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Final panel decision: How should the panel treat a nurse who admits they have not protected a person in their care?

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Find out how the NMC panel acted in this case. Not yet read the case? Read the charge and background here

The panel initially decided to make a two-year caution order. In reaching the decision, the panel referred to the Indicative Sanctions Guidance (ISG).

The panel identified the following aggravating factors in the case:

  • Serious harm could have been caused by the registrant’s failure to deal with the patient’s condition appropriately;
  • The registrant initially failed to show any insight into and a lack of remorse over his actions.

The panel identified the following mitigating factors:

  • There had been no previous regulatory findings against the registrant;
  • The registrant’s conduct related to a limited area of clinical practice; and
  • The registrant later showed that he realised the possible consequences of his actions and then took remedial steps.

The panel first considered whether to not take any action but it was agreed that this was not a case where to take no further action would be appropriate. This was on the basis that the conduct of the registrant was so serious that some form of regulatory action in the form of sanction must be taken. The panel next considered whether a caution order would be appropriate in the circumstances and agreed that this sanction was appropriate.

On reaching this decision, the panel made reference to paragraph 64 of the ISG, which states that ‘a caution may be appropriate where the case is at the lower end of the spectrum of impaired fitness to practise and the panel wishes to mark that the behaviour was unacceptable and must not happen again’.

The panel found that although the registrant’s conduct raised serious concerns in relation to his clinical judgement, it was evident that his actions did not come with any malice or intended neglect. In addition, no actual patient harm was caused. The registrant had reflected upon his conduct and gained an insight into the possible repercussions. Further, the registrant had remediated his failings by completing training.

The panel found that a conditions of practice order would not be appropriate in light of the fact that no concerns had arisen following this one-off incident. In addition, the registrant had remediated his clinical practice and undertaken training in the related area which would make it disproportionate to restrict his practice further.

Similarly, a suspension or striking off order would not have been appropriate as the misconduct could not be said to be incompatible with the registrant’s continuing practice as a nurse (paragraph 67 of the ISG) and such a sanction would go beyond what was necessary to uphold the public interest and would instead be merely punitive. There was no evidence of harmful deep-seated personality or attitudinal issues.

The panel agreed that a caution order would be sufficient in protecting the public, by maintaining confidence in the profession as it marked the registrant’s conduct as unacceptable. The panel also noted that there is a public interest in allowing a clinically competent nurse to continue to practise. A caution allows a prospective employer to note that there is a regulatory concern and ensures that a full risk assessment is carried out were the registrant to change employment.

In the circumstances, the panel was satisfied that a two-year caution order properly reflected the registrant’s misconduct and impairment, was in keeping with the ISG and was the appropriate and proportionate sanction in this case.

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