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Pauline Cafferkey cleared of all misconduct charges in NMC case

  • 20 Comments

Pauline Cafferkey, the nurse who survived ebola, has been found not guilty of professional misconduct following the conclusion of a fitness to practise hearing today.

The virus had affected Ms Cafferkey’s ability to alert health officials to her symptom of a high temperature when she returned to the UK in 2014 and so her actions did not amount to misconduct, the hearing panel said.

In response to allegations by the Nursing and Midwifery Council, Ms Cafferkey did admit to allowing a wrong temperature to be recorded when she arrived back at London’s Heathrow Airport after working as a volunteer in Africa during the height of the virus outbreak.

She also admitted she went on to leave a Public Health England screening area at the airport without flagging up her elevated temperature.

”The panel therefore concluded that her judgement had already been significantly impaired involuntarily”

NMC misconduct panel chair

However, she was cleared of misconduct because the panel concluded her actions were the result of illness and exhaustion.

Ms Cafferkey was also initially accused of being dishonest. But in light of extra medical evidence presented as part of the hearing, the NMC agreed to drop the charge because there was no case to answer.

The panel heard Ms Cafferkey’s temperature was taken twice by a doctor in the airport’s screening area, which was described as “busy, disorganised and even chaotic”, and found to be 38.2 and 38.3 degrees - higher than 37.5 degrees, the point at which further assessment is required.

Her two temperature scores were read out to her and another registrant, who was not named during the hearing. However, it ended up being recorded on Ms Cafferkey’s screening form as 37.2 degrees – within the normal range – and she was allowed to leave.

The doctor said the other registrant stated at the time she would record 37.2 degrees on the form and they would “get out of here and sort it out”. But Ms Cafferkey said she recalled the words “let’s get out of here” being used but could not remember who said it or who entered the temperature on her screening form.

Nursing and Midwifery Council

Ebola nurse Pauline Cafferkey speaks of anguish over NMC case

Pauline Cafferkey

The panel also heard Ms Cafferkey had taken paracetamol at some point because she realised she had a temperature.

Although it was only when she had made her way to the airport’s arrivals area that doctors realised she was at risk after she told them she had taken paracetemol and had a temperature. She was described by a doctor at this point as “acting extremely vague”.

However, during her final assessment at the airport by another doctor Ms Cafferkey was not asked if she had taken a paracetemol and she also did not volunteer this information. By that point her temperature, which was taken again another three times, only read above 37.5 degrees on one occasion and so the doctor cleared her for onward travel.

The panel concluded Ms Cafferkey’s actions could only be explained by her developing illness and state of exhaustion.

“It is inconceivable that she would leave the safe environment of the PHE screening area but for the fact that she was already seriously ill,” said the panel chair.

“The panel therefore concluded that her judgement had already been significantly impaired involuntarily,” they added.

NMC chief executive Jackie Smith said it was right this “highly unusual set of circumstances” had been thoroughly investigated.

“As the independent panel recognised, the NMC has an overarching duty to protect the health and wellbeing of the public and needs to ensure the maintenance of public confidence in the profession,” she said.

“The referral from PHE showed a highly unusual set of circumstances that clearly required a thorough and proper investigation.

“In circumstances like this, it is right for an independent panel to hear all the evidence to decide if any action is required.”

  • 20 Comments

Readers' comments (20)

  • Surely having seen the effects of Ebola she should have has more sense sick or not than to have risked bringing it into this country as for taking paracetamol earlier this could be construed as a skilled and knowledgeable health profession trying to evade testing results. As for going back to report try "shutting the stable door after the virus has bolted". She should be held to account as should all the parties involved. Surely most individuals investigated have had a "good" record at some time and if she had caused infection to spread and resultant deaths I don't think her good record would be much consolation to those involved. If she felt that ill she knew she was ill.

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  • Surely having seen the effects of Ebola she should have has more sense sick or not than to have risked bringing it into this country as for taking paracetamol earlier this could be construed as a skilled and knowledgeable health profession trying to evade testing results. As for going back to report try "shutting the stable door after the virus has bolted". She should be held to account as should all the parties involved. Surely most individuals investigated have had a "good" record at some time and if she had caused infection to spread and resultant deaths I don't think her good record would be much consolation to those involved. If she felt that ill she knew she was ill.

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  • Such a difficult one this. If her reasoning was impaired by virtue of her illness, then how can she be held to account? However, is the NMC going to extend this reasoning to others? The nurse reported for a drug error,on her 7th straight night, who hasn't slept properly and has the equivalent of jet lag (notorious for impairing reason and it is well documented that night duty has this effect.) The nurse who has diarrhea but cannot afford to take a day off from the nursing home because she does not receive sick pay and so puts residents at risk from salmonella? It's ludicrous that this case ever got to the hearing stage, as all of this information would, or should, have been available during the investigation. The NMC put nurses through the wringer for month upon month at an enormous cost to the nursing community who pay their registration fees to fund it. The NMC needs to be reined in. And I totally agree with the previous comment re: charges. We are not criminals and it is not a court of law, despite there being a legal representative present.

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  • michael stone

    ANONYMOUS 15 SEPTEMBER, 2016 11:35 AM

    What doesn't really seem to fit very well, is that surely if she was already ill-enough for her reasoning to be significantly impaired, then wouldn't the fact that she was ill, and suffering from something, be pretty obvious ? And, surely the airport would have known she had been caring for Ebola cases, so if she 'looked unwell' ...

    There is a lot which is unsatisfactory about this case - including how long it has taken to sort it out (perhaps the NMC has to work through its pending cases in order of when they were raised [you can see that 'prioritising high media-profile' cases seems unfair on the others] - in which case, the entire system is too slow for one reason or another).

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  • Pussy

    Vicky Thomas Yes,I agree with you.

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  • I don't understand why others who did the recording weren't under investigation. As always the nurse gets the blame. I left hands on nursing because one night a script came in for a syringe driver and I couldn't work out the dosage. I got in another nurse as I'd had a busy shift and thought I might have just been tired. Eventually we worked out that the script was incorrect, so written incorrectly, made up incorrectly and yet had I given it I'd be the one in the NMC court. It now appears that even if you are the patient and a nurse you can be the one to blame. It wasn't just the incorrect script, it was 3 blocked catheters, 2 palliative care patients, no food or drink break and 37 patients as well on one shift, day after day. Whilst I have a duty of care, where was my employers?

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  • michael stone

    ANONYMOUS 17 SEPTEMBER, 2016 9:28 AM

    Re your 'Whilst I have a duty of care, where was my employers?'.

    You might be interested in a BMJ piece David Oliver has just written:

    'David Oliver: Treating NHS staff fairly when things go wrong'

    http://www.bmj.com/content/354/bmj.i5007

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  • This is the end of nursing for me.
    The nursing Gestapo that we pay for masquerading as a "service" for nurses to "upkeep standards for the public" has pilloried this nurse in public for being ill and exhausted.
    Therefore we should all be in the dock as we all struggle at work when we are feeling exhausted - which is more often than not - mainly due to cuts and staff shortages.
    Do they REALLY have nothing better to do?
    Are there so few rogue nurses (surprise surprise, as most nurses are dedicated and honest) that they are starting to pick on innocent exhausted and unwell nurses??
    I will not be paying their "fee" next year because I am throwing in the towel. Are they really this stupid that they do not realise that the gutter press will report the salacious bits with pictures towards the front of the paper but when someone is innocent of charges, it usually appears in a little box on a page that no-one usually reads?
    Charging young people extortionate tuition fee's to become nurses was a gob smacking moment for me. Graduating with approx £40k debt (incl loans so they will be able to live and eat) to become public servants where they are never going to make a good comparative wage is going to make them look for a better paid profession. And good for them.

    This public humiliation in the media of Pauline Cafferkey is now the last straw. The NMC should be making a public apology. I will be looking for another job to take me to retirement. If they can do this to her then they can do this to me. Anything is better than this!

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  • Great news, I can't believe that a dedicated nurse who has worked hard to treat and prevent spread of ebola, would deliberately infect others on her return. Pauline I hope you can put all this behind you and continue with your good work. All the best Sheila.

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  • Phil Dup

    A nice little precedent has been set by the NMC here. If ever you mess up and are at risk of losing your registration just say you had a flu with a sky high temp or diarrhoea induced dehydration or even workplace shift pattern induced sleep deprivation - all those things will alter your ability to think clearly so heigh ho you will get away with any charges. Work might get a lot more fun now :-)

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