A Romanian nurse who shouted "are you mad?" at a dementia patient, reused needles and failed to admit to being sacked by a care home, has been struck off for a year.
Daniela-Florina Mysllinj was given a 12 month suspension order by the conduct and competence committee of the Nursing and Midwifery Council (NMC) last month.
She was given the sanction for a string of incidents relating to her time as a nurse at Warrengate Nursing Home, in The Warren, Kingswood, between October 2012 and June last year.
The nursing home has room for 40 residents, who suffer from illnesses such as alzheimer's, dementia, parkinson's, huntington's, multiple sclerosis, stroke, and motor neurone disease.
It takes private residents as well as those funded by the local authority, for respite, convalescence and palliative care.
The committee found that Ms Mysllinj shouted at a resident with dementia.
Giving evidence, a care assistant said: "She was shouting things like 'are you mad? I think she shouted 'are you mental?'"
Warrengate's registered manager said she thought Ms Mysllinj "struggled to understand dementia and how to deal with the behaviours associated with it".
Ms Mysllinj admitted telling a colleague that a resident with dementia "ought to be in a mental home".
When taking blood from a distressed patient, Ms Mysllinj left 12 needle marks on their hand and wrist, did not wear gloves, stuck used needles into the resident's air mattress instead of putting them in a bin or dish and used needles more than once.
The registered manager said it was "horrendous", with blood spots on the resident's bed and Ms Mysllinj attempting to collect dripping blood into a sample bottle.
When asked why she was not wearing gloves, Ms Mysllinj had said "we don't wear them in Romania".
Another incident involved the nurse creating the risk of a resident receiving an overdose of morphine sulphate because she did not know the initials MST stood for the same drug, and made a duplicate entry for it on a resident's chart - an error which was spotted and rectified quickly.
Ms Mysllinj also dishonestly failed to inform future employer Bupa that she had been employed by or sacked from Warrengate and said she had been working as a live-in nanny during her time at the nursing home.
The panel concluded: "Ms Mysllinj's acts and omissions were wide-ranging, encompassing both her clinical skills, as well as behavioural issues.
"Her conduct was not an isolated incident.
"Her behaviour fell significantly short of the conduct and standards expected of a registered nurse."
It said that it had no information about any steps taken by the nurse to remedy her shortcomings and said she could "repeat her dishonest behaviour in the future".
Mabs Rajan, 66, of Claremont Care Services, the company which owns Warrengate, said it hired Ms Mysllinj from an agency and that she received an induction and training from the nursing home.
He said: "We got the CV and it seemed to show she was a qualified nurse and we can only tell how good a nurse is until she starts work.
"After she started, information started coming to us as to her attitude towards residents.
"As soon as these started coming in she was called into the office and dismissed.
"Quite often they have the basic training and we have to add to that.
"She was given our induction and was deemed OK to administer drugs to residents and then she was trained in taking blood.
"She didn't learn much from that training, didn't pay attention or didn't have the capability.
"If people can't speak to the elderly in a respectable manner, why is she working in a nursing home?"
Mr Rajan said the correct outcome had been reached by the NMC.
"I hope other nursing homes will be vigorous and not let things go. We didn't do that.
"We saw that she wasn't suitable for us and dismissed her and to ensure she didn't end up doing this at another home we reported her to the NMC which isn't easy as there's so much paperwork involved, which puts off other nursing homes from doing the same," he said.
This week, a serious case review published recommendations after examining the failings at Orchid View care home, in West Sussex - where residents were treated with a lack of dignity, to poor nutrition, mismanagement of medication and staff shortages.
One of its key recommendations is for care providers to prove they can recruit and sustain a trained and skilled workforce to the Care Quality Commission.
Mr Rajan said he is "very much in favour" of the report into the failings at Orchid View.
But added: "It's important to employ competent people but there will be the odd individual who will slip through."
He said that there is a huge shortage of nurses in the UK and the dynamics of where nurses are recruited from has changed.
"For years and years we used to recruit nurses from overseas from places such as India, Zimbabwe, South Africa, the Philippines.
"Many of these countries were ex-British colonies where training emanated from the standards we have in this country so generally the nurses were pretty good.
"With some of the nurses that come from Europe, there is a language problem, unlike the ex-British colonies where English was taught, and they take time to pick it up.
"I don't know what the training is like in countries like Bulgaria or Romania but I have recently taken on someone nurses from Spain where the training is excellent and fuller than the training in this country.
"It's not as paper-based or management based as it is in this country. It's much more practical.
"It does vary a lot from where the nurses come from and depends on the standards of care in those countries."
When asked what has been behind the shift, he said: "It's politics. The closer ties with Europe.
"Our borders are open for Europe. The Government view is 'if we can employ someone from within Europe, where we are part of a union, then why go outside the union?'
"And it plays to voters by cutting down on immigration."