Findings in Relation to the Application by the Health Care Complaints Commission - Management Assignment Help

Assignment Task:

Task:

REASONS FOR DECISION

Background

1. On 13 January 2021 the Tribunal published its findings in relation to the application by the Health Care Complaints Commission (the HCCC) for orders under the Health Practitioner Regulation National Law (NSW) (the National Law) against Nelley Youssef, a Registered Nurse: Health Care Complaints Commission v Youssef; Health Care Complaints Commission v McArthur [2021] NSWCATOD 2. These reasons for decision should be read with the decision in Stage 1 of these proceedings.

2. The application to the Tribunal was heard together with a complaint against RN Seamus McArthur. The complaints against each practitioner were brought in relation to their conduct on 9 February 2017 when they were rostered to work on the respiratory and infectious diseases ward (Ward DB4) at Prince of Wales Hospital, Randwick NSW (the Hospital).

3. The background to the complaints was summarised in the earlier reasons: [4] Patient A was an 80 year old man who had been admitted to Ward DB4 the afternoon before after spending several days in the Intensive Care Unit (ICU) for hypotension with a background of infective exacerbation of chronic obstructive pulmonary disease (COPD). Patient A had an established laryngectomy stoma following surgery for laryngeal cancer in 2002. Patient A had a total laryngectomy, which meant that his larynx had been surgically removed and a permanent neck stoma created. That stoma was his sole airway. [5] Patient A sought RN McArthur’s assistance in preparing for a shower. RN McArthur at that time, with the consent of Patient A, applied a Mepilex occlusive dressing that covered the whole of Patient A’s stoma. Prior to applying the dressing, RN McArthur checked with RN Youssef to see if the application of the dressing would be appropriate, which course of action RN Youssef agreed to. RN McArthur then left Patient A to shower. [6] Some time later RN Youssef entered the bathroom and observed that Patient A was non-responsive. Attempts were made to resuscitate Patient A which were unsuccessful. [7] NSW Police attended, and an autopsy report was prepared for the Coroner and witness statements were taken from a number of Hospital staff. The autopsy report concluded that the disease or condition directly leading to death was “occlusion of the external airway in the context of a permanent tracheostomy after the treatment of laryngeal carcinoma”. The Tribunal was informed at the hearing that the matter is still being considered by the Coroner; there are no pending criminal proceedings.

1. Complaint One against RN Youssef was that she was guilty of unsatisfactory professional conduct under s 139B(1)(a) of the National Law in that her conduct was significantly below the standard reasonably expected of a practitioner of equivalent training or experience, in that she inappropriately responded to a request from a junior colleague for advice by agreeing that it was appropriate to apply the dressing to cover Patient A’s stoma; inappropriately provided the dressing to him; demonstrated a lack of knowledge of the underlying anatomy and clinical history of Patient A and that the stoma was his sole airway; failed to seek advice from a more senior colleague; and failed to remove the dressing when she found Patient A unresponsive in the shower.

2. Complaint Two was that she was guilty of unsatisfactory professional conduct under s 139B(1)(l) of the National Law in that she engaged in improper or unethical conduct relating to the practice of nursing in providing false and misleading information in a statement dated 27 February 2017 and in a letter to the HCCC dated 15 June 2017, when she stated that when she found Patient A the dressing was not in situ and the stoma was not covered.

3. Complaint Three was that she was guilty of professional misconduct, relying on the particulars of Complaints One and Two.

4. RN Youssef admitted most of the particulars of Complaint One, and denied the particular that she failed to remove the dressing when she found Patient A. She denied that she provided false and misleading information as alleged in Complaint Two. In response to Complaint Three, RN Youssef relied on her responses to Complaints One and Two.

5. The Tribunal found, on considering the evidence of Clinical Nurse Consultant (CNC) Rollason and that of RN Youssef, that RN Youssef had failed to remove the dressing from Patient A’s stoma; and that her statements that the dressing was not in place and the stoma was not covered when she found Patient A were positive statements that were not correct. The Tribunal found particular 6 of Complaint One, and the conduct the subject of Complaint Two, was proven.

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