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What should happen to a nurse who accessed a patient's record without the authority to do so?

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A nurse was accused of dishonesty when she accessed a patient’s clinical record without the authority to do so and then disclosed confidential information about the records to the patient

The charge

  1. On 26 June 2014, Nurse A accessed Patient A’s clinical records, when she had no authority to do so;
  2. 
She spoke with Patient A and disclosed confidential details of Patient A’s medical records to her;
  3. 
While the trust investigation was still ongoing, she contacted Patient A by telephone when it was not appropriate to do so;
  4. 
During the course of her disciplinary interview with Mr 1, she informed him that she told her colleague Ms 2 that she had accessed Patient A’s medical records when she did not;
  5. Her actions were dishonest in that she knew she had not had such conversations.

The background

The Nursing and Midwifery Council (NMC) received a referral about Nurse A’s practice while she was employed as a mental health nurse at a trust in Cornwall. It was alleged that Nurse A had inappropriately accessed Patient A’s clinical records and subsequently spoke with Patient A, disclosing confidential details of her medical records to her.

Nurse A then resigned from her post and Patient A made a formal complaint – the trust then started an investigation. During the investigation Nurse A, contacted Patient A by telephone and discussed the ongoing trust investigation. Patient A subsequently reported this to the trust.

At the hearing

Nurse A admitted charges 
1, 2 and 3 in their entirety 
but disputed charges 4 and 5. The panel then went on to consider the remaining charges and made the following findings. Charge 4 was found proved.

Nurse A accepted that she told Mr 1 that she told Ms 2 that she had accessed Patient A’s medical records. The panel then heard that Nurse A informed she had received a telephone call from Patient A on her personal phone, and then accessed her records.

Nurse A then stated to 
Ms 2 that she had “just looked at somebody’s notes and seen something I wish I hadn’t seen”. Nurse A then stated that Ms 2 responded, stating “that is why we shouldn’t look at notes”.

Nurse A told the panel that she was simply having a “bit of banter and/or chit chat” with Ms 2 in describing her access to Patient A’s records. However, Nurse A accepted that she made a judgement error that day and was very sorry and remorseful for her actions. She accepted that she did not complete an incident report for inappropriately accessing Patient A’s records or record the health concerns notified and she did not follow trust policy. The panel found this fact proved.

In relation to charge 5 The panel concluded that, in relation to charge 4, a reasonable and honest nurse would have concluded that Nurse A’s actions were dishonest because she was aware that she had not disclosed accessing Patient A’s clinical records to Ms 2. 
In addition, Nurse A would have realised that her actions were dishonest. The panel found this charge proved 
and was also of the view 
that her actions breached 
the NMC’s Code.

The panel felt that the facts found proved were of a serious nature and relate to a breach of confidentiality, in that records were accessed and discussed with Patient A, and which is further exacerbated by a finding of dishonesty. The panel concluded that fellow registered nurses would consider Nurse A’s actions 
to be unprofessional and inappropriate.

Share what you believe is the right action for the NMC panel to take below and then find out what they decided: Final panel decision and reasons

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