MH nurse slept with patient

[Ihaveaquestionn]

MH nurse at the local doctors surgery contacted my the patient (my friend) on Facebook after carrying out an assessment over the phone and discussing medication among other things.

The tone of the messaged escalated and they met up and had sex.

MH nurse then turned VERY nasty and borderline abusive over message when my friend made it clear they did not want to pursue anything more serious given their current life situation (MH problems, debt, work stress, children to support)

Not saying my friend is completely innocent here - it takes two to tango. But given the nature of their interaction it’s clear they could be in a vulnerable mental state and I am disgusted at this nurses behaviour. I think it’s completely unprofessional and inappropriate.

They also happen to be my point of contact at our local surgery - who I have been in contact with multiple times during a period of PND and other issues. I suppose I trusted this person and am now feeling quite shocked.

My friend won’t report them. Would I be unreasonable to?

(I have seen messages and pictures that confirm everything above. My friend is not making this up)

YABU - it’s none of your business, stay out of it

YANBU - you need to raise a concern for the sake of other patients

@poetryandwine
The reality is that even if the OP’s friend reports it that it may go absolutely nowhere.
The police may investigate.
The NMC might decide that there is no case to answer if the OP’s friend is hesitant to give evidence or the NMC could decide he’s not credible.
Likewise with the practice manager.
As I’ve said, I have experienced sexual assault by a consultant paediatrician in a hospital, who instead of being sacked is now the clinical lead for Children’s Services.
It doesn’t always go the way it should- even with all the right agencies doing the right thing.
That said, the OP is right to have the concerns but it’s not like the regulatory bodies for HCPs act as decisively if it’s a member of the public raising a concern rather than “one of their own”.

@Blue4YOU I am so sorry about your experience. It sounds horrific. How are you doing now?

I wonder whether the fact that the HCP was a consultant put a different complexion on the episode? Rightly or, in many cases, wrongly, rank carries authority.

The main concern here is not to traumatise OP’s friend to no end if he is fragile. The nurse needs to be dealt with as robustly as possible, but not at the expense of breaking someone. I very much hope the friend can be supported to play his part in bringing her down, but it may not be ethical to ask this of him. We can’t know.

Exactly - I am very concerned about my friend and do not want to cause him any distress but also cannot ignore the risk to other patients. I’m not going to do anything without thinking through every possible outcome. It is very hard.

I personally have NO evidence at all. I am absolutely convinced the evidence I’ve seen is legitimate and have no doubts about what has happened but cannot personally prove it

@poetryandwine
I couldn’t agree more.
Im a shell of the person I used to be. I feel like everyone thinks I’m a liar or “unhinged” or both.
I have horrific nightmares about him.
Ive started SH again (trigger warning so using abbreviations), started smoking again, am constantly irritated and tired, can’t sleep, have panic attacks and everywhere locally I go I am terrified of running into him (because I did once meet him on a train by coincidence and before he did assault me), have lost close relationships with family, have lost friends, have problems in my marriage, don’t trust anyone etc.

Its definitely not something to do lightly

I am very sorry, @Blue4YOU . Are you getting any help with this? Best wishes

you do have a duty beyond your friend though, and you can be outraged as a patient at that practice. You don’t need your friend’s permission to report this, and I’d say given he has MH issues he is the more vulnerable in this scenario so I think your call of duty goes behind his express permission surely?

she will be investigated but that wouldn’t necessarily need your friend’s permission either. She may have done this with other patient’s too?

i would try and put your wider concerns about her behaviour and the risk to other people above the fear that your friend will be upset with you if he finds out you have reported it

Have you been offered the Rewind Technique or EMDR? Both of these could help with flashbacks, panic attacks, nightmares etc. It's being stuck in the traumatic situation but being helpless to do anything about it (through fear or shock) that causes these reactions. The memory becomes frozen and unprocessed, which means that when you are reminded of it, it seems like you're re-experiencing it in the present. The techniques I mentioned can unfreeze the memory, so it can be processed and you can remember it as an unpleasant but not traumatic event and increase your sense of agency and control.

Lots of counsellors and therapists offer both these techniques and for some people it can only require one or two sessions to reduce the level of distress.

100% report it. You have a duty. That asshole deserves to be in prison. I really mean it. No matter what the situation, no matter how much provocation, a mental health nurse (or a psychiatrist or GP, or whatever) does not have sex with their patients. People with mental health problems are vulnerable - by definition. He took advantage of that.

Also, is this a regular thing? Maybe he often has sex with women he’s supposed to be caring for.

You don’t need your friend’s permission to report this, and I’d say given he has MH issues he is the more vulnerable in this scenario so I think your call of duty goes behind his express permission surely?

OP doesn't need his permission, any member of the public can contact the NMC if they have a concern about a registered nurse. But as OP personally has no evidence to back up her claims, if her friend does not wish to cooperate with an investigation and does not agree to talk to anyone from the NMC, or denies what has happened then the investigation is unlikely to go anywhere. PP telling OP the nurse "will" be struck off are jumping the gun. It will be looked into, but they can't strike someone off the Nursing register based on hearsay, there would have to be clear evidence of wrongdoing and even then there is no guarantee that removal from the register is the outcome as there are other sanction and recommendations that could be made depending on the evidence available. So for example, if there was clear evidence she'd searched for OP's friend and contacted them on social media, but no evidence a sexual relationship took place, that would be a breach of the NMC code but not necessarily a "striking off" offence.

@Pinkspice and @poetryandwine
Thank you both. I’ve had private EMDR therapy and it did help. I need more though, so am trying to book some sessions.

back to this nurse though- it is definitely not necessarily a striking off offence (it should be but I’m assuming the NMC has to take a proposed “striking off” to a Tribunal, just as the GMC does??).

Pp - it’s a female nurse and male patient.

it makes no difference in legal or misconduct terms but just so the OP is getting the advice she needs… Don’t want to derail your thread OP

You don't need to worry about all of that OP - social workers and police officers are very sensitive to this and will also seek evidence via the MH nurses phone. They have teams to deal with this. Your friend will be treated as a vulnerable person, their confidentiality respected at court and in the case (Will be called "Patient A" etc) even if they decide not to give evidence.

It'll be easy for the MH service to provide evidence / check that they are a patient under CMHT. That's sufficient for it to be pursued.

In this instance there is an over rising public protection safeguarding so you are right to be shocked, angry and upset at this nurse's behaviour. No good professional would breach that line with their patients / patients of their service - people they know are in midst of MH crises / vulnerable in any way. It is such a big red line no one would or should go near from a position of trust. That's why it's a criminal offence if the nurse worked with him before and he was still under the service.

police officers are very sensitive to this and will also seek evidence via the MH nurses phone.

Again, not necessarily. They can only seize her phone if they have reasonable grounds to suspect it contains evidence pertaining to a crime. If OP's friend is not willing to cooperate with any investigation of denies anything untoward has taken place they would not have grounds to seize her phone.

Thank you,@Tiani4 . That is incredibly helpful about both the phone evidence and the knowledge that the OP’s friend will be treated carefully.

I agree, you must. This is pretty much the most serious breach of professional standards possible, and there’s every chance that it’s happening with other vulnerable people.

Big development - I have spoken to my friend and essentially explained the severity of the situation. He has agreed that if I report her, he will tell the truth if asked. He is also sharing some screen shots of their conversations.

I have seen their conversations in more detail now and she has explicitly said she knows she is crossing a professional boundary.

So where do I go from here? Some people are saying go to the police first, others saying go to the practice manager.

My gut feeling is to report her to the NMC first and then let the practice manager know I have done so.

I have to admit I am worried he won’t be given the same treatment as a female victim, especially when it comes to the police. Not sure why I feel this way.

That's why it's a criminal offence if the nurse worked with him before and he was still under the service.

It may be a criminal offence. It depends on a number of factors, including the nature and extent of OP's friends MH issues. Whilst a Nurse sleeping with a patient is always unacceptable according to the NMC code of conduct, it may not always be deemed to be a criminal offence. There have been similar cases where no criminal charges have been brought due to insufficient evidence, but the NMC have taken their own action as they can work on the balance of probability, rather than having to prove beyond a reasonable doubt in court. Also, someone with mild/moderate anxiety and low mood whose cognition is fully in tact may be deemed as having the mental capacity to consent to sexual activity, whereas a paient detained on an inpatient under the Mental Health Act in the throes of a psychotic episode would be less likely to be deemed to have capacity. Again, either scenario would be unacceptable in the eyes of the patients employer and the NMC, but there are degrees of misconduct and proving criminality is more complex.

To be clear, I am in no way excusing or minimising this Nurse's appalling conduct. It's indefensible. But I think its important to manage the OP's expectations around what may or may not happen in the event she does report this, as there is a lot of assumption and oversimplification on this thread.

In terms of his MH - he absolutely has the capacity to consent to sexual activity. He is a bit of a player actually and that’s why I am worried he won’t be taken seriously.

In my mind it’s not about HIM as such, it’s about HER and the risk to other patients.

The messages from her are actually quite worrying, she doesn’t sound very stable either.

she’s also calling me later to discuss my own medication - I will probably ignore the call as I don’t think I can speak to her

Would just like to thank everyone for their thoughtful responses. I was very worried about posting this but you’ve all been very helpful and given me a lot to think about.

It's definitely worth reporting asap op as this person is in a position of trust

He is a bit of a player actually and that’s why I am worried he won’t be taken seriously.

The flip side of this is that some MH conditions can manifest in risky sexual behaviours or loss if inhibition so this is why every case needs to be looked at individually. Regardless, what this Nurse has done is a breach of her professional standards so I am pleased to hear you're going to report.

Just hypothetically and not attaching any suggestion to this situation, is it not possible for a nurse to be sexually exploited by a patient then? Would the assumption always be that she holds the power?

I think you raise a valid question but the fact is the nurse reached out to the patient via Facebook, instigated the sexual nature of the conversation, and has continued to pursue the patient and contact him via other social media platforms since they were intimate.

Im not saying he’s “innocent”, but he is the patient and therefore the victim I suppose.

I might be phrasing this wrong but I would argue that if she is vulnerable enough to be taken advantage of in this way she should not be practicing as a MH nurse?

Report! Was the chap a definite RMN? I would definitely contacted the head manager of his team (psych liaison / CMHT / HTT whoever it may be). That is not allowed (I work in Mental Health and there are strict boundaries not to cross! People we see are extremely vulnerable and we must be careful of our words and actions when we interact with people in crisis. Please encourage your friend to report (if she feels ready and able to) as this chap is likely to be doing this to other vulnerable individuals