Find out how the NMC panel acted in this case. Not yet read the case? Read the charge and background here
Determination on sanction
The panel decided to make a suspension order for a period of 12 months. In reaching the decision, the panel had regard to the live evidence from Nurse A who stated that nursing was her first career and she liked helping people and making them “feel comfortable and safe”.
With regards to Resident A she acknowledged that they required regular medication to achieve the desired therapeutic effect and that the missed medication could have adversely affected her care. Nurse A said that if she made a medication error now she would act differently in that she would immediately inform the GP and her managers and take the appropriate observations.
The panel identified the following aggravating factors in the case:
• The dishonesty directly involved her practice
• Nurse A placed her own interests above those of her patients
• Nurse A placed patients at potential risk of harm
• Nurse A tried to involve another colleague in covering up the removal of the supplements
• There were multiple instances of dishonesty.
The panel identified the following mitigating factors:
• Nurse A made early admissions to all the dishonesty
• Supportive references from her current employer were supplied
• Nurse A was open and honest with her current employer about the incidents
• There has been no repetition since these incidents
• There is no evidence of actual harm caused to patients.
The panel first considered whether to take no action but concluded that this would be inappropriate in view of the seriousness of the case. To take no further action would not protect the public or uphold the public interest. The panel next considered whether a caution order would be appropriate in the circumstances. However they found that the misconduct was not at the lower end of the spectrum and that a caution order would be inappropriate in view of the seriousness of the case. A caution order would not protect the public and so the panel decided that it would be neither proportionate nor in the public interest to impose a caution order.
The panel next considered whether a conditions of practice order would sufficiently protect the public. The panel was mindful that any conditions imposed must be proportionate, measurable and workable. The panel was of the view that there are no conditions that could be formulated which would address the issue of dishonesty. Therefore, it concluded that a conditions of practice order would not be sufficient or appropriate.
The panel then went on to consider whether a suspension order would be an appropriate sanction. The panel had regard to the Indicative sanction guidance and noted in particular paragraph 67. The panel was of the view the misconduct does not demonstrate a harmful deep-seated attitudinal problem. Although the panel bore in mind that this was not a single instance of dishonesty, all of the matters occurred within a five week period. The panel considered that Nurse A’s evidence “that is not who I am” is genuine
The panel considered that Nurse A had developing insight into her misconduct however, the panel bore in mind that she focussed her reflection on the impact on herself and her career rather than the patients.
The panel was of the view that a suspension order would satisfy the public interest requirements in this case. The panel decided that the maximum period of 12 months was appropriate. It bore in mind that this order would prevent Nurse A from earning a living as a registered nurse but considered that, as it was serious misconduct, there is a strong competing public interest making it necessary to send out a clear message that this is deplorable conduct for a registered nurse.
Was this the right course of action?
Do you agree with the panel?