Charge

On 1 to 3 February 2022 by audio visual link the Health Practitioner’s Disciplinary Tribunal heard a charge of professional misconduct laid by the Professional Conduct Committee appointed by the Nursing Council of New Zealand against Ms Pritika Anjani Pillay a registered nurse of Auckland (the nurse).

The charge related to events on the night shift of 6/7 July 2019 only.  The charge alleged that the nurse:

1. Slept in the nurse’s station while on duty during the nightshift, thereby putting the safety of the patients under her care at risk;
2. This particular related to the care of the patient who was found to have fallen from his bed in the early morning of 7 July 2019.  The particular alleged that the nurse compromised the health and safety of the patient in that she failed to:
   1. 1. Complete an incident report about the fall;
      2. Carry out any observations following the resident’s fall;
      3. Record in his progress notes any observations she had carried out following his fall; and
      4. Record the fall in the progress notes and/or she failed to communicate any concern for his welfare.

and that the conduct amounted to professional misconduct under s 100(1)(a) and/or (b) of the Act and that taken together or separately warranted disciplinary sanction.

Background

At the time of the events at issue, the nurse had only recently qualified.  She had been working a 0.9FTE role as nurse at Auckland Hospital since April 2019 as well as continuing to work at a rest home where she had worked full time from late September 2018.

The nurse worked a night shift at the rest home on 5/6 July 2019, finishing at 7am.  She then worked a shift at Auckland Hospital.  She was also rostered to work at the rest home again on the night of 6/7 July, she says, without being consulted.  She was concerned but felt she had some obligation to meet the expectation to work, so she did.  The nurse said that she was allowed to sleep while on her break and that she preferred to take her break in the nurses’ station rather than going to the staffroom.

After the nurse’s first round, she went to the nurse’s station and fell asleep.  A nurse care assistant (HCA) woke her and suggested the nurse take a break and if she were going to sleep, she should not do so at the nurses’ station.

At some point during the night the nurse was woken by the HCA in order to respond to a resident who had fallen out of bed.  The nurse attended then returned to the nurses’ station and went back to sleep.  At the end of the nurse’s shift she completed her notes but made no mention of the resident’s fall.

The nurse did accept that she fell asleep during the shift.  She says she was extremely tired because of the shifts she had been doing earlier.  However, she limited the period of sleeping to when she might have been on her break.  This was not a position that was sustained under examination.

Finding

The Tribunal found Particular 1 established and that the conduct on its own, was serious enough to warrant disciplinary sanction.  The Tribunal considered that the nurse intended to go sleep, rather than sleep because she was exhausted and struggling to stay awake.

The Tribunal found that the first element of Particular 2 on its own, was not sufficient for an imposition of a disciplinary sanction. The Tribunal considered it fell within the margin for error as recognised by the High Court’s decision in PCC v A, B, C & E [2021] NZHC 949.  However, the failure to complete an incident report was upheld and in combination with other elements of the charge, warranted disciplinary sanction.

The second element of Particular 2 was not upheld. The allegation that the nurse failed to carry out any observations on the resident who fell, is not established on the facts.

The Tribunal had no doubt that observations should have been recorded in the patient’s notes. However, while the third element of the charge was upheld, the Tribunal considered that on its own it did not warrant disciplinary sanction.

The Tribunal found the fourth element of the charge established and on its own warranted disciplinary sanction.

Considered together all the established elements of the second particular amounted to professional misconduct and deserved disciplinary sanction.  

Penalty

The Tribunal ordered:

• Censure;
• Conditions on practice for a period of one year;
• Pay $24,000 of the investigation, prosecution and hearing costs.

The Tribunal directed publication of the decision and a summary.