A former chief nurse at scandal-hit Stafford Hospital was a "bully" who intimidated staff and "wholly failed" in her management responsibilities in areas such as ensuring adequate staffing levels, a disciplinary hearing has been told.
Janice Harry acted in an "aggressive and intimidating" way and shouted at staff who raised problems with her, reducing some to tears, the Nursing and Midwifery Council (NMC) heard.
Harry denies a series of charges dating between 1998 and 2006 and related to alleged failures to ensure adequate nursing staffing levels and appropriate standards of record keeping, hygiene and cleanliness, administration of medication, provision of nutrition and fluids and patient dignity.
She also denies accusations of bullying staff who raised problems with her - allegedly creating a "stressful and unpleasant" atmosphere which discouraged staff from reporting problems, the NMC heard.
"The NMC case against the registrant may be summarised in this way, the case is based on serious failings in her management role," William Davis, for the NMC, said.
"It is not said that she was directly and personally responsible for the numerous examples of poor care delivered by staff at Mid Staffordshire NHS Trust, on the contrary the evidence suggests that her time on the wards with patients was limited.
"Rather the NMC say that she wholly failed in her management responsibilities to ensure, amongst other issues, appropriate staffing levels and the correct skill mix.
"The NMC also say the registrant took an aggressive and intimidating management style which created a stressful and unpleasant atmosphere for staff who as a result felt unable to report problems. When they did so they were treated rudely and there is evidence that on occasions they were reduced to tears.
"It was in this climate, the NMC say, that the problems at Mid Staffordshire became established. The NMC say that these failures amounted to misconduct by the registrant."
Harry was employed by Mid Staffordshire NHS Foundation Trust and its predecessor Mid Staffordshire General Hospitals NHS Trust from 1998 to 2006, the NMC was told.
From 1998 she was director of nursing and quality assurance at Stafford Hospital and in 2002 was appointed director of clinical standards and chief nurse as well as director of infection prevention and control.
She denies misconduct.
Harry denies all the allegations put before the NMC including an accusation of putting patients in danger by failing to ensure adequate nursing staff levels on ward 10D between 2002 and 2006, the accident and emergency department between 1998 and 2006 and the emergency admission unit (EAU) between September 2005 and June 2006.
She is also accused of putting patients at risk by failing to ensure an adequate mix of staff skills, on ward 10D, between 2002 and January 2006, A&E between 1998 and 2006 and the EAU between September 2005 and June 2006.
The charges include allegations of failing to communicate with nursing staff in an "appropriate" manner - allegedly shouting at nursing staff and using "inappropriate language".
She told a ward sister on one occasion that another member of staff was a "waste of space" and reduced one ward manager, named as Ms D, to tears, it is alleged.
Harry "tore shreds off" and ignored the concerns of another ward manager, named as Ms C, after Ms C told her that a patient was not well enough to be sent home, it is further alleged.
Harry is also accused of providing inaccurate information during a reconfiguration of services including telling the trust board in April 2006 that the impact of proposed cost savings would not be harmful to patient safety or care.
She also provided inaccurate information to the hospital management board in April 2006 that a proposal to change the ratio of qualified to unqualified staff from 60/40 to 50/50 or even 40/60 would not have an impact on the numbers of staff and standards of care, it is alleged.
She is accused of reassuring the trust board that nursing vacancies were being filled when she knew, or ought to have known, that recruitment at the trust was an "ongoing issue".