A Nepalese Nurse who had only recently come to the UK to work found herself referred to the NMC. She had cared for a dementia patient for a short period of time and her relative felt that her communication with the patient was poor as was the handling of her dignity and health condition that she was needing urgent care for. The relative complained to the trust who completed a local investigation. The trust then put in additional training, and a period of supervised practice and deemed she was then sufficiently retrained to continue to work without concern. However, the family member, also a Healthcare Professional, felt this was not sufficient and referred her to the NMC for investigation.

On contacting us, she was understandably confused and concerned about the referral and didn’t really understand why she had been referred. We immediately assigned her a case worker who spent time discussing the case with her and helping her learn why it was important for the NMC to investigate. We helped her learn so that she could do an in-depth reflection and show sufficient insight into the incident so as to reassure the NMC she was not a risk to future patients. We also suggested further training she may benefit from.

As part of their new strategy, the NMC has started to send registrants under investigation a form called a “Personal Contact and Employment details form”. This is a form that has always been sent to the registrant in order to ensure basic details are in place and they are aware of legal representatives. However, they have also now added to this form a context element which gives a series of questions which help them to understand the reasons the incident occurred, if there was anything about the work environment that may have contributed and, if so, did this negate any of the situations the registrant found themselves in.

We helped her complete this form, giving as much information as she could about this context. This was difficult for her to do as at the beginning she did not understand its importance and also found it difficult to put down in words her thoughts and feelings about what happened.

Through the mentoring we were able to provide, she was able to present a robust reflection and a good contextual background to the incident when the NMC reviewed this.

Her case was closed with no further action.

She is delighted as she can continue to work at the trust with no restrictions and continue to learn about the differences in healthcare here as opposed to her country of birth, which she felt contributed to the situation she found herself in.

She has kindly donated some funds to NMC Watch so that they can help towards the cost of such support to another registrant who may not be able to pay for this themselves.

This case study has shown the following lessons:

• Registrants may be more likely to engage if they have peer-to-peer support
• Registrants don’t often understand why they have been referred and the implications of the process
• Registrants  may not present themselves in the best light without the knowledgeable support of someone who understands the FtP process
• One-to-one support can be enhanced by written information ( as supplied by NMC ) but not replaced – understanding of insight and remediation takes time
• Local trust investigations may benefit from better communication with complainants following their findings to avoid ongoing referral to the NMC.