'Laying him flat would have put him at risk'

  1. 'Laying him flat would have put him at risk' Jun 2 2004

    By Guy Basnett, Crewe Chronicle


    A NURSING expert has told a jury she could see no legitimate reason why Barbara Salisbury laid an 81-year-old patient flat, increasing his risk of choking to death.

    Expert witness Deborah Bowey said a nurse of Salisbury's experience would have known removing Reuben Thompson's pillows could cause him to 'drown'.

    The prosecution alleges that the 47-year-old Leighton Hospital nursing sister took away the pensioner's pillows and oxygen knowing a lung condition would cause him to 'choke on his own secretions'.


    Mrs Bowey said: 'From what I understand of this patient, he was experiencing breathing difficulties. I would expect him to be nursed in a sat up, raised position.

    'If laid flat, I would expect increased pressure on his lungs. Also, it would put him very much at risk from aspirating his secretions, which could lead to choking.'

    Asked whether she would expect Salisbury, as an experienced nurse, to be aware of these potential consequences, she replied: 'Yes.'

    Mrs Bowey also told Chester Crown Court she could see no therapeutic reason why Salisbury would repeatedly boost the dosage of dia-morphine given to 76-year-old James Byrne.

    The prosecution claims Salisbury repeatedly pressed the boost button on his Graseby drug pump, making the machine's audible beep sound like a Space Invaders game.

    Robin Spencer, prosecuting, asked Mrs Bowey how many times she would expect a nurse to press the boost button even when turning a patient.

    She said: 'Whenever I have used the boost button in the past, it would be one or two presses. I know other nurses use up to three presses.'

    Mr Spencer said evidence from Salisbury's colleagues suggests she 'pressed repeatedly or held down' the button, giving 'many, many doses'.

    Mrs Bowey said she could see no value in administering such a large amount of diamorphine, and added: 'I would consider it not good practice.'

    She also told the jury Salisbury's alleged administration of the pain-killing drug to 88-year-old Frances May Taylor was unjustified.

    The prosecution says the nurse tricked doctors into prescribing dia-morphine to Mrs Taylor by saying she was suffering pain when she was comfortable. Mrs Bowey said she could not see anything in the records which suggests the pensioner was in pain, and said a flinch noted by Salisbury was inconsequential.

    She added: 'A flinch is not justification to start treatment with opiates, which is what diamorphine is. The indication for diamorphine is pain

    on a regular or continuous basis.'

    The expert witness described Salisbury's alleged insistence that she had to inject pensioner Frank Owen with diamorphine because another nurse would refuse as 'very unusual'.

    The prosecution claims Salisbury persuaded nurse Leigh Brundrit to help her needlessly inject the 92-year-old by falsely insisting he was in pain and saying another nurse, Elizabeth Crabtree, would refuse to treat him.

    Mrs Bowey said: 'I have never come across a nurse saying she would give analgesia because another nurse wouldn't. I would expect her to talk to the other nurse about it.'

    Salisbury, formerly of Lime Grove, Shavington, and now of Mold, is accused of attempting to murder four patients in her care between 1999 and

    2002. All have since died.

    She denies all the charges. The trial continues.


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  2. 2 Comments

  3. by   memphispanda
    I know this doesn't have anything really to do with the article...
    But the article makes it sound like the pump was able to give meds as often as the button is pushed, with no lockout or wait period between doses. Are there still pumps like this being used? Our pumps have a max dose per hour and a minimum time between doses.
  4. by   purplemania
    I wondered the same thing. Also, it is against policy here for anyone other than the patient to push the button. There is no acceptable reason for the nurse to do that, even one or two times, which seems acceptable in this scenario. But forgetting all that, if he had oxygen ordered, and she removed it, regardless of his position, that alone would be enough for her to be considered as "harming" the patient.

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