Denis O'Callaghan, Principal Lawyer, Gordon Legal
Being the subject of a notification to AHPRA can cause considerable stress and uncertainty. It is undoubtedly something that all practitioners aim to avoid.
At Gordon Legal, as lawyers representing nurses and midwives, we find that practitioners are reported to AHPRA for a broad range of reasons. However, we have certainly seen some recurring trends in notifications.
Below, are the top 5 most common causes of AHPRA notifications made against ANMF members. We’ve also included an outline of some basic tips for how you can avoid or minimise the risk of becoming the subject of an AHPRA investigation.
Misuse of medications
Nurses and midwives often work in environments where they frequently and routinely administer prescription medicines, including opioids and other drugs of addiction. This every-day part of practice can lead practitioners to become complacent about the strict regulations that apply to the possession, supply, administration and disposal of medications.
Practitioners, on occasions, can also be tempted to self-administer substances because of pain or stress they experience in often difficult and challenging work environments.
Being under the influence of drugs whilst practising as a nurse or midwife, or misappropriating drugs from your workplace, is taken very seriously by employers and AHPRA. Participating in this type of conduct will seriously jeopardise a practitioner’s registration, with consequences including suspension or restrictions such as random drug screening. Furthermore, in some cases, practitioners find themselves facing misconduct proceedings in VCAT and/or charges in the criminal jurisdiction.
Many people, including nurses and midwives, struggle with their mental health and other conditions such as chronic pain. Unfortunately, many practitioners fail to seek out the appropriate support and medical treatment, often leading to attempts to self-manage and medicate as outlined above. Help and support is available, and practitioners should reach out.
Tips to avoid or minimise the risk
The Nursing and Midwifery Health Program Victoria (NMHPV) provides free, confidential support for nurses and midwives experiencing sensitive health issues related to their mental health, substance use, family violence or any issue impacting their health and wellbeing. Services include counselling and support to connect with appropriate, ongoing healthcare.
Remember to reach out and get help early.
Your health
Further to the above topic, we often assist members under investigation who have been reported to AHPRA because they have an impairment. Such notifications usually relate to mental health conditions. Whilst this can seem like an intrusion on personal privacy, the Health Practitioner Regulation National Law gives AHPRA the power to investigate notifications about a practitioner’s health where there is concern that their health may be detrimentally affecting their capacity to practise their profession.
AHPRA and the Board do not penalise nurses and midwives simply for having health conditions. However, they can take action against a practitioner if they are not satisfied that the practitioner is appropriately managing their health condition and that there may be a resulting risk to public safety when that person practises as a nurse or midwife.
Tips to avoid or minimise the risk
Make sure that you seek help from appropriate medical practitioners, follow treatment advice and use leave entitlements to rest and recover if you recognise that a health condition may be impacting your work.
Professional boundaries
Principle 4.1 in the Code of Conduct for Nurses and Midwives explicitly states that nurses and midwives are required to maintain professional boundaries with patients. The relationship with a patient ends at the point a nurse or midwife’s role in their clinical care ends. The Code addresses what is said to be an “inherent power imbalance” between nurses and midwives and their patients, where a patient receiving healthcare is recognised as being particularly vulnerable.
The obligations under the Code of Conduct regarding professional boundaries are broad. Romantic or sexual relationships or interactions with patients contravene the Code of Conduct. Furthermore, this can extend to entering into personal or intimate relations with a patient’s family member. The requirements under the Code of Conduct apply no matter how limited or fleeting your care for a patient is and regardless of whether your clinical care for that patient has ended.
Tips to avoid or minimise the risk
ANMF’s Education Portal includes a collection of CPD modules covering professionalism and the law.
Unsatisfactory performance
The relevant Nursing and Midwifery Board of Australia Standards for Practice set out the performance expectations for nurses and midwives. You should refer to the Standards for your specific profession, published on the AHPRA website. Nurses and midwives are expected to demonstrate knowledge, skill and judgment, and exercise care at the standard expected of a health practitioner with the equivalent level of training or experience.
Examples of ANMF members who have been reported to AHPRA because of their unsatisfactory performance include practitioners who:
- made repeated errors in medication administration
- inadequately documented care provided
- failed to escalate care when patient conditions deteriorated
- failed to adequately manage patient falls and head injuries.
Tips to avoid or minimise the risk
It is important to be proactive about your performance and adherence to the Standards. Seek to identify deficits or areas of required improvement in your practice, particularly where you have received specific feedback from your employer. These areas of required improvement should be addressed, including by completing relevant CPD seminars, obtaining support and accessing training and education available in your workplace.
Furthermore, remember that you are responsible for your own practice and standards. Even if there is a culture in your workplace where others also fail to adhere to the Standards and it is common to ‘cut corners’, this does not shield you from an AHPRA notification nor serve as an adequate excuse.
Registration oversights
Oversights and mistakes when applying for or renewing your registration can have serious consequences. There are many ways in which these issues can arise, including where a practitioner:
- misses the deadline to renew their registration
- makes a false declaration about recency of practice, criminal history or CPD completion.
Tips to avoid or minimise the risk
Therefore, it is important to be proactive about managing your registration. Keep an eye out for reminder emails in April each year. Remember, on-time registration must be completed by 31 May. Make sure you keep proper evidence of your completed CPD, and immediately seek advice from the ANMF if you have been charged with any offence.
If you are the subject of an AHPRA notification, contact the ANMF immediately to arrange a referral to Gordon Legal for advice and representation.
