In January this year there was a great deal of media interest in the case of a nurse who did not instigate CPR on a patient. There was great debate about the case which resulted in the NMC putting out a statement to justify their decision making in a blog by Andrea Sutcliffe

This month the case returned to the NMC for review of the suspension order which was replaced by a striking off order. The nurse in question  disengaged from the process, stating she was retiring and returning to India. She was a nurse of 25 years experience with no previous regulatory concerns leading up to the incident or until she retired a year later.  The NMC state that she failed to show any evidence of her decision making, although in their own hearing notes they state that:

"on 6 August 2017, an 89 year old woman who was resident in a care home deteriorated rapidly. Mrs Nasiri left her in the care of a healthcare assistant and sought advice from 111. On her return Mrs Nasiri was told by the healthcare assistant that the woman was unresponsiveMrs Nasiri informed the assistant that the resident was dead. Mrs Nasiri was referred to the NMC by the coroner following the inquest. The panel considered three charges and found one proven, that Mrs Nasiri on observing that the woman had ceased breathing failed to attempt cardio-pulmonary resuscitation..."

Discussion on social media questions has asked a few questions:

1.  Why do the NMC still pursue with such fervour when the registrant has no intension of working again? Is it in the public interest to pursue a case when someone has retired? Would voluntary removal not be more appropriate - to retire gracefully. 

2. How does someone demonstrate clinical reasoning when this may be from experience rather than text book?

3. Would CPR of a frail 89 year old patient have been successful or traumatic?

4. When registrants disengage from the process what steps are taken by the NMC to help them understand the benefits of doing so?

A FOI told us that panel costs alone are £1,460 per day - plus additional expenses for panel's travel, witness expenses, panel secretary and so on. It is not possible to find out from the NMC website how many days her initial hearing was but on average these are 3 days. Potentially with the additional day for Strike Off hearing - this has cost £5,840 paid from from registrant fees. Is this a good use of funds for a case of a nurse that was never going to practice in the UK again?

The topic of DNACPR has become under the spotlight again during the pandemic - we must ensure conversations around death occur long before it becomes a reality. In the same way as we create a birth plan, a plan for our death should be the norm also so there can be no confusion when the time comes. We must stop shying away from talking about death or situations like this will continue to occur.