Charge
On 13 to 17 November 2023 and again on 7 February 2024 by audio visual link, the Health Practitioner’s Disciplinary Tribunal (the Tribunal) heard two charges of profesional misconduct laid by a Professional Conduct Committee (PCC) appointed by the Nursing Council of New Zealand (the Council) against Ms EN, registered nurse (the Nurse).
The evidence and closing submissions concluded on 16 November 2023 and it was agreed that the parties would not wait to hear the Tribunal’s decision on liability, preferring to receive an interim decision in writing and to reconvene via audiovisual link, should further submissions on penalty and name suppression be required.
A further penalty hearing was held by way of audio visual link on 7 February 2024 to hear submissions on penalty and name suppression.
The first charge alleged that while employed as registered nurse Case Manager over the period 16 August 2018 to on or about 24 March 2020 the Nurse breached boundaries by entering into an inappropriate and personal relationship with the father of the Nurse’s allocated client and later entering into an intimate relationship with him when she was or had recently been the allocated Case Manager.
The second charge alleged that while the Nurse continued to be the allocated Case Manager for her client, she failed to take appropriate professional steps in response to a text message from the mother of her client in which she said that she wanted to kill herself.
Background
The Nurse was assigned as the Case Manager of a young child from 3 August 2018. Between September 2018 and November 2019 the Nurse had made 7 visits with her client at the client’s home. The father of the client Mr [II] was not present on these occasions. The next appointment was to be a year later.
The mother of her client, Ms [EI] indicated she experienced anxiety and stress but said she did not need any help. The Nurse also noted that the client was “High need – short term”.
The Nurse had a number of personal interactions with Ms [EI] and Mr [II] during the time she was the allocated Case Manager and by late November 2019, Ms [EI] offered her husband’s building services to the Nurse’s parents and to the Nurse. The Nurse had recently separated from her husband.
The Nurse and Mr [II] continued to have contact and he helped the Nurse with other matters when she asked.
At the end of March 2020, Mr [II] moved into the Nurse’s home because of the COVID-19 lockdown restrictions. Mr [II] and his wife’s marriage had broken down in January 2020 and he had nowhere to stay that was close enough for him to see his children. By this time the Nurse and Mr [II] were closer friends but the Nurse said the relationship was not intimate until April 2020.
When Mr [II] left Ms [EI], she sent a text to the Nurse saying that he had left her. By March 2020 Ms [EI] believed that the Nurse and her husband were having an affair and messaged the Nurse saying she wanted to ‘kill herself’.
Finding
The Tribunal found both charges established and that they separately amounted to professional misconduct warranting disciplinary sanction.
The Tribunal accepted that in a relatively small community town it is not uncommon for nurses to be known to their clients in a different capacity before commencing a professional one. Therefore, management of the personal and professional relationships requires the setting of boundaries. This did not happen here.
The Tribunal considered that given the close proximity of the quarters it was more likely than not that the Nurse and Mr [II] had already entered into a sexual relationship at the time he moved into her home, or both parties knew that it was imminent.
The Tribunal considers the Nurse’s failure to disclose relevant information that she was evidently aware of and had a direct bearing on her competency to practise constitutes malpractice. The Tribunal also considers that the Nurse’s conduct has brought the profession into disrespute as this conduct would lower the reputation and good-standing of the nursing profession.
The Tribunal also found that when the Nurse received the text message from Ms [EI] that she wanted to kill herself, the Nurse did not take appropriate professional steps in response to the text message.
Penalty
The Tribunal made the following penalty orders:
- Censure
- Conditions on practice
- $26,938.96 which is a 20% contribution of the total costs of the Tribunal and the PCC.
The Tribunal directed publication of the decision and a summary.
The nurse has appealed to the High Court against the Tribunal's liability order finding the nurse guilty of professional misconduct in respect of both charges. The nurse has also appealed against that part of the penalty decision relating to the order of a censure, conditions and the amount of costs to be imposed.