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Thread: A senior nurse, found guilty of negligence

  1. #1
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    A senior nurse, found guilty of negligence

    A senior nurse, found guilty of negligence after inadvertently starving a geriatric patient, was censured by the Health Practitioners Disciplinary Tribunal and ordered to pay more than $10,000 at a penalty hearing.

    The nurse been found guilty of professional misconduct by the Health Practitioners Disciplinary Tribunal in August.

    Both the name of the nurse and hospital were suppressed.

    The tribunal found the nurse guilty of professional misconduct for not consulting a doctor or dietitian over changes to Leonard Stevenson's feeding and not reviewing it.

    Mr Stevenson - who had been in institutional care since 1995 - had to be fed with a tube. He had initially suffered a head injury, then developed epilepsy and finally had a stroke.

    He lost 16kg from 77kg over one nine-month period and weighed 57.3kg in February 2002.

    Geriatrician Dr Kirsten Holst, who saw Mr Stevenson when he was admitted to Palmerston North Hospital in March 2002, told the tribunal he looked "like he had been in Belsen" (a nazi concentration camp). He died in April 2002.

    Dr Holst had been "very concerned" that Mr Stevenson's intake of liquid nutritional supplement Jevity - his only food - had been halved to 1000 millilitres a day.

    Jevity was nutritionally complete at about 1350 calories (about 1400ml) a day - meaning his intake was not enough for his nutritional needs and probably not providing enough fluid to keep him hydrated.

    The nurse had been "devastated" when she found out Mr Stevenson had been deprived of nourishment over a long period and that his water had also been significantly reduced.

    The nurse indicated in a letter that the Jevity regime was reduced because of his abdominal pain and distension.

    "I failed to reassess that as, although aware of Mr Stevenson's weight loss, assumed this was due to his progressively worsening debilitating condition," she wrote.

    The tribunal said the nurse was "exceptionally well meaning", but by not seeking a doctor or dietician's advice, she acted contrary to Mr Stevenson's interests.

    "The most distressing part of this case is that while the care that Mr Stevenson received seems to have been loving, there is no doubt that he was being slowly starved and probably dehydrated."

    The tribunal held a penalty hearing in Wellington on November 21.

    It ordered the nurse to pay 10 percent of the costs of the tribunal and the director of proceedings, amounting to $10,327, of which $6327 was to be paid to the Nursing Council of New Zealand and $4000 to be paid to the Health and Disability Commissioner.

    The tribunal also ordered permanent suppression of her name and any details that may identify her.

    The nurse is now appealing the decision to the High Court.

    HELLO since when has a nurse been a fn Doctor!!! Nurses are there to carry out instructions from Drs and ensure the prescribed medication BY A Dr is administered to the patient. Wrong person is being charged here. Bloody Typical of our fd up so called justice system!!
    Actions speak louder than words or good intentions

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  2. #2
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    Its called being a scapegoat.

    Ultimately, the nurse is there to do doctors orders, but is required to perform duties and report to another doctor if afraid or in severe disagreement with the doctor. (At least I think thats how Mum put it).

    I presume that in this case that she didnt appeal to another doctor for whatever reason, she could be liable. But Im not a nurse, nor know anything about it apart from being brought up by one.
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    Sniper's dead right. What she failed to do was cover her arse by making sure that the treatment plan was correct.

    Normal procedure is to review the treatment with a peer, but most geriatric facilities run on one RN per shift and heaven help you if you cost the nursing home money by calling the Doctor who set up the treatment plan.
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  4. #4
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    Is not the problem that she *changed* the treatment *without* a doctors instruction ?
    The tribunal found the nurse guilty of professional misconduct for not consulting a doctor or dietitian over changes to Leonard Stevenson's feeding and not reviewing it.
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    No. The problem is that she DID follow the Doctor's initial instructions to make a change to the care plan without double checking with a peer, or the doctor, or a dietician, particularly when she noticed his condition deteriorating.

    It's a shit of a thing to do, but Sniper is right. The nurse is always made a scapegoat for these types of issues, even when the Doctor in this case most likely made the prescription mistake. The Nurse's job is to manage patient care and she shouldn't have implemented a change in care without review. Purely to cover her own arse you understand.
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    I dunno Jim and Sniper. That report is only a glimpse of the whole hearing and I'm sure that if she was implementing a regime prescribed by a doctor then she'd have a defence. It reads as though she reduced the quantity of Jevity of her own accord in order to save the patient from abdominal pain.

    I'd have thought a senior nurse would know the nutrition provided by this diet. Nurses aren't robots.

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    No, absolutely wrong Winston, and she would have been completely aware of all the things she was doing. She simply didn't cover her arse.

    Geriatric care is completely different to hospital care, and the biggest driver is keeping costs down and maximising profits. Calling a Doctor out to check a prescription costs money and can result in disciplinary action from an employer.

    My wife has been in a similar situation, but covered her arse by calling the Doctor to confirm the prescription. She was fired for calling the Doctor and exceeding that month's allocated budget for call outs.

    But that was OK because the place closed 2 months later.
    If a man is alone in the woods and there isn't a woke Hollywood around to call him racist, is he still white?



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    I couldnt have said it better Jim
    To every man upon this earth
    Death cometh sooner or late
    And how can a man die better
    Than facing fearful odds
    For the ashes of his fathers
    And the temples of his Gods

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    Quote Originally Posted by Bloody Mad Woman (BMW) View Post
    ..............................
    The nurse is now appealing the decision to the High Court.

    ...........
    i was developing a certain amount of sympathy for the nurse following the reasoning of Sniper and Jim2 [above] .........

    then i re-read the first post - and realised that she's soooooo penitant that she's appealing against the very reasonable [i thought - in view of the negligence concerned] penalty imposed on her.

    another thing

    yes, SHE was negligent, but logically, since her mistake wasn't noticed/remedied by a doctor in the entire 9 months the poor old chap was starving to death, it seems likely that he wasn't even seen/reviewed by a doctor in that place in all that time ...............?

    BASTARDS!!

    Yes - there HAS been a miscarriage of justice here - both the nurse and the institution should be publically identified - this is information to which the general public is entitled for its own safety.
    ... ...

    Grass wedges its way between the closest blocks of marble and it brings them down. This power of feeble life which can creep in anywhere is greater than that of the mighty behind their cannons....... - Honore de Balzac

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    Be a bit careful with the speculation. A lot of Nurses get absolutely hung out to dry. Theres layers upon layers in there, and the only thing she can be said to be guilty of is not covering her arse properly.

    I highly doubt that she deliberately starved a patient to death either deliberately or through negligence. Unfortunately for her there is no record of anything that she did to question the care plan. So she's "it". The Doctor is unquestionably ultimately at fault. Nurses do not prescribe. But the Doctor will get off because he's covered himself by passing the blame to the care tier of this organisation.

    This sort of thing happens on a daily basis. We only hear about the stuff that results in death.
    If a man is alone in the woods and there isn't a woke Hollywood around to call him racist, is he still white?



  11. #11
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    Sure you are right about the politics involved and am not even remotely suggesting she did it deliberately Jim2 ....

    but AM suggesting that it seems that a Doctor didn't see him during the 9 months he was starving to death because, if he had, it would have been obvious to that Doctor that something was wrong?

    [a loss of 16kg would SURELY have triggered some sort of investigatory response from a doctor, judging from the 'Belsen' remark made by the first Doctor to see him on admission to Palmerston North hospital] ...... which is surely pretty remiss on the part of the 'cannot-be-named' institution concerned?

    it can't be normal for institutional Doctors to leave it 9 months to check up on patients?
    ... ...

    Grass wedges its way between the closest blocks of marble and it brings them down. This power of feeble life which can creep in anywhere is greater than that of the mighty behind their cannons....... - Honore de Balzac

  12. #12
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    FWIIW I'm persuaded by Jim that there could be wider fault. The rest home itself deserves scrutiny.

  13. #13
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    Years ago mum as a psyc nurse was charged with negligence. Never went to the courts as the in-house investigation exonerated her. She had a patient die while in her care. Left a major scar that was never healed. Having said all that it sounds like the usual call by those with some clout. Go after the person least able to defend themselves. That way the real culprets still stay in charge. Looks like that is what happened here.

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  14. #14
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    .... there's no mention of the supervising doctor being included in the prosecution?
    ... ...

    Grass wedges its way between the closest blocks of marble and it brings them down. This power of feeble life which can creep in anywhere is greater than that of the mighty behind their cannons....... - Honore de Balzac

  15. #15
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    I Was Doing Work At An Old Peoples Home And One If The Nurses Told Me The Starve The Patients On Purpose Cause If They Weigh To Much Its Hard To Move Them And Take Care Of Them , I Was Quite Suprised But Such Is Life

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