RVN RCVS DC case

Re: RVN RCVS DC case

Rob Loxley — Thu, 17 Jan 2013 14:24:48 GMT

The law is an ass, but it's the ass we're stuck with!

Re: RVN RCVS DC case

Clive Ansell — Thu, 17 Jan 2013 14:09:10 GMT

[quote user="Emma Cooper"]

[/quote]

But the point is he does not have to although he may choose to. It could be that she has been a good employee of 14 years, and in theory she could carry on in the same position as a VN and head nurse, unchanged?.

Re: RVN RCVS DC case

Emma Cooper — Thu, 17 Jan 2013 13:21:19 GMT

Hi guys,

I've only scanned through the thread but I was at theNicholl hearing last week, so might be able to help or give some idea of the discussions that went on with witnesses....

Hannah/Clive/Robloxley - Tracy has had her name removed from the RCVS voluntary register. She is still a "listed" nurse, which means she keeps her qualification. I can explain this in more depth if you like (gave us at VN Times a right headache when we discovered this in the past), but in a nutshell, the VSA asks the RCVS to keep a "list" of qualified nurses. That's all there is in law. So once you're qualified - and on that list - you're an "LVN" for life and can perform Schedule 3 proceedures as long as your employer lets you. The college is taking steps to get the VSA changed to abolish the list and get its register recognised in law. Maybe some interested vets would like to read VN Times, we've been covering the issues of LVN vs RVNs for the past couple of years ;)

But, if she is still employed, which I doubt as she's got two young children (her reason for not appearing in person), her employer has gounds to dismiss her - she has been found guilty of professional dishonesty by a professional tribunal.

The RCVS did previously say they would put a black mark next to struck off RVNs on the electronic register on the website.

Regarding the burden of proof over the log entries - I had similar thoughts - but the college decided they were made by Tracy.

Robloxley - In terms of the interview with RCVS inspectors, when she admitting to updating Butch's records after the animal's death (which is what the DC has used as it's grounds for falsification) - an impartial vet from O'Reilly and Fee was there with her.

Best,

Emma C - Vet and VN Times - 01733 383561

Re: RVN RCVS DC case

Rob Loxley — Wed, 16 Jan 2013 22:07:38 GMT

[quote user="Hannah Wynne Richards"]If she's a VN then unfortunately it's true her employment can continue[/quote]

Her employer would surely now have grounds to dismiss her, and I guess she might have trouble finding future employment?

[quote user="Mark Hedberg"]My question was more about the standard of proof[/quote]

The burden of proof is on the RCVS; the standard of proof for criminal cases is ‘beyond reasonable doubt’; the standard of proof for RCVS disciplinary matters is ‘so as to be sure’ (the highest civil standard of proof which is tantamount to the criminal standard).
IMHO, I can't see how the College has proved beyond reasonable doubt that this lady billed up 4 drugs, when the system was open to anyone logging on as anyone else, which is the crux of the matter in finding her guilty, but then IANAL.

My reading of the report is that the nurse involved was neither present nor represented at the hearing. Did she have anyone advising/representing her at her prior interview with the College?

Interesting aside, the RCVS expert witness states "that Pentobarbitone was also used as an anti-convulsant as it was an old-fashioned remedy for the control of seizures. However when used in this way, the drug was normally administered in a weaker form i.e. not Dolethal. When used for controlling seizures the solution would not be pink coloured." Didn't Sagatal (to which I assume she refers) get withdrawn from the market years ago?

Re: RVN RCVS DC case

james herriot lied — Wed, 16 Jan 2013 13:25:23 GMT

[quote user="Mark Hedberg"]

Please note I don't wish to comment on whether the nurse is guilty or not; the standard of proof in this case makes me uncomfortable. I accept in advance any red stars this gets me; I wish to give no offense, and I admit that I did not personally attend the hearing.

But striking off is serious and the evidence simply seems a bit vague.

[/quote]

I'm in complete agreement with you there, Mark. The standard of proof here seems to be lacking, based on what you've cut and pasted. If the DC relied on a note from an interview, then that's a little lacking in rigour: what people say verbally can often be misconstrued, and when that's put onto paper it can be further open to misinterpretation. Were the DC played a tape of the interview? Did one exist? If so, did the nurse have a copy for use in her defence?

If the DC can't prove that nobody else entered the drugs, then where exactly is the certainty in the verdict? Anybody could have put those notes up. Surely the burden of proof rests with the DC to demonstrate that she did enter the drugs, not with the nurse to prove that she didn't?

I'm certainly hoping that the evidence presented here was more robust than the notes would suggest: if I ever get nobbled by a colleague with a grievance, I'd hope for rather more in the way of investigative rigour and a higher standard of proof than seems to be the case here.

Re: RVN RCVS DC case

Mark Hedberg — Wed, 16 Jan 2013 12:57:44 GMT

My question was more about the standard of proof; at the moment (and forgive me, i'm no lawyer) she said she wrote clinical data but denied putting in the injections on the file. There's a bit of a difference between writing 'the dog died' and putting chargeable injections on the file. They admit she had no financial motive for charging stuff on the practice management system. In fact, the practice has a non-password protected practice management system; so potentially, could someone else have put it on?

Certainly it's pure speculation on my part, but quite a lot of the case against the nurse seemed a bit of speculation as well!

(Just by comparison, Tomas Nasimek (Panorama vet) had a case dismissed last year against him because he claimed he couldn't be certain who put on charges on the file of an insured dog. )

But striking off is serious and the evidence simply seems a bit vague.

Re: RVN RCVS DC case

Hannah Wynne Richards — Wed, 16 Jan 2013 12:24:38 GMT

The real question is whether she willstill be a VN-because if so RCVS are powerless to really punish

Wynne

Re: RVN RCVS DC case

Gillian Mostyn — Wed, 16 Jan 2013 11:47:48 GMT

She will only lose the 'R' - the 'VN' bit is irrelevant - it is not a protected title so anyone can use it if they so wish.

Re: RVN RCVS DC case

Hannah Wynne Richards — Wed, 16 Jan 2013 10:47:36 GMT

If she's a non VN her employment can't continue as before-because it will be illegal for her to do anything more than kennel maid duties

If she's a VN then unfortunately it's true her employment can continue

Wynne

Re: RVN RCVS DC case

Clive Ansell — Wed, 16 Jan 2013 09:48:35 GMT

[quote user="Hannah Wynne Richards"]

if she qualified before RVN status existed she can't be stopped from continuing to work-an anomalythat should be done away with

Wynne

[/quote]

She can't be stopped from working anyway. I'm not sure if she retains her VN status or not, but her employment could in theory continue exactly the same but as a non VN. It is up to her employer if and how she is disciplined at work.

Re: RVN RCVS DC case

Hannah Wynne Richards — Wed, 16 Jan 2013 09:30:30 GMT

Honesty is the best policy-as my mother always drummed into me when I was a child

Having said that-if she qualified before RVN status existed she can't be stopped from continuing to work-an anomalythat should be done away with

Wynne

Re: RVN RCVS DC case

Mark Hedberg — Wed, 16 Jan 2013 08:51:14 GMT

Stem to Charge 2(b) - made entries in clinical records to the effect that drugs had been administered

114. As to the allegation that the Respondent made entries in the clinical records, the College relies upon the fact that the relevant entries carry the Respondent's name. It also relies upon the Respondent's admission during her interview with Mr Hepper and Mr Allen on 1 July 2011. In addition it relies upon the fact that the Respondent accepts she inputted some information on the computer records on 3 February 2011, which was completed shortly before the injection details were recorded, both being recorded sometime after Butch's death.

115. The Respondent denies that she entered details of these four injections on the computerised records. However this denial appears to be at odds with the Respondent's admission on 1 July 2011. The Committee is satisfied that the interview note is an accurate record of the interview and that the reference to the Respondent writing up the computerised records can only be understood as including details of the four injections. This is also consistent with the undisputed fact that the Respondent had shortly before that, entered what she described as "clinical text" on the same computer record. The Committee recognises that the computerised records are not password protected but it notes that it was usual within the Practice for members of staff to use their own names. After careful consideration the Committee is therefore satisfied that the Respondent entered details of the four injections.

116. As to the allegation that the Respondent had not administered the drugs the Committee has already found, as part of its consideration of Charge 2(a) that it was sure that the Respondent did not administer the drugs.

117. As to the allegation that the Respondent had not been informed that all or any of these substances had been administered, the Committee has already found that it is sure that the Respondent did not administer these drugs. Moreover there is no evidence that any other member of staff had informed the Respondent that they had been administered. Further the Committee notes that it is not part of the Respondent's case that she had been informed that someone else had administered the injections. Her case is simply that she did not make the entries on the computer record. Accordingly the Committee is satisfied that the Respondent had not been informed by any other member of staff that any, or all, of these substances had been administered to Butch on the morning of 3 February 2011.

118. Accordingly it finds the facts of the stem to Charge 2(b) proved so that is sure.

Charge 2(b)(i) - Dishonest in making entries

119. The Respondent had no reasonable basis for making any one of the four entries concerning these drugs. The Committee finds that the Respondent did not administer any one or all of these drugs on 3 February 2011 and that she had not been informed by colleagues that they had done so. The Committee notes that these injections would be chargeable items and is satisfied that the general public would regard the making of incorrect entries in such circumstances as dishonest. The Committee also notes that the Respondent was a senior nurse within the Practice and was highly experienced. Moreover, as set out in her letter dated 20 April 2011, she has lectured to and trained veterinary nursing students for many years. The Respondent has provided no explanation for these entries other than to deny that she made them. After careful consideration of all of the evidence, the Committee is sure that the Respondent knew that she was acting dishonestly when she made each of the four entries regarding these drugs. Accordingly it finds the facts of Charge 2(b)(i) proved to the required standard.

Re: RVN RCVS DC case

Mark Hedberg — Wed, 16 Jan 2013 07:59:12 GMT

There wasn't a great deal of good practice at that practice, was there? Although that circumstantial evidence seems to be composed solely of who the panel felt more believable. (The vets appear to have corrected their story at least once.) Hearsay.

Incidentally, noroclav and baytril may not be rational antibiosis, but enrofloxacin and amoxicillin are a synergistic combination and this is why it's commonly used.

Insinuating that the nurse was trying to hide evidence was poor practice; we're talking about a dog that had just died, surrounded by hemorrhagic diarrhoea. Do you HONESTLY want that kind of potential contamination back in the drawer?

Also, raise your hand if you've never accidentally entered case notes or treatment while logged in as another nurse or vet. Not through conspiracy, just not checking who was logged in.

Also...where's the motive? What possible reason is there? an offhand reference to 'panic' is simply speculation.

I'm probably being a bit devil's advocate here, but circumstantial evidence cuts BOTH ways, and there are more than one Sherlock Holmes and Poirot stories that would have gotten laughed out of court in real life. I do not know any of the parties, but I like a bit more evidence for my hanging parties, thank you.

Re: RVN RCVS DC case

Utlendigur — Tue, 15 Jan 2013 21:17:35 GMT

Skimming through, it sounds like the practice was in the habit of keeping part used bags of fluids and their giving sets to re-use on another patient and the dog died shortly after being hooked up to a drip - could another possibility be that a drip contaminated with pentobarbitone - from another animal that was pts - was used? Pentobarbitone was found in the samples - but was it at a high enough concentration to kill the dog?

Re: RVN RCVS DC case

Evelyn Barbour-Hill — Tue, 15 Jan 2013 19:46:48 GMT

I have read the whole report through.

[quote user="Gillian Mostyn"]I suspect the harsh penalty was as much to do with what couldn't be proved as what could![/quote]

If that were the case – and perhaps it is – it would be a gross injustice. These weaselly comments about "not proven" should not be permitted.

Re: RVN RCVS DC case

plantagenet — Tue, 15 Jan 2013 18:18:42 GMT

I wonder if their VDS subs will go up now?

Not such a bed of roses being a registered professional, I know many nurses who have realised that and don't want it.

Apart from being able to sign someone's passport photos I'm not sure its that much of an advantage.

And why don't they have their own royal college, you wouldn't get the medical Drs letting nurses join the the GMC.

Re: RVN RCVS DC case

Jill Nute — Tue, 15 Jan 2013 18:08:09 GMT

http://www.rcvs.org.uk/complaints/disciplinary-hearings/ for further details, scroll down to the table of hearings & click on the relevant section

Re: RVN RCVS DC case

Anne Seawright — Tue, 15 Jan 2013 17:27:03 GMT

Phew! Glad I am not the only one!

Re: RVN RCVS DC case

Clive Ansell — Tue, 15 Jan 2013 17:22:42 GMT

RCVS will possibly release more details in due course. There isn't enough information to make sense of it yet, we don't know if the dog is dead, or why she would say she gave meds when she didn't, or falsify clinical notes ???

Re: RVN RCVS DC case

Dagmar Steele — Tue, 15 Jan 2013 17:18:54 GMT

me too, didn't get it....

Re: RVN RCVS DC case

Tim Browning — Tue, 15 Jan 2013 17:15:02 GMT

I also am thick and thought the same , is the dog dead or what?

Re: RVN RCVS DC case

Anne Seawright — Tue, 15 Jan 2013 17:12:07 GMT

Am I the only thick person who doesn't understand? Is the dog dead or alive now? Was she trying to kill it or save it or did she just make a mistake? And what did she have to gain from putting in the records she gave 4 unprescribed drugs if she didn't? Long hard day so I could be completely missing the point....

Re: RVN RCVS DC case

Clive Ansell — Tue, 15 Jan 2013 16:28:42 GMT

Although off the register and no longer a RVN, can she still use the title VN?

I guess she can still work in clinical practice, even the same practice, she just no longer has RVN status. In fact she could continue working exactly as before??

Re: RVN RCVS DC case

Gillian Mostyn — Tue, 15 Jan 2013 16:21:26 GMT

[quote user="Mark Hedberg"]...the question now is, what effect will this have on Ms Nicholls?[/quote]

It all comes down to who is willing to employ her...and in what capacity!

Re: RVN RCVS DC case

Mark Hedberg — Tue, 15 Jan 2013 16:09:32 GMT

Possibly - but what could be worse than being struck off, if she had been convicted of injecting the dolethal?

...the question now is, what effect will this have on Ms Nicholls?