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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
Having announced its decision that Nurse A’s fitness to practise was impaired, the panel proceeded to consider the matter of sanction, and look first at the mitigating and aggravating factors in this case.
The panel identified aggravating factors:
- Nurse A’s actions had the potential to cause harm to a vulnerable and dependent patient;
- The misconduct included a breach of patient confidentiality;
- The failings took place over a significant period of time during which Nurse A did not adhere to the relevant trust’s policy, which was clear and comprehensive;
- The failings related to more than one area of practice, namely record keeping and maintaining professional boundaries.
The panel identified the following as the primary mitigating factors:
- There was no evidence of issues relating to Nurse A’s practice apart from the incidents identified in this case;
- Nurse A made attempts to engage with the process, has accepted the majority of her failings from an early stage and has expressed remorse;
- Nurse A has demonstrated some insight in her written response;
- Although misguided, Nurse A’s behaviour toward Patient A was well intentioned;
- The absence of evidence of any actual harm to service users.
The panel first considered whether to take no action. The misconduct in this case was too serious, so they concluded that this would be inappropriate.
The panel next considered whether to make a caution order. In light of the record keeping and confidentiality issues in this case, the panel bore in mind that the misconduct was not at the lower end of the spectrum and that there was a risk of repetition, so a caution order would not restrict Nurse A’s practice and would therefore not provide any protection to the public.
The panel considered a suspension order and concluded that such an order would be disproportionate and punitive as it recognised that Nurse A’s actions, although misguided, were not borne out of malicious intent and were intended to assist Patient A.
The panel next considered a conditions of practice order.
The panel bore in mind that Nurse A has demonstrated insight into the inappropriate aspects of her relationship with Patient A. The panel recognised that there was no evidence of harmful deep seated attitudinal issues or of general incompetence. It was of the view that there were identifiable areas of Nurse A’s practice in need of retraining and capable of remedy, namely safeguarding, record keeping and maintaining professional boundaries. It was also of the view that a conditions of practice order was sufficient to maintain confidence in the nursing profession.
The panel determined to impose a conditions of practice order for a period of 18 months. This period of time would Nurse A give the opportunity to demonstrate to a reviewing panel that she has addressed the identified concerns and that she can practise safely.