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A nurse is struck off.

Eddie Mair | 16:59 UK time, Thursday, 16 April 2009

The BBC News coverage is here.

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You can read the full judgement here too.

Below are the Nursing and Midwifery Council panel's reasons for its decision on what sanction to apply in the case of Margaret Haywood.


"Reasons for decision on the Sanction stage

When considering what if any sanction to impose the panel has had regard to the indicative sanction guidance published by the NMC. It has taken into account the public interest and the registrant's own interests. By the public interest the panel is referring to the need to protect the public, to maintain standards of nursing in this country and to maintain public confidence in the profession and the NMC. The panel has sought to strike a proportionate balance between those interests and the aggravating and mitigating factors of the case.


First the panel considered whether to take no action but decided that the misconduct was too serious.

Next the panel has considered whether it should impose a caution. Such a sanction is available to the panel under the 2004 Rules provided it does not exceed 5 years. The panel took into account that no patients were directly harmed during the filming and that she has a previous good history. The panel read the two testimonials submitted by the registrant both of which were relevant and appropriate. It took account of the fact that there had been no repetition of her behaviour since although it would be hard to conceive whether an opportunity for this would have been possible since the airing of the programme and her identity was known.

However, the panel consider that her misconduct was not an isolated incident in the sense that filming took place on only one occasion but was concerned that breaches of confidentiality took place on many occasions with hours of filming being collected.

In addition the panel decided that she was not acting under duress but had accepted the role of undercover nurse knowing that this would entail breaking confidentiality. In fact, in an interview she had said that she was "worried that the patients or their relatives would feel I had been a double agent and that I had betrayed them or betrayed their confidence......" Nevertheless she went ahead with the filming.

The panel is not satisfied that the registrant has demonstrated any real insight into her misconduct. Although she admitted the facts of the charge, she did not admit that they amounted to misconduct. When initially asked by one of the members of the panel would she make that film again she explained she would not do so because of the troubles she had experienced by being brought before the NMC. It was only when pressed that she indicated that now that she knew about whistle blowing policies she would not make another film.

Taking all these matters into account, the panel does not consider that a caution order is an appropriate or adequate sanction in this case.

Next the panel has considered whether or not it is appropriate to impose a Conditions of Practice Order. The panel rejects that course. This was a deliberate decision by the registrant, a decision whereby patient confidentiality was compromised. Moreover, Conditions of Practice would be impractical as they have to have measurable and achievable aims and outcomes.

Next the panel has considered whether or not to impose a suspension order. A suspension order is appropriate if the misconduct is not fundamentally incompatible with being a nurse. The panel is of the view that the misconduct found is fundamentally incompatible with being a nurse. The registrant embarked upon filming many vulnerable, elderly patients in the last stages of their lives knowing that it was unlikely that they would be able to give any meaningful consent to that process, in circumstances where their dignity was most compromised. The registrant could have attempted to address shortcomings by other means. But this was never a course of action which she fully considered. She was intent of capturing the realities of life on the ward by means of filming.

In the view of the panel this was a major breach of the code of conduct. A patient should be able to trust a nurse with his/her physical condition and psychological wellbeing without that confidential information being disclosed to others. Only in the most exceptional circumstances should the cardinal principle of patient confidentiality be breached. Those circumstances did not pertain here. Although the conditions on the ward were dreadful, it was not necessary to breach confidentiality to seek to improve them by the method chosen. In any event, this method was unlikely to benefit the patients that were on the Ward at the time of filming and under her care.

The panel has therefore decided to strike the registrant off the register.

Interim Order

Reasons

Given the seriousness that led the panel to order the Registrant's name to be struck off the register, it would not be in the public interest for her to be able to practice as a nurse pending an appeal. In the panel's view it is necessary in the public interest for an interim suspension order to be made."

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