A senior nurse accessed more than 180 medical records of retirees, as well as staff members at the care home where she worked. Photo / 123rf
A senior nurse at a retirement village accessed health information about her colleagues, including records that detailed breast reconstruction surgery and treatment for alcoholism.
While some staff members gave her verbal permission to access their Covid test results, they didn’t expect her to look at any other personal health information and were concerned when they found out she had.
Other people, such as a pharmacist who supplied the rest home with medicines, never permitted the nurse to access any of her health records, but found out she had anyway, including documentation regarding her breast reconstruction surgery.
She said the knowledge this information had been accessed had impacted her professionally and personally.
“The only reason I can think she accessed my records is out of pure nosiness,” she told the tribunal.
“She would have been totally aware of her obligations.
“I have lost trust in [her], and to an extent in the nursing profession.”
The woman said that as a pharmacist, she also had access to other people’s health information and was extremely careful about what she looked up.
The nurse, who has interim name suppression, accessed the health files of 181 people over the age of 65 who were not in her direct care, the records of multiple children and some people who had been dead for decades.
She also accessed the records of 45 staff members, though many of these instances were done with verbal permission.
The nurse was employed as the clinical nurse manager at a rest home in 2018 and oversaw its dementia and hospital facility, which was attached to a larger retirement village.
During her time there, the regional District Health Board trialled a digital health record system at the village and other aged care locations to attempt to streamline those records.
It was meant to be used for checking when patients of the facility were transferred to hospital, how long they were likely to be admitted for and when they would be returned, as well as keeping a record of their necessary health information.
But when the Covid outbreak hit in 2020, it was taking a long time for Covid test results to be returned to staff who were possibly infected.
So, with their verbal permission, the nurse would log on to the system to see if they had tested positive or negative. This was before RAT tests could be freely purchased by the public.
While this was a breach of the terms of use of the system, it was overlooked by the care home’s chief executive because of the challenging circumstances of working during the pandemic.
However, when that chief executive found out the senior nurse had accessed other aspects of staff files, after complaints from staff members, she reported it to the District Health Board, which then reported it to the Nursing Council.
The Nursing Council pressed charges of professional misconduct and today, after a hearing, the Health Practitioner’s Disciplinary Tribunal found the woman guilty.
At the tribunal hearing, Matthew McLelland, a lawyer for the Nursing Council, said the nurse had effectively been “trolling” for health information.
“She was well aware that what she was doing was outside the rules and did it regardless,” McLelland said.
“All of it was very personal information to which she had no entitlement to access.”
McLelland said the nurse was accessing the health records of young children, people who had died and people who had nothing to do with the retirement village.
He said the Covid access was not authorised and was inappropriate, but conceded it was done in the context that tests were taking a long time to be returned, and the village was short-staffed.
“But, she must have known when she was looking at a 3-month-old baby, she shouldn’t be doing that,” he said.
“Whichever way you look at it, this is a very serious, continuous breach over a two-year period of people’s health information.”
The retirement village’s chief executive told the tribunal access to staff members’ Covid test results was made during “desperate times”.
However, she understood that the nurse also began accessing other information contained in those staff files.
In one case, the chief executive said the nurse had told her she had noticed in the files that a staff member was being treated for alcoholism.
It was after this conversation that the chief executive reported the matter to the District Health Board.
The nurse didn’t turn up to the tribunal today but had previously told the Nursing Council that the chief executive had instructed her to look up much of the information.
The chief executive denied this, but admitted knowing the nurse was searching for Covid test results with staff members’ permission.
A senior staff member at Health NZ Te Whatu Ora gave evidence that after a report from the retirement village, they launched an audit into the nurse’s use of the file system.
As part of that audit, they notified the Privacy Commissioner and the Nursing Council and created a spreadsheet to track the files that were accessed.
The Te Whatu Ora staff member told the tribunal nine staff members at the retirement village got in contact and were “very distressed” as the information accessed was personal.
While many people, including staff, were notified their health records had been accessed, the DHB opted not to inform people who were not residents of the retirement village, nor staff, to avoid causing distress.
They made this decision after advice from the Privacy Commissioner.
It was the Te Whatu Ora staff member’s opinion that using the system for Covid checks was inappropriate.
“There is a process for accessing personal information and that wasn’t followed,” she told the tribunal.
The woman said the DHB did not manage to establish why exactly the nurse had accessed so many health records.
The tribunal will deliver its decision on the penalty for the nurse at a later date.
Jeremy Wilkinson is an Open Justice reporter based in Manawatū, covering courts and justice issues with an interest in tribunals. He has been a journalist for nearly a decade and has worked for NZME since 2022.