Hard Patient Doesn’t Excuse Unprofessional Conduct of LPN
Re Abudi (LPN#38762) (CLPNA) (2022) is a case where an Alberta Licensed Practical Nurse (“LPN”) was found guilty of pushing a patient and then failing to provide appropriate care. The LPN received a substantial penalty.
This case is important because it is illustrative of the conduct expected of an LPN, regardless of how stressful and challenging the situation.
The following are the pertinent facts found by the Alberta College of Licensed Practical Nurses Hearing Tribunal:
- The Regulated LPN Ms. Abudi worked in the dementia care unit of a care facility
- A dementia patient, PN, was having an argument with another patient over a cup in front of another nurse
- The other nurse asked Ms. Abudi for help, so she stepped in to help
- Patient PN was agitated and became verbally aggressive
- The Regulated LPN grabbed PN’s wrists and pulled her out of the area toward her room
- The Regulated LPN moved PN in to her room and then stood in the doorway blocking her from exiting
- PN was very agitated. She was raising her hands and yelling and ended up hitting the Regulated LPN in the face
- In response, the Regulated LPN grabbed PN’s wrists and pushed her to the floor, then left the room and closed the door. PN sustained some bruising on her buttocks
- The Regulated LPN thereafter did not immediately do an assessment of PN’s condition
- The Regulated LPN received an employment suspension and had her LPN license suspended pending the outcome of the hearing
Analysis / Conclusion
The Regulated LPN admitted to the conduct set out in the summary of facts above. The CLPNA Hearing Tribunal found that the facts amounted to unprofessional conduct and went on to consider the penalty.
In weighing the penalty to impose, the Hearing Tribunal considered it particularly important that PN was a vulnerable dementia patient and that it was important to deter this sort of conduct by this LPN and all other LPN’s in the future. The Hearing Tribunal also took into consideration that the LPN cooperated with the investigation and admitted the conduct. However, the factor the Hearing Tribunal focused on the most was the nature and gravity of the proven allegations. The Hearing Tribunal’s comments on that were as follows:
The nature and gravity of the proven allegations:
These allegations are serious in that Ms. Abudi became agitated and was yelling at PN and then placed her hands on PN and forcefully took PN to her room, and pushed her to the floor. Ms. Abudi added to PN’s agitated state and PN ended up injured as a result of this incident. Ms. Abudi also failed to meet certain policies in the workplace and failed to report the interaction to PNs Guardian, along with failing to properly document PN’s medication. It is an expectation that LPNs will follow procedures, policies and care plans that are set forth for the residents and patients in their care. These allegations are particularly grave, as the safety, wellness and trust of a vulnerable resident was at stake and was not protected by Ms. Abudi’s actions.
The Hearing Tribunal imposed severe penalties in this case. The Regulated LPN’s license had already been suspended pending the hearing, and it remained suspended. The rest of the penalties imposed on the Regulated LPN were as follows:
- She was required to pay 25% of the costs of the investigation and hearing
- She was required to review and reflect on a large number of CLPNA policies relating to handing difficult situations, patient care, dementia care, ethics, etc.
- She was required to complete a series of educational courses at her own cost, related to ethics, controlling personal anger, patient rage, medical charting, etc.
She was eligible to reapply to have her license reinstated upon completion of the above, and the Registrar would then determine if she met the qualifications for reinstatement
The CLPNA Hearing Tribunal obviously took this situation seriously, because an LPN can never be allowed to push a patient. However, this situation is not a classic and simple case of patient abuse. The patient was yelling at the LPN and hit her in the face. The LPN reacted badly. Many people would likely react just as the LPN did in this case. However, LPN’s – and any other regulated nurse – are held to a high standard of professional conduct and must never react this way. The penalty imposed in this case was heavily focused on educating this LPN and giving her the tools to react professionally in the future.
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