Failure to supervise leads to a finding of professional misconduct

A common query by those in the position of a supervisor is what is their responsibility for those they supervise. A decision by the NSW Civil and Administrative Tribunal (NCAT) last week is a reminder of the potential significant ramifications for health practitioners who fail to meet their supervisory obligations.
 
The proceedings in question related, in part, to a nurse’s failure to ensure that observations were conducted by the staff under their supervision at a frequency directed by the medical staff. The failure of the nurse resulted in a finding of professional misconduct.
 
Whilst the nurse escaped suspension or cancellation of their registration, which was available to NCAT once it found professional misconduct, the nurse was the subject of a reprimand and a number of conditions have been placed on their registration. The reprimand will be noted on the nurse’s AHPRA record, which is available to the public.
 
In reaching its decision NCAT accepted expert evidence given during the proceedings, which concluded that ‘the role of the NIC (nurse in charge) is to ensure the smooth running and operation of a unit in the absence of the nominated Nurse Unit Manager. This includes ensuring that the allocated RNs are aware of their responsibilities in relation to the completion of observation rounds and that they are attended. It is also reasonable to assume that the NIC would relieve staff when they were on allocated break which would increase the responsibility associated with ensuring all rounds were completed in a timely and appropriate manner’.
 
When making a decision that the conduct amounted to professional misconduct, NCAT took into account the fact that the conduct was deliberate and ongoing. That is, the failure to undertake the observations as directed, was a common occurrence in the ward. Further, NCAT found that it was not just mere professional incompetence but was a deliberate departure from accepted standards.
 
Whilst this matter also involved issues in relation to the manner in which the nurse conducted and recorded some of the observations themselves, and that this together with the supervision failures were cumulatively serious enough to make a finding of professional misconduct, it is possible that a failure to supervise staff in isolation, is also sufficient for adverse disciplinary findings to be made against staff.
 
The health regulators have in recent times been more willing to make adverse findings against those in charge of shifts where there is a failure to adequately supervise the staff to ensure that they as individuals meet their obligations. Supervisors are required to ensure that staff under their supervision are aware of their responsibilities and that they attend to them. A failure to do this exposes the practitioner to an adverse disciplinary finding and potentially suspension or cancelation of their registration.