The parties submitted a joint statement of agreed facts. Whilst the respondent did not made admissions about the alleged conduct, she was open to the Tribunal making findings in relation to them. The parties came to an agreed position on characterisation of the conduct as professional misconduct and in relation to sanctions.

Held, finding professional misconduct and imposing sanctions:

• The Tribunal is satisfied that the respondent has behaved in a way that constitutes professional misconduct;
• The respondent is reprimanded;
• The respondent is disqualified from applying for registration as a registered health practitioner for a period of four years;
• The respondent is prohibited from providing any health service until she is granted registration as a health practitioner under the National Law.

Health practitioners - Complaint by the Nursing and Midwifery Board of Australia - Professional misconduct - Unprofessional conduct - Failure to notify Board of convictions or charges - Alter, delete or falsify patient notes or records - Procuring, dishonestly and without the consent of the owner, controlled drugs without justification - False and misleading statements to authorities - Reprimand - Disqualified from applying for registration for 4 years - Prohibited from providing any health service until granted registration as a health practitioner

Criminal Law Consolidation Act 1935 s 134

Health Practitioner Regulation National Law South Australia Act 2010 Sch 2 ss 5, 130, 133, 193, 196

Public Sector (Honesty and Accountability) Act 1995 s 26

Briginshaw v Briginshaw [1938] HCA 34; [1938] 60 CLR 336

Dental Board of Australia v Da Silva [2023] SACAT 15

Medical Board of Australia v Brown (Review and Regulation) (Corrected) [2023] VCAT 1075

Medical Board of Australia v Win (Review and Regulation) (Amended) [2015] VCAT 1289

Ms H Luu with Mr J Livori appeared for the applicant

Mr M Anders with Ms Nathaniel appeared for the respondent

This is an edited version of the Tribunal's decision pursuant to s 60 of the South Australian Civil and Administrative Tribunal Act 2013. The patient referred to in the Complaint has been de-identified in accordance with the Tribunal's anonymisation policy. Other facts and details that may lead to the identification of any person may have also been anonymised or omitted. These changes do not affect the Tribunal's decision or its reasons for decision.

1. By Complaint dated 25 September 2024, the Nursing and Midwifery Board of Australia has referred to the Tribunal the following matters concerning Sarah Rebecca Nolan under s 193 of the Health Practitioner Regulation National Law, (otherwise referred to as the National Law) being Schedule 2 to the Health Practitioner Regulation National Law (South Australia) Act 2010, on the grounds that the Board reasonably believes that the respondent has behaved in a way that constitutes professional misconduct.
2. By way of background, the respondent was born in June 1984, she is therefore currently 41 years-of-age. She obtained a degree of Bachelor of Nursing from the University of South Australia in 2004, and, first obtained registration as a nurse on 18 January 2005. She was at the time of the conduct, which is the subject of the referral, registered as a Registered Nurse Division 1, pursuant to the National Law. She was subject to the provisions of the National Law but is not currently registered as a health practitioner in any health profession under the National Law, her registration having lapsed on 31 May 2023. Ms Nolan has not sought to renew registration since then.
3. At all material times, the respondent was subjected under s 39 of the National Law, to a Code of Conduct for Nurses (Code of Conduct) effective from 1 March 2018, Registered Nurse Standards for Practice, effective from 1 June 2016 and the Council for Nurses Code of Ethics for Nurses effective from 10 November 2021.
4. There are five allegations that have been raised in the Complaint against the respondent.
5. The first relates to attempted misappropriation of patient medication. At the time of the conduct in question, the respondent was employed by the Northern Adelaide Local Health Network (NALHN) at the Modbury Hospital as a Senior Nurse.
6. The allegation is that she engaged in professional misconduct within the meaning of paragraphs (a) and/or (b) and/or (c) of the definition of professional misconduct under s 5 of the National Law, and/or unprofessional conduct within the meaning of unprofessional conduct under that section in that, on or around 17 May 2022, she attempted to misappropriate medication belonging to a patient, who had been booked in for surgery at the Modbury Hospital, the patient who will be referred to, or is referred to in the Complaint, as 'UWX'. In essence, the gravamen of the complaint is that the respondent had misappropriated a number of dexamphetamine tablets which the patient had booked into with the hospital, having a diagnosis of attention deficit hyperactivity disorder, and that the respondent had taken, or at least attempted to take, some of those tablets for her own purposes.
7. Allegation 2 relates to the falsification of medical records. The Complaint alleges that the respondent engaged in professional misconduct within the meaning of paragraphs (a) and/or (b) and/or (c) of the definition of professional misconduct under s 5 of the National Law, and/or, unprofessional conduct within the meaning of the definition under that section, in that on 17 May 2022, she authored information on UWX's medication chart and patient notes which was false in a material particular, with an intention to mislead. It is alleged that in essence, the conduct involved a nurse junior to the respondent who discovered a discrepancy in the number of tablets in the patient's bottle. The respondent when becoming aware indicated that she would attempt to rectify the discrepancy in the number of tablets remaining to avoid either herself or that nurse from facing potential disciplinary action.
8. Allegation 3 of the Complaint alleges that the respondent engaged in professional misconduct within the meaning of paragraphs (a) and/or (b) and/or (c) of the definition of professional misconduct under s 5 of the National Law, and/or unprofessional conduct within the meaning under s 5 of the National Law, in that on or about 17 May 2022, she failed to comply with various NALHN procedures regarding the handling of medications, again relating to the dexamphetamine medication concerning patient UWX. There are a number of procedures that have been put in place by the local health network in relation to the handling of such medications. It is alleged that in relation to the respondent that she failed to properly administer, store or dispose of that medication in accordance with those guidelines.
9. In relation to the fourth allegation, it is alleged that the respondent provided false information and created or produced false documents, and that she therefore engaged in professional misconduct within the meaning of paragraphs (a) and/or (b), and/or (c) of the definition of professional misconduct under s 5 of the National Law, and/or unprofessional conduct within the meaning of that term under the same section, in that between on or about 14 June 2022 and 29 November 2022, she provided information to NALHN and the Board which was false with an intention to mislead. In particular, on or about 18 July 2022, she created and/or produced a false document to NALHN as evidence in support of her response to NALHN. That allegation also involves another nurse who was junior to the respondent. In essence, upon that nurse finding a discrepancy in the number of dexamphetamine tablets regarding UWX, there had been some discussion between them about covering up that discrepancy. It also involved an allegation that the respondent then manipulated a Facebook account relating to that nurse, as a result of which a message appeared to have been sent from her to the respondent in regard to providing an explanation or making attempts to make sure that the discrepancy wasn't discovered by their superiors.
10. The final allegation relates to a failure to provide the Board with notice of relevant events. The Complaint states that the respondent engaged in professional misconduct within the meaning of paragraphs (a) and/or (b), and/or (c) of the definition of professional misconduct under s 5 of the National Law, and/or the definition of unprofessional conduct in that she failed to provide the Board with notice of relevant events within seven days of becoming aware of the events, contrary to s 130 of the National Law. Those events relate in particular to an assertion that on 9 October 2022, the respondent was charged with aggravated attempted theft on 17 May 2022, contrary to s 134(1) of the Criminal Law Consolidation Act 1935 (the CLCA), aggravated theft on 17 May 2022, contrary to s 134(1) of the CLCA_,_ aggravated dishonest dealings with documents on 17 May 2022, contrary to s 140(4) of the CLCA and as a public sector employee, failing to act honestly on 17 May 2022, contrary to s 26(1) of the Public Sector (Honesty and Accountability) Act 1995. These offences are each punishable by a sentence of imprisonment of 12 months or more and therefore are relevant events within the meaning of s 130(3)(a)(1) of the National Law, which was in force at the time. The respondent became aware of the charges referred to on or about 9 October 2022 but did not provide the Board with notice of the charges referred to within seven days of becoming aware of them. It is alleged that the respondent's conduct was inconsistent with the Code of Conduct and s 130 of the National Law.
11. The full hearing has proceeded today on the basis that the respondent does not admit the allegations but nevertheless does agree to the Tribunal making findings in accordance with an Agreed Statement of Facts, which have been prepared by the parties and provided to the Tribunal.
12. In essence, as we understand the respondent's position, she doesn't acknowledge or admit the allegations wholesale. We note that the criminal charges that were laid against her have been discontinued. It is her right notwithstanding the fact that she doesn't admit the allegations, that she does not take issue with the Tribunal making findings of fact in these proceedings, that is disciplinary proceedings against her based on the allegations and she therefore agrees with the Statement of Facts that have been provided. We note the respondent agrees with the characterisation of the conduct that has been a position reached between the parties, which we will come back to shortly. She also agrees with the proposed sanctions, which have been stated in the Agreed Statement of Facts. The Tribunal, of course, in considering findings of fact in any disciplinary proceedings must be satisfied on the balance of probabilities, subject to considerations of the High Court in Briginshaw v Briginshaw [1938] HCA 34; [1938] 60 CLR 336 (Briginshaw) that it is appropriate to make findings.
13. It is incumbent on the Tribunal to be satisfied that any agreed position reached between the Board and the respondent is appropriate, bearing in mind of course, that the paramount consideration under the National Law for the responsible Tribunal in administering that law, is the protection of the public. We remind ourselves that we must independently be satisfied on all of the evidence before us, according to the civil standard of proof, having regard to the comments of the High Court in Briginshaw at pages 362 and 363, (per Dixon J), that findings in accordance with the agreed position reached are appropriate. We do take into account here that both the Board and the respondent are represented by very experienced counsel in this jurisdiction and, that's a matter which the Tribunal may consider in reaching a decision that is appropriate to make factual findings in accordance with an agreed position between the parties.
14. Based on all of the evidence before us, we are satisfied that it is appropriate to make those findings and accordingly therefore to record that each of the allegations, notwithstanding the fact that the respondent does not admit them, are proven to the requisite standard.
15. We do note that in relation to the practitioner, the respondent, that it is relevant to the Tribunal in approaching the issue of sanction that she comes before us with no alleged history of prior misconduct.
16. We are satisfied that the agreed position reached by the parties as to the characterisation of each of the allegations is appropriate. In relation to Allegations 1-4, we record findings of professional misconduct, in accordance with the definition under s 5 of the National Law, and, in relation to Allegation 5, we record a finding of unprofessional conduct, in accordance with the definition under s 5.
17. We do intend to approach the issue of sanction globally, being satisfied that in terms of the overall conduct of the respondent, it can properly be viewed as a course of conduct. We do note that in terms of the Allegations 1 and 2 that it can be inferred that it is isolated conduct, which whilst remains unexplained, nevertheless of course, it is open to us as we have found that the allegations as particularised in the Complaint are made out. We consider that the conduct of the respondent following the discovery of the discrepancy in relation to the medication, was a response to that, and, therefore for that reason we consider that a global approach to sanction ought to be followed.
18. We have been provided by Ms Nolan, through her counsel, with several references, some or most of which, as Mr Anders has properly submitted, are more in the nature of letters of support from family members, but there are two references from previous colleagues of the respondent.
19. We have also received from the respondent a statement setting out a summary of her professional experience, her education, training, community involvement and volunteering and a brief letter or report from a psychologist, who she has recently commenced seeing in relation to anxiety and depression, in particular. We do accept, of course, that many of those issues are issues that have arisen because of these proceedings. We have no doubt that it has been difficult for the respondent, in terms of the fact that she had worked for a number of years in the nursing profession and that she now feels a sense of loss in relation to that occupation. However, going back to the fundamental considerations for the Tribunal in imposing sanctions in disciplinary proceedings, we must always have in mind the protection of the public. However, we must also ensure that any sanctions that are imposed maintain the public confidence in health practitioners and also that the issue of general deterrence dictates that a strong message is sent by the Tribunal that such conduct will not be tolerated.
20. We have been referred to a number of authorities, in particular the decision of the Medical Board of Australia v Brown (Review and Regulation) (Corrected) [2023] VCAT 1075 which is a decision of the Victorian Civil Administrative Tribunal. We note in particular at [9], there is a reference to the fact that the respondent in those proceedings did not admit the allegations against him, but agreed to findings being made that those allegations were proved, and, that it was submitted on his behalf, that there was a benefit to the community in him not contesting the matters and avoiding witnesses being cross-examined and that therefore he ought to be given some credit in relation to that. We note further at [27], however it was stated by the responsible Tribunal that even though the respondent denied the allegations, that there should be caution exercised in determining whether or not that does show proper insight into the conduct and remorse ([38] and [39]).

The troubling aspect in relation to sanction in this matter for the Tribunal is this: if the respondent's conduct (according to our findings) had simply stopped at attempting to take the dexamphetamine tablets or alternatively taking them, it would be a very different proposition as to the length of any disqualification period which we impose. What makes this conduct in particular more serious, in fact very serious, is the dishonesty and the respondent's conduct which resulted thereafter.

We refer to the decision of Dental Board of Australia v Da Silva [2023] SACAT 15 at [55-59], a decision of this Tribunal in which there was a reference to a Victorian decision in the matter of Medical Board of Australia v Win (Review and Regulation) (Amended) [2015] VCAT 1289 in which it was stated that "the honesty and reliability of health practitioners is essential to ensuring that patients receive proper care and that patients and other practitioners place trust in the expertise of those providing health care. It is also essential when practitioners are dealing with the Board and other regulatory agencies - those bodies rely on practitioners honestly providing information which is important to decisions regarding registration and other matters".

The troubling aspect, in particular in relation to Allegation 4, is that the respondent on our findings, attempted to deceive her superiors and with that the Board, AHPRA, and the subsequent investigation, by manipulating a Facebook account to make it appear as if a junior nurse had sent her a message. That in our view, is very serious because not only did it mislead the authorities, but it potentially put that junior nurse in danger of her career being compromised and there was an imbalance of power between her and the respondent. That in our view, says a lot about the fitness and the propriety of the practitioner. Further to that, on being charged with criminal offences involving her conduct on our findings, the respondent then failed in accordance with the requirements under the National Law, to report to the Board and AHPRA that fact.

When we have had very careful regard to all of the evidence before us, including the material that has been tendered by the respondent, we are well satisfied that the agreed position on sanction between the parties is appropriate.

And, so for those reasons, we will formally reprimand the respondent, pursuant to s 196(2) of the National Law. Pursuant to s 196(4)(a) of the National Law, we will disqualify her from applying for registration for a period of four years from today. Pursuant to s 196(4)(b) of the National Law, we will prohibit the respondent from providing any health service until such time as the respondent is registered as a health practitioner under the National Law.

1. We also make an Order that the respondent pay the Board's costs of and incidental to these proceedings as agreed, or in default of agreement as set by the Tribunal. We do urge the Board under the circumstances, to consider the respondent's realistic ability to pay costs, given her current financial circumstances.
2. This is an edited version of the ex-tempore reasons provided by the Tribunal to the parties on 28 October 2025.