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.

OP I am sorry that you haven't been offered support by your organisation but not surprised. I spent time working as a front line child protection worker and we all wanted to get through our careers without any child on our caseload getting seriously harmed, it seemed more luck than judgement and we knew that our employer would drop us hard and fast if anything did go wrong. It is a very isolating place to be in.

OP, firstly I want to echo what PP have said about the letter having to state all the possibilities, and dismissal is possible in cases of gross misconduct.

I am surprised that you have not been suspended on full pay in the meantime if it is gross misconduct, while the investigation (which can be very lengthy in the NHS, I know) is carried out - did you go off sick straight away?

OP: Daisychain is right.
How long has this been going on and has anyone advised re delays, etc, when hearing may take place?
Meanwhile you should have been offered EAP type support and as you are off with stress and anxiety you should have been referred to OHP as a duty of care to ensure you are fit to attend the hearing.
Meanwhile if you aren't suspended you need to look into whether you should return to work. If you are at work there is an argument to say you are safe to be there and a dismissal would undermine managerial judgement.

It sounds like a formal sanction short of dismissal is likely but try to ensure you don't end up with a bad absence record as well.

I am nervous about giving too much detail as I don't want to be identifiable and compromise any confidentiality issues. I don't know what EAP stands for I'm afraid but no there was no offer of Occupational Health and I had to push to self refer. My attendance was very good before this but I really have not been able to work during this investigation. I feel it has destroyed me. I understand the need to be thorough and impartial but if frontline staff treated patients in this way we would be in trouble. I don't understand why there can't be some support and information for staff going through this harrowing experience.

EAP means employee assistance programme, and if it exists, can offer services like advice and counselling - exactly what's on offer will depend on what the employer pays for, I guess. It's fairly common in big corporates, but I don't know about public sector.

but no there was no offer of Occupational Health and I had to push to self refer

Sometimes events take over and there is such a hive of activity surrounding the investigation that the human being at the centre of the issue is forgotten. It is dehumanising, but perhaps it's understandable under the circumstances, OP and not intentional on the part of those involved in the investigation. Something to rationalise (in order to cope with it) rather than feeling it's a punishment?

OP I've checked and it seems EAP is provided, but I expect it could depend on your NHS Trust as to how you leverage the Service.

If you have access to your intranet, you could try searching for it, as it gives you completely independent access to the counselling and your employer does not have direct visibility of you using the service, for confidentiality reasons. They are bound by Confidentiality regs.

Please try and access some more counselling OP, you really do sound traumatised. If their attitude was similar to some of those on here then that's hardly surprising.

I am surprised that you have not been suspended on full pay in the meantime if it is gross misconduct, while the investigation (which can be very lengthy in the NHS, I know) is carried out

It’s rare that we suspend - would have to be no part of any job they could do without risking the investigation. We have moved staff into other posts/changed supervision/access to systems etc.

Every single letter we send relating to disciplinary/long term sickness etc has the details of our EAP on it. Doesn’t mean staff bother accessing it, of course.

I'm so sorry Esmerelda. I was in the same boat. After 30 unblemished years with no problems or mistakes I went to work when I was ill because we have a draconian sickness policy and made a really bad mistake which although the person was not harmed long term they had to go into hospital and have IV antibiotics. i was just sacked.
I spent a month in bed with serious depression and then had to go in for cancer investigations as they thought i had cancer. I don't but it turned out to be a serious illness.
Past unblemished record counted for jack shit. i had left the NHS a year previously and this was a private employer.
It does very much depend on the trust you work for. My NHS trust would have been very supportive and I very much doubt it would have come to this. Others aren't so supportive.
I'm so so sorry it has come to this everyone should be cut some slack we all make mistakes and it's far more important that we are open and honest about those mistakes and take steps to get the support to make sure they don't happen again.
I've been scratching about for work ever since and suffering from serious depression. I hope they see sense in your case and just suggest retraining in that area. Stay strong.

My heart absolutely goes out to you. This is why I am quitting nursing as of next week.
I am terrified of something like this happening to me because we are too stretched and under resourced to do our jobs properly.
You cannot safely look after such a high number of patients, and the minute a mistake is made it all comes down on you like a tonne of bricks. I've seen it happen to too many of my colleagues and I've had enough.
You poor, poor thing. Hugs from me x

and I'm pretty certain that whatever it was you forgot, was because you were also looking after another 10 thousand patients, one of which had arrested/fallen out of bed/some kind of imminent danger. I get it, OP. You are only human x

This was me 2 years ago - 20 year unblemished record seen as a rising star/mover & shaker etc made a stupid mistake.

Did the right thing and accepted responsibility, investigation process was horrendous as was the hearing. Absolutely flagrated myself at the hearing, could not have been more remorseful and felt a deep sense of shame. Was found to have committed gross misconduct and downgraded and offered such piss poor jobs I had no option to resign. Then threatened with referral to NMC for resigning. It really took me to the brink where I thought "would my death be what they wanted."

I wish I had lawyered up and did not rely on RCN rep. I wish I had someone who has fought my corner and flung back at that all the times I put my job over everything. I didn't deserve to lose my career over this and wish I could have had the strength to go into the disciplinary all guns blazing.

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.

^ This, 100%. I'm so sorry you have not had support - it's not okay. Is it usual in your Trust for the line manager to undertake the investigation? Seems a bit wonky to me. It really should be done by someone impartial and uninvolved. It sounds like there were a lot of factors that contributed to your error. They need to be given due consideration. It's very short-sighted just to blame an individual without looking at the whole system. If they dismiss you and someone else makes the same error in the same context, then it was a wasted opportunity. You do need to push back as well. If you were unwell and didn't take sick leave because of the consequences then you must state that.

I feel so sorry for you. You deserve kindness and understanding.

My God. I am truly shocked at the pain expressed by people working in health care who give so much for so many years. Then when you hit a crisis and need the support of the organisation there is literally nothing there. Worse, you are seen as an enemy to be punished and vilified. And those who judge have likely never been in your shoes. They could not hack the hours, the stress and the sheer blood, sweat and tears of our daily lived experience. I do not wish for poor practice to be ignored but surely there can be some humanity in all this.

Then when you hit a crisis and need the support of the organisation there is literally nothing there.

I’d be genuinely amazed if there was no support available to you both before, during and after the incident.

It’s a common theme with hearings that the wrongdoing is blamed on depression/anxiety/home issues/understaffing. When checked there is almost never any diagnosis/record of any discussion with a manager about it. One continued to blame understaffing when there were almost double the required number of staff on duty. Perception isn’t always truth.

I am in the process of putting measures in place to help staff to talk any it and deal with issues - work and home related. In truth, most of the support is already available. Staff just aren’t aware of it or choosing not to use it.

And those who judge have likely never been in your shoes. They could not hack the hours, the stress and the sheer blood, sweat and tears of our daily lived experience.

We’re a very small NHS trust, and we always make sure the disciplining officer either has the relevant background or has somebody with that background as professional advisor. So a nurse would not have a hearing without a manager with a nursing background being in the room.

That's just how I feel whenever I visit a hospital Esmerelda. Something is rotten to the very core. Actually as a patient I think i could forgive a serious error, owned and apologised for (maybe not the wrong leg being cut off) What I can't own is exactly as you describe, a service that truly seems not to give a flying fuck about anyone. In your shoes, if you have the money I'd write and say they have failed you and made you ill. Tell them the length of time they have taken, the failure to provide EAP or OHP, etc. and that you are resigning in light of that and feel you have no alternative. Then watch them fizz as they smell the potential constructive dismissal.

I have twice hired an ex NHS HR professional. Twice they have been out if date and technically incompetent.

Please do not resign, OP. At least see the process through to a conclusion, as you don't know yet what the outcome may be.

MoreSlidingDoors, if the ‘support’ offered by your organisation has an unsupportive, blaming attitude, unwilling to look at external factors (e.g. staff numbers are only part of understanding; skill mix, patient acuity and staff morale are factors too among other things) then of course your staff don’t access it.

EAPs do not have an 'attitude', they are entirely separate to the organisation and are helplines for large numbers of organisations, they are run by companies like AXA. The people you speak to don't go and check all your policies before they answer, it's simply emotional support and sometimes some legal support (though they don't usually offer legal advice for employment issues, for obvious reasons).

Oh dear, Stressy, showed yourself up there!

MoreSlidingDoors, hopefully your trust has been successful with the exceptional approach that you describe. However, what I’m hearing is the same thing we get. You say there’s an officer with a nursing background, that turns out to be someone who hasn’t practiced on the frontline in recent years and often never at the trust they are at. With the best will in the world, they don’t truly appreciate the issues if they aren’t facing them. That would never happen in medicine: however high up the doctor in the managerial ladder they still maintain frontline work but in nursing and midwifery managerial work is an escape from that. It’s so easy to forget how decision making in humans is affected in the middle of a hectic night shift. Even over the last 5 years acuity has changed massively - what was high dependency care then is normal now and austerity has compounded problems. You say staffing is fine, what I see is an increase in junior staff requiring more and more support as the experienced staff burn out and leave. Or bank and agency staff who can’t access IT systems or staff pulled from other wards who aren’t familiar with the environment or specialty they’re asked to work in therefore more likely to make an error despite being competent clinicians. But staffing numbers were ok so that’s not looked at any further. There is so much evidence about these issues, but management (and, it seems, HR) don’t understand or don’t want to deal with it. We raise concerns but the constant dismissal of them obviously leads to us doing that less and less. The last thing you want to do after a hectic shift is be told yet again you should be able to cope. Take a look at the WHELM report. It was commissioned by the RCM as a definitive look at the issues facing midwives which would be a blue print to improve conditions. Turns out the findings were exactly the issues we all expected which would be quite awkward to deal with. So it was hushed up.

And if this incident was last year, it sounds as though it is not being managed according to usual HR principles. Surely it should be done in a timely manner to minimise distress, but it’s somehow allowable for other departments to break policy or make an error even though it’s having such negative consequences for you.