Struck off: Nurse told patient it was “time for the big sleep”


By Melissa Clark


A NURSE who told a dying dementia patient it was “time for the big sleep” has been struck off.

Shiona Nelson made the heartless comment in front of relatives, one of whom fled the room in tears.

Ms Nelson, from Kirkcaldy, Fife, was in charge of training young nurses in a care home in the town.

Shiona Nelson was in charge of mentoring student nurses at the home


Following a disciplinary hearing in Edinburgh this week, the Nursing and Midwifery Council (NMC) said her behaviour was “wholly unacceptable” and that she was unfit to practise.

The experienced nurse was charged by the NMC with making the “inappropriate comment” to the woman, known only as “Patient B” in 2009 at Adam House care home.

She faced four other charges, which were also found proved, including allowing a student nurse to practise taking blood samples from the patient.

She also carried out an intimate examination on another patient which was not “clinically justified” and happened without the supervision of a doctor.

The hearing was told that Ms Nelson had been registered as a nurse since April 1983 and was responsible for mentoring all student nurses at Adam House.

Emma Taylor, a Dundee University student who was being mentored by Ms Nelson, told the hearing: “Patient B was in a poor condition with a chest infection and dementia. She was very elderly.

“Ms Nelson said to her, ‘It’s time for the big sleep.’

“The family were already upset because she was quite poorly.

“Her granddaughter ran out of the room crying.”

Ms Taylor was asked by the NMC Case Presenter, Yusuf Segovia, what she thought about the words used.

She said: “It was insensitive. The family were upset and did not want to hear it.”

Asked what she thought Ms. Nelson meant by the comment, she explained: “Just that it’s time to die really.”

Ms Taylor, who is now a practising nurse, added: “As a nurse, we would never use that term. I’ve never seen it apart from that incident.”

In its written judgement on the case, the NMC stated: “It is…wholly unacceptable, in the panel’s view, for Ms Nelson to comment as she did, to a patient who was seriously ill and in receipt of end of life care.

“This comment was made by an experienced nurse, in the presence of the patient’s next of kin. This was made at a vulnerable time and they were quite clearly distressed and upset by it.”

The panel also found the charge of performing an intimate examination of “a vulnerable, elderly patient with no clinical justification to be an extremely serious matter.”

They said the hearing had been told the examination was “never done anymore” and, even if it was, it would be done by a GP and with the family’s consent.

The NMC concluded: “Ms Nelson was considered to be a competent nurse and had been appointed as a trainer and mentor to student nurses.

“The panel  also noted her explanations…and her apparent acceptance of some of the allegations against her together with an absence of any malice.

“Nevertheless, the panel is of the view that her misconduct was extremely serious. She demonstrated a complete disregard for the vulnerable, elderly patients in her care.

“Her conduct, in the panel’s view, showed a complete lack of respect for the dignity these patients. She also displayed this conduct to a student nurse for whom she had responsibility for training and mentoring.”

Ms Nelson, who was not present or represented at the hearing, was suspended from the 47-bed care home on 19 November 2009 for her misconduct.

She officially resigned on 30 December 2009 from the home which was run at the time by the biggest care home operator in the UK, Southern Cross Healthcare.

However, when the company ran into financial difficulties, Four Seasons Healthcare took over the home.


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