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What should happen to a nurse who did not seek advice after a resident fell in a care home?

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What do YOU think should happen in this case? 

you are the panel

you are the panel

The charge

In October 2015, having been made aware that Resident A fell, Nurse A did not: 

  • Seek advice or support from the other nurse on duty;
  • Seek medical assistance;
  • Adequately assess or record Resident A’s mental capacity to decide if they needed medical advice or assistance; or whether it was in Resident A’s best interests to receive medical advice or assistance.

In October 2015, and in relation to Resident B, Nurse A did not follow Resident B’s covert medication care plan or ‘My Support Plan’ in relation to the administration of medication, he: 

  • Said to Resident B ”I don’t have to use the needle do I”, or words to that effect;
  • Attended upon Resident B with a kidney bowl or cannula;
  • Suggested to Resident B that he would administer the medication or make future arrangements for the administration of medication by needle/injection to coerce Resident B to take his medication 
  • Did not document the matters referred to above.

The background

Nurse A was employed as unit manager for Meadowcroft Healthcare based at the Connell Unit. 

On a night shift in October, 2015 Resident A suffered a fall and Nurse A failed to seek medical advice or support from his colleagues. Resident A refused to be assessed, see a GP or be seen by paramedics but Nurse A failed to assess and record whether it was in her best interests to receive medical attention. The following day, Resident A was found to have a fractured hip.

Resident B was receiving care at the unit from Nurse A and refused to take his medication. As a covert action was not possible, Nurse A showed him a cannula to coerce him to take his medication and tried to persuade him to do so. This was not in line with the resident’s care plan and it was alleged that Nurse A failed to document his actions.

During both events it was also alleged that Nurse A failed to seek the advice of his managers and colleagues.

At the hearing

Nurse A admitted all of the charges, so the panel announced these as proved.

After considering the terms of the Code and Nurse A’s actions the panel determined that the facts amounted to misconduct. They went on to decide if, as a result of this misconduct, Nurse A’s fitness to practise was currently impaired.

The panel took note of his reflective account and was particularly impressed by the courses he had undertaken, references provided and the remorse that had been shown. The panel further took account of the high regard in which colleagues at the home held him, as well as the references and testimonials from his current employer and other staff.

The panel noted that, when questioned about how Nurse A would handle the situation differently in the future, he was able to provide satisfactory and detailed answers by reference to some recent examples from his current nursing practice. Nurse A demonstrated that he was a safe practitioner and that the risk of repetition was remote.

The panel noted that it had been 14 months since these incidents and there was nothing to suggest that Nurse A repeated the misconduct in that time. The panel further noted that, prior to these incidents, Nurse A had a career that spanned several years without incident.

The panel was impressed by a large number of references and testimonials from people who worked with him both in the past and currently.

Results of the fitness-to-practise panel

The ftp panel can impose four different sanctions:

  • Not impaired: the panel finds that the registrant’s fitness to practise is not impaired; therefore they can continue to practise 
  • Conditions of practice: this will prevent a registrant from carrying out certain types of work or working in a particular setting, it may require them to attend occupational health or do retraining. The order can be applied for up to three years and must be reviewed by an FTP panel again before expiry
  • Caution: the nurse or midwife is cautioned for their behaviour, but is allowed to practise without restriction

  • Suspensions: the nurse or midwife will be suspended from practice for a period of initially not longer than one year, but this can be extended after review by an FTP panel

  • Striking off: a nurse or midwife is removed from the register and not allowed to practise in the UK. The nurse or midwife must apply to be readmitted to the register

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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