Kevin Lloyd Picones was a registered nurse at a child and adolescent mental health unit in a regional city in New South Wales. The mental health facility provides care to children and young people with a range of mental health conditions. In September 2015, allegations emerged regarding unprofessional behaviour on the part of Mr Picones, including prescribing restricted medication to his young patients. The Health Care Complaints Commission commenced disciplinary proceedings against him as a result.

Background Facts

Patient A was 15 years old. She was an involuntary patient with intense suicidal ideation and emotional dysregulation. She had also attempted self-harm. Patient B was 14 years old. She was admitted with a diagnosis of anorexia. Patient C was 16 years old. He had a benzodiazepine addiction and was admitted to the facility following a drug-based suicide attempt.

In September 2015, Patient B reported to a staff member that Mr Picones had supplied her with Phernagan without a prescription. She produced a tablet from her pocket and pointed out one that had been taped under a table. Patient A corroborated this allegation and said that she and some other patients had had Phernagan provided to them on more than one occasion by Mr Picones.

In October 2015, an internal investigation disclosed further allegations that Mr Picones supplied cigarettes to patients, made sexualised remarks to a patient, disclosed personal information about staff members, provided patients with access to his phone, failed to intervene when a patient was self-harming and advised a patient on how to overdose. Mr Picones denied all of these allegations except that he allowed a patient access to his phone.

In March 2016, Mr Picones left his employment and in April 2016, resumed employment at the Nepean Hospital. In June 2016, the Local Health District released a report finding that some of the allegations were substantiated and recommended a warning. This report was provided to Nepean Hospital who suspended Mr Picones for four months before placing him on work restrictions.

In January 2017, the Nursing and Midwifery Council (NMC) imposed similar restrictions on Mr Picones. On 8 September 2017, the Health Care Complaints Commission filed a complaint in the New South Wales Civil and Administrative Tribunal regarding Mr Picones' conduct with patients A, B and C. It was further alleged that Mr Picones provided Patient C with Temazepam, Valium and Tramadol on multiple occasions without any prescription or records.

In a written statement dated 22 February 2018, Mr Picones made some admissions including that he had provided Phenergan to Patients A, B and C as well as another patient without any prescription or records. However, he claimed that this happened only on one occasion. He admitted that this was a breach of the Nurses Code of Conduct and Code of Ethics.

Findings

The Tribunal found that Mr Picones was not a truthful witness, therefore where the account of other witnesses contradicted his, the evidence of the others were generally preferred. As a result, the Tribunal found most of the allegations proved.

In the absence of sufficient evidence, the Tribunal was unable to find that Mr Picones failed to intervene when Patient A was self-harming, had advised Patient B on how to overdose, or that he had inappropriately provided Patient C with Temazepam, Valium and Tramadol.

The Tribunal noted that the patients were extremely vulnerable by virtue of their age, their mental health issues and emotional crisis as evidenced by their suicide attempts and ideation.

The Tribunal found that Mr Picones was unlikely to adopt appropriate professional boundaries or abide by his obligations of candour and disclosure to professional bodies and regulators. It therefore ordered that his registration be cancelled and that he be prevented from applying for a review of this cancellation for 12 months.

It was recommended that during these 12 months, Mr Picones undertake some form of individual counselling, professional training and ongoing mentoring in relation to ethics and professional boundaries.

Mr Picones was ordered to pay the costs of the Commission.