Nurse loses bid to overturn disciplinary action for using ‘pain compliance technique’

A Cairns nurse has lost his appeal against disciplinary action after using a “pain compliance technique” on a patient who refused medication.

A Cairns nurse who says he used a ‘pain compliance technique’ to administer oral medication to a patient out of fear for his safety has lost his appeal to be spared disciplinary action. Picture: iStock

A Cairns nurse who says he used a “pain compliance technique” on a patient because he was at risk of physical harm has lost his appeal to be spared disciplinary action.

John Kaitara, an enrolled nurse at the Cairns and Hinterland Hospital and Health Service, was suspended from his job after he was alleged to have used “excessive or inappropriate force” on a patient while administering oral medication in September 2024.

An investigation into the incident found he had violated his standards of conduct, warranting disciplinary action, and Mr Kaitara was asked to “show cause” as to why he should keep his job.

Mr Kaitara subsequently launched an appeal against Queensland Health with the Queensland Industrial Relations Commission.

In an 18-page judgement delivered in November, Industrial Commissioner Samantha Pidgeon found the decision to carry out disciplinary action against Mr Kaitara was “fair and reasonable”.

In his appeal, Mr Kaitara argued the incident was not properly investigated by CHHHS, that he wasn’t given the opportunity to respond to witness evidence, and that the health service applied an unreasonable standard to him given the “sudden nature” of the incident, among others.

Mr Kaitara said he used a “pain compliance technique” on a male patient to release a paper cup from the patient’s mouth, so he could have oral medication administered.

Mr Kaitara admitted to holding the patient’s wrist in one hand, lifting his arms above his head and removing the patient’s finger’s from the paper cup.

Commissioner Pidgeon said there was no proof Mr Kaitara and other stuff were at imminent risk of harm. Picture: iStock

Mr Kaitara consequently applied “pressure point compliance” to the patient’s infra-orbital nerve, which sits beneath the eyes, with a “graduated use of force” so the man released the cup and Mr Kaitara could administer the medication, according to Queensland Health.

It was found that prior to the incident, the patient had sworn at and thrown a cup of water on another nurse, and Mr Kaitara argued he used the technique as he and other staff were at significant risk of physical harm.

He also asserted he used the least amount of force necessary to obtain compliance from the patient, and stopped as soon as the man did so.

However, commissioner Pidgeon said there was no proof staff safety was in immediate danger.

“While the patient was being non-compliant and had thrown water on Ms Hope (nurse), there is no evidence that there was an imminent risk to the safety of the employees present or to the patient that could not have been addressed by waiting for additional support,” commissioner Pidgeon said.

“There is nothing in the submissions or material before me to indicate that the sudden change in circumstances in the room provided reason for Mr Kaitara to depart from the (CHHHS) restraint procedure, or in any case, use the pain compliance technique.”

Commissioner Pidgeon also found that Mr Kaitara had not been given any direction to apply force by the supervising registered nurse, and in fact had been asked to stop.

“If the conduct had complied with the restraint procedure and had been done at the direction of a registered nurse, Mr Kaitara may have had a reasonable excuse for the conduct and it would not have been deemed inappropriate,” she said.

Commissioner Pidgeon further found that the CHHHS’s investigation into the incident was sufficiently thorough, having included a clinical review and careful consideration of both Mr Kaitara’s and other evidence.

Originally published as Nurse loses bid to overturn disciplinary action for using ‘pain compliance technique’