Nurse wins challenge for being struck-off over ‘inappropriate’ patient relationship

A psychiatric nurse who had a “wholly inappropriate” relationship with a vulnerable patient has won a High Court challenge against a decision to strike him from the register.

The nurse accepted he was guilty of professional misconduct over his contact with the woman over a two-year period, continuing after he moved to another job. However, he claimed a Fitness to Practise inquiry had breached his constitutional right to fair procedures before a report recommended his removal from the register.

Mr Justice Anthony Barr quashed the report and said the case should be referred back to the Fitness to Practise Committee (FPC) of the Nursing and Midwifery Board of Ireland.

The nurse had brought judicial review proceedings challenging the legality of the October 11th 2018 report. He did not object to the findings of professional misconduct and had made “certain admissions”.

However, he did object to the report and recommended sanction. The nurse said that challenged statements were put before the committee in breach of an “express agreement” that they would be excluded. He also said he had made an offer not to take his name off the inactive register of nurses — an offer which would have prevented him from ever working as a nurse again. He said this was rejected with no reason given.

The nurse was employed by the HSE in 2007 to provide counselling to the woman, who is in her 30s, for an anxiety disorder. After he moved to another part of the country in 2008, his “therapeutic engagement” with her ended, but he continued to have contact with her.

The woman later made an allegation to another counsellor that she had had a relationship, including sexual relations, with the nurse between March 2007 and June 2009. A HSE inquiry and Trust in Care Report made “adverse findings” against the applicant, although it appeared that some of the more serious complaints of there being a sexual relationship may not have been upheld in the report, Mr Justice Barr said.

Among the admissions the nurse made were that he “breached the parameters of a normal therapeutic relationship” with the patient; that on one or more occasions, he took her to locations outside normal clinical settings, he failed to have regard for the fact that she was an emotionally or psychologically vulnerable person and failed to fully report the volume and nature of text messages and phone calls between him and the woman.

The Fitness to Practise Committee cited the seriousness of the misconduct, the volume of text messages, continuing after the woman had left the mental health services, and the nurse’s “failure to express any remorse for his actions.” The challenged documents were only before the committee on a preliminary issue and it was “proper” that the board was then provided with all relevant materials, it was argued by the respondents.

Mr Justice Barr said it was difficult to see how the CEO, having expressly agreed to the exclusion of certain documents, could then justify those documents being placed before the Fitness to Practise Committee. In breach of the terms of the agreement, the entirety of the challenged documentation was placed before the Fitness to Practise Committee, the judge said.

The committee should have addressed the applicant’s offer never to seek to have his name removed from the inactive register. Although the inquiry process has not concluded, the judge said it was appropriate to intervene and strike down the Fitness to Practise Committee report, and to remit the matter back to the Fitness to Practise Committee for fresh consideration.