After an agency nurse at a care home locked a resident in their room, they received a police caution for false imprisonment and faced the Nursing and Midwifery Council’s fitness-to-practise panel
The charge
Nurse A received a police caution for the offence of false imprisonment.
The background
Nurse A was an agency nurse employed at a care home. It was alleged that Nurse A and a colleague entered the room of Resident A, an older patient diagnosed with dementia, and discovered them in an agitated state and incontinent of faeces and urine. Following failed efforts to care for, and calm, Resident A, Nurse A locked Resident A in their room and carried on with their duties. Nurse A informed relief staff of their actions, and completed an incident report stating that they had been injured. Nurse A was suspended by the agency.
Nurse A was interviewed by police and admitted locking Resident A in their room but stated that Resident A had assaulted them and that their actions prevented harm to others. Nurse A received a caution for false imprisonment.
At the hearing
Nurse A accepted the charge. The panel found the facts proved. The NMC’s representative submitted that Nurse A’s fitness to practise was impaired and that Nurse A had not worked as a registered nurse for a year. The NMC’s representative submitted that Nurse A had been unable to demonstrate full remediation of their behaviours. They also submitted that Nurse A’s reflections demonstrated a lack of insight and a high risk of repeating their behaviour. The representative submitted that the public would consider their behaviour unacceptable.
Nurse A’s representative asked the panel to find Nurse A’s fitness to practise not impaired. They referred to Nurse A’s reflective statement and submitted that it demonstrated significant insight and remorse. They further submitted that Nurse A understood it was never acceptable to lock a resident with dementia in a room for any reason, and accepted full responsibility. Nurse A’s representative referred to several training certificates Nurse A had completed and submitted that Nurse A’s training and insight reduced risk to patients and public.
The panel considered that Nurse A’s behaviours placed Resident A at an unwarranted risk of harm; brought the nursing profession into disrepute; and breached a fundamental tenet of the nursing profession.
The panel had sight of Nurse A’s reflective piece and appreciated its quality and detail. Nurse A accepted the charge and fully engaged with the NMC investigation. The panel considered that Nurse A demonstrated an understanding of how their actions put Resident A at significant risk of harm. Nurse A demonstrated remorse in writing, an understanding of why their actions were wrong, and how it impacted negatively on the nursing reputation.
The panel noted that Nurse A did not accept their fitness to practise was impaired, and did not provide oral evidence at the hearing. The panel would have appreciated hearing directly from Nurse A about how they incorporated their reflections and training into practice.
When considering whether Nurse A remedied their practice, the panel took Nurse A’s training certificates and colleague testimonials into account. Although some were relevant, Nurse A had not been working in a care home environment for residents with degenerative illnesses.
The panel considered that Nurse A’s remediation was mainly theoretical. It considered that a risk of repetition remained and that a finding of impairment was necessary for public protection and in the public interest.
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