A case study highlighting how failing to meet the requirements of a supported practice plan led to a nurse finding herself the subject of a Nursing and Midwifery Council’s fitness to practise hearing
Nurse A, who was employed at a hospital in Scotland was accused of failing to adequately complete the requirements of a supported practice plan. In connection with Patient A, she was also accused of:
- Failing to appropriately escalate that Patient A was experiencing bleeding;
- Failing to provide care in a clean and hygienic environment;
- Failing to correctly prepare medication for intravenous (IV) administration;
- Failing to correctly assemble a needle and syringe;
- Failing to correctly administer medication;
- Failing to correctly label medication.
Nurse A worked at a hospital in Scotland. In 2014 she sought support from her manager because she was struggling with some clinical aspects of her role, including cannulation and administering IV drugs.
In 2015, concerns were raised by colleagues about a number of elements of her practice, and in 2016, a supported practice plan was put in place. However, when a review meeting was held she was unable to evidence any of the competencies within the supported practice plan.
Nurse A was caring for Patient A, who had just recently a delivery. The manager identified that Nurse A had failed to carry out the necessary care for Patient A over a number of areas. She failed to notice that Patient A was bleeding; failed to correctly prepare IV medication; failed to correctly assemble a needle and syringe; failed to correctly administer oxytocin and failed to correctly label medication.
Nurse A accepted that she did not recognise that Patient A was bleeding, that she needed constant prompting and that she lacked knowledge of medications.
At the hearing
Nurse A admitted all the charges in their entirety. As such, the charges were found proved. The panel took into account the evidence cited by the NMC and evidence given by Nurse A. The panel also felt her actions amounted to breaches of the Code. Nurse A admitted that she lacked the competence required of a nurse and that her fitness to practise is currently impaired by reason of her lack of competence.
The parties agreed that Nurse A’s lack of competence has put patients at risk of harm, brought the reputation of the nursing profession into disrepute and breached a fundamental tenet of the profession.
Nurse A demonstrated acceptance of responsibility and remorse for her actions in a reflective statement. She accepted personal circumstances negatively impacted her work and she lost confidence in her ability to work as a nurse. Nurse A fully realised and accepted that her failings placed Patient A at unwarranted risk of harm.
Since the events Nurse A has not practised as a nurse and instead worked as a lecturer, so the parties agreed that the registrant has not remediated her failings. The parties agreed that the concerns about her lack of competence remain and are likely to be repeated. The parties agreed that Nurse A’s fitness to practise was currently impaired.
Furthermore, the parties agreed that the lack of competence concerns, despite a supported practice plan put in place, were so serious that it engaged the public interest and a finding of impairment needed to be made to uphold professional standards and public confidence in the profession.