An aged care nurse has had her registration cancelled after she misappropriated medication in several nursing homes, and following a number of criminal misdemeanors, including pretending to be the victim of a home invasion.
Between 2003 and 2015, Elizabeth Luque worked in several nursing homes across two states, and was repeatedly found to have breached their medication handling procedures.
She was also found to have engaged in “unethical and dishonest” behaviour outside of work.
On Friday, the Civil and Administrative Tribunal of New South Wales found that Ms Luque was “unfit” to practice in the nursing profession and she has now been banned from providing any health services at all.
“The conduct was extremely serious, calculated and dishonest, and sustained over a prolonged period,” the tribunal said in its findings.
But why did this action take so long?
The fact that Ms Luque, despite committing serious misdemeanours, was able to move from nursing home to nursing home for over a decade begs the question – does Australia have strong enough checks and balances when it comes to recruiting aged care staff?
Ms Luque first registered to be a nurse in Queensland in 2002.
In 2003, 2005 and 2007, Ms Luque faced criminal proceedings in Queensland. In each case, she was penalised with a fine, but no conviction was recorded. In 2007 she was put on probation for 18 months.
Ms Luque moved to NSW in 2013.
In 2013, the nursing home where she worked fired Ms Luque following breaches of their medication handling policy.
The Nursing and Midwifery Council investigated the case in August 2013, but took no action against Ms Luque.
However, the Pharmaceutical Services Unit reviewed the case in October 2013 and found that “at best” Ms Luque demonstrated a lack of understanding of the requirements of the legislation and “at worst” her actions “could suggest that she may have misappropriated Schedule 8 drugs”.
Still, no action was taken against Ms Luque.
In June 2014, a different nursing home fired Ms Luque due to her breaching their medication handling policy. The Council was not notified of the breach.
In February 2015, another notification was made against Ms Luque for handling of restricted medications at yet another nursing home. A further allegation was made that Ms Luque had lied about her professional credentials.
In March 2015, the Council suspended Ms Luque’s nursing registration. That suspension continues to this day.
Ms Luque was subsequently involved in a number of criminal proceedings, including theft and making a false accusation to police.
“These proceedings concern a lengthy and very troubling history of improper, unethical and dishonest conduct that occurred both within and outside of Ms Luque’s professional responsibilities,” the tribunal noted on Friday when it handed down its decision.
“All of the proved conduct reflects most seriously upon Ms Luque’s fitness in the public interest to practise as a nurse,” it said.
Ms Luque “poses a very substantial risk to the health and safety of the public and that the only appropriate outcome is that her registration as a nurse be cancelled.”
The tribunal pointed out that caring for older Australians is such a serious matter a royal commission has been established to investigate it.
“Nursing home and aged care residents are extremely vulnerable populations, by reason of their age, related health conditions, and possible difficulties in communicating to authorities if the care they receive is substandard or otherwise improper.”
“We have found that the practitioner moved through three aged care facilities, improperly accessing restricted drugs at each.”
Ms Luque’s case raises the question of how could one offender be able to be employed time and time again, only for the same corrupt behaviour to occur.
Does Australia need a better way of monitoring and recruiting staff?
In his report for the Australian Workforce Taskforce, John Pollaers called for a centralised database of aged care staff.
He recommended the Aged Services Industry Council consider “centralising registration for all care staff and volunteers to ensure that all workers have completed mandatory police checks”.
Christine Smyth, a solicitor with Robbins Watson who specialises in law affecting the elderly, told HelloCare she would like to see tougher checks for those who work in aged care.
“In my view, simple police criminal history checks are insufficient in protecting our elderly and vulnerable citizens from predatory behaviour by those who might seek to exploit our elderly whilst providing care,” she said.
“Mere police criminal history checks do not identify whether a person is suitable for employment with the aged and vulnerable.
“Importantly, they do not address matters of employment disciplinary proceedings of the type discussed in this case.”
When no conviction is recorded, as was the case for Ms Luque between 2003 and 2007, the proceedings will not show up on a police check. Similarly, police checks only generally cover the state the check takes place in.
Ms Smyth said she would like the checks applied to childcare staff also to be applied to aged care workers.
‘Working With Children Checks’, or the Blue Card system, as it is known in Queensland “is quite extensive in what it covers off on” and applies for both staff and volunteers.
“The blue card check is an ongoing assessment of a person’s eligibility to work or volunteer with children based on their known past police and disciplinary information held by certain professional organisations,” Ms Smyth said.
Ms Smyth said we have tighter checks and balances for children because they are legally considered a vulnerable population. Older people are also a vulnerable population, Ms Smyth said.
If we apply one principle to childcare workers, the same principle should apply for older people too, she said.
No system will be a complete panacea, Ms Smyth said, but tougher checks could “give a sense of comfort” that more thorough checks have been carried out.
Ms Smyth said that with the growing number of people being cared for at home, the need for regulation of employees may become even more complex to monitor, and greater scrutiny is needed.
“Having a single centralised national data base akin to the Queensland Blue Card System for working with vulnerable people would provide a greater safeguard to community members who seek the services of care providers.
“This will likely to be increasingly necessary for our elderly as the current ideology is to keep the elderly out of institutions for as long as possible, through the shift to at home care services under the my aged care system,” she said.
Under the Department of Health’s ‘Police Certificate Guidelines’, all aged care staff, including some contractors, must have a police check that must be no more than three years old.
Conviction for murder, sexual assault, or any other assault preclude a person from being employed in aged care.
However, all other offences must be assessed by the employer, for them to make their own decision.
“An approved provider’s decision regarding the employment of a person with any recorded convictions must be rigorous, defensible and transparent,” according to the guidelines.