Rena Simitsis: Gold Coast University Hospital AIN fails to overturn misconduct finding

A Gold Coast nurse has failed to overturn a misconduct finding after she failed to appropriately monitor an at-risk mental health patient, who attempted suicide during her inattentive watch.

Gold Coast University Hospital AIN Rena Simitsis. Picture: Facebook/Gold Coast University Hospital - GCUH

A Gold Coast nurse has failed to overturn a misconduct finding after she failed to adequately monitor an at-risk mental health patient, who attempted suicide during her inattentive watch.

Gold Coast University Hospital (GCUH) assistant in nursing (AIN) Rena Simitsis appealed the two findings of misconduct, and a third of contravening a relevant standard of conduct, to the Queensland Industrial Relations Commission (QIRC).

On February 25, Industrial Commissioner Jacqueline Power struck out one of the misconduct findings, but upheld the finding related to the patient’s attempted suicide.

According to Commissioner Power’s written decision, Ms Simitsis had three allegations made against her in January 2024, most seriously that on April 14, 2023, she “failed to conduct 15-minute visual observations of an at-risk consumer … in the Mental Health Pod at Gold Coast University Hospital Emergency Department, which allowed the patient to attempt suicide in the Mental Health Pod bathroom”.

The patient was classified as at-risk because of a previous suicide attempt, the commission heard.

The patient attempted suicide at Gold Coast University Hospital on the morning of April 14, 2023. Picture: Mike Batterham

Ms Simitsis was also alleged to have provided “false and/or misleading information” to other members of the female’s treating team both before and after the attempted suicide, and that she made “false entries on the patient observation record”.

All allegations were initially upheld, leading to Ms Simitsis’ appeal to the QIRC.

In her submissions as to why the findings should be overturned, Ms Simitsis argued that although hospital policy was that observations must be made visually, “the GCUH culture for acceptable visual observation has been for observations to be undertaken via CCTV rather than through a patient’s window,” and that both registered nurses (RNs) and AINs “regularly” undertook observations in this manner.

“[Ms Simitsis] submits that the RNs on her shift were comfortable with her using CCTV to observe patients but acknowledges that this was an error on her behalf and apologies for what ensued because of her use of CCTV,” Commissioner Power said.

She further argued that although she now recognised information she logged around the time of the suicide attempt was incorrect, she held an honest belief it was correct at the time of recording.

In response to Ms Simitsis’ submissions, the Department of Health cited GCUH policy documents, which stated visual observations “MUST [their emphasis] be done at the patient’s window and not through the CCTV monitor”.

The department further argued that the two record entries made by Ms Simitsis around the time of the suicide attempt listed the patient as being “awake, laying in her room,” when the CCTV evidence directly contradicted this.

It denied there was a culture of RNs and AINs using CCTV at the hospital as an effective method to conduct observations.

The department argued that as an AIN of 14 years, with continuous service in the ED since 2014, Ms Simitsis ought to have known and complied with the relevant policies.

Commissioner Power found Ms Simitsis’ conduct in her use of CCTV involved “serious negligence that almost led to a disastrous outcome,” and upheld the misconduct finding regarding that allegation.

However, the allegation Ms Simitsis provided “false and/or misleading” information to her colleagues was not substantiated, and this misconduct finding was set aside.

Commissioner Power found Ms Simitsis did retrospectively amend one of her entries, but not others as alleged by the department, although the finding she contravened a relevant standard of conduct was not overturned.

Originally published as Rena Simitsis: Gold Coast University Hospital AIN fails to overturn misconduct finding