A former nurse at Lincoln County Hospital is alleged to have repeatedly altered patient records and forged staff signatures to steal morphine from the premises.
Kimberley Cooper, 39, is alleged to have falsified morphine entries relating to 20 patients over 40 different occasions.
The thefts were discovered after stock records showed seven ampoules of the powerful pain killer had gone missing from the ward where Cooper worked in just one day, it is claimed.
It is alleged Cooper had become reliant on the Class A drug following her own medical problems and was stealing it for herself.
Cooper is accused of “abusing her position” while working on a gynaecology ward at Lincoln County Hospital between October 2013 and July 2014.
Justin Wigoder, prosecuting, told the jury at Lincoln Crown Court: “Nurses are in a position of trust in a variety of ways, one of those is to make sure patient records are accurate.
“The prosecution say because of what has happened, and what can be proved to have happened by a handwriting expert and other evidence, is that Cooper has been falsifying, forging and altering patient records and the hospital’s drugs books.
“She is doing that because she is stealing the morphine, most likely for herself.”
Mr Wigoder told the jury morphine is so powerful that it is classified under the Dangerous Drugs Act as a Class A drug which puts it on the same level as heroin, crack and cocaine.
“It follows that hospitals which use morphine as pain relief have to keep it very securely and have a number of checks and balances in place to ensure that is carefully controlled,” Mr Wigoder added.
The court heard Cooper was a nurse on Branston Ward at Lincoln County Hospital, a gynaecology ward whose patients did on occasions require morphine for pain relief.
Mr Wigoder said all transactions relating to morphine sulphate required two signatures from the nurse who drew up the medication and another witness, and were recorded in the ward’s Controlled Drugs Record Book.
“If you are going to steal morphine you need to make quite a lot of false entries,” Mr Wigoder told the jury.
“You will hear from a handwriting expert there is strong evidence that it was Cooper who was making those false entries.”
The prosecution also allege “it is significant” that there are no alterations in the drugs record books when Cooper was on sick leave between April 20 and July 7, 2014.
Mr Wigoder said: “The simple fact is that while she is off alterations don’t appear in the books.”
It is alleged that Cooper falsified three morphine entries for one patient who had already been discharged from the hospital.
“Fairly obviously you can’t give drugs to someone who is no longer in hospital,” Mr Wigoder told the jury.
On another occasion it is alleged that records showed a female patient was prescribed 45 milligrams of morphine when she in fact received just 20 milligrams.
A doctor also said he would only prescribe individual morphine doses of ten milligrams and that any doses of 15 milligrams in his name would have been forged, the jury heard.
The morphine stock records were checked after seven ampoules were found to be missing at the end of the day on July 14, 2014.
Mr Wigoder told the jury: “From November 11, 2013 until July 14, 2014 with the gap I have told you about (when Cooper was off sick) the records in relation to 20 different patients have been forged and over 40 different occasions. In total 430 milligrams of morphine were stolen.”
Mr Wigoder added: “This is where the real harm of the case comes, because any doctor or any nurse looking at that patient would not know that medication had not been prescribed.”
Cooper was initially arrested on July 15, 2014.
Mr Wigoder said: “She denied any part in this and said on some of the days she had not been at work.”
He told the jury although this may have been correct on some occasions, she would have been at work the following day.
“We can show she had the opportunity to alter the records and steal the morphine,” Mr Wigoder said.
Giving evidence nurse Jane Gilbert, who worked on the same ward, admitted there had been a previous incident where one ampoule of morphine had gone missing and Cooper was not working.
Nurse Gilbert confirmed she did notice a crossing out in the drugs register when she signed it herself at 5pm on July 14, 2014.
She said: “I said that there was a crossing out and that we would be in trouble.”
Cooper, of Tomlinson Way, Ruskington, denies one charge of theft, four charges of forgery and one charge of possessing a Class A drug.
The trial continues on Thursday.