Nursing and Midwifery Council v Mary-Jo Teague
Mary-Jo Teague, a paediatric nurse employed by Belfast Health and Social Care Trust (“the Trust”), was issued with a six month conditions of practice order as a result of her failure to provide adequate care to Child A.
The panel found that although there were failures in ward systems these did not remove Nurse Teague’s personal responsibility to Child A. The panel also found that as Nurse Teague was unable to demonstrate that she had remedied the failings in her practice since the incident, her fitness to practise was impaired.
Child A was admitted to hospital on the night of 10/11 November 2010 with breathing difficulties having been previously assessed in Accident and Emergency. She was 17 years old and had metachromatic leucodystrophy (a genetic disorder affecting lipid metabolism), epilepsy and learning difficulties. Child A was admitted to a side room on a paediatric ward and Nurse Teague was allocated to care for her. At around 22:30, Child A’s condition appeared to be stable and her mother left the ward for the night leaving her with her father, Mr A. During the night Child A’s condition deteriorated and despite medical intervention, Child A died.
The following charges were admitted by Nurse Teague:-
- Failure to involve Child A’s parents in discussions relating to her plan of care
- Did not carry out a full nursing assessment on admission
- Inappropriately used an SCEWS (Sick Children’s Early Warning System) chart for a child aged 6-12 years
- Did not calculate the SCEWS for Child A
- Did not accurately record a fluid balance or ensure that oxygen saturation monitor level alarms were appropriately set
- Did not undertaken and/or document observations of Child A after 01:30 until 07:00
The panel firstly had to consider if there was misconduct on the part of Nurse Teague before making a finding on whether her fitness to practise was currently impaired. In considering misconduct the panel heard evidence relating to the systemic failures on the ward relating to documentation and a culture of poor leadership and bad practice. The panel found that Nurse Teague had a personal responsibility as an experienced paediatric nurse to identify and document Child A’s care needs irrespective of this. The failure to engage with Child A’s family and the omissions detailed above, demonstrated basic failings in nursing care which was evidence of a serious breach of a duty of care owed to a patient. This was sufficiently serious to amount to misconduct.
Following the events in question, the Trust recommended that Nurse Teague should undergo a supervision period of 6 months supported by a mentor and complete an action plan. At the time of the hearing despite being instructed to start the 6 month action plan in October 2011, the registrant had completed only 3 months of the action plan. There was evidence to suggest that the registrant whilst willing and committed to remedy her past failings, had not had a continuous period of working 6 months on the action plan and there had been no regular review of her progress or real evidence of support from the Trust. There were also concerns that Nurse Teague was not proactive enough in seeking the support she needed.
The panel held that it had not seen evidence to demonstrate that Nurse Teague had fully remedied her misconduct and could not say with certainty that the actions taken so far would render her behaviour unlikely to be repeated. For this reason, the panel held that Nurse Teague’s fitness to practice was currently impaired and as a result a conditions of practice order was imposed. This demanded that she should complete the action plan, be subject to monthly reviews regarding her progress, maintain a reflective diary and to undertake a project on end of life care.