Director of Proceedings v Mr R

Health Practitioners Disciplinary Tribunal, 842/Nur16/349D (25 August 2016)

The Director of Proceedings laid a charge against Registered Nurse, Mr R, in the Health Practitioners Disciplinary Tribunal ("the Tribunal") concerning a breach of professional boundaries in his professional relationship with a mental health consumer ("the consumer"). 

Mr R was working as a full time forensic health nurse within a community mental health team where the consumer was a client.  As part of his role Mr R had provided care to the consumer which included assistance with communication and transportation to and from court appearances and assistance in locating emergency accommodation and respite.  Mr R also, as part of the treatment team for the consumer, regularly attended meetings at which the consumer's mental well-being and treatment planning was discussed.  Mr R had knowledge therefore that the consumer had several mental health issues including issues with alcohol.

On 6 September 2013 after attending one such meeting Mr R encountered the consumer in the local township and enquired where she was living.  Mr R subsequently arrived at the consumer's address, in a DHB car and carrying a bottle of wine.  Mr R gifted the wine to the consumer and then asked her to come into the motel unit with him.  Mr R and the consumer then engaged in sexual intercourse.  Mr R subsequently left the motel room, but, upon missing a call from the consumer, returned later that afternoon and sexual intercourse again took place. 

The matter proceeded by way of an agreed summary of facts whereby Mr R accepted that he had sexual intercourse with the health consumer and that by doing so his conduct amounted to professional misconduct as per s 100(1)(a) or (b) of the Health Practitioner's Competence Assurance Act 2004 ("the Act").  The Tribunal found that for Mr R to have "behaved in the way he admits … unquestionably amounted to malpractice, and brought the profession into disrepute".  The Tribunal further stated that it had "little difficulty in concluding that the Practitioner's conduct [constituted] such a serious departure from the standards which the public is entitled to expect from nurses that … the Tribunal [was] obliged to impose a penalty".

In considering penalty the Tribunal assessed the aggravating features of Mr R's conduct which it found included an element of premeditation.  The Tribunal also noted that whilst there was no suggestion that Mr R had forced himself on the consumer in a physical sense, "the whole point of the prohibition on health practitioners entering into romantic or sexual relationships with patients is that the existence of the professional relationship blurs and undermines consent".  The Tribunal acknowledged the mitigating features particular to Mr R, including his "30 years of dedicated service" and "impeccable record to date" but ultimately considered that "an outcome … which did not include an order that the practitioner's registration be cancelled would not discharge the Tribunal's responsibilities to the public and the profession". 

The Tribunal's formal orders included censure of Mr R, cancellation of his registration, and a condition that prior to applying for re-registration Mr R successfully complete a course of study to be approved by the Nursing Council of New Zealand which "focuses on or includes instruction on the maintenance of professional boundaries".  Mr R was also ordered to pay 30% of the costs associated with the proceedings.

In order to protect the identity of the health consumer the Tribunal permanently suppressed Mr R's name, his place of residence and work and "any other identifying details in relation to those matters".  An order was made in the same terms for the health consumer.

The Tribunal's decision can be found at: https://www.hpdt.org.nz/Charge-Details?file=Nur16/349P


Last reviewed February 2019