Conditions of Practice 25 February 2015

Transcription

1 Conditions of Practice 25 February 2015 Name of Registrant: Robert Carl Sturch NMC PIN: 08F0181E Part(s) of the register: Registered Nurse Sub Part 1 Adult 29 October 2008 Substantive Order Reviewed: Suspension order Outcome: Suspension order replaced with a conditions of practice order for a period of 9 months - to take effect upon the date of expiry of the current order, namely 27 March 2015 Determination on substantive order: Mr Sturch, This is a mandatory review in accordance with Article 30(1) of the Nursing and Midwifery Order 2001, of the substantive suspension order placed on your registration. The suspension order was originally imposed at the substantive hearing held in March and May 2014 and was made for a period of 9 months. The order is due to expire on 27 March The charges found proved by way at the substantive hearing involved failures in communication, assessments of patients, record keeping and in the administration of medication. The substantive panel found that you had demonstrated a lack of knowledge of the medication you were administering, and it noted that your errors occurred over a protracted period of time, whilst you were undergoing a period of close supervision and support. The panel at the substantive hearing determined that your behaviour breached The Code: Standards of conduct, performance and ethics for nurses and midwives (2008) and amounted to a lack of competence, and it found that your fitness to practise was impaired by reason of your lack of competence. Page 1 of 6

2 The panel today had sight of a bundle of documents provided on your behalf, which included: a number of training certificates detailing courses you have undertaken subsequent to the substantive hearing; a reference from your current employer, dated 18 February 2015; and a written statement from you. Mr Mulchrone, on behalf of the NMC, outlined the history of this case for the panel. He referred the panel to the reasons given by the panel at the substantive hearing in May 2014 and, in particular, the following extract: Your case will be reviewed before the expiry of the nine month period. This panel considered that the panel reviewing this case may be assisted by the following: A reflective piece which demonstrates your insight into the nature of your lack of competence and impact of it on patients Testimonials and references from a current employer in a health care environment. This should include reference to your ability to reflect on your practice and evidence of how you have applied course learning in the work place A personal development plan, demonstrating steps you will take to address the areas of concern and achieve the required competencies Evidence of how you have developed your communication skills in a health care context Evidence of how you have developed your record keeping in a health care context. Mr Mulchrone informed the panel that it is to your credit that you have provided some of the documents recommended by the substantive panel. He pointed out that you had not received the substantive panel s decision letter, in which the recommended documents were set out (this was confirmed by you in oral evidence). Mr Mulchrone submitted that, in the absence of some of the suggested documents, the panel may be minded to find that your fitness to practise remains impaired. Mr Mulchrone invited the panel to consider whether a conditions of practice order could replace the current suspension order and afford adequate public protection. You gave evidence to the panel under oath. You explained that you have been working as a Service Manager for a private healthcare company since May You accept that you had problems with your communication skills, but stated that, in your current role, good verbal and written communication skills are essential. You told the panel that, as part of your role, it is also essential that you communicate effectively with different members of the multi-disciplinary teams. You undertook a communication and assertiveness course, and sought support from the Chief Executive of your current company in order to improve your skills in this area. You said that you are required to carry out risk assessments and prepare written reports, and you still have contact with patients. You explained that you have secured a place on a medicines awareness course, but Page 2 of 6

3 said that you would need to check the scope of the course to ensure that it would not be in contravention of your suspension order. During cross examination, you said that you have learnt from your previous errors; you stated that you now recognise when to ask for help. You explained that you would ask for help if you were not 100% sure of a particular process or if you lacked knowledge in a specific area. You told the panel that you recognise that your actions put patients at risk of harm. You acknowledged that you have not worked as a registered nurse since 2012, and said that you would benefit from some support and supervision were you to return to practice, in order to ensure patient safety. During panel questions, in relation to any support that you feel you would need when returning to practice, you identified the administration of medication as an area where support would be helpful. You explained what you have learnt from the communication course you undertook, and told the panel that written and verbal communication is an essential aspect of nursing to ensure that the correct information is shared amongst different members of the team. The panel considered all of the information before it, including the submissions of Mr Mulchrone, on behalf of the NMC, and those made by you. The panel heard and accepted the advice of the legal assessor. The panel exercised its own judgement in determining whether your fitness to practise remains impaired. It has borne in mind the need to protect the public, to maintain public confidence in the nursing profession, and to uphold proper standards of conduct and behaviour. The panel was impressed by your oral evidence, which it found to be articulate, unguarded and honest. Having regard to the documents you provided, and your oral evidence, the panel considered that you have taken considerable steps to attempt to address the deficiencies in your practice, particularly in relation to your communication and record keeping skills, despite being in a non-nursing role. Further, the panel noted the documents before it in which you have recorded your assessment of patients as part of your current role. You are now working in a position where you are required to check medication, albeit not administer it. The panel was of the view that you have reflected upon your previous failings and demonstrated an awareness of the way in which your previous acts and omissions impacted upon patient safety. You were also able to confidently explain the way in which previous colleagues preferences may have affected your ability to administer medication. However, although you have been working in a healthcare setting, you have not practised as a nurse for over two years. Therefore, your communication and record keeping abilities have not been tested in a clinical setting. The panel also noted that you have not had the opportunity to administer any medication or undertake full nursing assessments of patients for a significant period Page 3 of 6

4 of time. Further, you stated that you would benefit from some sort of support were you to return to nursing practice, particularly in relation to the administration of medication. In the light of the above, the panel determined that there remains a risk of repetition of your clinical failings, albeit a lower risk than that identified by the substantive panel. Accordingly, the panel concluded that your fitness to practise remains impaired. The panel then considered what, if any, sanction to impose in this case. The panel has taken into account the NMC s Indicative Sanctions Guidance (June 2012). The panel has borne in mind that the purpose of a sanction is not to be punitive, though any sanction imposed may have a punitive effect. The panel noted that its powers are set out in Article 30(1) of the Nursing and Midwifery Order The panel first considered whether to let the current order lapse and take no further action but decided that it would not be appropriate in this case, given your numerous clinical failings, and the absence of remediation in a clinical setting. To take no action would neither protect the public, nor address the public interest. The panel then considered a caution order. The panel recognised that a caution order would not restrict your practice and the panel therefore concluded that such an order would not in any way protect the public, given the risk of repetition identified. The panel next considered whether a conditions of practice order, in place of the current suspension order, would be appropriate. The panel was mindful that any conditions imposed must be proportionate, measurable and workable. The panel was of the view that there are identifiable areas of your nursing practice in need of further training, specifically in relation to undertaking full nursing assessments of patients, and the administration of medication. The panel noted that you have indicated an intention to return to nursing in the future, and a willingness to undertake training and comply with conditions. It determined that it could formulate workable conditions which would adequately address the risk which you present, whilst providing you with the opportunity of a staged return to practice. The panel determined that the following conditions, imposed for a period of 9 months, would address your particular deficiencies and would provide sufficient protection to patients: 1. You must not carry out the administration of medication unless directly supervised by a registered nurse. Such supervision is to consist of being observed at all times whilst administering any medication. This condition is to remain in force until such time as you are deemed competent in the safe administration of medication [see condition 2 below]. Page 4 of 6

5 2. You must be assessed and deemed competent in the safe administration of medication by your line manager, mentor or supervisor (or their nominated deputy) and, on completion, send evidence of your competence to the NMC. 3. You must work with your line manager, mentor or supervisor (or their nominated deputy) to formulate a Personal Development Plan specifically designed to address the deficiencies in the following areas of your practice: a) Undertaking full nursing assessments of patients; b) The administration of medication. 4. You must forward to the NMC a copy of your Personal Development Plan within 28 days of the date on which you take up a nursing appointment. 5. You must meet with your line manager, mentor or supervisor (or their nominated deputy) at least every month to discuss the standard of your performance and your progress towards achieving the aims set out in your Personal Development Plan. 6. You must send a report, not more than 28 days old, to the NMC prior to any NMC review hearing or meeting from your line manager, mentor or supervisor (or their nominated deputy) setting out the standard of your performance and your progress towards achieving the aims set out in your Personal Development Plan. 7. You must notify the NMC within 14 days of any nursing appointment (whether paid or unpaid) you accept within the UK or elsewhere, and provide the NMC with contact details of your employer. 8. You must inform the NMC of any professional investigation started against you and any professional disciplinary proceedings taken against you within 14 days of you receiving notice of them. 9. a) You must within 14 days of accepting any post or employment requiring registration with the NMC, or any course of study connected with nursing, provide the NMC with the name/contact details of the individual or organisation offering the post, employment or course of study; b) You must within 14 days of entering into any arrangements required by these conditions of practice provide the NMC with the name and contact details of the individual/organisation with whom you have entered into the arrangement. Page 5 of 6

6 10. You must immediately inform the following parties that that you are subject to a conditions of practice order under the NMC s fitness to practise procedures, and disclose the conditions listed at (1) to (9) above, to them: a) Any organisation or person employing, contracting with, or using you to undertake nursing work; b) Any agency you are registered with or apply to be registered with (at the time of application); c) Any prospective employer (at the time of application); d) Any educational establishment at which you are undertaking a course of study connected with nursing or midwifery, or any such establishment to which you apply to take such a course (at the time of application). The current suspension order will therefore be replaced with a conditions of practice order for a period of 9 months, to take effect on the date of expiry of the suspension order, namely 27 March This decision will be confirmed to you in writing. That concludes this determination. Page 6 of 6