Nursing and Midwifery Board of Australia v Collins
[2011] QCAT 270
•3 June 2011
| CITATION: | Nursing and Midwifery Board of Australia v Collins [2011] QCAT 270 |
| PARTIES: | Nursing and Midwifery Board of Australia (Applicant/Appellant) |
| V | |
| Karen Patricia Collins (Respondent) |
| APPLICATION NUMBER: | OCR162-10 |
| MATTER TYPE: | Occupational regulation matters |
| HEARING DATE: | On the papers |
| HEARD AT: | Brisbane |
| DECISION OF: | Judge Fleur Kingham, Deputy President |
| DELIVERED ON: | 3 June 2011 |
| DELIVERED AT: | Brisbane |
ORDERS MADE: | 1. Ms Collins is reprimanded. 2. Ms Collins must pay to the Board a fine of $500 within 30 days from the date of these orders or such further time as the Board may allow. 3. Ms Collins’ registration as an enrolled nurse is suspended for a period of 3 months, but that suspension shall be wholly suspended for a period of 1 year from the date of these orders and shall not be activated unless Ms Collins is subject to further disciplinary proceedings during that 1 year period. 4. Ms Collins must pay the Board’s costs of these proceedings fixed in the amount of $2,000 within 90 days from the date of these orders (or such further time as the Board may allow). |
| CATCHWORDS: | OCCUPATIONAL REGULATION – HEALTH PRACTITIONER – NURSING – DISCIPLINARY – where Nurse trained and practiced in New Zealand – where endorsement not required in New Zealand to administer medication – where Nurse apparently competent to administer medication but not endorsed to do so –where Nurse administered medication for 9 years before lack of endorsement identified – where Nurse co-operated fully once matter was raised – what disciplinary action should be taken Health Practitioners (Professional Standards) Act 1999, s 405P(1) Health Practitioner Regulation National Law (Queensland), ss 199, 289(4), 204, 205 Health Practitioner Regulation National Law Act 2009, s 9 |
APPEARANCES and REPRESENTATION (if any):
This matter was heard on the papers pursuant to s 32 of Queensland Civil and Administrative Tribunal Act2009 (QCAT Act).
REASONS FOR DECISION
Ms Collins has been an enrolled nurse since March 1978. Between January 2000 and May 2004 and then again between November 2004 and July 2009, she administered medication without holding the necessary endorsement. She also practised unlicensed for a period in 2004/2005, having failed to renew her enrolment during a period she was ill.
Ms Collins was trained in New Zealand, where endorsement was not required to administer medication. She maintains she completed a course in Queensland which entitled her to apply for endorsement several years ago. She said she assumed her employer would take any necessary action after the training.
Ms Collins presented to the officer who investigated the matter for her employer as cooperative, honest and forthcoming. She freely offered what little information she had and did what she could to assist the investigation. She immediately and willingly ceased administering medication when she was informed it was outside the scope of her authorisation.
The organisation involved in offering the nominated course has no record of her participation, nor does her employer who appears, also, to have played a role in organising and offering it to its employees. Ms Collins appears to have a detailed and accurate recollection of the course, how and by whom it was delivered, what she had to do to complete it and the names of some other participants. One of them does recall Ms Collins doing the course, others could not say.
The Board has not alleged Ms Collins was deceptive in her dealings with either the Board or her employer.
The system of registration and endorsement is intended to ensure that only those who are trained and educated perform specific duties, in this case administering medication. It is not merely a matter of form. It is a strategy to protect patients and due regard must be paid to the requirements.
It is of concern to the Tribunal that the hospital did not pick this issue up for a very lengthy period; some 9 years. During that time a nurse not endorsed to do so was administering medication without authorisation. This indicates a serious flaw in the hospital’s procedures for checking registration status.
Although the documentation is lacking, the Tribunal has proceeded on the basis that Ms Collins is appropriately trained to secure endorsement.
This is consistent with the Board’s acceptance that her competence to perform the duties of an endorsed enrolled nurse is not in question. Ms Collins provided the Board with references from a number of her professional colleagues who paint a consistent picture of a nurse who is positive, diligent in the care she provides and patient focused. This case does not raise any concerns about patient safety. However, steps should be taken to assess and endorse this nurse so patients may receive the services she is competent to offer.
[10] Regardless of any lack in the hospital’s process, it is a nurse’s responsibility to understand the scope of their authorisation to practice and to remain within its bounds. Ms Collins cannot shift that responsibility to her employer. She renewed her enrolment on numerous occasions during the charged period. It might be expected that she would have noticed her enrolment details did not contain the necessary endorsement. The importance of attention to her registration status was specifically brought to her attention by the then Queensland Nursing Council who wrote to her during the period her registration lapsed.
[11] The Tribunal regards this as a case of unsatisfactory professional conduct. Ms Collins has neglected to give proper attention to her enrolment status. It is not a case of deliberate disregard for professional requirements.
[12] The parties have jointly proposed a sanction which, with some variation, the Tribunal has accepted as adequate and appropriate. Ms Collins will be publicly reprimanded and fined. The parties proposed a fine of $1,500, which the Tribunal considers excessive in light of the other penalties that it will impose and given the view it has taken of Ms Collins’ conduct. The purpose of these proceedings is not punitive. A fine of $500 is a significant penalty for someone on a nurse’s salary.
[13] Ms Collins’ enrolment will be subject to a 3 month suspension. That penalty will be wholly suspended for 1 year, provided she does not face any disciplinary proceedings during the year. The suspension serves to deter others from flagrantly disregarding registration requirements. The suspension of that penalty reflects the Tribunal’s view that Ms Collins neglected this issue, albeit for a lengthy period, rather than deliberately disregarded the requirements.
[14] Ms Collins must also pay the Board’s costs of the proceedings, fixed at $2,000. The Board brought these proceedings in fulfilment of its statutory function. Their costs are funded by fees paid by members of the profession. In most cases, those against whom disciplinary grounds are established will bear the Board’s costs of the proceedings. Ms Collins cooperation in the proceedings has ensured that the costs have been kept to a minimum in this case.
[15] The sanctions described above are appropriate to maintain professional standards and public confidence in the profession. They will reinforce to Ms Collins and to other nurses the importance of being aware of and observing the limits on their scope of practice.
[16] One further order was sought, the effect of which is that the Tribunal may not review the orders for a period. This order is unnecessary, in light of the transition from the state based regime under the Nursing Act 1992 and the national scheme brought into effect in Queensland when the National Law (Queensland) was adopted by the Health Practitioner Regulation National Law Act 2009.
[17] These proceedings were commenced under the Nursing Act 1992 and were required to be dealt with as if that Act had not been repealed.[1] The Board must give effect to the decision as if it were a decision under the National Law (Queensland).[2] Under that law, there is no provision for the Tribunal to review the orders it has made or any conditions that it has imposed.[3] The suspension order will be exhausted after 1 year if Ms Collins complies with its terms. If she does not, the term will be activated.
[1] Health Practitioners (Professional Standards) Act 1999, s 405P(1).
[2] Health Practitioner Regulation National Law (Queensland), ss 289(4), 204, 205.
[3]Health Practitioner Regulation National Law (Queensland), s 199 and Health Practitioner Regulation National Law Act 2009, s 9.
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