By Emma Young
A Joondalup mental health nurse has been deregistered for a year after choking a patient and digging a finger into their eye.
The Nursing & Midwifery Board of Australia took registered nurse Brian Roha Smith to the State Administrative Tribunal alleging professional misconduct after the 2014 incident at Joondalup Health Campus' Mental Health Unit.
Mr Smith was deregistered for a year. Credit: Gabriele Charotte
The tribunal noted the unnamed patient's history of non-compliance with medication administration.
Its ruling detailed the incident, which began with a nurses' meeting about the best way to give the patient an intramuscular injection.
It was agreed that one would talk to the patient one-on-one first to minimise distress while the others stood by.
After this happened, Mr Smith was helping administer the injection when the patient patient began to shout "you're all fucked", or words to that effect, the judgement said.
"The patient began shouting at and verbally abusing the nursing staff, including the respondent.
"The respondent was one of the last nurses in the room when he became involved in a physical altercation with the patient."
Other nurses described to the tribunal how the two fell from the bed, the patient landing on his back and Mr Smith on top.
"The respondent's arm was around the patient's neck [appearing] to restrict the patient's airway, while the patient punched the respondent several times on his head and face," the judgement read.
"The respondent maintained the hold for approximately 10-15 seconds."
"The patient told the respondent to 'get off me' or words to that effect; and the respondent placed his finger into the patient's left eye.
"The patient was pulling on the respondent's hair and the respondent shouted for the patient to stop.
"During this time, nursing staff instructed the respondent to 'let go' or words to that effect; and the respondent released the patient, following which he placed his hand on the patient's throat and stood up by placing pressure on that area of the patient to push himself up."
Mr Smith left the room and was then treated for injuries at the hospital's emergency department.
He resigned a week later and made a voluntary undertaking to the board not to practice until the matter was resolved.
Mr Smith admitted to the tribunal that he had used "unnecessary and unreasonable force" and inappropriate physical restraint.
He also admitted to breaching the Code of Professional Conduct for Nurses in Australia in failing to respect the dignity of a person receiving care; to provide safe and competent nursing care; and to promote and preserve the trust and privilege inherent in the nurse-patient relationship.
He told the tribunal that in his defence, he had practised in the field for 30 years without prior disciplinary history, that he found the incident extremely distressing and had held true fear for his safety.
"The respondent considers it was a very sudden situation that happened very quickly, his adrenaline was running high and he was disoriented from the punches to his head and the fall to the floor," the judgement said.
Mr Smith undertook to complete further education and training in the areas of de-escalation, conflict resolution and management of aggression should he practise again.
He was ordered to pay costs of $1700.