For the reasons set out below the Tribunal is satisfied that it is appropriate to impose disciplinary action on the respondent in the terms suggested by the parties.
The Nursing and Midwifery Board of Australia (applicant) made a referral under the Health Practitioner Regulation National Law (South Australia) Act 2010 (National Law) regarding the conduct of Ms Victoria Shields (respondent).
The parties have provided the Tribunal with a joint book of documents, a statement of agreed facts, and written submissions. They have also proposed consent orders.
The facts are not contentious. They are set out in the Statement of Agreed facts, and in the documents provided in the joint book of documents.
The respondent is approximately 45 years of age. She first obtained registration as a registered nurse in January 2014 and has held general registration with the Board as a registered nurse under the National Law since that time, although, due to the matters the subject of this complaint she has effectively not been practising as a nurse since 14 February 2021. She held her registration subject to an undertaking not to practise between February 2021 and 11 June 2024 and from 12 June 2024 to current, has held her registration subject to undertakings limiting the scope of her practise and requiring oversight of her practices. Effectively she has been performing administrative duties in that time. She is intending to return to practise.
During the times relevant to the complaint, she was working in the Oncology Ward at the Royal Adelaide Hospital (RAH). Part of that role required her to routinely access pain relief medication, including Schedule 4 and 8 medications as part of her employment
During her employment she was subject to a number of professional standards. These include the Registered Nurse Standards for Practice (2016) which requires nurses to comply with legislation, common law, policies, guidelines and other standards or requirements relevant to the context of practice when making decisions, use ethical frameworks when making decisions, maintain accurate, comprehensive and timely documentation of assessments, planning, decision making, actions and evaluations; the Applicant's Code of Conduct for Nurses (in effect from 1 March 2018) (Code of Conduct);. the International Council of Nurses Code of Ethics for Nurses 2012, adopted by the applicant and effective from 1 March 2018 to 9 November 2021 (Code of Ethics).
Between 6 January 2021 and 14 January 2021, the respondent misappropriated hydromorphone, a Schedule 8 medication.
Between March 2020 and 14 January 2021, the respondent misappropriated pregabalin, a Schedule 4 medication from the RAH.
She did so by accessing the Automated Dispensing Cabinet (ADC) and making false entries.
The medication taken was for her own personal use.
The applicant was charged with 22 counts of theft by South Australia Police. Fourteen counts were withdrawn. The applicant pleaded guilty to eight counts of dishonestly dealing with property without the owner's consent. She was sentenced, without conviction, to a 2-year good behaviour bond.
The applicant asserts (which is Ground 1 of the complaint) that the admitted conduct contravenes the professional standards and constitutes professional misconduct as defined in the National Law. The respondent accepts that position. We agree that the conduct the subject of Ground 1 is appropriately classified as professional misconduct.
Ground 2 relates to false entries in the ADC on 13 and 14 January 2021. She withdrew 24 medications from the ADC for her own use rather than for the purpose of administering them to patients. Further, an ampule of hydromorphone was administered to a patient with integrated waste of 0.9ml which, instead of being disposed of as per hospital policy was taken by the respondent for her own use.
The applicant asserts that this admitted conduct also contravenes the professional standards and amounts to professional misconduct. The respondent accepts that position. We agree that the conduct, the subject of Ground 2, is appropriately classified as professional misconduct.
On 24 February 2021 the Board required the respondent to undergo a health assessment under s 169 of the National Law. She attended an appointment with Professor Baigent for the purposes of a medical assessment. Amongst other things he opined that: the respondent had a severe Opioid Use Disorder; the respondent had a panic disorder with agoraphobia; the respondent required treatment and time to adapt to maintenance opioid therapy before she could re-enter into the profession; once in remission the respondent could return to work with ongoing monitoring from her treatment team; the respondent will require regular drug screening to prevent relapse; and the respondent was impaired by her Opioid Use Disorder and that before treatment and commencing maintenance therapy, she was unable to control her use and her prior use potentially placed others at risk.
Whilst practising between March 2020 and January 2021 ('the relevant period'), the respondent knew or ought to have known that she had an impairment as defined in s 5 of the National Law, namely an Opioid Use Disorder. In addition to hydromorphone, she used other medications like pregabalin, gabapentin and citalopram, along with fentanyl. She did not seek medical or psychological treatment during the relevant period. This affected her ability to practise safely and ethically as a nurse. This meant that she reflected a lack of qualities essential for the practice of nursing, including the exercise of judgement to uphold the broad principles of public health and safety. These matters are the subject of Ground 3 - the respondent has or may have an impairment that detrimentally affects her capacity to practice the profession, and Ground 4 - practising whilst she knew or ought to have known she had an impairment. Again, the parties have a joint position that the agreed facts relating to Ground 3 and Ground 4 amount to professional misconduct, and we so find.
The respondent asks the Tribunal to take into account her personal factors. These include a health condition that commenced in her 20s and has continued with episodes of dizziness, brain fog, migraines and tinnitus. There are issues concerning her family life and financial pressures ultimately leading to separation from her husband with a need to look after three children. She has since had treatment to deal with her opioid addiction. She made admissions immediately when the offending came to light, both to her employer and to South Australia Police. She has sought psychological help. She has been effectively suspended from practice as a nurse since February 2021 to June 2024, and after that has been working subject to strict undertakings (and has been performing administrative duties). She has been abstinent for more than four years and has received effective treatment for her migraines. She continues to engage with medical professionals and is in remission from her addiction. She co-operated with the Australian Health Practitioner Regulation Agency (AHPRA) and is appreciative of both how AHPRA and her employer have handled the matter.
The respondent submits that she is embarrassed and ashamed of her actions and is genuinely remorseful. She accepts that a period of suspension is appropriate.
The applicant points to, amongst other things, the seriousness of the conduct, the need to protect the public, and the concepts of both general and specific deterrence. The applicant acknowledges the positive steps taken by the respondent to obtain treatment, and the insight demonstrated through her admissions and guilty pleas. The applicant notes that there are no prior disciplinary findings against her. The applicant accepts the mitigating factors relied upon by the respondent as being relevant. We note that the relevance of mitigating factors in disciplinary matters is somewhat different to that in the criminal law. In the disciplinary proceedings, such as these, the protection of the public is the aim of the law, and matters (such as drug dependency) that might explain conduct often reinforce the need for orders to be made in these kinds of proceedings to protect the public.
The parties have provided the Tribunal with proposed consent orders.
This is a matter to which the Tribunal should have regard. The view of the regulator as appropriate sanction is to be accorded weight and there is a public interest in encouraging parties to reduce litigation and save costs. However, the Tribunal is not bound by any agreement between the parties. It is a decision for the Tribunal, not the parties, as to the appropriate sanction to impose.
The medical evidence is to the effect that significant progress has been made in treating her conditions. This reduces (but does not eliminate) the risk of future conduct recurring. The proposed conditions that the parties propose on her return to practice are onerous and help to minimise the risk of future conduct occurring. The positive steps taken to make admissions, take full responsibility for her actions and obtain treatment are matters of significant weight. Without those steps and the demonstration of insight into her behaviour the applicant would have sought a longer period of suspension.
The Tribunal is satisfied in all the circumstances (including the level of personal responsibility taken demonstrated by the admissions made, insight demonstrated and commitment to effective treatment) that the proposed orders, including the Schedule of Conditions are appropriate.
[2]
The respondent has behaved in a way that constitutes professional misconduct pursuant to s 196(1)(b)(iii) of the National Law.
The respondent is reprimanded pursuant to s 196(2)(a) of the National Law.
The respondent is suspended for a period of three months from the date of these orders pursuant to s 196(2)(d) of the National Law.
The respondent is subject to conditions pursuant to s 196(2)(b) of the National Law in the terms included in the attached "Schedule of Conditions".
The respondent's conditions are subject to a 12 month review period pursuant to s 196(3) of the National Law.
The respondent is to pay the applicant's costs to be taxed or agreed pursuant to s 195 of the National Law.
[3]
1.1 The practitioner must not practise other than at practice locations that are approved by Ahpra.
[4]
1.2 After approval of practice locations, the practitioner must not be the only registered health practitioner at any practice location.
[5]
1.3 The practitioner must not access an entire Standard for the Uniform Scheduling of Medicines and Poisons (SUSMP) schedule unless directly observed by a nominated observer who is a registered health practitioner.
[6]
1.4 The practitioner must not access defined substances unless directly observed by a nominated observer who is a registered health practitioner.
[7]
Any substance listed in Schedule(s) 4(d) and 8 of the SUSMP as amended from time to time and as published at https://www.tga.gov.au/publication/poisons-standard-susmp, and any pharmaceutical items with an active ingredient listed in Schedule 4(d) and Schedule 8 of the SUSMP.
[8]
1.5 The practitioner must not access the following medication(s) pregabalin and/or any pharmaceutical items containing this ingredient unless directly observed by a nominated observer who is a registered health practitioner.
[9]
1.5.1 This restriction does not apply to access to medications prescribed to the practitioner for a genuine therapeutic purpose by another registered health practitioner.
[10]
1.6.1 comply with the Ahpra protocol: Supervised access to medication(s) in force at the date these conditions are imposed and then as updated from time to time.
[11]
2.1 The practitioner must not practise other than at practice locations that are approved by Ahpra.
[12]
2.2 The practitioner must nominate a senior person at each practice location (senior person).
[13]
2.3 From the date of publication of a practice location, the practitioner must:
[14]
2.3.1 not take substances unless prescribed, approved or administered by a nominated prescribing practitioner.
[15]
2.3.2 complete drug screening including urine and hair testing at group two frequency or as otherwise directed.
[16]
2.4.1 all registered health practitioners responsible for prescribing, approving, or administering substances for them (prescribing practitioner), and
[17]
2.4.2 a treating mental health professional from whom they are receiving treatment of their health condition (treating practitioner).
[18]
2.5 The practitioner must comply with the Ahpra Protocol: Drug screening in force at the date these conditions are imposed and as updated from time to time.
[19]
'Treating mental health professional'is defined as a registered health practitioner, psychiatrist, general practitioner, nurse practitioner, addiction specialist, psychologist, or an alcohol, tobacco and other drugs counsellor or the equivalent
[20]
3.1 The practitioner must not practise other than at practice locations that are approved by Ahpra.
[21]
3.2 The practitioner must comply with the Ahpra Protocol: Manage health in force at the date these conditions are imposed and as updated from time to time,
[22]
3.3 The practitioner must nominate a treating mental health professional from whom they are receiving treatment of their health condition (treating practitioner).
[23]
3.4 The practitioner must nominate a senior person at each practice location (senior person).
[24]
'treating mental health professional'is defined as a registered health practitioner, psychiatrist, general practitioner, nurse practitioner, addiction specialist, psychologist, or an alcohol, tobacco and other drugs counsellor or the equivalent.
Parties
Applicant/Plaintiff:
Nursing and Midwifery Board of Australia
Respondent/Defendant:
Shields [2025] SACAT 104
Legislation Cited (1)
Practitioner Regulation National Law (South Australia) Act 2010
Cases Cited (1)
Nursing and Midwifery Board of Australia v Shields [2025] SACAT 104 (31 October 2025)