Sunday 19 November 2017

Review reveals need to improve public approach

Fitness to practise: call for review of complaints procedure against nurses. Picture posed.
Fitness to practise: call for review of complaints procedure against nurses. Picture posed.
Eilish O'Regan

Eilish O'Regan

THE committees which assess complaints about nurses that have led to a fitness to practise hearing need to improve their approach to public protection, according to a new report.

It follows a newly-completed review, commissioned by An Bord Altranais, the regulatory body for nurses. It was carried out by a UK monitoring authority which was invited to examine the fitness to practise process here.

It found that members of the judging committee, who have other jobs, should avoid other commitments on the day of the hearing, observing that just 13 of the 18 members were present after a lunch in one case.

There needs to be more training available to those who sit on the committees. The report found there was too much delay in hearing cases after a complaint is made.

It noted that after sitting in on one committee hearing, the members did not make any express reference to patients, patient safety, or acting in the public interest.

"On several occasions however the committee members expressed concern for the nurses involved and not for the patients, and this may be the results of the substantial majority of professional representation on the committee," it said.

Fitness to practise hearings for nurses – which are to be held in public under updated legislation – are currently conducted behind closed doors and reported on in summary, without naming the hospital or care home involved.

An analysis carried out by An Bord Altranais last year of 115 inquiries, involving allegations of professional misconduct against nurses, show one in three had problems with alcohol or drug abuse.

Recurrent areas of incompetence among nurses were management of drugs, infection control, care of bed sores, use of out-of-date practices and poor judgment.

A published summary of recent hearings revealed a number of cases:

• A nurse, who struck a female hospital patient across the face and pulled her hair, has been found guilty of professional misconduct. The committee imposed a sanction of censure which will remain on her record.

• A nurse caring for a resident of a nursing home accepted a cheque for €2,500 from an elderly woman when she knew or ought to have known that this was inappropriate.

The nurse failed to notify her director of care in a timely manner that the money was accepted or borrowed.

The nurse went on to lodge the cheque and failed to act in the best interests of the resident. The committee found the nurse guilty of professional misconduct and imposed a sanction of censure.

• A nurse employed in a hospital, who had a drink problem over seven years, failed to engage with her occupational health department by attending scheduled appointments.

She also failed to provide one or more blood and urine samples and did not attend for duty on occasions when she was rostered.

She did not provide adequate medical certificates during one or more absences from work and on one occasion did not tell her manager she was leaving before the end of her shift.

The committee decided that the nurse should be struck off the register.

• A nurse working in a nursing home scalded a resident while attempting to remove a peg feeding tube. The hearing was told the nurse failed to provide an adequate level of care to a patient who has since died and did not notify a doctor in a timely manner.

The nurse also did not notify the late woman's family of any deterioration in her condition. The committee found the nurse guilty of professional misconduct and censured her.

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