An adult nurse working at a care home for older people was found asleep and, as a result, was unable to assist care staff with an emergency involving an unresponsive resident
That Nurse A, while working in a care home; 1.1 Slept on duty and knew that this was not permitted; 1.2 Did not respond to the emergency buzzer in a prompt manner.
Nurse A was an adult nurse employed at a care home for highly dependent older people until their dismissal a year before this hearing.
Nurse A had two previous Nursing and Midwifery Council (NMC) referrals in relation to their employment, which resulted in a case examiner ‘warning’ being issued about them. These concerns were to do with failing to recognise and escalate concerns about unwell and deteriorating patients, as well as failures in medication administration and assessments of patients.
Regarding the current charges, Nurse A was the sole registered nurse on duty at the home. At around 6am, carers at the home found a resident in one of the upstairs bedrooms unresponsive and struggling to breathe. One of the carers activated the emergency buzzer to summon Nurse A to assist; when Nurse A failed to arrive after several minutes, one of the carers went downstairs to look for them and found Nurse A asleep in the lounge.
As a consequence of being asleep, Nurse A failed to attend promptly to assist care staff with the resident. Nurse A did not attend the resident’s room promptly once alerted. When Nurse A arrived, they caused further delay by returning downstairs to collect observation equipment before properly attending to the resident.
At the hearing
Nurse A was not present at proceedings; they were served with notice of the hearing.
At the outset of the hearing, the panel was informed that prior to proceedings a provisional agreement of a Consensual Panel Determination (CPD) had been reached with regard to this case between the NMC and Nurse A. The agreement set out Nurse A’s full admission to the facts alleged in the charges. Nurse A admitted that their actions amounted to misconduct, and that their fitness to practise was currently impaired by reason of that misconduct.
The legal assessor reminded the panel that they could accept, amend or outright reject the provisional agreement reached between the NMC and Nurse A. Further, the panel should consider whether the provisional agreement would be in the public interest.
It was understood by parties in this case that the final decision on findings of impairment and sanction was a matter for the panel.
The panel heard oral evidence from six witnesses who worked at the care home. Nurse A also provided a reflective piece for the proceedings, where they accepted their actions were unacceptable. The NMC accepted that the Nurse A’s reflective piece demonstrated a candid acceptance of personal responsibility as well as their understanding of the seriousness of their actions.
The panel acknowledged that Nurse A did not have an unblemished career prior to the incidents and recognised that they were subject to
the warning issued by the case examiners.
The panel also bore in mind that Nurse A had not practised since their dismissal from the care home a year ago and, in light of this, the parties agreed they had not yet demonstrated remediation of their failings through safe practice as a registered nurse in a clinical setting. The parties agreed that there was a risk of repetition of the misconduct, and that a finding of current impairment was required on public protection grounds.
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