A NSW Professional Standards Committee recently found a Registered Nurse guilty of unsatisfactory professional conduct in relation to a complaint about her care and treatment of a patient in an Aged Care Service.

The patient was an elderly lady with deteriorating health who required assistance with all personal care. She also suffered from MRSA, a chronic skin condition which caused her torso to be covered with open wounds and scabs. A doctor prescribed a bleach bath treatment to treat her skin condition. However, the instructions regarding this were only delivered orally to another nurse who then passed on the information to the RN. The treatment was not documented in the patient’s file, progress notes or anywhere else in the facility. As the facility did not have a bathtub the treatment was administered by soaking towels in a 50:50 bleach-water solution and wrapping them around the patient’s body.

The bleach treatment led the patient’s skin to become raw and inflamed with one arm oozing serous fluid and emitting an odour. The patient was then taken by ambulance to hospital.

The Committee’s findings of unsatisfactory professional conduct involved:

  • Administering the bleach treatment in the absence of a written treatment order.
  • Failing to seek out educational information so as to educate herself and staff on the treatment and how to administer it.
  • Directing another RN to record instructions for the administration of the treatment, even though she was responsible for the preparation and administration.
  • Failing to cease the treatment in circumstances where
    • The bleach smelled strongly;
    • The bleach had burned the skin of an assistant who had administered the treatment;
    • The bleach solution bleached the nurse’s clothes.
  • Failing to ensure consent was obtained from the patient’s guardian as it was a new treatment.

The Committee reprimanded the RN and required her to undergo mentoring and further training.

Two other nurses also had complaints made against them regarding their care and treatment of the patient. No finding of unsatisfactory professional conduct was made against them. However, the Committee did raise criticisms of their conduct.

To read the decision in Nursing and Midwifery Professional Standards Committee of NSW and Bennett, Maksimova and Matriano, click here.