Nurse asks not to be struck off after admitting failings in the care of a vulnerable patient

A nurse who admitted failings in the care of a vulnerable care home resident has told a professional conduct hearing that she would like to return to a different field of nursing in future if she is allowed to keep her registration.

A Nursing and Midwifery Council (NMC) panel heard that Julie Elizabeth Burton had not worked since allegations about her conduct were raised in May 2018, in relation to the care of a woman named as ‘Patient A’ at the Mount House and Severn View care home in Shrewsbury, operated by Barchester Healthcare.

Representing herself at the hearing, Ms Burton said she had been deeply affected by the incident and subsequent investigations, and would not wish to return to a care home environment once she is ready to start working again.

The panel concluded on Tuesday that one charge – that she had not recorded frequent enough observations about the patient – was proved by admission, and a further seven were found proved.

The charges found proved were that Ms Burton had attempted to take a blood pressure reading from the side on which the patient had a broken arm or shoulder, failed to call 999 after recording abnormal heart rate, temperature, blood pressure and respiration observations, and did not seek to admit the patient to hospital for low fluid intake.

Ms Burton had then failed to notify the NMC when Barchester Healthcare began disciplinary proceedings against her, which she was required to do within 14 days under a previous conditions of practice order imposed by the NMC in January 2018. 

The hearing reconvened on Wednesday to hear submissions from Ms Burton and Isabelle Knight, the barrister presenting the case for the NMC, on whether the charges amounted to misconduct, and whether Ms Burton’s fitness to practice was currently impaired as a result.

Ms Burton told the panel that at the time of the alleged misconduct her judgement was being impacted by a lack of support from the management in relation to her previous conditions of practice order, and she had also recently lost her father.

She added that the fact other professionals – including a doctor, occupational therapy team, carers and the night nurse – had not raised any concerns about the patient was also a factor in her decision not to escalate the patient on Saturday, May 26, when the concerning observations were recorded.

She said: “It wasn’t a safe environment and I was unsupported, but at the end of the day I had a responsibility. As soon as I came on duty I should have admitted this lady to hospital.

“I had a duty of care. I should have acted, and I didn’t, I delayed by 24 hours which I should not have done.”

Ms Burton asked the panel not to strike her from the nursing register, saying she was currently training as a counsellor and would like to work with the substance misuse team in the future.

She said: “I do believe I am in recovery and that my fitness to practice is still impaired and I need more time.

“I am seeking support with this and if I did return to nursing I would not return to that sort of environment again.”

Ms Knight told the panel it was also the NMC’s view that the charges as proved did amount to misconduct and that Ms Burton’s fitness to practice was currently impaired.

She said: “The NMC’s position is that the actions of Julie led to a delay in the patient receiving the appropriate care. There was a delay of around 24 hours.

“The patient’s son, in his complaint, states that the patient had complications in hospital when she was admitted due to the length of time the patient was dehydrated.”

In relation to Ms Burton’s failure to notify the NMC of the discipliniary proceedings with Barchester Healthcare, Ms Knight said: “While this is a serious concern, there is no evidence Julie was trying to cover this up nor was she trying to act dishonestly.”

Ms Knight said there was “evidence Julie has insight into her failings”, but that this was “limited”, with her statements to the NMC and live evidence to the hearing focussed on mitigating factors and “what other people had done wrong”.

The panel will reconvene on Thursday to hand down its decisions on misconduct and impairment.