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Case Study 21: a success story of remediation, employment, and support

Jan 29, 2024 | Case Studies | 0 comments

This nurse was referred to the NMC at the end of 2022. She had an initial interim condition of practice order imposed which seemed workable. Conditions orientated around being supervised by another registered nurse on every shift, not working agency, and achieving certain competencies. However, she struggled to gain employment having left her previous role where the incidents occurred and who referred her.

She joined NMCWatch after this point seeking support during her process but also wanting assistance on how she could get work to achieve her conditions.

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A case worker was assigned, another registered nurse, who mentored her and helped her look at her job applications and how to disclose them to potential employers. During this time we referred her to Humans Ltd, an organisation that works closely with us to represent those undergoing employment disputes or Fitness to Practice investigations. Humans took her through the process of the tribunal, an avenue that she didn’t realize was open to her and after many months of negotiations were able to secure a substantial settlement for her with the employer accepting that the environment in which she worked had contributed to the incidents. 

NMCWatch then began working with the representative to assist this nurse in requesting an early review of her conditions in the hope that they could be made more workable to assist her in gaining employment. We helped her write a list of all job applications which were many – to show the reasons given for not being successful – the majority of which stated the Conditions of Practice, or just being under investigation.

Whilst we were waiting for a date for the interim review, she managed to find an amazing employer who ran a small care home and could see the potential this nurse had if she was just given the chance and given support. Due to the size of the nursing home, and its remote location recruitment was difficult and so the manager was struggling to fulfill the requirements of:

“You must ensure that you are supervised at any time that you are working. Your supervision must consist of working at all times with, but not always directly observed by, a registered nurse or medical practitioner”

This was causing her to manage some issues as it would mean recruiting another registered nurse to work at home to fulfill the supervision. We requested that this condition be amended to state that once she had been deemed competent supervision could be removed”. At her first interim order review hearing this was not successful, the NMC felt the risk was too high and the registrant could not demonstrate enough evidence to show she had addressed the issues to remove this risk as she had not been in work.

Luckily because the manager was so supportive she employed this nurse as an HCA until she could recruit another full-time nurse. She then went on to recruit another nurse and the supervision could begin. After 3 months we asked for another review of the conditions and at this point the supervisory element was successfully removed and conditions only orientated around frequent review meetings with the manager to monitor progress instead. This was a very positive step forward, the Legal Assessor at the hearing no doubt assisted the panel in deciding by giving clear guidance on interim orders being a risk assessment only of CURRENT risk and not about confirming facts around the case. We were able to show the risk had changed by providing evidence of CPD, reflective work, and supporting statements from her manager.

We are now working with the NMC to agree undertakings that the registrant can accept to get her case closed

This case shows us:

  1. The need to work with employers to gain workable Conditions of Practice to achieve remediation and strengthen practice
  2. The need to secure the RIGHT JOB with the right support
  3. The need for a support program in place to enable the registrant to learn what is required of FTP process

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