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Surujdeo Narain 0434209
Allegations and Plea
The College alleged that the Member committed acts of professional misconduct in that, while practicing as a nurse at a homecare agency, he: failed to maintain the confidentiality of client health information and failed to promptly report a client’s death; failed to seek assistance appropriately or ensure timely nursing care was provided for a client; and inaccurately charted client visits. While practicing at another employer, it is alleged that the Member: failed to indicate a number of charted entries were late entries; failed to document an order for an NG tube chronologically; failed to document medication administration; failed to assess or document when a client returned from another facility; and failed to assess or document for clients on a number of occasions. The College alleged that this conduct would be regarded as disgraceful, dishonourable or unprofessional.
The Member admitted to the allegations that took place while he was employed by the Agency and the Facility. He admitted that the conduct in relation to both employers would be regarded as unprofessional. The College and the Member jointly submitted an agreement to the following facts.
From 2011 to 2012, the Member worked for the Agency as a casual nurse. He was terminated in February 2012, as a result of the incidents outlined below.
On December 30, 2011, at 1300 hours, the Member administered intravenous hydration to Client A. in his home. The Member provided his personal phone number to the Client’s family against Agency policy and proceeded to leave to attend to other clients with the intent to return later. At 1630 and 1640 hours, the Client’s family contacted the Member with concerns. The Member advised that he was too busy to return. The Member called the Agency and requested assistance, however no other nurse was available. The Member returned to Client A.’s home around 2000 hours. As the Member provided care, the Client experienced decreased levels of consciousness and the Member called 911. Although paramedics intervened, the Client was pronounced dead at 2045 hours. The Member failed to report Client A.’s death and removed the Client’s confidential health information from the home to make a copy for personal use. The Member returned the Client’s health record on January 1, 2012.
On December 30, 2011, the Member recorded on an Agency payroll document that he treated six clients that day. However, given the distances between clients, it would not have been possible for care to have been provided as documented.
On January 28–29, 2012, contrary to Agency policy, the Member failed to notify the Agency that he was unable to reach Client B. on two consecutive visits.
Between 2009 and 2014, the Member worked as a part-time staff nurse at the Facility and was terminated as a result of the following incidents. On October 4, 2014, he was assigned to provide care to Client C. between 0700 and 1900 hours, who had suffered a stroke. The Client’s condition deteriorated overnight and, during morning rounds, the physician noted that the Client was in respiratory distress. At around 1300 hours, the Client’s family noticed Client C. had stopped breathing and notified the Member. The Member assessed the Client and left the room to call a code blue. Client C. was pronounced dead at 1350 hours. In the documentation, there are three entries by the Member that were charted out of chronology, which the Member failed to indicate were late entries. The Client’s family expressed concern that the Member failed to respond appropriately when he was notified Client C. had stopped breathing and failed to call the code blue with appropriate urgency. In response to these concerns, the Clinical Practice Leader was assigned to monitor the Member’s practice.
While being monitored, between November 18–20 and 24–26, 2014, the following incidents occurred: on November 20, the Member incorrectly documented an order for a Client’s NG tube out of chronology; on this date, the Member also failed to document administration of Lasix; on November 24, the Member failed to assess a client or document an assessment upon return from another facility; and the Member also failed to assess or document for other clients between November 18–26.
The Panel found that the facts supported findings of professional misconduct, including a failure to keep records as required, and that the Member’s conduct would be considered unprofessional.
Submissions on Order
The College sought an oral reprimand and terms, conditions and limitations on the Member’s practice. The Member would be required to complete specified remediation activities in preparation for a series of meetings with a nursing expert, within a period of 18 months. The Member would be required to complete nursing courses regarding the Practice Standards, Health Assessment, Communication and Medication Administration. Until these activities are completed and for a period of 12 months following the completion of these activities, the Member would be required to notify current and new employers of the decision. The Member would also be required to advise the College of his employers. The Member would only practise for an employer who agreed to advise the College if the Member breached the standards of practice of the profession and perform random spot audits of the Member’s practice. The Member would enter into a mentoring relationship with a Registered Nurse employed at the same facility as the Member. The Mentor will notify their employer if the Member has breached the standards of practice and will notify the College when mentorship is no longer required.
The Panel accepted the joint submission as reasonable and in the public interest. The Member accepted responsibility for his actions and cooperated with the College by agreeing to the facts and proposed penalty. The penalty satisfied the principles of specific and general deterrence, rehabilitation and remediation, and public protection. In particular, the proposed penalty provided sufficient protection for the public and remediation for the Member by way of random audits of the Member’s charting and timesheets.