A mental health nurse was fired after he crossed the line by contacting a schoolboy he had been treating on social media and sent him sexually suggestive messages. Photo / 123RF
A mental health nurse was fired after he crossed the line by contacting a schoolboy he had been treating on social media and sent him sexually suggestive messages. Photo / 123RF
A mental health nurse was fired after he crossed the line by contacting a schoolboy he had been treating on social media and sent him sexually suggestive messages.
The nurse first met the vulnerable teenager in July 2019 after he was referred to the mental health service by his school counsellor concerned by his suicidal thoughts.
He spent eight months under the nurse's care with treatments including face-to-face intervention, psycho-education, co-ordination of services, including referral to a private psychologist, and ongoing risk assessment.
However near the end of the therapeutic relationship or immediately after, in March 2020, the nurse failed to maintain professional and ethical boundaries by contacting the young man on social media, Deputy Health and Disability Commissioner (HDC) Dr Vanessa Caldwell found in a report released today.
One of those inappropriate personal messages included a request to send a selfie.
In other messages the nurse commented about what the boy was wearing and said "Ooo would like to [see you] running now if [you're] just in shorts lol," with a "smirking face" emoticon after the boy stated he might go for a run.
The boy raised concerns with his mother about the sexually suggestive messages and on November 26, 2020, she contacted the general manager of the mental health service and supplied screenshots.
The nurse was stood down on full pay following a meeting on the same day.
On November 30, the mental health service wrote to the nurse.
"From the information we have so far, at best, it appears that your conduct has been inappropriate and breached professional boundaries.
"At worst, it appears that you may have been trying to take advantage of a young, vulnerable person, and potentially grooming him."
Despite the nurse claiming he had no intent to engage in a sexual relationship with the teenager he was dismissed immediately for serious misconduct on December 8.
Deputy Health and Disability Commissioner Vanessa Caldwell said maintaining professional boundaries was an integral part of health services. Photo / Supplied
The mental health service notified the Nursing Council of New Zealand (NCNZ) which made a referral to the HDC for investigation.
Dr Caldwell concluded the messages were clearly inappropriate, although the nurse denied any sexual motivation.
"However, the mental health service raised concerns that RN B may have been trying to groom or take advantage of Mr A, and I share these concerns.
"Despite RN B stating that the messages were not sent with sexual intent, I consider that the messages do carry a sexual undertone."
She said sexual intent didn't need to be proved to confirm the messages were improper.
"RN B should not have been sending any messages that were personal in nature to a current or former patient, regardless of sexual intent."
The nurse also blamed he had been suffering from burnout, due to his case load, when he was messaging the boy.
He told the HDC he was now able to recognise when he was becoming overwhelmed and burnt out when he had previously not had any experience with the feeling.
The actions were considered to have flouted the established standards and breached the Code of Health and Disability Services Consumers' Rights.
As a healthcare provider, the services provided by the nurse were required to comply with professional, ethical, and other relevant principles.
Maintaining professional boundaries was an integral part of the provision of health services, she noted in the decision.
"I consider the nurse contravened professional boundaries and ethical standards by initiating contact with the young man outside of a professional setting, and sending messages of a personal nature."
The inherent power imbalance existing between healthcare consumers and their providers continued after the end of the professional relationship, because of the nurse's knowledge of the young man's personal circumstances and mental health, Caldwell said.
"Trust is fundamental to the relationship in ensuring the consumer is assured the provider is acting in the consumer's best interests.
"It is critical that relationships between health professionals and their clients stay within the professional realm, to avoid any exploitation or abuse of power."
It was recommended the nurse undertake further training on identifying and maintaining professional boundaries.
Caldwell also suggested the Nursing Council of New Zealand consider the fitness of the nurse to practice and whether any competency or conduct reviews were required.
She further proposed the mental health service undertake an audit of the nurse's caseload to ensure there were no other cases of professional boundaries being crossed, and provide appropriate support if necessary to any affected patients.
The nurse was also referred to the Director of Proceedings to consider any further action against the provider involving the Health Practitioners Disciplinary Tribunal, the Human Rights Review Tribunal or informal resolution by way of agreement.
"The potential harm to a vulnerable young person by behaviour initiated by the nurse was significant, and there is public interest in ensuring that such a risk is minimised."
