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Presence, politeness and patience

May 24, 2021 | Opinion | 7 comments

An interesting end to this week came with me attending a hearing of one of our group members. She had invited me to attend as an observer, as although she had union representation felt she may need additional support and someone to listen so as to explain the decision making and everything that had happened afterwards in more detail that she could understand. I gladly attended as it is useful to hear how panels conduct themselves, remind myself of different styles of case presenters and see the neutrality given by legal assessors. It’s also just interesting from a professional learning perspective.

As usual the hearing was scheduled to start at 9am and by 10.15 still had not commenced. It is pretty much routine, in my experience, that hearings always start later than the time given. Tricky to understand why they are ever scheduled to start at 9am when they rarely do, but it is what it is an we must be kind and be ready.  Waiting in the wings the nurse or midwife must, as the clock ticks, conjuring up all sorts of imagined concepts as to why the delay is occurring, when the reality is most likely due to panel members not being able to connect, transcribers non arrival or just someone getting their cup of tea!. The shakey registrant is then finally  beckoned in when the panel decide at the time they are ready, glued to their virtual screen until that point and not moving from the spot incase it is time.

There seems an acceptance that delays are just part and parcel of the hearing day and yet little information is given to the one waiting  their fate. It is acknowledged that process is stressful and yet a simple aspect as good time keeping good relieve some of this immediate stress for those  who have spent a restless night before in unbroken sleep and likely many weeks before that preparing and psyching themselves up to the starter block. As has happened many times before, I explained to the nurse in question that this was normal and reassured that this was not a reflection on her or how they prioritised her case. I explained that no one was meeting in the background with quiet private chats and planning her demise nor that there was some anterior motive. I gave suggestion that  it was most likely panel members not connecting in to the virtual portal and usual administrative shenanigans. When the registrant wanted to hang up and run, I reassured and helped breath her back to calmness and reminded of the importance of being present. My role had begun even before the hearing itself had, of keeping the nurse calm retaining their focus and remaining available at the drop of a hat when panel secretary commands she enter.

On joining the meeting ( 1hour and a half after planned start time ) there then started a debate about whether I should or should not be allowed to observe. It was a public hearing so as such any member of the public could attend, as they can when the hearings are held in person. Any member of the public can attend including relatives of those who have referred, colleagues of those who have referred, students and indeed journalists. In the nature of being open and honest, I put my full name down and my organisation as being NMCWatch – perhaps that was the sticking point – surely not! The meeting adjourned (again) – I suspect so the panel could discuss it, during which time I suggested to the registrant to let her legal representative know that I was happy to speak with the panel to reassure  them if it would help. I would have also gladly explained to them that as a registrant myself I am aware I am bound by my professional code and know how to conduct myself in said processes. On rejoining the chair opened up further discussion during which the registrant’s lawyer, stated to the panel she had no objection to my observing, the case presenter for the NMC, stated she had no objection to my observing, the nurse themselves stated they had no objection to my attending. So who did?!! The panel adjourned again… At this point ( nearly 2 and a quarter hours after planned start time of hearing ) I suggested to the nurse that I bow out of observing so as not to cause her any more delays or stress from further delay to her hearing starting – she was clear, she wanted me there, she needed my support. I reminded her, as I had before, that likely some of the hearing would be held in private anyway ( which at that time had not been explained to hear by either her lawyer, the legal assessor or the chair ) so as with any hearing the “observer gallery” is always recused from observing this part anyway – she understood.  On rejoining there seemed a very bizarre further discussion whereby the chair stated the differences between a public and private hearing and when the observers would be allowed to observe and when they would not. Had she read my mind?! As the only observer I could only assume this was directed at me! There then followed a question by one of the panel members asking the legal assessor to advise on who was allowed to “record” the hearing whether in note form or other wise and the legal assessor gave a bland statement in regards to secretarial role taking charge of “recording” and the chair then reiterating this as well as clarifying further that if transcripts of the hearing were required the registrant could request these after the hearing had concluded. “All observers must be aware no recording must be made” Were they suggesting I would covertly record the session? Do they not realise that we are in fact in fear of our regulator and would not risk such a breach of the luxury of being able to observe – how odd to even think it. To give them their due a virtual hearing does have the potential for being less able to control the room and what goes on in it, but do we need to remind them again that we are accountable for our conduct in and out of work! One of the panel members then clarified this direction was aimed at everyone in the room and not just the observer ( me! )

It rather struck me that this was an odd kind of cat and mouse game. If the chair had actually asked me I could have given verbal reassurance of my role there, my understanding of how the hearing would proceed and what as an observer I could and couldn’t do ( basically just observe – hence the name!! )

If given the opportunity I could have reassured the panel that my role there was to be able to offer morale support to the registrant who I had got to know through the support group, and once the hearing had concluded be able to offer further support to explain what had happened and why.

With a witness for the NMC there is a witness liaison person, who’s role is to do just that and ,support the witness – perhaps if the registrant  had been given this too my role would not have been required?Is a registrant have less rights to have a supporter than a witness for the NMC? It also struck me that there was a sad undercurrent to what wasn’t being said – openly and honestly. It felt like I was being told, and the registrant also, to stay quiet, know my place and behave. This is not something I have experienced with other panels when I have observed hearings, however this time there were 2 registrant panel members – was this the difference today? Did this demonstrate the undercurrent  that runs through our profession and is the fundamental problem – our profession does not like being observed by fellow professionals? Surely not!! The feeling that started that session of was of that of mistrust – the panel appeared to not trust my motivation for being there but obviously couldn’t say that directly, so clearly and politely kept me in order. Bizarre behaviour to say the least, especially when, if asked, I could have reassured them in a very few words and a lot quicker than it took them to adjourn a number of times, no doubt discuss “in camera” and relay to the room on returning.

But as always occurs both the nurse who’s hearing it was, remained present, polite and patient. I as a nurse accountable to my regulatory body regardless of whether there as an observer or witness, maintained my professionalism, politeness and patience. When explaining their “direction” I nodded so as to reassure them and when the hearing went into the inevitable private session, as it quickly did after eventually getting started, I thanked them, stated I would of course wait to be let back in when told and on rejoining thanked them for letting me back in.

It was an extremely interesting insight into the psychology and  power play that occurs and I had to remind myself to be kind, perhaps the panel had had poor experiences of observers in the past.

The hearing once it got going concluded swiftly with only an hour and a half of actual presentation from both sides before a further adjournment for the decision to be made  – albeit  nearly 5  hours later. We had to chuckle that the time taken to hear the actual evidence was shorter than the time to adjourn, review, advise and return the decision. However,  in the end a decision that was proportionate and appropriate. The nurse patiently present throughout, but silenced with no opportunity to speak at any point other than to confirm her name and PIN number, observing all of the stopping and starting, dazed like a rabbit in the headlights. Patiently waiting, nodding like an expectant puppy waiting for treats.  For everyone else in the room it was just “another day in the office”, hours ticked off,  paid to be there  by the fees of the two registrants’  who weren’t.   Funny old world…

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7 Comments

  1. Lorraine kennedy-Snaith

    Cathryn this is a very good read . Glad to see that you have produced it for us to see.
    The nurse awaiting her fate.
    Sounds awful.
    Are you treated better if you are a criminal?
    Sounds like the nurse made a good call to ask you to support and observe.
    We all at times need support. This is the very reason at work if you need help. Who do you go to ?
    When the person closes the door when you ask for help you don’t go back for help.
    The system is all wrong!
    What will become of the future workforce?

    Reply
    • Cathryn Watters

      thank you for your comments – it is interesting isn’t it the power play and how we almost relinquish the same expectations of treatment towards us when faced with our regulator – we are fearful for correcting them incase they will think badly of us – Stockholm syndrome perhaps?

      Reply
  2. Dr Umesh Prabhu

    Excellent summary Are regulators are accountable?

    Protecting patients and supporting staff are two sides of same coin

    All regulation must be fair and action taken must be proportionate

    Reply
  3. Lesley Bailey

    It was much the same during my hearing. The timekeeping was dreadful. I didn’t speak throughout the three days apart from to confirm my name and PIN. The Chair and NMC counsel referred to me as Miss Bailey throughout ( which is the one option that is incorrect) instead of by my correct title – which is Dr. They were both aware of this but chose not to use it. My barrister used Dr throughout.

    Reply
    • Cathryn Watters

      Basic manners cost nothing but mean so much. If we used the incorrect title for one of our patients we would expect to be pulled up on it so why do we fear doing so with our regulator?

      Reply
  4. JAMAL SIDDIQI

    Why couldn’t registrant speak freely?

    Reply
    • Cathryn Watters

      in an interim order you can only speak to confirm your name and pin then you present a reflection and evidence in writing which your barrister will present. You can ask to address the panel but people rarely do. In a substantive hearing you will be given time to give evidence and be cross examined. However it is still a almost staged process rather than a transparent and free debate and conversation to get to the crux of the issues.

      Reply

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