A telehealth nurse who disconnected at least 49 callers, including those who later needed an ambulance, has been found guilty of professional misconduct.
Senia Kelemete, 43, of Manukau deliberately hung up on concerned patients after they said hello, after listening to their symptoms, after asking how she could help, and sometimes mid-greeting, the Health Practioners Discliplinary Tribunal has found.
The healthline is the Ministry of Health funded Healthline, which is contracted to and run by Medibank Health Solutions. It employs 96 nurses, most of whom are set up to work from home using a computer, phone and headset. The line receives about 1000 calls per day.
In Wellington this morning, the tribunal heard evidence from Healthline team leader Karen Webb that Ms Kelemete hung up on at least 49 callers between May 2011 and January 2012.
The registered nurse worked from home until she was dismissed in February last year.
In a call at 7.54pm on May 30, 2011, a caller stated that he had chest pain and tingling in his left hand.
Ms Kelemete asked about his breathing before hanging up.
The caller was on the line for 12 seconds.
In documentation, Ms Kelemete wrote: "I accidentally ended this call" - but a screen shot shows her deliberately moving the mouse over the "terminate" button.
While the button is part of the software, nurses are taught never to use it.
Screen shots over the next few months show Ms Kelemete checking her emails, opening medical records, instant messaging, and checking a screen that showed how long she would have to wait for her next call before disconnecting worried patients.
Callers lasted between a few seconds and around 30 seconds before the nurse cut them off.
During a 24-second call in September, Ms Kelemete said "Sorry I'm losing you," to the caller before cutting them off.
In October she said "I can hardly hear you," before checking how long the queue was for the next call and hanging up.
On August 29, a caller rang and complained her husband was having trouble breathing. Upon listening to this, Ms Kelemete ended the call.
The caller rang the healthline back and spoke to another nurse, saying that she had been disconnected.
As a result of this, an ambulance was called for her husband.
After Ms Webb, who leads a team of 17 nurses, noticed Ms Kelemete's average call time had dropped, she was called into a conduct meeting and agreed to lift her practice.
She acknowledged she had been disconnecting calls, but provided no valid explanation, Ms Webb said.
"She suggested that one of her colleagues had said that calls could be disconnected when staff are tired and feel like hanging up, but a review of the culture of night staff indicated that there was no similar performance pattern."
Her performance improved for two months, before she began disconnecting calls again in mid December.
On December 19, a caller rang to say her husband had taken four Zopiclone tablets and she was unable to wake him.
Ms Kelemete said she would call an ambulance, and the caller hung up.
There is no evidence of Ms Kelemete calling an ambulance.
A week later, a caller rang concerned about her friend who had septicaemia and had missed two days of penicillin injections, and was now experiencing pain "over her heart". Ms Kelemete hung up.
There was no evidence Ms Kelemete tried to call back any of the callers.
The health line found Ms Kelemete had commited serious misconduct, and she was dismissed in February 2012.
Ms Webb said the behaviour was "unprecedented."
Ms Kelemete had worked at the health line since 2006, but in mid-2011 her team leader noticed her call times had dropped off suddenly, with an unusual pattern of calls between 3-5 minutes and 30 seconds long.
She worked nights and weekends, where calls were usually longer "because the callers are generally more unwell a lot of people are lonely or worried and need someone to talk to," MS Webb said.
Ms Kelemete's calls dropped from an average of about eight minutes in 2010 to three and a half minutes in October 2011.
Ms Kelemete was not at the hearing and did not provide any defence.
Professional conduct committee lawyer Matthew McClelland said the excuses she had made to her supervisor - that she was "tired" and that a colleague had said hanging up was okay - were not real defences. He recommended that her nursing registration be cancelled.
But after a brief adjournment, the tribunal ruled Ms Kelemete's registration be suspended for two years. If she wanted to return to practice, she would have to undergo a review by the nursing council and be under supervision for a year.
Tribunal chairman Dr David Carden said the fact that Ms Kelemete was a well-qualified nurse who had performed to high standards before the Healthline incidents had been taken into account.
She had worked as a public health nurse for a Pacific health organisation before Healthline, and this was a community that had high need of nurses, he said.
It was understood that Ms Kelemete was struggling with health issues of her own at the time.
Ms Kelemete was ordered to pay costs of $3000.
- © Fairfax NZ News
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