A nurse who had an ‘inappropriate’ relationship with a ‘vulnerable’ mental health patient on her ward for up to five years has been suspended over her ‘stupid’ behaviour.
Margaret O’Brien admitted to becoming ‘friends’ with Patient A while working as a staff nurse in the male section of Moorside Unit, a psychiatric ward at Trafford General Hospital.
While Mrs O’Brien admits exchanging phone numbers with the patient, who was being treated for a mental health condition, she claims that the relationship was merely platonic.
However Patient A accused her of having a sexual relationship with him and that he was ‘controlled’ by her – though a panel was unable to find this to be true ‘on the balance of probabilities’.
She was called before the Nursing and Midwifery Council (NMC) on charges of misconduct in her duties as a nurse.
After analysing texts exchanged between the two, the NMC said: “There is no doubt in the panel’s mind that the totality of the texts exchanged between them demonstrates the existence of a relationship which went beyond the level acceptable of professional contact.”
A key charge against Mrs O’Brien was that her relationship with the patient was ‘sexually motivated’.
During the panel’s investigation into the nature of the relationship, there were suggestions from the patient and other nurses on the ward that they had shared a sexual relationship.
A text message between two colleagues of Mrs O’Brien’s, allegedly sent in November 2012, claimed she was ‘shagging yet another patient (no surprise there then)’.
One of her colleagues claimed she thought this was ‘common knowledge’ on the unit.
The text message was subsequently reported to line managers – leading to Mrs O’Brien being suspended over the accusations – which Mrs O’Brien claimed were only ‘malicious’ rumours.
She was subsequently allowed back to work at the Moorside Unit, a service provided externally to the hospital by Greater Manchester West Mental Health NHS Foundation, in January 2013 when no evidence was found.
However, a few months later, Patient A began asking nurses on the ward on numerous occasions what would happen if he was found to be having a sexual relationship with a nurse, but insisted that he was only asking ‘hypothetically’.
It was not until September 2013 that he made clear he wished to report a sexual relationship he claimed he had been engaged in with a nurse for a ‘number of years’.
He claimed that ‘sexual conduct had occurred’ in the hospital and in hotels when he was not on the ward.
However the panel found: “There is no supporting evidence for this assertion and it is not established on the balance of probabilities.”
The patient showed the ward manager at the time a series of text messages that he deemed evidence of the sexual nature of their relationship.
The panel only found one text from Mrs O’Brien that had direct sexual references, and found that the majority of exchanges involved the nurse deflecting the patient’s approaches.
The exchange in question occurred on November 20 2012 and read:
‘INAPPROPRIATE RELATIONSHIP’: A test message conversation between Mrs O’Brien and Patient A (Please note: MM have mocked up this image using accurate text but this is not an actual screengrab)
Patient A: ‘I need u you to go to the bank, I need at least 1200 to sort things out and ill see u at 1 at the Traf x….Do you want to get a hotel room? X’
Mrs O’Brien: ‘Going Trafford Centre at 12:30, see u at about 1 if that’s ok with u sir. And to answer your question yes x’
Patient A: ‘Mmm naughty x Let me know when uve been bank x’
Mrs O’Brien claimed that the reference to the hotel room was merely ‘a joke’ and that she meant she needed a holiday.
A year earlier when quizzed on the exchange, she had claimed that the text had been ‘purely banter and never anything more’.
The only other text of a directly intimate nature was one written by Patient A on June 12 2013 in which he wrote: ‘….I want a steak from Café Rouge mmmm then go bed with u mmmmm xxxx’.
Mrs O’Brien replied: ‘see what I can do Café Rouge. Bed no x’
The panel concluded: “These latter responses from Mrs O’Brien are, in the panel’s view, consistent with many of her responses to Patient A which appear to be designed to divert him from what he is asking. She expressly rejected his reference to going to bed.”
The panel also pointed out that Patient A’s texts contain ‘many references to his power to jeopardise her job’, accompanied by requests for money.
In October 2013 Mrs O’Brien resigned from the hospital, but issued a statement denying the explicit accusations made towards her.
Mrs O’Brien said: “I did not want to get involved and told him so but unfortunately he said I had to as he had evidence we were friends. He asked for money and I refused. This is when he reported me.
“It was a platonic relationship only, you see by text he was asking for money all the time. I realise I have been very stupid in this situation I should have reported it straight away.”
MISCONDUCT: The panel decided that Mrs O’Brien’s fitness to practice was impaired and so she was given a suspension order (image courtesy of Google Maps, with thanks)
The panel accepted Mrs O’Brien’s insistence that the text she sent, which involved the patient booking a hotel room for them to share, was ‘purely banter’.
They said: “Although the panel has found that Mrs O’Brien’s personal relationship with Patient A was not sexually motivated, the Code clearly expects that nurses will maintain professional boundaries and will not form personal relationships with their patients.
“The panel has no doubt that Mrs O’Brien breached these provisions in a substantial and serious way, over a significant period of time, and as such her behaviour amounted to misconduct.”
In deciding a sanction against Mrs O’Brien, the panel considered numerous aggravating factors, including that it was not an isolated incident, the relationship was with a vulnerable patient sustained over a period of time and she failed to show any appreciation of her impact on the patient.
However, the panel did point out that Mrs O’Brien had expressed regret over the relationship, that it was not sexual in nature and that it had not caused any harm to Patient A.
They also said: “The content of the text messages from Patient A became increasingly demanding and threatened to expose the relationship so as to cause Mrs O’Brien to lose her job.
Mrs O’Brien’s fitness to practice was deemed ‘impaired’ and she was given a suspension order for 12 months ‘to mark the impact that [her] behaviour has had upon the reputation of the nursing profession’ and to give her time to reflect on her misconduct.
Mrs O’Brien was not present during the hearing.
She wrote a letter to the panel to explain her absence, which read: “This is not because I am ignorant or don’t care but because the whole thing has made me depressed and unwell.
“I find it hard to know he has told such lies. I have only ever had the patient’s interest at heart. I can’t believe by doing someone a favour it has come to this.”
Main image courtesy of Jaroslav A. Polák, with thanks.