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FInal panel decision: What should happen to a nurse who used a member of her own family as a night-sitter?

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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

Determination on sanction

The NMC case presenter submitted that Nurse A’s dishonesty was deliberate and involved a misuse of power. He also submitted that there was a personal financial gain and a risk to Patient A. 

Nurse A’s representative submitted that she made early admissions to all of the charges. She submitted that Nurse A continued to work as a registered nurse and that she had no previous regulatory history. She submitted that Nurse A was highly unlikely to repeat the misconduct as this has been a salutary lesson. 

In reaching its decision on sanction, the panel identified the following aggravating factors:

  • Deliberate and premeditated dishonesty;
  • Repetition of the dishonesty involving Patient A, his family, Nurse A’s work colleagues and the public services;
  • Misuse of power and a breach of trust in Nurse A’s position as a nurse;
  • Nurse A intended to make a personal financial gain by employing a member of her family to care for Patient A;
  • There was a risk to Patient A as the night sitters were unregistered;
  • Patient A was a vulnerable patient;
  • Nurse A’s lack of insight.

The panel identified the following mitigating factors:

  • This was misconduct which involved one patient;
  • Nurse A engaged with the NMC and the hearing;
  • Nurse A made early and full admissions;
  • Nurse A had no previous regulatory history;
  • A positive testimonial from Nurse A’s current employer as a nurse;
  • Positive testimonials from the community who are aware of the charges;
  • Some remorse shown to Patient A’s family;
  • No evidence of actual harm to Patient A.

The panel considered whether to impose a caution order. The panel decided in its findings on impairment that Nurse A presented an ongoing risk to the public. The panel decided that this case involved serious dishonesty and was therefore not at the lower end of the spectrum of impairment.

The panel next considered, but rejected, imposing a conditions of practice order. 

The panel noted that there are no clinical issues with Nurse A’s practice as a nurse. The panel was concerned about Nurse A’s lack of insight into the nature and extent of her misconduct. Consequently, the panel rejected a conditions of practice order.

The panel therefore went on to consider imposing a suspension order.

The panel found that Nurse A’s dishonesty was serious and noted the aggravating features concerning it being deliberate, premeditated and involving a vulnerable patient. The panel decided that Nurse A did attempt to make a personal financial gain and that she abused her position of trust as a nurse. The panel found that she did not have sufficient insight into her misconduct and that she continued to pose a significant risk of repeating this behaviour.

The panel found that Nurse A’s behaviour was fundamentally incompatible with being a registered professional. The seriousness of Nurse A’s case is incompatible with ongoing registration.

The panel decided to strike Nurse A’s name from the register.

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