First published 1 April 2017, by Cathryn Watters
Why is it just as you think life is mellowing out, things are ticking along nicely something happens to knock you off your stride again?
My D-Day was the 22nd February 2017. I was dealt the biggest blow imaginable professionally – struck off by the NMC (Nursing and Midwifery Council). To be honest, when I was first notified of the allegation I didn’t really take it seriously. It was so absurd that I thought at some point, someone rationale would step in and call a halt to the whole thing – how naive was I. My date for the hearing in front of the Fitness To Practice Committee came and I still hoped that some semblance of common sense would kick in from my regulator.
In January 2016 I completed my time at my previous employer – not the best ending to what had started full of hope in making a difference and carving a new, patient-focused service. It had all gotten rather nasty after I had my riding accident. The character of those in the organisation of “hit her while she’s down” was a shock to observe as I had thought better of them. Accusations were flying around all over the place which I could show were complete lies and extensions of the truth, most likely sparked by my refusal to compromise safe patient care and not sit by whilst managers slowly bullied their way to the top.
eIt all culminated in my reaching a settlement agreement with them as I had neither the energy nor psychological strength to fight against their self-promotional games that were being played in a scrabble for many of the senior managers to retain their positions whilst the company was being taken over. I’d seen it before but had hoped that this organisation would be different. Unfortunately, history repeated itself and it just reaffirmed that those who rise to the top don’t get there on their morals! Still, as always, move on, learn and take the experience to the next phase whatever that may be. I was unsure what I wanted to do next, I was pretty confident I didn’t want to do a service development role again, the last two drained the life out of me with little thanks for what I achieved at the end. I enjoyed being part of a team, teaching and training, but also missed the direct patient care and I never thought I would say it, but a busy unit! Whilst gathering my thoughts I started applying to agencies, so I at least had options of earning whilst I made my decision. Luckily the settlement agreement gave me a few months’ grace if I was careful so there was no pressure to run headfirst into a job, I could wait and choose the right one.
Applying to agencies was exasperating, frustrating, tedious, repetitive and in some cases scary. Little data protection when having to send certificates, and documents, multiple times because either they got lost or the person that was dealing with it had left etc. One agency recruited me so fast that they had work within a week – I politely said no, far too quick for checks for my liking. There are many fantastic agency nurses out there and their ability to work flexibly without any strong roots I admire but I quickly realised that I need a team around me.
Back to my routes – chemotherapy nursing – on the bank so I could gently ease myself back was the preferred option. I spoke to colleagues at one of the leading private providers in London and they were thrilled to have me join – a real ego boost for a confidence level that was in the toilet! Unfortunately, just as I was about to commence work with them, I fractured my ankle – you know my history with breakages that year – “the year of being made of china” it will be called!! However, they showed their metal and were more than happy to wait, content that I was just the type of nurse they were looking for, having known me for many years and pleased to have me on the team. Once healed, I started working for them in April, only a few hours a week initially, as my confidence had been severely knocked, it had been a while since I had worked on a busy chemotherapy unit and I was still physically not 100%. The flexibility they offered was just right and over the next 6 months, I gradually built to full-time hours, loving every minute of it.
During this whole period, I received a letter from my regulator – the NMC. Stating that I had been reported to them as a result of one of the application forms I had completed. There was a query over one of my certificates and it transpired that it looked like the date had been changed on it. I had filled in so many application forms, my guilt was that I hadn’t studied my certificates that closely as had no reason to suspect they were out of date or inaccurate – my tendency to rush things being the achilles heal that caught me out, but how many of us could say – “it could have so easily been me”. I was advised in-between communication with them to just put it to the back of my mind and continue to work, but I informed my employer in the ethos of openness and honesty. They were extremely supportive and were sure it would turn out to be a mistake.
September came and I was ill-prepared for what followed. I have never been to court but can only compare it to how a prisoner may feel when standing trial, knowing they are innocent but facing certain hanging. 3 panel members, only one of which is a clinical member sit waiting, I learnt later, with the standpoint that you are guilty until you can prove your innocence. I had talked to my barrister about whether I should plead ” guilty ” but she advised me to tell the truth which was that I had no explanation for the date change on the certificate, but knew it had not been myself who had changed it. I stated that my filling in the application form with the date was not done out of any malice or need to mislead, merely a busy mum rushing her paperwork. After all, it wasn’t a court of law and humanity and commonsense should surely prevail or so I thought.
I cried and sobbed through the 2-day hearing, not able to attend for the final “results” day because if it were bad news I wanted to be at home – safe. Being in attendance during the harrowing first two days, though, I was assured would count in my favour, many people do not attend. I was determined that it would show the panel that I was fundamentally a good person and deserved their humanity. It transpires, however, that some panels do not possess the personality trait of humanity, they are so cynical about life that they presume everyone is guilty and deserves to be punished. So, after nearly 30 years of unblemished nursing service, with testimonials from ex-colleagues speaking up for my character and ability as a nurse, with support from my current employer to show I had worked for nearly a year with no issues arising – on a unit that treats 30 – 40 patients a day, so a high-risk environment I went like a lamb to the slaughter. My employers were even willing to provide any supervision the panel see fit so as to comply with any conditions of practice they may impose, which was very humbling as I was only a bank nurse in my mind and it was going above and beyond for me. With my confidence still in “the system” being just and fair, the verdict came … STRIKE OFF… BANG!!!!! Disbelief, grief, horror, panic – no words to describe the feelings that ensued. The overall helplessness that they decided on no other outcome, no other option that they could have imposed – they could have done nothing… they could have implemented conditions of practice ( a bit like points on your licence )… they could suspend for anything from weeks to months to a year… but no I was deemed a risk to the public and struck off because I continued to show no insight into my actions by denying them. No pass go… no get out of jail free card… thrown on the rubbish heap.
Devastation is not even a word that comes close. My complete disbelief was that it could come to this. My shame that “everyone” would know. My frustration that those inadequate nurses that I had come across in my career that I hadn’t reported because I believed everyone deserves a chance to improve, would be sitting back and laughing. My anger that on reading other past cases, nurses who have caused actual patient harm but admit and show remorse get off with a lesser charge. I had finally found an employer which cared for their staff as much as their patients, after having a number of years working for organisations that struggled with this concept and now my pin number was held ransom, locked away for 5 years and without it I was nothing – unemployable.
I have nursed since I was 17 1/2 years old, full of expectation and excitement. Naive maybe but always maintaining that it was a career about caring and always the most important person is the patient, I know nothing else – what am I supposed to do now? The sheer desperation that you go through – the rollercoaster of emotions is so overwhelming – I have become very low at times and still ask the question, would anyone notice if I was gone? I am no longer a nurse – I now have no purpose – I am useless… I have always been able to rely on my work to sustain us and now I didn’t even have that. How would we manage? An astronomical mortgage, four children under 14 who don’t demand more than any others but who we want to provide for and allow them to fulfil their dreams, a new business starting off but by no means ready to support us completely, the list goes on. It’s incredible, people say “it’s only a job” but for me, nursing is everything about me, it’s who I am, and I know nothing else. I’m told I shouldn’t let it define me, it’s a small part of who I am, it does not define me, I am a mother and a wife, a friend and a sister, an aunt and so much more, yet still, I feel empty. The ability of a group of people who don’t know you to have such a catastrophic impact on your life is terrifying. Then my practical head kicks in, I have 4 beautiful children who make me so proud every day. I have a husband, who I have known almost as long as I have nursed who has watched my career develop and grow and who is inspiringly supportive it makes me weep. I have a wonderful home and a great lifestyle and many wonderful friends, I have more than most. I may not be able to nurse but am sure in time I will find a niche and in the meantime, we have the bakery to build – thank god. For now, I turn to what I always do and write – cathartic and healing it works for me.
Since this has happened I have linked with many others who have been in a similar situation to me and am shocked at what I found out. It seems, I wish I knew this before, that if you do not accept the NMC charges, you are in denial and are maintaining dishonesty. There is no innocence until proven guilty. Someone I have met through doing the petition said that she was struck off after a 40 year unblemished career and the panel chair stated “it’s not up to us to prove the charges, it is up to you to prove your innocence”. In no other forum would this be allowed and yet the regulator of one of the largest groups of carers can not care for its own staff. When my managers found out the outcome of the hearing they cried, they said to me “but we need good nurses like you in the profession”, it seems not. I teach my children consequences, encourage them to show honesty but also not to be fearful of telling the truth. What society are we creating when a professional regulatory body can not show the same principles? Humanity and common sense are a rarity for this organisation it seems.
I completely agree that we need to have a regulator – there are a lot of dishonest people out there – but I am not one of them. If we can’t trust our regulator to be fair and supportive then what is the point? There was no humanity shown throughout the hearing as I sobbed and tried to get the words out. I even at one point had to disclose some very personal information which I have never had to disclose in an open forum before. I thought it would give the panellists some insight as to why the truth is so important to me – it fell on deaf ears and instead humiliated me even further. As I was physically shaking after disclosing and overwhelmed by a panic attack that hit me like a train, I had to ask for a break in proceedings as the panel were clearly unable to show any compassion and safeguard me – no duty of care to the registrant it seems. Stiff talking to myself in the toilets – a touch of water on the face and in I go for more humiliation. Someone described the hearing they went through as being made to feel like Shipman was a saint and they were lower than muck on his shoes. That seems a fair analogy to me.
Yes, I made a mistake – I should have ensured I double-checked the forms and associated paperwork properly and then I may have spotted something was not right. But how many nurses fill out these application forms and do the same and are never hauled in front of the panel? My barrister told me that it is often a case of luck that these cases are brought in front of the NMC, a series of events that given another day may end differently. It seems the outcome of them is equally subject to a roll of the dice, not based on any parity or proportionality. The frustration that I had already decided I did not want to work for them is so immense, why did I even apply in the first place? But the panel felt that was a lie also as I only didn’t work for them as I got “caught”. A group of 3 people who have never met me, based their findings on probability and assumptions rather than the evidence given. I didn’t work a single shift for the agency in question, or any agency on the basis of the information and as soon as I found out there was a problem informed all parties putting my applications on hold – what more could I have done? When I made the decision to work at the unit in London I did all the relevant courses and more when I started with them, as any decent employer puts in place anyway so my certificates were never out of date for any patient care. This counted for nothing, as the NMC stated that I “could have done so”. Are we now living in an era where George Orwell’s thought police really do exist? They have taken away my ability to earn a living. I still have not claimed any benefits as I don’t believe in doing so, I am old school, I believe in earning for myself and will find a way of doing so. But to have that choice taken away from you with no chance of reproach to me seems immoral.
I am still proud of having been a nurse and all that I achieved, I know I was bloody good at what I did and made a difference to those I looked after. People that are important and care about me know it too. Those who are pointing the finger and laughing will get caught one day I am sure – I hope. I have wrapped myself in knots trying to come up with what happened to the certificate. I have proof of ex-colleagues lying and fabricating evidence in my previous employment to meet their own means, but do I use it and bring their downfall? There is no guarantee of their outcome, and bitterness and hate is a very negative energy. I wish them luck but more so I wish their patients luck, as they are the ones who will suffer. It’s always been about the patients, as I say I am old school.
I can appeal the panel’s decision. I have the appeal notice and skeleton argument all written, More highs and lows of finding out that the RCN won’t support an appeal ( pay for my lawyer ) as there is not an above 50% of winning the case. Then finding some very supportive people through The Nurse’s Defence Union who looked into legal aid for me but we have too much equity in the house so don’t qualify – we may not be able to pay the mortgage but hey! Then my darling husband and I looked at whether I can represent myself. I can but if I lose it could be a costly risk. I have 28 days from the hearing date to submit the appeal notice – it has come around very quickly.
I ask myself if I was reinstated would I want to nurse again – to be honest no. There have been times in my career when I have said that I don’t want to nurse anymore – but to have the choice taken away from you is very scary. The things I have learnt since this whole experience began mean that I sadly no longer have faith in the vocation I joined all those years ago. The characters and behaviours that I have witnessed from those not keeping the patient in the centre but lying to achieve better for themselves, are more common than not. I think I would always be looking over my shoulder, worried that a simple mistake could bring me back to the nightmare that has been the last few months and I am unsure that my psychological state is strong enough to endure any more trauma. There are just not enough pills for that one!
There will be a way through this and there will be something positive that comes of it, one of my friends said I was a phoenix – very overwhelming to be told that when you feel that your life is burning in front of you!! But she explained that I have faced many things throughout my personal and professional life and have always managed to make a way through, reinvent myself where necessary and move on not dwell. I still don’t quite believe her at the moment but am touched by the words. To friends and family that I have not told personally what has been going on please forgive me, the shame associated with this is huge, despite my innocence I am a character that always believes I am at fault and having to deal with those who may express disappointment is too great to bear at the moment. Forgive me – I am the cowardly lion!
Someone else I have met through doing the petition asked the group I belonged to “why are you all fighting so hard to hang on to a profession that clearly does not care about you?” Because without doing so the patients suffer, I guess. Many of us, not all, have spent a career putting the patient first, it’s what we do.
As youngsters beginning on a career full of hope we took a pledge, The Nightingale Pledge – I believed in it at the time;
“I solemnly pledge myself before God and in the presence of this assembly to pass my life in purity and to practise my profession faithfully.
I will abstain from whatever is deleterious and mischievous, and will not take or knowingly administer any harmful drug.
I will do all in my power to maintain and elevate the standard of my profession and will hold in confidence all personal matters committed to my keeping and all family affairs coming to my knowledge in the practice of my calling.
With loyalty will I aid the physician in his work, and as a missioner of health, I will dedicate myself to devoted service for human welfare.”
I think most nursing students now, or those qualified over the last 10 years would probably laugh at being asked to read the above – there lies the point.
I grieve for what I have lost – it is a kind of bereavement – but I celebrate what I have had and the incredible people that I have met along the way. To the not so incredible, and at times vindictive, I wish you luck, and hope you find the ability to reflect and one day walk in my shoes – they won’t fit!
Things learnt along the way:
- Since 2008/9 6,243 nurses have been deemed “impaired” with 2,107 being struck off…
- In 2014/15 £ 57 million was spent on fitness-to-practice cases – imagine how the NHS could benefit from that sort of money!
- The GMC register an average of 250,000 doctors, out of these they have 10,000 referrals yearly BUT only 200 are sanctioned with restrictions. This versus the NMC which registers an average of 750,000 nurses but has approx 4,500 referrals yearly BUT leading to 1,300 being sanctioned.
- Since 2008/9 sanctions have gradually increased year on year.
- In 2013/14 a total of 858 sanctions were given and 537 resulted in striking off the registrant. Those proportions are consistent but wrong – surely not all of them were beyond reproach?