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Brooke Steinhoff (formerly Rasinaho) 0554998
Allegations and Plea
The College alleged that the Member performed sternal rubs or other acts of physical discomfort upon the Client; recruited or assisted a colleague to perform sternal rubs and to flick the Client’s head and face, or to perform other acts of physical discomfort upon the Client; acted in an intimidating or threatening manner toward the Client; failed to intervene to protect the health and well-being of the Client when she was being abused by a nurse; and engaged in conduct that would be regarded as disgraceful, dishonourable or unprofessional.
The Member admitted to the allegations, and the College and the Member jointly submitted an agreement to the following facts.
The Member worked in the emergency department of a hospital. The adolescent client had been brought in by police after having been found bleeding from the wrists, with a decreased level of consciousness due to alcohol and drug consumption. She had no identifying information with her and she was not willing or not able to provide her name to staff, despite several attempts to gather this information.
The assigned nurse, Nurse A, performed a light sternal rub because the Client was not responding to voice or touch. The Client winced and moved her arms and shoulders, which indicated that she was conscious. Nurse A stopped applying the sternal rub.
The Client was conscious and interacting with staff but was non-verbal when Nurse A went on break. While Nurse A was on her break, the Charge Nurse asked staff to rouse the Client to try to obtain her name. The Member volunteered to assist. The Member and Nurse B went to the Client’s area. The Member performed two sternal rubs on the Client, who was not responding to voice or touch, causing the Client physical discomfort. If Nurse B were to testify, she would say she saw the Client shaking her head, resisting, crying and squirming. The Client did not give her name when asked by the Member. Nurse B was uncomfortable with the Member’s actions and left after about 30 seconds.
The Member then paged Nurse C to assist. Nurse C applied sternal rubs and flicked the Client in the head and face, causing her discomfort. The Member did not intervene.
The Member made a number of suggestions in the Client’s presence: she suggested changing the Client’s Attends, inserting a catheter, calling the police and cutting dreadlocks (the Client’s hairstyle).
If the Member were to testify, she would say she raised the possibility of calling the police because of the Client’s young age, and she talked about cutting hair because she had a friend who had had to cut her hair in order to remove dreadlocks.
During this time, the Member and Nurse C asked the Client for information about her identity. The Client was crying and did not respond. The Member and Nurse C left.
When Nurse A returned from break after approximately 40 minutes, the Client’s heart rate was over 130 bpm. She was upset, crying and gasping, and she could not catch her breath. She was transferred to the mental health unit. A physical assessment was conducted. The Client’s sternum was bruised and tender after she received at least six sternal rubs by Nurse A, Nurse C and the Member.
The Panel had concerns as to whether the allegations were proven by the facts in the Agreed Statement of Facts. After multiple submissions and advice from independent legal counsel, the Panel made certain findings of professional misconduct.
The Panel made no finding of professional misconduct with respect to the portion of the allegations that the Member assisted a colleague in applying sternal rubs, flicking the Client’s face or head, or applying other acts of physical discomfort upon the Client, but did find that the Member recruited her colleague to do so.
The Panel found that, although recruiting a colleague to perform these acts of physical discomfort for a non-clinical purpose amounted to a breach of standards, it did not amount to verbal, physical or emotional abuse of a client since the action was directed toward a colleague and not toward the Client.
The Panel found that the evidence supported findings of professional misconduct with regard to the remaining allegations. The Member contravened the Professional Standards, the Therapeutic Nurse-Client Relationship standard and the Ethics standard. She abused the Client verbally, physically or emotionally. The Member’s conduct was unprofessional.
Submissions on Order
The College and the Member jointly sought an oral reprimand and a three-month suspension. The Member would be required to complete specified remediation activities in preparation for a series of meetings with a nursing expert. For 12 months from the date the Member’s suspension ends, she would be required to advise the College of her employers, provide employers with a copy of the Panel’s decision and reasons, and only practise for an employer who agreed to advise the College if the Member breached the standards of practice of the profession.
The Panel accepted the joint submission as reasonable and in the public interest. The Member accepted responsibility for her actions and cooperated with the College by agreeing to the facts and proposed penalty. The Panel found that the penalty addressed the elements of general and specific deterrence, rehabilitation and remediation, and public protection.
The seriousness of the Member’s conduct was an aggravating factor. Her conduct represented a significant and troubling breach of trust in the therapeutic relationship. Mitigating factors included the Member’s cooperation with the College, her admission and acknowledgement of the unacceptability of her actions, and her willingness to engage in remedial action.