A nurse who punched a pensioner in intensive care and told her she was ‘going to die’ has escaped being struck off.

Terence O’Reilly ‘lost his patience’ with the 80-year-old after she lashed out at him as he tried to stop her getting out of her bed in the middle of the night, the Nursing and Midwifery Council heard.

O’Reilly, 54, grabbed a handful of her hair and punching her in the chest.

He then screamed, within inches of her face: ‘You are going to die, you f***ing bitch!’

The patient was reduced to tears after the shocking incident in the 14-bed East Wing intensive care unit at London’s St Thomas’ Hospital on November 14, 2008.

The NMC panel ruled his fitness to practice was impaired and issued O’Reilly with a caution order for five years – even after ruling they could not be satisfied ‘that such misconduct would not be repeated’.

Christopher Pataki, for the NMC, earlier told the hearing: ‘His coduct was akin to that expected in a street brawl rather than that expected between a nurse and a patient in an ICU.’

O’Reilly, a nurse since 1978, immediately apologised and conceded that his behaviour had been ‘inappropriate’, the panel heard.

He was sent home early and an internal investigation was launched.

O’Reilly, of Calcot, Berks, has since left his job with the Guy’s and St Thomas’ NHS Foundation Trust in February 2009.

He denied physically attacking the woman, referred to as Patient A, but admitted holding her arms down and shouting at her.

Patient A had been in intensive care for about two weeks in order to receive treatment for respiratory problems following surgery.

She was attached to cardiac and blood pressure monitors, a catheter and sometimes a chest drain.

O’Reilly had volunteered to care for the woman and one other patient throughout his shift but complained that his workload was becoming overwhelming later that night.

The hearing was told that several senior nurses had called in sick, leaving more junior staff than unusual to run the 12-and-a-half hour night shift.

Mr Pataki said: ‘On the night of November 14, 2008 Mr O’Reilly, while working a shift on the intensive care unit at St Thomas’ Hospital, attacked a patient in his care and used physical force against that patient.

‘She was elderly and still in her bed.

‘He shouted at her and threatened her, and his coduct was akin to that expected in a street brawl rather than that expected between a nurse and a patient in an ICU.

‘It is the council’s case that Mr O’Reilly’s conduct amounts to the physicaly and verbal abuse of a vulnerable and elderly patient.’

Lucy McKinnon, defending, said her client admitted only that he had held down Patient A’s arms and shouted at her, and denied the other charges.

She said: ‘He accepts that there was an incident and that his conduct during that incident was inappropriate.’

The NMC panel found all the allegations against O’Reilly proved, save for an allegation that he headbutted the patient.

Chairman Andrew Popplewell took into account that O’Relly had been a nurse since 1978 and had an unblemished record.

Mr Popplewell said: ‘This was an isolated incident and although O’Reilly’s conduct had the potential to cause patient harm no physical harm occured. O’Reilly has displayed a degree of insight and contrition.

‘In the circumstances the panel has concluded that a caution order for five years, the maximum, is an appropriate, sufficient and proportionate sanction