A NURSE, who cared for Tocumwal hospital patients Bob Cooling and Ralph Grenfell, has told the inquest into their deaths that she remains haunted by the “excruciating” pain suffered by Mr Grenfell in the final hours of his life in October 2005.
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Cindy Oakman, nee Perryman, told the inquest before NSW Coroner Mary Jerram, she believed she was not assisted by the hospital’s visiting medical officer, Dr Balaji Rao, in her efforts to alleviate Mr Grenfell’s pain.
She told how her experiences in October 2005 with Mr Grenfell had influenced her request for a colleague on January 7, 2007 to take her place alongside Dr Rao when he had ordered atracurium, a skeletal muscle relaxant, for Mr Cooling.
She said Dr Rao ordered the same drug as well as pancuronium, for Mr Grenfell prior to his death, 15 months before.
Mrs Oakman told counsel assisting the coroner, John Agius, she had not seen Dr Rao administer either drug to Mr Grenfell in the early hours of October 5.
However, she said she had no reason to doubt her own entries made in medication orders for Mr Grenfell, even though the 50mg of atracurium she noted was larger than the 5mg administered by Dr Rao according to his own notes.
There was no reference by the doctor in his notes to Mr Grenfell having been given pancuronium, even though Mrs Oakman records it as having been ordered at 4.10am on October 5.
Mrs Oakman said it was Dr Rao’s request for atracurium for Mr Cooling prior to his death on January 7, 2007, that had revived her trauma related to Mr Grenfell’s death.
She said after Mr Grenfell’s death she had suffered nightmares and feelings of guilt.
Mr Grenfell, 69, who had been admitted for bowel cancer, had become aggressive towards staff from the pain on October 4 and 5.
In response to questions from Mr Agius, Mrs Oakman said she had been in regular contact in the 24 hours prior to Mr Grenfell’s death with Dr Rao about his condition
Dr Rao had prescribed intramuscular injections of morphine every two to four hours in addition to his ongoing medication.
When Mr Grenfell was found by colleague Cheryl Madden attempting to get out of bed due to the pain, Dr Rao was called and he attended the hospital.
Mrs Oakman said Mr Grenfell’s arms and legs were tied to the bed before he was given medazepam.
Mrs Oakman confirmed Dr Rao had then ordered a 50mg dose of atracurium to be delivered intravenously.
Later in the treatment room she showed Dr Rao where she had found the atracurium.
“He went through it and found the pancuronium and went off with that,” she said.
The inquest continues today.