Disciplinary hearing.

[Esmeralda67]

I have worked in the NHS in different clinical roles for almost 30 years. Had promotions and no issues from clinical or behaviour point of view in that time. Clean record. Last year I made a serious mistake and a patient could hve died as a consequence. I recognised what I had done and accepted an investigation was necessary. However I have been repeatedly told that I now could face a summary dismissal for gross misconduct and I don't know how to go on. I fully accepted my mistake and feel destroyed by the whole process. Not one person in the organisation has offered any support and the stress and anxiety is killing me. I have my hearing soon and I honestly feel suicidal at the prospect. I have lost my career my good name and risk losing my income. I have support from friends but feel so isolated and ashamed.

I'm afraid that's how it works @Princessdebthe1st
You remove the people who have historically caused patient safety errors so they cannot repeat offend.

Indeed.

Trying to fix cultural issues as seen in the likes of Mid Staffs by not following disciplinary process in the light of potential misconduct is bonkers.

Wow! I agree that patient safety is paramount and at no point would I sweep these things under the carpet but if the individual is singled out and sacked then there is no opportunity for improvement. People work within a team and a system not in isolation. Because of confidentiality my colleagues will not be told the nature of my issue so who is learning? Who is benefitting? Does 30 years of unblemished record truly count for nothing? If so then maybe I am better out of it because the sheer numbers suggest that staff will always make mistakes. Would you sack them all? I honestly am not making excuses but this is punitive to the extreme.

Pretty, it is not an offence. Any healthcare professional who tells you that they have never made a mistake is either lying or so lacking in self awareness as to be dangerous. Handled and supported correctly people who have made errors can become your most effective patient safety advocates.I am a senior member of the patient safety team in one of the largest NHS organisations in the UK and this is the approach we take. And just as a matter of interest, if we got rid of everyone who makes a mistake who do you think will be looking after the patients.

@MoreSlidingDoors I'm really inclined to agree with you.
Time served within any organisation shouldn't be mitigation alone for their actions.
I'm sorry but patient safety is paramount and a full and proper review is really important for everyone to learn from it. Which the op seems to agree with.

There is no mention of what happened to the patient. Did they make a complaint or did they know what happened to them?

I have been really badly treated by some clinicians within the NHS and they do act invincible and think that they shouldn't have to answer to things because of the length of time they have served, their degree or whatever else, their union, ACAS etc

I would wonder why the process has taken so long? I imagine to gather all the info but that would be the only thing I would query.
Sorry your mental health has really suffered. It's awful. But what happened with the patient as well ? are they suffering too?

We must all live with the consequences of our actions and mistakes. That includes things like knocking someone over and killing them when we drive or Making a mistake at work. Or breaking things that are precious.

I believe there is a difference between someone who knowingly covers up or lies about practice and somene who makes an error. Even if their training and experience suggests they should have known better. If you only have staff without any mistakes of any magnitude then you will be cared for by very junior and inexperienced staff who simply haven't had time to mess up yet. Surely staff have to learn and be supported in that. I find your zero tolerance approach very harsh but if as you say that is the norm now then I truly fear for the future of our NHS as well and maybe it is time to go.

In response to roundligament the patient was compromised by my failure to act but (thank God) subsequently made a full recovery and there has not been a complaint as far as I am aware. I have never disputed that an investigation was necessary and no one has suggested I deliberately caused harm, but does sacking me mean this will never happen again? To anybody? Or would my experience actually inform practice better?

I find your zero tolerance approach very harsh

Where are you getting that from?! Many cases don’t get as far as a hearing. The ones that do are very, very serious indeed.

It sounds like you needlessly caused a patient harm. That should be investigated, and if it’s found to be a matter covered by disciplinary policies it should rightly be heard. It doesn’t mean you will or should be sacked. But if I nearly kill someone (for example) then a row with my husband (for example) shouldn’t mitigate for that mistake being made.

So you left someone to suffer, when you are meant to keep them safe/ make them comfortable.

Yes you should face a disciplinary. Time served is irrelevant. Maybe you are becoming immune to people's pain having worked there for thirty years.

If you think it's taking a long time to investigate contact HR.

I hate it when i am left to suffer without my bell. Or have an infection ignored. Or get told to breathe through pain. Or get double dosed on pain killers.

Lessons can be learnt from your actions by others regardless of if you're still working at the trust or not.

And finally if you ignored something so bad that the patient could have died you really do need to think about the reasons why you did that.

@MoreSlidingDoors

You dont explicitly have a zero tolerance policy but we all should any way for failing to act on a patients care to such a degree they could have died.

Jesus Christ it's not harsh OP it's to protect society and the most vulnerable we need to have a zero tolerance policy!!
Owning up to it doesn't make it ok

Maybe it.depends on why you failed to act, was it because you were busy elsewhere, didn't know what needed to be done, didnt escalate concerns, didn't listen to your colleagues. Maybe that's what they look at. Did they hold a patient review at the time.

OP, I would post this on a professional forum or possibly not post at all. You will get responses that have no understanding of systems errors, the Swiss cheese model and a just culture (with some notable exceptions). It is easy to say that removing people who makes errors makes healthcare safer. In reality that is far, far too simplistic and unless we look at systems and processes then the errors will happen at all, just a different person will make them.

I agree, look into information about a ‘just culture’. Stay away from social media (unless professional). It makes people feel better to assume only bad people make mistakes. It’s simply not true. I’m absolutely not saying there should be no investigation etc but zero tolerance is an unhelpful ideal. In addition it leads to the smaller errors not being reported so the systems don’t get looked into so bigger errors then get made.

Esmeralda, I completely agree. My colleagues and myself live in fear of this happening to us. In my line of work, the Trust will not sign off an investigation report unless there’s a learning objective (ie blame) for a nurse or doctor. Due to differences in the disciplinary system, the nurses are the ones to get the blame as the doctors learning outcomes are hard to evidence as they aren’t directly employed by the hospital. Usually, the actual problem is a system error (staff shortages, high activity or acuity, inadequate skill mix, delays due to insufficient IT infrastructure for the tasks we must only do electronically now, missing or broken equipment). All these we raise to middle management and our concerns are dismissed. So when they lead to problems or delays these same managers who carry out the investigations are hardly going to admit they have any role to play. Instead, they blame a nurse who was at the end of the line of a string of problems. Moreslidingdoors - the errors you describe are completely different to those where patient safety is compromised due to the state of our working environment. Yes, of course there are clinicians who aren’t fit to practice but they will have a string of concerns raised or smaller incidents throughout their career. Princessdeb is giving me some hope that things may change but it needs a huge shift in thinking.

Just wanted to send you these OP
I don't work in healthcare, but a professional field where people can make mistakes with big consequences.
We are all human. And mistakes are part of how we learn.
Can you talk it through with a friend or colleague? More counselling could help?
Know that whatever will happen, you will survive, you will get through this. And sometimes the darkest hour is just before dawn.
Best of luck OP.

OP, your union should have told that in addition to the normal rules of being able to bring a companion or union rep, in situations where loss of job would lead to loss of career (there are test cases on this in both healthcare and teaching) you also have the right to bring a lawyer to any hearing. In your shoes, I'd get one lined up. Don't just rely on the union, sometimes they are quite close to senior execs and do trade offs you won't know about.

Highway, so much of what you say is so true. Every time you're short staffed, wrong skill mix, equipment failure, drug shortage, write it on an incident form and send it to management. Keep a copy, when a mistake happens due to any of these things it's a tiny bit of evidence to say it was escalated, management knew and nothing changed. The answer will probably be that will be dealt with separately and you'll still get the blame but you have to try and stand up to the bullying blame culture. All you can do is act in the best interests of your patients, sadly some staff dont and should not be practising and some are incredibly uncaring and arrogant but always seem to get off lightly.

Have you spoken to ACAS at all? They were excellent when I was facing disciplinary. They helped a lot with the legal aspects, such as how the disciplinary was conducted being completely wrong. They might be able to help you with the process and any appeals you could make against the outcome.

Also is there any way you can try to see a counsellor or someone to help with your anxiety? Sorry you're going through this. It's awful and terrifying. With mine, I knew I'd done wrong but it didn't stop me feeling sick with the worry of it all

I have to say I am really pleased that the responses after my post have been balanced and supportive. A just culture helps everyone (staff and patients).

OP - there but for the grace of God...

Some of these responses are so typical, yet still depressing.

Thank you for kind messages. I really don't want to create an "us and them" approach but it is so easy to judge when reading a report at a civilised hour over a cup of tea when you can have a wee when you need one and judge other people for their short comings. At 4 in the morning after several night shifts (which was the case here) and a busy unit dealing with trauma and distress and trying to keep a smile and follow protocols and support other staff and deal with issues in personal life (bit more than a row with my partner!) then it can feel very different. Something got missed. I will regret it forever but does that mean I have to sufer indefinately? Maybe it does.

OP

And thank you to all who work in the NHS with these risks hanging over them. Yes things need to be investigated but we want to encourage system change to minimise the risks not make people scared, anxious etc

Unfortunately, you can’t have a fair investigation without a) asking difficult questions and b) digging to a certain extent. That it upsets people is an unfortunate byproduct, but there isn’t really any way around it.

Esmerelda I don't know fully the circumstances, only what you've posted on here (and nobody else knows either), but please know that "this too will pass".

What seems overwhelming now, and all too easy to reproach yourself for, will at some stage no longer be a crisis, but a phase that happened, with all the dehumanising that goes on as part of the investigation process.

Keep it in perspective even while those around you might turn it into a witch hunt or who might need to follow the tick box exercise of the process.

Perspective: this is not some evil act committed in malice and in a premeditated way. Your action was not evil nor premeditated but somehow the ball was dropped, whatever. You can't change it.

You seem to have a sensible head on your shoulders and know that realistically, whatever has happened, you cannot turn back the clock nor undo whatever "it" was you did/didn't do. After 30 years, no matter what good you have done during those years, now through the cruelty of that thing called "Life" you're potentially being hauled over the coals.

Keep your head high, cooperate with the process and quite honestly take the rap, if that's required. One step at a time.

They do have to give the worst case scenario, to pre-warn you. It's possible a bullet point buried in their 20 page Disciplinary process. One step at a time, don't prejudge or predict, it will drive you round the bend. So sorry you're going through it

Not one person in the organisation has offered any support

This sticks out to me and speaks volumes