The aim of this assessment is to develop your understanding and evaluation of the professional

The aim of this assessment is to develop your understanding and evaluation of the professional conduct of a nurse/midwife in the case study provided. The case study is a decision statement selected from Decisions of the Professional Standards Committee from the Nursing and Midwifery Council New South Wales – The Health Care Complains Commission (HCCC). Details: Your work should be structured using the following guidelines: Section 1: Summary of the case. Section 2: Identify and critically discuss the relevant professional errors that potentially contributed to the incident. Section 3: Critically discuss how your practice might change and develop because of your knowledge of this incident. Submission requirements:. Please be mindful of the University word count policy: +/-10%. -Your work should contain at least 8 quality references. -Section 1 should include the citation for the case study. -Sections 2 and 3 are the main body of your work. -Ensure sections 2 and 3 include citations to: NSW Health policy documents and/or NMBA Standards for Practice document(s) and/or the National Safety Quality Health Service (NSQHS) Standards. -You should also include other relevant documents and/or journal articles. -Ensure each section of your work contains citations as required. -Please include a reference list. Civil and Administrative Tribunal, NSW Case Name: Health Care Complaints Commission v Youssef; Health Care Complaints Commission v McArthur Medium Neutral Citation: [2021] NSWCATOD 2 Hearing Date(s): 24, 25, 26 August 2020 Date of Orders: 13 January 2021 Decision Date: 13 January 2021 Jurisdiction: Occupational Division Before: L Pearson, Principal Member J Flood, Senior Member B Clarke, Senior Member S Lovrovich, General Member Decision: 2020/00081521 Health Care Complaints Commission v Youssef: (1) Leave granted to amend the complaint; (2) The respondent is guilty of unsatisfactory professional conduct and professional misconduct; (3) The following directions are made: (a) The applicant is to provide to the Tribunal and to the respondent a statement as to the protective orders it is seeking as a consequence of the finding of unsatisfactory professional conduct and professional misconduct, together with the evidence on which it intends to rely, and submissions, on or before 5 February 2021; (b) The respondent is to provide to the Tribunal and to the applicant evidence and submissions in response, on or before 26 February 2021; (c) The applicant is to provide to the Tribunal and to the respondent any material in reply, on or before 5 March 2021; (d) The parties are to provide to the Tribunal a range of dates for the Stage 2 hearing after 10 March 2021, on or before 20 January 2021. 2020/00081523 Health Care Complaints Commission v McArthur: (1) Leave granted to amend the complaint; (2) The respondent is guilty of unsatisfactory professional conduct; (3) The following directions are made: (a) The applicant is to provide to the Tribunal and to the respondent a statement as to the protective orders it is seeking as a consequence of the finding of unsatisfactory professional conduct, together with the evidence on which it intends to rely, and submissions, on or before 5 February 2021; (b) The respondent is to provide to the Tribunal and to the applicant evidence and submissions in response, on or before 26 February 2021; (c) The applicant is to provide to the Tribunal and to the respondent any material in reply, on or before 5 March 2021; (d) The parties are to provide to the Tribunal a range of dates for the Stage 2 hearing after 10 March 2021, on or before 20 January 2021. Catchwords: PROFESSIONS AND TRADES – health practitioner – registered nurse – whether conduct significantly below standard – whether provision of false and misleading information – whether conduct improper or unethical – whether unsatisfactory professional conduct – whether professional misconduct Legislation Cited: Civil and Administrative Tribunal Act 2013 Health Care Complaints Act 1993 Health Practitioner Regulation National Law Cases Cited: Chatoor v Health Care Complaints Commission of NSW [2020] NSWCA 111 Chen v Health Care Complaints Commission [2017] NSWCA 186 Health Care Complaints Commission v Achurch [2019] NSWCATOD 20 Health Care Complaints Commission v Attia [2016] NSWCATOD 167 Health Care Complaints Commission v Hanna [2018] NSWCATOD 113 Health Care Complaints Commission v Karalasingham [2007] NSWCA 267 Health Care Complaints Commission v Kennedy [2017] NSWCATOD 72 Health Care Complaints Commission v Shrimpton [2019] NSWCATOD 25 Health Care Complaints Commission v Wilcox [2020] NSWCATOD 10 Sabag v Health Care Complaints Commission [2001] NSWCA 411 Texts Cited: Nil Category: Principal judgment Parties: 2020/00081521: Health Care Complaints Commission (Applicant) Nelley Youssef (Respondent) 2020/00081523: Health Care Complaints Commission (Applicant) Seamus McArthur (Respondent) Representation: 2020/00081521: Counsel: I Chatterjee (Applicant) Solicitors: F Shah, Health Care Complaints Commission(Applicant) K Doust, NSW Nurses and Midwives’ Association (Respondent) 2020/00081523: Counsel: I Chatterjee (Applicant) Solicitors: F Shah, Health Care Complaints Commission (Applicant) L Alexander, NSW Nurses and Midwives’ Association (Respondent) File Number(s): 2020/00081521 2020/00081523 Publication Restriction: Under cl 7 of Sch 5D to the Health Practitioner Regulation National Law (NSW) disclosure to any person or entity of the name of the patient set out in the schedule to the complaints is prohibited. REASONS FOR DECISION On 13 March 2020 the Health Care Complaints Commission (the HCCC) applied to the Tribunal under the Health Practitioner Regulation National Law (the National Law) for orders against Registered Nurses Nelley Youssef (proceeding 2020/00081521) and Seamus McArthur (proceeding 2020/00081523). At a directions hearing on 24 July 2020 an order was made that both proceedings be heard together, with evidence in one to be evidence in the other. The complaints against each practitioner are brought in relation to their conduct on 9 February 2017, when they were rostered to work on Ward DB4, the respiratory and infectious diseases ward at Prince of Wales Hospital, Randwick (the Hospital). Patient A was an 80 year old man who had been admitted to Ward DB4 the afternoon before after spending several days in the Intensive Care Unit (ICU) for hypotension with a background of infective exacerbation of chronic obstructive pulmonary disease (COPD). Patient A had an established laryngectomy stoma following surgery for laryngeal cancer in 2002. Patient A had a total laryngectomy, which meant that his larynx had been surgically removed and a permanent neck stoma created. That stoma was his sole airway. Patient A sought RN McArthur’s assistance in preparing for a shower. RN McArthur at that time, with the consent of Patient A, applied a Mepilex occlusive dressing that covered the whole of Patient A’s stoma. Prior to applying the dressing, RN McArthur checked with RN Youssef to see if the application of the dressing would be appropriate, which course of action RN Youssef agreed to. RN McArthur then left Patient A to shower. Some time later RN Youssef entered the bathroom and observed that Patient A was non-responsive. Attempts were made to resuscitate Patient A which were unsuccessful. NSW Police attended, and an autopsy report was prepared for the Coroner and witness statements were taken from a number of Hospital staff. The autopsy report concluded that the disease or condition directly leading to death was “occlusion of the external airway in the context of a permanent tracheostomy after the treatment of laryngeal carcinoma”. The Tribunal was informed at the hearing that the matter is still being considered by the Coroner; there are no pending criminal proceedings. The Complaints The complaints against each practitioner were amended by consent at the hearing. Particular 1 of Complaint One against RN Youssef originally was that RN Youssef had “advised a nursing colleague” to apply the dressing, and was amended to be that she “responded to a request for advice from a junior colleague by agreeing that it was okay” to apply the dressing. Particular 1 of Complaint Two against RN Youssef and RN McArthur originally was that each had provided false and misleading information “to the Hospital” in their statements of 27 February 2017 and 9 March 2017 respectively; the reference to “the Hospital” was deleted from particular 1 of Complaint Two against each of RN Youssef and RN McArthur. RN Youssef There are three complaints against RN Youssef. Complaint One is that she is guilty of unsatisfactory professional conduct under s 139B(1)(a) of the National Law in that her conduct was significantly below the standard reasonably expected of a practitioner of an equivalent level of training or experience, in that she: Inappropriately responded to a request for advice from a junior nursing colleague by agreeing that it was okay to apply a Mepilex occlusive dressing to cover Patient A’s stoma (particular 1); Inappropriately provided a Mepilex dressing to her colleague to be used to cover the stoma before Patient A commenced his shower (particular 2); Demonstrated a lack of knowledge of the underlying anatomy and clinical history of Patient A (particular 3); Demonstrated a lack of knowledge that the laryngectomy stoma was Patient A’s sole airway (particular 4); Failed to seek advice from a more senior colleague regarding the appropriate management of Patient A’s laryngectomy with respect to the appropriate dressing to cover his stoma while he showered (particular 5); and Failed to remove the dressing from Patient A’s stoma when she found him unresponsive in the shower, thereby failing to ensure he had a clear airway when resuscitation efforts were commenced (particular 6). Complaint Two is that she is guilty of unsatisfactory professional conduct under s 139B(1)(l) of the National Law in that she engaged in improper or unethical conduct relating to the practice or purported practice of nursing, in providing false and misleading information: In a statement dated 27 February 2017 when she stated that at the time she found Patient A unresponsive, “I noticed that the Mepilex Border dressing was no longer in situ. The stoma was not covered and I did not see the dressing in the surrounding area”, in circumstances where the dressing was in situ at the time (particular 1); and In her letter to the HCCC dated 15 June 2017 when she stated that when she found Patient A unresponsive “the Mepilex dressing was no longer in situ, the stoma was not covered”, contrary to s 99 of the Health Care Complaints Act 1993 in circumstances where the dressing was in situ at the time (particular 2). Complaint Three is that she is guilty of professional misconduct, relying on the particulars of Complaints One and Two both individually and cumulatively. RN Youssef admits in response to Complaint One that she agreed a Mepilex dressing would be suitable, and that she provided a Mepilex dressing. She admits that she had a lack of knowledge of the underlying anatomy of Patient A’s altered anatomical state after his laryngectomy in 2002, and denies that she did not have knowledge of Patient A’s clinical history. She admits she had a lack of knowledge that the laryngeal stoma was Patient

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