The resident had been with the aged care organisation for many years. She had an acquired brain injury, an intellectual disability and difficulty speaking. Her finances were being managed by State Trustees.
Some of the resident’s money was held by the aged care organisation in an account in her name. In October 2012, the registered nurse sent an e-mail request to the financial controller indicating that she was in the midst of sorting out the resident’s investments and finances and requesting the transfer of money.
At the time, the registered nurse had no legal authority to manage the resident’s financial affairs or request the money. She had no formal or recorded authority to act on behalf of the resident in any capacity.
Two weeks later, the registered nurse arranged for the resident to sign an Enduring Power of Attorney in her favour.
It was not until April 2013 that the board of the aged care organisation became aware of the payment to the registered nurse. Subsequently, a notification was made to AHPRA and an application made to VCAT to have the power of attorney revoked.
The registered nurse repaid the money, plus interest. In the Tribunal proceedings, she admitted that she had engaged in professional misconduct under the National Law.
It is clear from the Tribunal’s Reasons that it considered the registered nurse’s conduct to be very serious. It found that she had violated the boundaries that ought to be in place between nurses and patients or, in the case of aged care, nurses and residents. She clearly acted in conflict of interest and by her conduct had undermined the trust in and reputation of the nursing profession.
The Tribunal noted in its Reasons that:
“ [31] It is not apparently an express rule of conduct that registered nurses may not take or seek to exercise control over the finances of a patient or a resident in their direct or indirect care. In our view, it certainly comes within the requirement to observe professional boundaries but some form of express requirement should also be considered by the Board, in our view.
[32] Similarly, it might be wise for aged care facilities to consider having an express prohibition on a nurse (or other employee) seeking to take or exercising control over the financial affairs of a vulnerable resident, if they do not already do so. We do not have any role in relation to health care workers who are not regulated under the National Law, but we wish there to be no doubt that it is not appropriate conduct for a registered nurse.”
The Tribunal ordered that the registered nurse be reprimanded, imposed conditions on her registration (including that for a period of 6 months she may not have contact with any patients or residents of her place of work).
The decision is a reminder of the seriousness with which the courts regard exploitation of vulnerable persons, such as residents in aged care, and the high expectations upon workers in aged care to maintain appropriate professional boundaries.
Prudent aged care organisations should have policies to help define professional boundaries and prohibiting workers seeking control over the financial affairs of residents. Further, all staff should be trained in those policies.
To read the Tribunal’s decision, click here.
