A mental health nurse who attempted suicide after being referred to the regulator is looking for others willing to share their experience of the fitness to practise process as part of a new research project.
Clare Nurse, who is studying for a Master’s in Research Methods in Psychology at Swansea University, hopes her dissertation research will help shed light on the impact of FtP on all aspects of registrants’ lives and identify how support could be improved.
“I remember receiving one set of paperwork and I just sat on the floor crying”
In 2017, Ms Nurse, who had experienced mental health problems for many years, was referred to the Nursing and Midwifery Council for having an inappropriate relationship with a patient.
At the time, she was seriously unwell and her judgement was impaired, but she accepted that her breach of conduct was “completely wrong”.
After being referred to the regulator, she took an overdose and was admitted to a psychiatric unit.
While she said she understood the need for NMC intervention, she said aspects of the way the FtP process was handled had affected her already fragile mental wellbeing and recovery.
If it had not been for support from family, friends and union representatives, she stated: “I would have taken my life”.
“I remember receiving one set of paperwork and I just sat on the floor crying and it took everything in me to not walk out the door and do something stupid,” she told Nursing Times.
“The whole process made me feel worthless, a horrible person – I already felt those things about myself and it felt like I was getting beaten with a stick,” she added. However, she said she was determined to complete the FtP process.
“I had broken the code and felt that I should go through it to take accountability for my actions, but also because nursing was such a big part of my life and I didn’t want to just give up on it,” she said.
“I had broken the code and felt that I should go through it to take accountability for my actions”
Having been on an interim suspension order, she attended a full hearing in March this year where she was given a 12-month suspension. She felt the panel were “fair” and judged her case on the facts.
She said she was now keen to find out how others felt about the process, including whether they felt they had experienced a fair hearing.
She is looking for nurses and midwives who have been through FtP procedures or who are part-way through the process to share their thoughts and experiences via an anonymous online questionnaire.
“I want to look at the full impact – physical and mental – but also whether the process changes them so they do not want to go into nursing again,” said Ms Nurse, who said she had not yet decided whether or not to try and return to practice herself.
She said she was particularly interested in whether nurses and midwives felt they were able to put across their side of the story. “I suppose it is really about fairness. Is the process fair?” she said.
She told Nursing Times that she hoped the study would inform work to reform and improve FtP processes.
“I can’t change my past or my actions but I wanted something good to come out it,” she said. “Ultimately, I want to create learning so another nurse doesn’t find themselves in a similar situation.”
Her call for research contributors comes just after the NMCWatch group launched a new social media campaign to raise awareness of the impact of FtP.
The campaign, which includes a short film and posters designed specifically to be shared on platforms like Facebook and Twitter, features comments from nurses and midwives who have been referred to the NMC and describe the toll this has taken on many aspects of their lives.
It is based on research by NMCWatch which surveyed more than 150 nurses who went through the FtP process with some revealing they had considered suicide.
More than half said their mental health had been affected with respondents reporting issues such as difficulty sleeping, low self-confidence, loneliness and isolation.
“I was on suicide watch for three months due to the shock – especially as in my case I did not do anything wrong,” said one respondent who claimed she had been “hounded out” of her job, because of anonymous allegations that turned out to have been made by her ex-husband.
More than one in five who took part said they had decided to leave nursing with many complaining about a lack of “empathy” or “compassion” in the way their case was handled – or an assumption of guilt.
“The NMC assumed that by the fact I was in front of them it had to be justified,” said one who claimed they were seen as “guilty from the outset” and had been “fed to the wolves”.
Another said it had been “by far the most horrendous experience of my life”. “I still suffer from flashbacks. My life hasn’t been the same since,” the nurse added.
A spokeswoman for NMCWatch said the social media drive, which has been supported by Doctors Association UK, was part of their ongoing efforts to push for better emotional and practical support for registrants.
“One aim is to try and make the general public aware of the issues and that it is not as straightforward as rogue nurses and midwives getting their just desserts. We have had positive feedback from the public and fellow professionals,” she said.
“Our new approach to fitness to practise is all about moving away from a culture of blame to one that encourages openness”
The NMC recently launched a new FtP strategy designed to make the process fairer, less confrontational and less distressing for all concerned.
“Our new approach to fitness to practise is all about moving away from a culture of blame to one that encourages openness, honesty and real learning when things go wrong. At the heart of it is ensuring that all those involved in the process are treated compassionately and with respect,” said NMC director of FtP Matthew McClelland.
“We are working closely with employers to make sure they are supported and able to resolve more issues at a local level so that we receive only the right referrals,” he said. “Where we do receive referrals, will give proper consideration to the context in which mistakes happen.”
He noted that steps the NMC was taking to improve support for registrants going through FtP included setting up an “emotional support” helpline.
“We know that fitness to practise has an impact on people and we are planning to provide more support to help,” Mr McClelland told Nursing Times.
“As we continue to improve our ways of working, we are introducing an independent emotional support line for professionals involved in fitness to practise,” he noted.
He also said the body was looking at ways to ensure registrants – who did not have access to legal representation – were able to get independent and free legal advice.
“Many nurses, midwives and nursing associates involved in fitness to practise get excellent legal representation from their professional body or trade union. However, others are not legally represented,” said Mr McClelland.
He added: “That’s why we’re also exploring whether we can work with an independent organisation to provide pro bono legal advice to those who wouldn’t otherwise be legally represented.”