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Although given a 12-month suspension order – having been found unfit to practise as a result of misconduct and a lack of competence – someone takes on work as a registered nurse at nursing homes
Nurse A is accused of:
1. Breaching a 12-month suspension order imposed by the Nursing and Midwifery Council (NMC) by working as a registered nurse (RN).
2. Dishonest conduct in relation to charge 1 as the nurse knew he was subject to a suspension order preventing him from working as an RN.
In January 2011, an NMC panel had found Nurse A’s fitness to practise impaired by reason of a lack of competence, misconduct and a police caution for fraud. He was given a 12-month suspension order and sent an outcome letter the same month.
In September 2012, the NMC was made aware of allegations that, over a period of nine months, Nurse A had worked shifts as an RN at Nursing Homes A and B, via Recruitment Agency A, while under the suspension order. The agency was informed about the suspension order by a third party and referred Nurse A to the NMC.
At the hearing
Nurse A provided a written statement and gave evidence. Several statements and documents were also given to the panel from witnesses. Ms 1, a manager at Nursing Home A, provided shift rotas confirming the dates Nurse A was booked to work between January and September 2012.
Nurse A showed remorse, conceded that his fitness to practise was impaired and admitted the charges in full. He told the panel of his career history – long and unblemished prior to the issues raised in January 2011 – and shared health details, which he said meant he could not cope and clouded his judgement. He said his health and family circumstances were now more stable, and apologised for his conduct. He also suggested his employers knew he was suspended but said they still offered him shifts as a nurse.
The panel found Nurse A’s actions were a serious breach of the Code, namely:
- Be open and honest, act with integrity and uphold the reputation of your profession;
- You must recognise and work within the limits of your competence;
- You must inform any employers you work for if your fitness to practise is called into question.
It submitted that, in this case, the dishonesty was serious as it was not an isolated incident but intentional and repeated over a long period of time. Nurse A deliberately disobeyed an order imposed by the regulator within two weeks of it being imposed; the panel considered it his responsibility to cease working while suspended. It noted that he knew he could work as a healthcare assistant but deliberately took work as a nurse for financial gain.
The panel found Nurse A’s actions fell far short of the conduct and standards expected of an RN, amounting to misconduct. It asserted that, although there was no evidence of actual harm to patients, there was an inherent risk of harm in his practising while suspended.
It was satisfied that Nurse A brought the profession into disrepute, with his honesty and integrity coming into question for a second time. It also found that his persistent dishonest behaviour indicated a deep-seated attitudinal issue.
The panel found Nurse A to be at the early stages of insight, as he sought to lay blame on external factors on more than one occasion and showed a lack of acceptance of the previous finding of lack of competence. It concluded there was a real risk that, should such pressure arise again, Nurse A would disregard an NMC order, so a finding of impairment was necessary on the grounds of public protection.
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