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A nurse working in a care home faced the fitness-to-practise panel after concerns were raised about their practice, including completing a report in advance to save time at the end of their shift
The charges
1. On a night shift, following an incident with Resident A where Resident A fell, Nurse A:
a. Did not complete a full assessment of Resident A or document/record any assessment, actions, observations and care provided;
b. Did not identify and respond to concerns in a timely manner, including but not limited to their failure to call emergency services in a timely manner;
c. Put bed rails in place without first completing a risk assessment and/or failed to document it;
2. Completed the progress report in advance, in relation to one or more of the following Residents:
a. Resident C;
b. Resident D;
c. Resident E;
3. Their actions at charge 2 above were dishonest as they knew that the information they recorded was inaccurate.
The background
During a night shift, in which Nurse A was in charge at a care home, it is alleged that Nurse A failed to adequately care for Resident A, who had fallen and they subsequently failed to provide care and/or record any care provided to Resident A.
Resident A was later sent to hospital, with a fracture in their leg/knee – believed to have been as a result of the fall. It is alleged that there was a delay in identifying concerns and calling an ambulance in a timely manner. It is also alleged that Nurse A put up bed rails, without first carrying out a risk assessment on the same night with regard to Resident A, having found them on the floor after they had fallen out of their bed.
It is alleged that Nurse A completed progress reports for three residents in advance, namely that they filled them out at the start of the shift, and they read as if the residents had slept through the night and had been checked without any issues.
Nurse A was dismissed by the home after this incident.
At the hearing
At the start of the hearing, Nurse A’s representative made admissions, on their behalf, about charges 2a and 2c. These were proved by way of admission. The remaining charges were found proved.
Nurse A gave evidence under oath. They explained their current role, which was at a hospital rather than a nursing home and said that they felt much more supported than before. Nurse A explained that they were under great pressure at the time of the incidents that led to their referral to the NMC and that they felt that the home was not being run systematically. Nurse A said that they understood that the workload at the home was too much for them and that they have learnt from their mistakes.
The panel was of the view that Nurse A’s actions (except charge 1c) fell significantly short of the standards expected of a registered nurse and amounted to breaches of the Code.
The panel had regard to the fact that the entries in charge 2 were pre-written and inaccurate, so could have placed vulnerable patients at risk of harm. Their actions had compromised vulnerable patients in their care, as well as their colleagues, and had taken place to save time at the end of their shift. The panel found that their actions amounted to misconduct.
The panel found that Nurse A put patients at an unwarranted risk of harm, brought the profession into disrepute and breached a fundamental tenet of the profession. It considered that they failed to accept their failings and continued to blame those around them at the home for what happened. The panel felt that there was a risk of repetition.
The panel was satisfied that Nurse A’s fitness to practise was impaired.
Results of the fitness-to-practise panel
The FtP panel can impose four different sanctions:
- 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
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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