Fitness to practise process ‘damages nurses’ careers’, regardless of outcome

Survey finds many exonerated nurses leave the profession or return to a lower position

Survey finds many exonerated nurses leave the profession or return to a lower position

Picture: Charles Milligan

Almost two thirds of nurses and midwives found to be fit to practise after being investigated by the regulator suffered damage to their careers or quit the profession entirely, according to a new survey.

The survey by NMCWatch, a support group for registrants who are referred to the Nursing and Midwifery Council (NMC), highlights the career outcomes of those who have undergone a fitness to practise (FtP) investigation.

Its online poll, carried out over 11 months up to February 2019, drew responses from 105 people who said they had been through an FtP process that resulted in the regulator finding there was no case to answer.

Negative impact, despite no case to answer

Of these, 67 respondents reported that the investigation had a negative impact on their career. The survey found that:

  • 24% (25 nurses and midwives) returned to work at a lower position than before their referral.
  • 22% (23) quit the profession altogether.
  • 18% (19) have not worked since their case concluded.

Of the total respondents, 30% (32) returned to the same level of job, and 6% (6) to a higher level position.

‘No smoke without fire’

The NMCWatch survey consisted of 10 questions and drew a total of 146 responses.

NMCWatch founder Cathryn Watters said a registrant could receive a ‘no case to answer’ result if the NMC dismissed the case during its investigation process, or if the case went to an FtP panel but the allegations were found to be not proven and/or their practice was found to be unimpaired.

Despite such conclusions, Ms Watters said these nurses and midwives were often stuck with the stigma of being guilty.

‘The constant response from people outside of the process is, “well, you got away with it, didn’t you”, or “there’s no smoke without fire”,’ she said. ‘It feels to them that that they are still not believed.’

Life after an NMC referral

Sandra Byrne: ‘You don’t know
where to turn.’

Practice nurse Sandra Byrne knows the strain registrants can experience after being referred to the NMC.

‘I was suicidal, twice,’ she said. ‘You don’t envisage at the beginning that this could possibly take 18 months.’

Ms Byrne was referred to the NMC in April 2016 after giving the wrong patient a B12 injection, during what she said was an extremely busy and unsupported time at work.

She admitted the incident, however she was also accused of incorrectly and falsely filling in patient documentation, and not obtaining consent during a cervical screening procedure.

In November 2017, the NMC found Ms Byrne had no case to answer and was fit to practise as a nurse. She said she received notification of the result from the NMC, but ‘there was nothing in there for support’. 

‘Terrified of doing something wrong’

‘You don’t know where to go, you don’t know where to turn,’ she said. ‘You’re absolutely terrified of doing something wrong or saying something wrong, because your confidence is at rock bottom.’

Though at first she returned to her old employer, Ms Byrne left soon after due to a lack of support. It was a year before she felt comfortable enough to apply for another nursing job.

‘Emotionally and mental health-wise, returning is a huge, huge, thing,’ she said.

She now has an ‘incredibly supportive’ employer, but said a skills development or refresher course from the NMC would have helped to build up her confidence before she returned to work.  

For others in the same position, she advised: ‘Wait until you feel ready and take it one step at a time. Do not give up on nursing altogether.’


Too long away from work

The time registrants were away from practice while the FtP investigation was underway was also a factor, Ms Watters said. ‘A lot of people struggle to get employment afterwards as they have been out of work for sometimes 18 months to two years,’ she said.

Ms Watters called on the NMC to provide mental health resources and a skills refresher course to such registrants who have been unable to work for a significant period.

She also urged the NMC to ensure employers make appropriate referrals to the regulator, to avoid registrants facing the process for no reason.

NMC taking a new approach

Earlier this month the NMC unveiled details of new support measures for nurses and midwives facing a fitness to practise investigation.

The support packages will include emotional support and the option of legal assistance with the FtP process.

NMC director of FtP Matthew McClelland said the regulator was committed to treating registrants with ‘fairness and respect’, and its new approach reflected this.

‘We want to move away from blame to encourage a culture of openness and honesty when things go wrong, taking greater account of the context in which mistakes happen,’ he said.

He said the regulator looked forward to working with NMCWatch in the future ‘as we continue to improve the way we do things’.

Data from the NMC’s annual FtP report shows 269 nurses who appeared before a panel in 2017-18 were found fit to practise, while 243 were struck off the register and a further 666 faced a lesser action.

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