Auckland's Starship Children's Hospital. Photo: RNZ / Cole Eastham-Farrelly
While a baby was turning blue from not getting enough oxygen nurse Vickie Wade sat on a La-Z-Boy armchair with her laptop on her knees and her headphones in.
In the same room, an alarm had been blaring for nearly half a minute, red text on an oxygen monitor reading "apnoea".
By the time another nurse intervened the infant's oxygen levels were critically low at just 20 percent and its heart rate was below the normal range.
Despite being warned to concentrate on the infants in her care Wade was found five minutes later back in the armchair with her headphones on.
Then a few months later a similar incident happened, with her colleagues needing to intervene in the care of another infant in her charge.
According to a ruling from the Health Practitioner's Disciplinary Tribunal released on Tuesday, Wade was working in the neonatal intensive care unit (NICU) at Starship Hospital in December 2019 when the first incident occurred.
Part of the nurse's duties was to check and set the levels for the alarms wired to oxygen and heart rate monitors attached to infants in their care.
An alarm would not trigger until an infant went approximately 20 seconds without taking a breath at which point a high red line alarm would sound.
Another nurse on shift assumed that Wade would check on the infant but after 10 seconds she went and checked herself, only to find Wade oblivious to the alarm.
The infant was turning blue due to a critically-low oxygen level and its heart rate was below normal.
Despite being asked to record the incident in red writing - an industry standard to denote a serious event - Wade was reluctant to and only recorded fragments of the incident.
The other nurse asked her to concentrate on the patients but five minutes later, she found Wade back in the armchair.
Wade's manager gave evidence to the tribunal that the infant was 25 weeks old, at risk of developing chronic lung disease and in the 24 hours before had experienced multiple similar incidents.
In her view, the nurse should have been close at hand and monitoring the child closely.
Wade was called to a formal meeting in February 2020 to discuss the incident and two days following it a similar incident happened.
This time another of Wade's colleagues told the tribunal she was working at the NICU when an alarm began sounding to signal that another infant's heart rate was dropping. A second alarm was then triggered to signal that oxygen levels were decreasing.
Just as she was about to intervene she saw Wade get up from an armchair in the corner of the room and turn off the alarms before sitting back down.
Wade's colleague checked the child and found its skin grey with a low oxygen and low heart rate. She was about to use an infant resuscitation device when it began to recover on its own.
Again, Wade did not chart the incident.
In a third incident, a woman who had given birth made a complaint to the hospital after Wade refused to help her hold her baby, and suggested she go and get the infant herself despite being bedridden.
After she complained she told the tribunal Wade was "cold" towards her and made her feel unwelcome at the hospital.
Wade was then charged with malpractice, negligence and bringing the profession into disrepute and the tribunal held a hearing into her conduct in November last year.
Today it opted to cancel her registration, censure her and order her to pay $33,000 in legal costs.
Wade did not attend the hearing but told the Professional Conduct Committee that investigated the incidents that she was doing professional development training on her laptop when they occurred.
"The tribunal is doubtful that the practitioner was completing professional development as she contended at one stage, but even if this was the case, doing so with headphones in and allowing an electronic device to distract her from her primary duty is unacceptable," the tribunal's ruling today reads.
The tribunal said it had no difficulty in finding Wade's conduct amounted to negligence.
"…Infants within the NICU are amongst the most vulnerable groups a registered nurse can care for," the tribunal said.
"While there is no evidence of harm arising to the infants, this was due to the care provided by other nurses who had their own responsibilities, and in spite of the practitioner's repeated indifference to her professional duties."
- This story was originally published by the New Zealand Herald.