Standard of nursing care in a correctional setting
- Published 07.04.2021
The Queensland Civil and Administrative Tribunal recently determined a disciplinary referral relating to whether a registered nurse had engaged in professional misconduct relating to her care of a patient in a correctional centre.1
Nursing staff were required to treat and monitor a prisoner who had suffered a head injury at the correctional centre. There were no medical staff on-site, but assistance was available at a nearby regional hospital.
In advance of the hearing, the practitioner made limited admissions of professional misconduct but the matter proceeded because significant matters remained in contest. The findings made confirmed the standards of care applicable in a correctional setting, especially where there may be serious consequences from delayed care.
In addition to the evidence of witnesses and an independent expert, the Tribunal had before it CCTV footage of the events that occurred within the correctional center, including when the patient was under observation in a medical unit.
Relevantly, the CCTV showed the patient was capable of walking immediately after he sustained the head injury. Several hours later, he was cleared to return to his cell even though it was apparent his health had deteriorated and wheelchair transportation was required. The nurses acknowledged they ought to have recognised his deterioration and did not undertake adequate observations and examinations. Immediate transfer to the nearby hospital should have been their response.
After watching the CCTV footage and receiving evidence, including from an independent expert, the Tribunal found the practitioner’s behaviour was explained by her belief the prisoner was faking his symptoms. The practitioner’s registration was cancelled.
This case is a sharp reminder that there is one standard of care for patients, whether they are in a correctional setting or in a hospital with clear supervision structures and medical staff on-site. It is particularly relevant for health practitioners caring for patients incapable of approaching staff when unwell or incapable of communicating whether due to their injuries or because of language barriers.