Wiltshire nurse who cut off patient's toe punished in hearing

Eleanor Trowell faced a misconduct hearing after carrying out the unnecessary amputation while working a shift as an agency nurse for Wiltshire Health & Care.

She later expressed remorse for her mistake and alleged systematic failures at her former employer were partly to blame for what happened.

On March 8 2018, at Patient A’s home, Trowell failed to adequately review her notes before assessing and treating a foot, failed to follow the relevant care plan and did not obtain advice from the tissue viability team or vascular surgeon about the correct treatment of a toe.

The nurse then “inappropriately removed [Patient A’s] toe”, a panel hearing summary states. Trowell admitted to all of this and it was also proved that she had not sought consent from the patient before carrying out the procedure.

At a previous hearing which noted her “tendency to deflect blame”, Trowell received a conditions of practice order, which controls the circumstances under which a nurse can treat patients.

This order prevented her from working as a community nurse unless directly supervised by another registered nurse, ordered her to improve knowledge of tissue viability, wound management and escalating concerns, and tell her case officer of any changes to her employment or course of study.

It had lasted 11 months and was due to end in May, but the Nursing and Midwifery Council Fitness to Practise Committee decided in February that this would be replaced with the less serious punishment of a 12-month caution order after hearing how she had learnt from her mistake.

Picture: GETTY IMAGES

Eleanor Trowell registered as a nurse in 2014 and worked at the University Hospital Southampton in October 2020 on a respiratory ward with Covid patients. She had to leave the hospital in May 2021 for reasons which have been kept private and may be health-related.

Applying for jobs proved difficult due to the restrictions of her order and she told the panel she would like to be an aesthetics nurse. The role would have other trained nurses available on call if there were any problems and she could work with clinical supervision and a mentor if needed.

She added: “There were a number of systematic failures at the Wiltshire Health and Care. There were no supervisors available to get support from and care plans were not updated.

“[I am] very sorry for what happened and will make sure [I] never work outside [my] code of conduct again.”

The panel was satisfied that her potential risk to patient safety had been reduced to the extent that a caution order would “adequately protect the public”.

This penalty is considered suitable when “the case is at the lower end of the spectrum of impaired fitness to practise and the panel wishes to mark that the behaviour was unacceptable and must not happen again”.

For the next 12 months, her employer - or any prospective employer - will be notified that her fitness to practise had been found to be impaired and that her practice is subject to a restriction. The committee said in their summary: “This would mark not only the importance of maintaining public confidence in the profession, but also send the public and the profession a clear message about the standards required of a registered nurse.

“At the end of this period, the note on your entry in the register will be removed. However, the NMC will keep a record of the panel’s finding that your fitness to practise had been found impaired.”