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Final panel decision: What should happen to a nurse after a patient she discharged died from a haemorrhage?

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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 determined that the facts found proved breached the following provisions of the nursing profession as set out in the 2008 NMC Code of Conduct.

In all the circumstances, the panel was satisfied that the facts found proved were sufficiently serious to constitute misconduct.

The panel then went on to consider whether your fitness to practise is currently impaired by reason of your misconduct.

The Care Quality Commission (CQC). The Trust itself accepted that there were systemic failings at the time of these incident. The panel also recognised that witnesses spoke of Nurse A positively as a nurse and there was evidence regarding the failings of the trust at the time.

The panel was provided with a reflective statement written by Nurse A, evidence of relevant training she had undertaken and positive references and testimonials.

The panel also had sight of her written reflection provided to the NMC following the coroner’s inquest into Patient A’s death in which Nurse A recognised the importance of accurate record keeping.

You have remained employed at the trust as a registered nurse and have been practising without cause for concern over the past five years, and have been promoted to a more senior role in the same area.

The panel recognised that Nurse A had engaged with these proceedings, was remorseful in relation to what occurred regarding Patient A and the impact it had on her family and that she had been practising safely as a nurse since.

In these circumstances, the panel concluded that the risk of the misconduct identified in this case being repeated was low to the extent that it does not warrant a finding of current impairment on the grounds of public protection. 

But Nurse A breached fundamental tenets of the profession and it has found that her actions, in permitting the discharge of a patient who required assessment by a consultant beforehand and who subsequently died, have brought the reputation of the profession into disrepute.

The panel was of the view that the public would not accept such failings with regards to essential nursing practice and would further not accept her failure to take full responsibility for your actions.

Accordingly, the panel has determined that your current fitness to practise is impaired by reason of your misconduct on public interest grounds.

Decision on sanction

The panel identified the following as aggravating factors:

  • Your actions contributed towards a patient’s death;
  • The failure to take responsibility and your deflection of blame upon others.

 The panel identified the following as mitigating factors:

  • The remorse you have demonstrated and the remediation you have undertaken;
  • This case relates to an isolated incident in that it relates to one shift;
  • You have been practising without restriction or cause for concern for over five years since the incident;
  • The positive testimonials and references you provided.

The panel also had regard to the context of the incident, namely the systemic failings at the trust at the time of the incident and the poor quality of the local investigation.

The panel has found current impairment solely on public interest grounds and therefore, in its decision on sanction, it was not necessary for it to address public protection concerns as it has not identified any current risk to the public or to patients.

Having regard to all the above, the panel concluded that the public, in possession of the full details of this case would be satisfied that a caution order was appropriate and further that such an order was necessary to maintain public confidence in the profession and its regulator.

The panel carefully balanced the severity of your misconduct and determined that the caution order should be for the maximum period of five years, in order to properly mark the seriousness of your misconduct.

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