A nurse who arranged for a unregistered family member to provide services as a night-sitter faced the Nursing and Midwifery Council’s fitness to practise panel
you are the panel
That Nurse A:
- Failed to undertake an adequate and documented assessment of Patient A prior to his discharge home;
- Failed to provide Patient A with night carers who were registered with companies registered with the Care Quality Commission;
- Attended at the home of patient A’s daughter to request payment in cash of £550 for night care services;
- Failed to escalate to her line manager a complaint about her conduct in a timely fashion and/or at all;
- Was dishonest in that she sought to conceal the complaint;
- Requested Colleague A to include the cost of £187 for night-sitting services in an invoice for Patient A’s care;
- Her conduct was dishonest because she sought to create a misleading impression of who the payment was to.
Nurse A, a registered nurse, arranged a 24-hour package of care to enable Patient A to return home after being admitted to hospital and then transferred to a care home.
This comprised of a private carer from 8am to 8pm, but the company was unable to provide night-sitters. Nurse A arranged for this to be undertaken by a member of her family – an unregistered night-sitter.
She did not carry out an assessment and failed to inform Patient A’s family that one of the night-sitters was a member of her family and that neither were registered with companies registered with the CQC to provide night care services.
She then attended Patient A’s daughter’s house and provided an invoice requesting £550 in cash for the night-sittings, and Patient A’s daughter gave Nurse A a cheque.
She then contacted the adult social care contact centre to express concerns about what Nurse A had done. A complaint was sent to her company by email, and she received it but failed to escalate it to her line manager. They only became aware when Patient A’s daughter called them.
At the hearing
The panel found that Nurse A’s actions fell seriously short of the conduct and standards expected of a nurse and amounted to misconduct. It found that, while she has expressed some remorse, her insight was insufficiently developed. In coming to this conclusion, the panel were concerned that she did not understand the consequences or have full insight as to the impact that her misconduct had on Patient A, his family, her colleagues, the home and the public, as well as public confidence in the professions and public services.
The panel noted that Nurse A sought to distance herself from the gravity of her misconduct. The panel also found that her written reflective piece was inadequate and decided that she had not remediated her misconduct.
She demonstrated insufficient insight and took limited steps to remedy the concerns arising from the misconduct. The panel found that there was a real risk of her repeating her misconduct.
The fact that she placed Patient A in the care of a member of her family and another unregistered night-sitter potentially exposed Patient A to an unwarranted risk of harm. In doing so, she brought the profession into disrepute and breached one of the fundamental tenets.
The panel also considered Nurse A’s dishonesty and it determined that, in this case, her fitness to practise was impaired on both public protection and public interest grounds.
Results of the fitness-to-practise panel
The ftp panel can impose four different sanctions:
- Not impaired: the panel finds that the registrants’s fitness to practise is not impaired; therefore they can continue to practise
- Caution: the nurse or midwife is cautioned for their behaviour, but is allowed to practise without restriction
- 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
- Suspension: 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