Processes for disciplining nurses for unprofessional conduct of a serious nature : a critique

Aims: This paper critiques the deliberative processes used by the discipline panels of an Australian statutory nurse regulating authority when appraising the alleged unprofessional conduct of nurses and determining appropriate remedies.

Background: Little is known about the nature and effectiveness of the deliberative processes used by nurse regulating authorities (NRAs) disciplinary panels established to appraise and make determinations in response to allegations of unprofessional conduct by nurses.

Methods: A qualitative exploratory descriptive/pragmatic research approach was used. Data were obtained from two case-orientated sampling units: (1) 84 Reasons for Determination made between 1994 and 2000 and (2) a purposeful sample of 12 former and current nurse regulating authority members, nurse regulating authority staff and a nurse regulating authority representative who had experience of disciplinary proceedings and/or who had served on a formal hearing panel. Data were analysed using content and thematic analysis strategies.

Results: Attitudinal considerations (e.g. whether a nurse understood the 'wrongness' of his or her conduct; accepted responsibility for his or her conduct; exhibited contrition/shame during the hearing; was candid in his or her demeanour) emerged as the singularly most significant factor influencing discipline panel determinations. Disciplinary action is taken appropriately against nurses who have committed acts of deliberate malfeasance. NRAs may not, however, be dealing appropriately with nurses when disciplining them for making honest mistakes/genuine practice errors.

Conclusion: Traditional processes used for appraising and disciplining nurses who have made honest mistakes in the course of their work need to be substantially modified as they are at odds with the models of human error management that are currently being advocated and adopted globally to improve patient safety and quality of care in health care domains.

Opening up a can of worms: how do decision-makers decide when witnesses are telling the truth?

Correctly determining witness credibility is integral to a fair trial. Assessments of credibility made by the triers of fact are made, amongst other things, by reference to behavioural stereotypes that are commonly thought to be associated with lying and truth-telling. These stereotypes are worthless but pervasive. In this study, potential jurors were given information such as would be given by way of judicial direction and/or expert testimony on those behavioural indicia that are useful in detecting deception. Major changes in perceptions of what does and does not work were found. This has significant implications for the conduct of criminal trials. Recommendations are presented which, it is argued, can be of real, practical, assistance in enabling decision-makers to assess the credibility of witnesses. © 2013 The Australian and New Zealand Association of Psychiatry, Psychology and Law.

Perceptions of credibility of sexual abuse victims across generations

The success of prosecutions of perpetrators of sexual abuse often depends substantially upon the perceived credibility of the victim witness. However, perceptions of credibility may vary by generation of the observer, and the constitution of juries may therefore lead to bias. In this study we examined whether perceptions of credibility of female victims of sexual abuse varied across generation Y, generation X, "baby boomers", and "builders". One hundred and twenty-eight jury-eligible members of the community from each generation (N=512) responded to ten questions assessing the perceived believability, competence, trustworthiness, demeanour and sexual naiveté of females providing testimony related to alleged sexual abuse. Although consistent between-generation differences were not found for all questions, or all four groups of generational cohorts, in instances where significant differences were found, it was consistently the older generation groups (builders and baby boomers) that attributed less credibility to the victim than the younger generation groups (generation Y and generation X). The implications of these findings are discussed.