By Staff Reporter

Last updated 11:40, Wednesday, 28 May 2008

A "malicious" nurse who slapped an elderly dementia patient so hard she left a bright red hand print on her leg has been struck off.

Sophia Nkungwana, 63, hit the vulnerable 74-year-old woman on her thigh when she refused to take her medication at a care home in west Cumbria.

She then grabbed the confused resident – who also suffered from a serious heart condition – by her pyjamas and pushed her over, the Nursing and Midwifery Council heard.

Nkungwana was convicted of common assault on the patient on July 23 last year at Workington Magistrates Court and fined £250.

A misconduct panel found her guilty of misconduct and ruled that her fitness to practice had been impaired by her conviction.

Chair Pauline Derbyshire said: “This was an elderly and extremely vulnerable patient who suffered from mobility problems and dementia.

“The slap was sufficiently hard enough to leave marks on the skin, and we consider that this behaviour is a breach of the nursing code of conduct and the registrant’s fitness to practice is impaired by reason of misconduct.”

Hannah Capgrass, for the NMC, said the patient, referred to as Resident A, had been at the Riverside Court Care Home in Maryport for five years and suffered from severe dementia.

She was unable to walk after a stroke and spent much of the time sitting on the floor, “moving around by shuffling on her bottom”.

She was unable to have a conversation, answering just yes or no to simple commands and was often confused.

She also suffered from a serious heart condition that frequently caused her heartbeat to slow to dangerous levels.

Miss Capgrass said: “This was a serious physical assault on a very vulnerable patient.

“It was a malicious assault that was not just about one blow to the inner thigh that left marks on the skin, but was also a push.

“The patient was unable to effectively communicate and that was something known to this nurse.

“Whether the patient was aware or not of what was going on, this was an abuse of authority and a breach of trust.”

On March 28 last year, Nkungwana was on duty on a night shift with two care assistants at the home, where she had worked for 18 months.

The home, run by Four Seasons Health Care UK, has 45 beds, 30 of which are used for elderly and mentally ill patients, the panel heard.

At about 10pm, Nkungwana approached Resident A, who was sitting on the floor in her pyjamas, to give her medication from a beaker.

But when the elderly woman refused to take the pills, Nkungwana slapped her hard on her inner thigh, leaving a bright red hand print.

The woman then knocked the beaker out of Nkungwana’s hand and the nurse grabbed her by her pyjamas, pushing her over.

A care assistant witnessed the assault and shouted at Nkungwana: “What are you doing? You can’t do that.”

The woman was later examined by the care assistants, but suffered no other injuries in the assault.

The attack was reported to the police and social services two days later and Nkungwana was suspended from the care home during the investigation.

When interviewed by police, she denied slapping or pushing the woman but admitted that she had had some difficulty administering her medication that night.

She was later charged with common assault, which she denied, and was convicted after a short trial at Workington Magistrates Court.

Nkungwana, now of Woodley, Reading, Berkshire, was also dismissed from her job at the care home.

She did not attend the London hearing and did not respond to the charge against her.

Pauline Derbyshire, chair of the NMC panel, said Nkungwana’s actions were “so serious” that only a striking off order would do.

She said: “There was clear evidence that her behaviour caused the patient harm and no evidence that this nurse has shown any insight into her failings.

“There is also no evidence of regret or apology, or even that the registrant was under any duress at the time of the incident.

“This nurse hit a vulnerable patient who refused to take her medication.

“This was far too serious for us to take no action.

“We therefore have no option but to order that the registrant be removed from the register.”