey GF dunno how serious you were about doing yourself a loan nd a top up to help me out cos Id happily repay it with no problems with that…..I just need to be safe probably 8k but I can make do on 5k if I had too n 8k was too much on top of what u need. Plez just let me know Im as desparate as u are for valis hahaha” (sic)

The nurse provided written information to the Nursing and Midwifery Council of NSW in which she “strongly” denied allegations that she had supplied Schedule 4 and Schedule 8 drugs to Patient B. She also denied having borrowed money from that person.

However in a decision handed down this month, the NSW Civil and Administrative Tribunal found the content and context of the many SMS exchanges between the nurse and both Patient A and Patient B corroborated the allegations in the complaints.

An expert witness was strongly critical of the nurse, telling the Tribunal that her conduct exceeded professional boundaries and involved “dishonest, unprofessional, unethical and irresponsible” behaviour.

In sourcing drugs from her employer, the respondent exposed her employer, the patient and herself to accusations of unlawful conduct, said the expert. In addition, the respondent’s misconduct was exacerbated by the potential harm to which she exposed Patient B by providing prescription only drugs to her for which no prescription had been issued.

“It is sufficient by way of summary to note that the respondent unlawfully obtained illicit drugs and provided them for reward to a vulnerable patient without any appropriate medical justification,” the Tribunal found.

“We have no hesitation in concluding that in all the circumstances, the conduct of the respondent which is the subject of these proceedings as we have described in the aggregate, constitutes professional misconduct and we so find.”

A Stage 2 hearing will be conducted to determine protective orders. Both the HCCC and the respondent have been given time to make their cases on what protective orders should be made.

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