A nurse who was drunk at work on at least four occasions over an eight-year period has finally been struck off.
Mary O'Brien is no longer allowed to work as a nurse after the Nursing and Midwifery Council (NMC) last week found her "conduct put patients at risk of harm" and ruled she was unfit to practise.
However, it has emerged concerns were raised about Mrs O'Brien as far back as 2007 - and she had already appeared in front of the NMC in 2012 for being drunk at work in 2009.
She was handed a caution for her behaviour but was allowed to continue working as a nurse.
Mrs O'Brien was still under the caution when she was found to be drunk on two subsequent occasions and was finally struck off last week.
Questions were last night being asked about how Mrs O'Brien had been allowed to work with elderly, disabled and terminally ill people despite repeatedly turning up drunk for work over an eight-year period.
During one of the incidents she failed to give out medication, gave insulin to one patient, fell asleep, and abused colleagues.
She also failed to notice when a gastric tube had become dislodged from a resident and fluid was leaking on to the floor.
Kieran McCarthy MLA, from the Stormont health committee, said: "It is incredible; how could that even be possible?
"Talk about being shocked, it's horrific that a person with that sort of record can go from one post to another working with extremely vulnerable people.
"There does seem to be some kind of serious systemic failure."
Fermanagh and South Tyrone MP Tom Elliott also expressed concerns about the case.
"I am just wondering how this could have been allowed to happen," he said.
"It does seem like there has been a shortfall there and I hope that Gortacharn Nursing Home has reviewed its employment practices."
Mrs O'Brien was suspended and referred to the NMC after admitting drinking before turning up for work at Gortacharn Nursing Home in Lisnaskea, Co Fermanagh, in July 2014.
Despite this, she was invited to return to work as a healthcare assistant at the facility, but was found to be drunk again in February 2015 and was sacked as a result.
The owner of Gortacharn last night declined to comment on the matter.
Mrs O'Brien was previously disciplined by the NMC in 2012 for falling asleep in a chair after turning up drunk to work at Drumclay Nursing Home in Enniskillen in 2009.
During the hearing relating to the 2009 incident, the NMC raised concerns of evidence of another similar incident when Mrs O'Brien was working as a registered nurse in the Republic of Ireland.
The NMC hearing in London last week heard Mrs O'Brien, who was not present for the two-day hearing, started working as a staff nurse at Gortacharn on February 26, 2014.
The panel found Mrs O'Brien arrived for a night shift at 7.50pm on July 4, 2014, and there was no cause for concern at that stage.
However, when a colleague went to ask for help at 11.30pm, she found Mrs O'Brien to be unsteady, avoiding eye contact and she smelled of alcohol.
The duty manager was informed and Mrs O'Brien was sent home.
The following day she admitted drinking alcohol before coming to work and was suspended and referred to the NMC as a result of her actions.
The NMC panel said Mrs O'Brien was later asked to return to work at Gortacharn as a healthcare assistant.
During a subsequent night shift on February 9, 2015 she was said to be behaving inappropriately, her speech was slurred and she admitted she had taken a drink.
"The home management decided they could no longer employ Mrs O'Brien," said the NMC.
The incidents at Gortacharn occurred while Mrs O'Brien was the subject of a four-year caution order from the NMC imposed as a result of the incident at Drumclay.
During an NMC hearing in 2012, a colleague from Drumclay told the NMC that Mrs O'Brien was "making exaggerated hand movements, talking really loudly and complaining about the work she had to do".
Nurse Alice O'Brien said she later found Mary O'Brien asleep in a reclining chair and had to raise her voice to wake her up.
She described how O'Brien became abusive, calling her a "deviant" on being told she had telephoned the manager of the home.
During the shift, Mary O'Brien failed to give one patient three different types of medication and fitted a nasogastric tube - a plastic tube inserted into the stomach via the nose and throat - while drunk.
She didn't notice when the tube became dislodged and fluid dripped on to the floor, and also gave insulin to a patient while drunk.