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The panel, in reaching its decision, had regard to the public interest and accepted that there was no burden or standard of proof at this stage and exercised its own professional judgement.
The panel was of the view that Nurse A’s actions did fall significantly short of the standards expected of a registered nurse, and that Nurse A’s actions amounted to a breach of the Code.
The panel was of the view that Nurse A’s dishonest behaviour would be considered deplorable by members of the public. Further it determined that Nurse A’s actions did fall seriously short of the conduct and standards expected of a nurse and amounted to misconduct.
Decision on impairment
The panel next went on to decide if as a result of this misconduct Nurse A’s fitness to practise is currently impaired.
The panel acknowledged Nurse A’s admission that their fitness to practice is currently impaired.
Nurses occupy a position of privilege and trust in society and are expected at all times to be honest and open and act with integrity. They must make sure that their conduct at all times justifies both their patients’ and the public’s trust in the profession.
During Nurse A’s oral evidence, they demonstrated some insight which has developed since the allegations arose. Nurse A had demonstrated remorse for their actions and an understanding of why what they did was wrong and how this impacted negatively on the reputation of the nursing profession.
The panel determined that there had been a potential risk of harm to patients had Nurse A secured the qualification, as it would have allowed Nurse A to practise beyond their ability. However, this did not happen.
The panel reminded itself that currently, there are no patient safety concerns. To the contrary, Witness A submitted that no previous clinical concerns have been raised regarding Nurse A’s practice in all the time they had worked with Nurse A.
The panel therefore decided that a finding of impairment is not necessary on the grounds of public protection.
The panel bore in mind that the overarching objectives of the NMC are to protect, promote and maintain the health safety and wellbeing of the public and patients, and to uphold/protect the wider public interest, which includes promoting and maintaining public confidence in the nursing and midwifery professions and upholding the proper professional standards for members of those professions.
The panel determined that, in this case, a finding of impairment on public interest grounds was required.
Determination on sanction
The panel considered the following aggravating and mitigating factors:
- Case concerns two separate incidents of dishonesty;
- Nurse A demonstrated limited insight and admissions to the local investigation.
- Nurse A has engaged with the regulatory process;
- Nurse A has undertaken reflective sessions;
- Nurse A has demonstrated a developing level of insight;
- Nurse A has demonstrated remorse for your failings;
- Nurse A has recognised the impact of your failings on the public, your colleagues and the reputation of the profession.
The panel noted that no personal gain was achieved by Nurse A’s dishonesty and that no risk to patients occurred as a result of their dishonest conduct. When considering the particular context of the charges, the panel was of the view that Nurse A’s dishonesty was at the lower end of the spectrum.
The panel first considered whether to take no action but concluded that this would be inappropriate in view of the dishonest misconduct found proved. The panel decided that it would not be in the public interest to take no further action, and would not mark that the behaviour was unacceptable.
The panel considered whether it would be proportionate to impose a more restrictive sanction and looked at conditions of practice. The panel has been told that there have been no clinical concerns in relation to Nurse A’s practice before or since the allegations occurred.
Also, the panel could not determine any workable conditions which would be relevant to the misconduct found proved. In light of this, the panel concluded that no useful purpose would be served by a conditions of practice order.
The panel has decided that a caution order would adequately address the public interest concerns in your case. For the next two years Nurse A’s employer or any prospective employer will be on notice that Nurse A’s fitness to practise had been found to be impaired.
Having considered the general principles above and looking at the totality of the findings on the evidence, the panel has determined that to impose a caution order for a period of two years would be the appropriate and proportionate response. It would mark not only the importance of maintaining public confidence in the profession, but also send the public and the profession a clear message about the standards required of a registered nurse.