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The NSW Civil and Administrative Tribunal has cancelled a nurse’s registration after finding that she engaged in improper and unethical conduct in relation to an incident directed at a vulnerable patient.
The Respondent was an enrolled nurse who worked at a residential aged care facility which catered for approximately 30 elderly residents some of whom suffered from various stages of dementia.
The facility utilised a particular type of therapy known as Doll Diversion Therapy to assist residents. Doll Therapy is primarily used to help women reminisce about the time they were mothers and assists to calm them when thinking that they are holding and looking after their baby.
One resident, who was suffering from advanced stages of dementia, believed that these dolls were her real babies. She regularly interacted and cared for them. The Respondent knew that the resident believed that the dolls were real babies and that she could easily be upset by conduct which affected her view of the dolls.
The Health Care Complaints Commission alleged three complaints against the Respondent, being:
The Respondent removed one of the dolls from the crib and banged the head on the dining room table in the presence of the resident. This was done for the purpose of amusing herself in circumstances where she knew it was likely or was reckless to the likelihood, that her actions would cause distress;
The Respondent attempted to collude in the investigation by approaching a coworker and asking them to provide false information by saying words to the effect of “can you please tell them that I just dropped it accidentally? And nothing. I didn’t smack it on the table.”
The Respondent engaged in unsatisfactory professional conduct of a sufficiently serious nature to justify suspension or cancellation of her registration, and/or engaged in a more than one instance of unsatisfactory professional conduct that, when considered together, amount to conduct of a sufficiently serious nature to justify the suspension or cancellation of her registration.
The Nursing and Midwifery Board’s Code of Conduct requires nurse to practise honestly and ethically and support an inclusive environment for the safety and security of the individual person.
Further, the Board’s Standards requires nurses to practise in a way that ensures the rights, confidentiality, dignity and respect of people are upheld, and to demonstrate respect for others to whom care is provided.
The Tribunal thoroughly tested the evidence which included a range of coworkers who witnessed the event, and a cross-examination of the Respondent. The Tribunal was satisfied that all three complaints were established. It found the Respondent guilty of unsatisfactory professional conduct under s 139B(1)(l) of the Health Practitioner Regulation National Law (NSW) and that the conduct was sufficiently serious to justify a finding of professional misconduct.
In imposing its orders on 4 November 2024, the Tribunal cancelled the Respondent’s registration as an enrolled nurse and prohibited her from providing any health service for 12 months.
Whilst this decision arose from a demonstrably poor level of care in the aged care sector, it reaffirms the strong view taken by tribunals when there are clear departures of standards expected of practitioners caring for vulnerable patients.
It is also of note that as the conduct occurred in the aged care setting, the Respondent may also be the subject of a banning order imposed by the Aged Care Quality and Safety Commission, preventing her from working in the aged care sector.