This research examines factors leading to disciplinary against nurses in New Zealand for professional misconduct. A multiple case study approach was used to analyse Health Practitioners Disciplinary Tribunal cases that were referred from the Nursing Council of New Zealand Professional Conduct Committee (PCC) between 2012 and 2014. The aim of the research was to critically examine the factors contributing to situations where nurses fail to exercise the judgement necessary to practice professionally. It seeks to understand more about how to recognise and manage challenging situations, including both personal and professional risk, and to focus awareness on our conduct as professional people. Each case represents examples where elements of nurse’s behaviour in a specific clinical and/or social context can be analysed and interpreted in relation to the normative expectations of the profession.
The analysis shows that the three conceptual categories are present in each of the cases. The naïve or needful categories indicated nurses who were incapable of responding adequately to situations because they were unable to communicate effectively with clients and colleagues, were isolated and therefore unable to ‘benchmark’ best practice. Poor communication, lack of knowledge, and isolation of team members led to fragmentation of clinical decision making and inappropriate responses to client situations. Individual nurses and their colleagues should notice moments when their own or others responses are inappropriate or unreasonable in the context of a client’s care, particularly responses that are a recurring pattern. Employers could work to reduce factors causing professional isolation and frustration, such as ongoing friction between team members and workload issues.