Charge

On 7 November 2023 the Health Practitioner’s Disciplinary Tribunal (the Tribunal) heard three charges of profesional misconduct laid by a Professional Conduct Committee (PCC) appointed by the Nursing Council of New Zealand (the Council) against Ms Vickie Wade, of Auckland, registered nurse (the Nurse).

Charge 1 alleged that the Nurse failed to respond to acute apnoea monitor alarms of a baby in her care, was wearing headphones and/or was distracted by an electronic device.  The Nurse was also hesitant to document and/or failed to document the aponoeic episode in accordance with NICU policy.

Charge 2 alleged that in relation to another infant in her care, the Nurse failed to respond appropriately to the acute apnoea monitor alarms, was wearing headphones and/or distracted and failed to document the apnoeic episode.

Charge 3 alleged that the Nuse was unprofessional and/or disrespectful in her interactions with the parents of another baby.  She was indifferent to, unsupportive and judgemental of the baby’s mother.

The full charge can be found at Appendix A to the decision.

The Nurse did not attend the hearing which proceeded on the basis of formal proof.

Background

The Nurse was working in NICU at Starship Hospital at the time of the alleged incidents. Part of the NICU nurses’ regular duties is to check that alarms and limits are set correctly on the monitors for each infant.  If correct alarm limits are set an orange bar will show on the screen while an audible alarm is going.  The alarm will stop if the infant corrects itself.  If the condition does not improve, the alarm sound will change and the line will turn to red.  An apnoeic episode will not alarm until an infant goes approximately 20 seconds without a breath.  This will usually result in a ‘high’ red line alarm.

The events relating to the first two charges occurred at different times, however the Nurse responded in similar fashion on both occasions.  The monitor was flashing red and said ‘apnoea’.  Another nurse in an area close by could see the monitor and that the heart rate and oxygen levels were decreasing.  She thought the Nurse would attend to the infant but after ten seconds the alarm continued so that nurse responded.  Meanwhile, the Nurse the subject of the charge was sitting in a Lay-Z-Boy chair in the corner of the room with her laptop on her knees and her headphones in.  The Nurse was reluctant to record the apnoeic events as she was expected and did not do so.

The third charge concerned the Nurse’s behaviour and attitude towards a mother of a newborn.  The mother had a caesarean section and was in hospital for two weeks after the birth of her son.  The mother said she felt the Nurse treated her differently than other mothers and made her feel very unwelcome.

It is alleged the Nurse was reluctant to get her son out of the incubator despite the fact the mother could not walk after the operation and struggled to stand.

Finding

The Tribunal found the three charges established. 

Charge one amounted to malpractice, negligence and bringing the profession into disrepute.  A reasonable member of the public expects that nurses would attend to vulnerable children in their care and that they would not be distracted by electronic devices. They would also acurately record incidents when they occur. The Tribunal is mindful that the Nurse’s behaviour is not consistent with principles of the Nursing Code to be readily accessible when on duty, and to keep clear accurate records.

Charge two is almost identical to charge 1.  While the Tribunal did not find particular 2.3 relating to record keeping established, overall, the analysis from charge 1 applies.

Charge 3 amounts to negligence.  Each particular of the charge demonstrates that the Nurse did not carry out her duties in a professional way.  In not carrying out her role in a professional way brings discredit to the nursing profession.

The Nurse’s behaviour in all three charges was considered to be a significant departure from acceptable standards and therefore warrants discipline.

Penalty

The Tribunal made the following penalty orders:

1. Cancellation of registration
2. Censure
3. $33,728.66 which is a 45% contribution of the total costs of the Tribunal and the PCC.

The Tribunal directed publication of the decision and a summary.