A highly experienced psychiatric nurse who broke a patient's nose when he punched him was yesterday warned he will "almost inevitably" go to jail.

Freeing Patrick Maguire on bail to be sentenced on Monday at Craigavon Crown Court, Judge Patrick Lynch warned that while he was "mindful of the extreme stress" faced by those dealing with mental health patients, it had to be "balanced against the nature of the trust that has been reposed in this situation".

"This was a gross breach of that trust," added the judge.

At an earlier hearing Maguire, from Tollymore Brae in Newcastle, admitted causing actual bodily harm to the male patient, wilfully neglecting the patient at the Bluestone Unit in Craigavon Hospital, and attempting to pervert the course of justice on October 27 last year.

Prosecuting lawyer Nicola Auret yesterday told the court how the patient, who suffers from a bipolar disorder, had been admitted to the unit experiencing an "episode with psychotic features".

She described how he had become "extremely distressed" at the hospital's emergency department, threatening a member of staff and setting fire to it.

In the early hours of October 27, at around 4am, the man was standing against the wall in the corridor of the unit when Maguire took him by the elbow to guide him back to bed but the patient "threw a punch at the defendant".

It was then, however, that Maguire "punched him three times to the face and he was put to the ground" where he remained for a short time until he was helped to his room.

Ms Auret said the victim sustained an injury to his nose and there was blood on the corridor floor, which Maguire wiped up before changing his own top.

Recounting how the incident was captured on CCTV, she said that at one stage a female staff nurse could been seen on the footage asking what had happened and was told that "a patient punched Paddy Maguire so had to be put to their room and in the process hit his nose off one of their knees".

While the nurse could not remember who told her that account, Maguire reported "there had been an incident, that he had been punched, the patient was restrained and he had hit his nose" so needed medical attention.

Ms Auret said at around the same time the patient phoned police to report that he had been assaulted. He later required an operation to his nose, which had suffered a displaced fracture.

Investigating police seized the CCTV footage as well as various documents which Maguire had filled in, with Ms Auret telling the court that "in none of the documents did (Maguire) file a truthful account of what happened".

It was that aspect of the case which formed the base for the charge of perverting justice, while it was Maguire's failure to get medical attention for the victim that formed the other charge of wilfully neglecting the patient.

Arrested and interviewed, Maguire gave a prepared statement where he set out how he was attacked first, but then refused to answer further police questions.

Ms Auret told the court that while Maguire had a clear record and had admitted his guilt, there were numerous aggravating features to the case, including the "gross breach of trust, the assault of a very vulnerable man that that defendant was supposed to care for", all of which was "compounded by his attempt to cover up what he had done".

Defence QC Charles McKay revealed Maguire had been a qualified nurse for 38 years and said the assault had been "an impulsive reaction to being swung at by the injured party".

"He impulsively reacted in a defensive way initially, but he would accept that he went beyond what would be proportionate in striking this man a number of times," said the senior lawyer.

He said that Maguire "accepts that he lost his self-control in a situation where he should not have done so... he should have been able to cope," and had "expressed he is ashamed and disgusted at what he has done".

Adjourning sentencing to Monday, Judge Lynch said he wanted to consider all the materials before him.

Belfast Telegraph