A veteran nurse broke down in tears while telling a tribunal how she saw a colleague at Stafford General Hospital pulling a dementia patient around by his pyjamas with his genitals exposed and then called him an “animal” .
Healthcare assistant Bonka Kostova first pushed the 73-year-old man into the bathroom and on to the toilet before pulling him out by his pyjama collar and shouting at him, the Nursing and Midwifery Council heard.
Staff nurse Jane Wilkinson then broke down in tears as she described Kostova shouting: “I hate him, I really hate him.
“He is like an animal. I can't bear working with him.”
Mrs Wilkinson, who has been a nurse at the hospital since 1985, said Kostova was hard-working but could sometimes be abrupt with other members of staff, but that it was to do with her Bulgarian accent and demeanour.
However, on this occasion Kostova, who had qualified as a midwife in her home country, was “losing it”, Mrs Wilkinson said.
“She just seemed to be out of control with what she was saying.
“I have been a nurse for a long time and I have never witnessed anybody saying anything like that at all and she did appear to be almost losing it really.”
The tribunal heard that the patient had been in the hospital just over a month receiving treatment for kidney stones when the incident took place just after 3am on July 22, 2010.
He was said to be aggressive in his speech or manner around 80% of the time and usually had a one-to-one carer looking after him who would sometimes need the assistance of another if the patient became particularly difficult.
On this occasion, that carer went for a break, leaving Kostova in charge.
The hearing comes after a damning report into failings at the hospital, which found “appalling and unnecessary suffering of hundreds of patients”.
The report into Mid Staffordshire NHS Foundation Trust highlighted the neglect of patients between 2005 and 2009.
Some were left for hours sitting in their own faeces, food and drink was left out of reach and hygiene was so poor that relatives had to clean toilets themselves.
But in his report, Robert Francis QC refused to point the finger at any organisation or individual, instead blaming an "insidious negative culture", including a tolerance of poor care standards and a culture of "self-promotion rather than critical analysis and openness".
At today's tribunal, Mrs Wilkinson said Kostova, known by colleagues as "Bonnie", would often "huff and puff when talking with patients with dementia".
"I believe this was due to her nationality," she said.
But Mrs Wilkinson added that she never saw her being rude to patients, and would only be "abrupt" with other members of staff, and would always carry out her duties.
While Kostova had received general training in looking after vulnerable adults, she had not received specific training for dementia patients, ward manager Sharon Matthews told the tribunal.
It was also possible that Kostova, who would often work extra shifts, had worked more than 40 hours in the week leading up to the incident, which happened in the early hours of a Thursday morning.
But Mrs Matthews would have been unaware of how many extra hours she had done if they had not been on her ward, where the incident happened.
The tribunal heard that after taking over care of the Alzheimer's sufferer, Kostova would have then been responsible for her regular 15 patients as well as the one-to-one care of the 73-year-old man.
But she would not have to look after him for more than an hour, the tribunal heard.
Alison Jepson, the hospital's matron of medicine, interviewed Kostova after the incident and said the carer denied pushing and dragging the patient around, saying she was guiding him.
Kostova said she noticed the patient was straining for the loo as he was walking around the ward and so guided him into the toilet.
"He walked outside (the toilet) without any pants or trousers at all so I needed to sort him out to protect his dignity", Kostova said to Ms Jepson.
"I didn't pull him - that is not what I had done," she said.
Kostova also said it would have been difficult for her to manhandle him because he was much taller and bigger than her but admitted shouting at him.
She did acknowledge the patient could be very unsteady on his feet due to his medication.
Ms Jepson told the tribunal she thought Kostova did not treat dementia sufferers as human.
"It came across that Bonnie felt the patient was not human because he had Alzheimer's disease," she told the tribunal.
"I'm unsure whether Bonnie understood the extent of her actions and the severity of the consequences."
When questioned about this description by the panel, Ms Jepson said Kostova would acknowledge the feelings of the patient's wife and family but not him.
"She wasn't acknowledging that he would have feelings. She didn't understand that by raising her voice and shouting - she didn't acknowledge that he could be upset as a result of her actions," Ms Jepson said.
The NMC panel is deliberating the facts of the case in camera. An overall verdict is expected tomorrow or Thursday, a spokeswoman said.
Kostova was suspended after the incident and has not worked at the hospital since, Mid Staffs Trust's medical director said.
Robert Courteney-Harris said: "This incident was dealt with very swiftly when it happened in 2010. The member of staff was suspended pending our investigation and never returned to work at our Trust."