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What should happen to a nurse who visited a patient when he had no clinical need for doing so?

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The charge

While employed as nurse at an NHS trust, it was alleged that Nurse A breached professional boundaries with Patient A between April and May 2015 by: 

  • Visiting Patient A when he had no clinical need to do so on one or more occasion;
  • Giving a mobile phone to Patient A;
  • Holding hands with her.

The background

Nurse A was a registered nurse employed at a Healthcare NHS trust in Sussex. He was referred to the Nursing and Midwifery Council by the assistant director of nursing at the trust. The referral raised concerns about allegedly inappropriate behaviour towards Patient A by Nurse A, who had attended to her while she was a patient in the hospital. Patient A was discharged from hospital in 2015 and returned to a care home.

It was alleged that Nurse A sought to pursue a relationship with Patient A and attended her home when there was no clinical reason for doing so. Patient A suffered from Korsakoff’s syndrome and had been deemed as not having capacity regarding major decisions or relationships. It was alleged that Ms 1, the deputy manager of the home, saw Nurse A with Patient A on two separate occasions. 

On the first occasion Ms 1 found Nurse A in Patient A’s room holding her hand, and on the second occasion, Ms 1 saw Nurse A visiting the home and giving a mobile phone to Patient A.

At the hearing

Nurse A admitted all the charges – these were announced as proved by way of admission. The panel then considered whether those facts amounted to misconduct and, if so, whether his fitness to practise was currently impaired. The NMC has defined fitness to practise as a registrant’s suitability to remain on the NMC register unrestricted.

Nurse A said that he had reflected on his actions and now understood that they were neither appropriate nor acceptable. He accepted that he had crossed professional boundaries and breached the NMC code of conduct. He also said that he had undertaken training on ethics and maintaining professional boundaries in the workplace. He assured the panel that he had learnt lessons and that he would never repeat these mistakes in the future.

Nurse A indicated that he was were fully aware that his visits to Patient A had been closely monitored by staff at the home and at no point did he attempt to conceal his identity or the fact that he was a nurse. Nurse A submitted that he had addressed these deficiencies through online training in the areas of ethics and maintaining professional boundaries in the workplace. 

When determining whether the admitted facts amounted to misconduct, the panel had regard to the terms of the Code and the public interest. It concluded that Nurse A’s actions and behaviour fell seriously short of the standards reasonably expected of a nurse and amounted to misconduct. 

The panel next went on to decide if, as a result of this misconduct, Nurse A’s fitness to practise was currently impaired. It considered that Nurse A had crossed professional boundaries – breaching fundamental tenets of the nursing profession and bringing the profession into disrepute. 

The panel considered that Nurse A had made efforts to remediate his misconduct by undergoing training in ethics and maintaining boundaries in the workplace. He was able to provide a number of positive references and testimonials. The panel therefore concluded that the risk of repetition of his misconduct was low.

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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