As I reach my eighth year of NMCWatch, I am thinking back to the person I was on 12th June 2017, when I set the group up. I was angry, frustrated that I had been put through this horrendous process and indignant that I had been treated in this way. “How dare they!!!”.

Written by Cathryn Watters.

It’s fair to say that I was on a mission to expose the NMC for their callous nature, and a crusade to bring fairer justice to the FtP process. But I was realistic and determined not to let my anger mask what was going on. I have always been someone who seeks solutions rather than problems, I am most definitely urgent in my approach – expecting everyone to deal with issues I feel are important with my same tenacity and urgency. This is something I have learnt about myself over the last eight years and perhaps something I would not have learnt had I not been through my FtP. I am no doubt “on the spectrum”; not to play down those with formal neurodivergent diagnoses, but in some respects, I think the majority of people I know probably are. It is a spectrum after all! 

The mistakes I made, 1 to 5.

My NMC experience was relatively quick, certainly in comparison to those I have witnessed since. After being referred I found myself at hearing 10 months later, having had no interim order and allowed to pretty much just get on with things and ignore the fact that I had been referred. This was my first mistake.

As I often do I pushed the shock and disbelief to the back of my mind and just “got on with it”. Head down, busy busy busy, thinking the longer I worked the more likely it was that the NMC would just wind this stupid scenario up and leave me alone. My second mistake.

The hearing

When it came to my hearing, a brief meeting with my RCN lawyer gave me the impression that although this wasn’t going to be a walk in the park, a suspension was the worst I was looking at and, depending on the panel, I may even be able to convince them to give me a conditions of practice. After all 26 years of service with no previous issues raised has to count for something surely? My third mistake.

On turning up to the hearing I was like the proverbial rabbit in the headlights. Pretty much sobbing through each day, at no point did I recognise I was too unwell to proceed. I trusted that both the panel and my barrister would advocate for me and if they felt my mental health was impeding safe process, would press pause for me – my fourth mistake.

I attended the first two days of the hearing but recognised that if I were to attend the third and the news was bad, I would not make it home. Therefore, I stayed in the security of my home, busying myself with my animals and letting the sunshine soak into my soul in an attempt to convince myself that the sunny day was a good omen. Talking to my Mum who had died in 2011, I remember being grateful that she wasn’t here to see this and how ashamed I was that I had let her down. Staying at home that day was my first good decision, most definitely saving my life. 

I was struck off the register in February 2017. Sheer bloody devastation. 

Looking back and reading my blogs from that time I can’t remember a lot of it. But the overarching emotion was shock. Shock that everything I had worked for had gone in those three days. Disbelief that a panel of three could hold the key to my profession and lock the door on it with no acknowledgement of my clinical expertise. Ultimately I was immensely angry that I had allowed it to happen, that I had made myself vulnerable and not protected my career better. I tried to blame others as a way to reduce the trauma to myself. It was the NMC’s fault in my eyes, the agency’s fault for not making the application process easier, my old employer’s fault for using a training company that was providing suboptimal training etc etc. 

Understanding and acceptance

At the end of the day I put myself in that position, no one else, it was a harsh approach by the NMC but it’s not personal, it’s the system. I dug down, ignored the trauma and got fighting. I can’t stand injustice and have always been fiercely indignant if I feel someone is wronged or not listened to. I always thought this was the result of my childhood trauma, but now seeing one of my children have the same pursuit of the truth, I realise that nature and nurture walk a fine line. Abuse survivors will often talk about the second voice, the younger child that is there but pushed down and often ignored. The loss of the ability to trust your own instinct or judgement and the over-reliance on others is common and certainly something I battled with. Now in adulthood, still rubbish at listening to that inner voice, I struggled and still do at times, with boundaries. I think this is a result of my past. 

During my NMC hearing, I can remember telling the panel that they had to believe me as I always had a fierce need to tell the truth. Due to not being believed when I was a child, now in front of my regulator, it was vital for me to be believed. I shared being a victim of abuse to show the panel how impossible it was for me to be dishonest and that having that accusation against me was a horrendous attack on my character that I was struggling to balance. Disclosing this was hard, but I felt it was important. I stupidly thought that this would help the panel understand who I was and that I could never be dishonest because of it. My fifth mistake.

Panels are not allowed to see the human inside a referee and make a judgement based on probability. They can only look at facts, or the facts that the NMC choose to present, and determine our fate on that innocuous civil standard of a “balance of probabilities”. Whether I had suffered childhood trauma or not was irrelevant – these were the facts and they were going to be proven. 

I remember coming out of day two and saying to my barrister that it had felt like I had been abused all over again – people in a position of trust, turning their backs and just hearing what they wanted to hear and determining their version of events that suited their narrative. But I think this is what fuelled my response – the lioness tearing through, determined to make them listen. 

Appeal

I only had a few months between lodging my appeal in March 2017 and attending the High Court in July. By August I was in front of a new panel at the NMC who at last were human. I got my PIN back with the order revoked immediately. This was an incredibly speedy process and one I am most grateful for. Observing other cases since, and the monumentally long process they face, I think, like some of them, I may have withdrawn if it had taken any longer. My experience was, I like to think, fate playing a hand in my future; speeding me through FtP so I could get on with the job I was meant to do… perhaps.

At the time of my appeal, only 52 FtP cases had gone to the High Court for appeal. Out of these, only seven were won with barristers and I was only the second person to represent themselves and overturn the NMC decision. The first was my friend and mentor Vassanta Suddock, who inspired me right up until her sad death last year. Appealing was most definitely my second good decision.

New chapters

It’s true that the birth of NMCWatch was from a place of anger. But the group has been a catalyst for me in so many ways, most importantly to learn more about myself. Now, looking back I can see where I went wrong and it was long before my referral to the NMC. Previous conflicts in roles had overwhelmed me. I was successful but felt a kind of imposter syndrome. A defiant inability to tow the corporate line above patient and staff welfare led to someone who was in all aspects burnt out. I had had some wonderful mentors who had tried to help, but the disclosure of my abuse years earlier, the death of my mother, and the stress of needing to be the sole breadwinner at one point in our family life had brought a tsunami of decisions and behaviour that likely led to my referral. The blunt tool that is the FtP process cannot be expected to unpick that, and I have learnt the importance of recognising when it’s time to stop. I used to feel that giving up and stopping was a failure on my part, but now I realise that it’s just recognising you have done the best you can and that it’s time to begin a new chapter. 

I returned to work at the same unit I was working at before my hearing, for another 6 years. And I am so grateful for the patience of the team I worked with. But I was not the same practitioner and despite their support, I was working towards ending my career without realising it. However, this time it would be on my terms, not snatched away from me. But after nearly eight years I have decided it’s now time to draw a line. I like to take my time!

Looking back to move forward

I am now grateful for the FtP experience as it led me to work with the incredible people I now work with and gave me the confidence to speak up in the way I do now. The negative aspect of what I do with NMCWatch is that I have to accept that now, I will not work again as a nurse. Some of this is a choice – yes I could probably get a job somewhere, but I don’t want somewhere, I’m worth more. My career has always been about feeling I am making an impact. If making an impact by advocating for those vulnerable during FtP makes me unpalatable to employers, then so be it, it’s a price I am lucky enough to be able to pay now and a moral decision that is more important to me than the days when I was earning nearly £3k a week.

My message to any of you early on in your FtP experience:

• Your personal life will always impact your professional – be honest with yourself and press pause if the balance is off.
• Be honest and own the mistakes you have made – life is for learning and the learning never stops.
• Be realistic about what the FtP process can and can’t do – it’s about you and no one else.
• Understand the system is broken but you can fix your part in it – don’t let it destroy you.
• Remember, you are stronger than you feel right now, these feelings will pass.
• Give yourself time – you are vulnerable and not at your best when going through FtP – now is not the time for big decisions. 
• Panic not – there is life outside of healthcare, you have so many skills and you are worthy of them all.
• Don’t let FtP define you. 

To the NMC, I would ask them to read my appeal submissions including the extract below:

“There are many dishonest nurses out there but I am not one of them. These nurses unfortunately still practice today because they have spoken of remorse, remediation and reflection but have done so, in some cases, because it will ensure they can maintain practice. This does nothing to protect the public, it merely creates a tick-box exercise to appease the needs of the NMC. I have witnessed the dishonesty of colleagues and members of teams I have managed and consequently had to discipline. Cases of fraudulent claims of timesheets. Mileage claims and accidents at work falsely recorded. Cases of moonlighting and sick leave due to excessive hours. 

Dishonesty is a very difficult thing to prove – how can you prove to someone that you are honest? The only way is to show that person’s history and any pattern of behaviour. The NMC considers dishonesty to be a more severe crime than patient harm in many instances. The cases shown in my bundle confirm this. For example, if I had made a medication error but shown remorse for my mistake, reflected on it and shown how my practice was going to change, I would have probably received a lesser sanction. The NMC considers dishonesty, once proven, to have two outcomes; suspension or strike-off. There is no room at any point to consider that someone may not be dishonest, but instead, guilt is assumed until innocence is proven. 

Finally, my case was always about so much more than my PIN number. I am not the only nurse to have been treated harshly by the NMC. They continue to treat their registrants in a manner that, regardless of whether current legislation ties the hands of their legal team, is wrong and not in the public interest. There is a fundamental ethos which runs through all FtP hearings of guilty until proven innocent which is against our basic human and legal rights to a fair trial.”

NMC, have you honestly reflected and remediated?

Do you have true insight into your actions?

Will you avoid repetition?

Our 796* members will testify you still have a long way to go.

*at publication