A SCHOOL nurse alleged to have failed to manage the case of a suicidal teenager has been cleared of misconduct at a Nursing and Midwifery Council hearing in London.
The hearing at the Old Bailey was told that Donna Moore should have alerted doctors within 48 hours of discovering 15-year-old Helena Farrell had an eating disorder, suffered from depression and had a history of self-harm.
The Kirkbie Kendal schoolgirl had swallowed a handful of paracetamol and had claimed she was sexually assaulted on a recent trip to Germany.
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Moore, who covered five secondary and 20 primary schools, waited almost six days to refer the case to mental health professionals, but the council ruled that this was “a reasonable period of time.”
The teenager, who suffered from bulimia, depression, and had self-harmed in the past, killed herself just three weeks after meeting with Moore.
She hanged herself from a tree close to the Castle Green Hotel, Kendal, on January 4 last year, with Coldplay’s The Scientist playing on loop in the background.
Moore first saw Helena on December 4, 2012, and noticed potential mental health problems, the Nursing and Midwifery Council heard.
The nurse noted the teenager needed an ‘urgent referral’ and informed Child and Adolescent Mental Health Services on December 10, it is said.
Moore was heavily criticised in a report by the Cumbria Local Safeguarding Children Board for suggesting Helena's behaviour was ‘a normal histrionic adolescent response’.
Lyn Moore, from the Cumbria Partnership NHS Foundation Trust, said the case should have been urgently referred within 24 to 48 hours of the initial assessment as Helena presented ‘a high risk.’ She conceded there was no ‘robust policy’ to support the need for an urgent referral, but said Moore had left it to chance that someone would see her email to administrative staff.
“This was a case of a child presenting a risk of self-harm, and somebody who should have been referred quickly to Child and Adolescent Mental Health Services.
“I think that a 15-year-old girl with a history of bulimia, a recent attempted overdose, and any example of sexual assault is going to cause great concern to a nurse. Any form of eating disorder is also classified as self-harm.”
Moore’s solicitor Stephen Graham told the hearing it was a ‘cruel misrepresentation’ of the evidence to suggest that his client could have done more to prevent the teenager’s death.
“We have heard evidence of the fact that school nurses had no training to assist them in recognising potential issues around suicide and self-harm,” he said.
“There was no management structure in place at the time and you have heard evidence from the trust that the new management structure had only just come into practice.
“Prior to that the system was ineffective and it would appear from the evidence that each nurse had a large case load.
“Whenever the registrant’s line manager was not working or on holiday there appeared to be no system where that case could then be sufficiently managed in her absence.”
Mr Graham claimed Moore had, in effect, submitted her referral within two working days.
Moore denied failing to manage the case by not referring it to child’s services or making a quick referral to mental health services.
She also denied failing to complete a safeguarding profile for Helena.
The tribunal ruled that she faced no charge to answer in respect of failing to make a referral in a reasonable period of time.
She also has no charge to answer in failing to refer Helena to children’s services, and of failing to complete a safeguarding profile for Helena.