Tribunal decision offers key professional standards lessons for nurses and midwives

A recent NSW Civil and Administrative Tribunal (NCAT) decision has important lessons for NSW nurses and midwives on taking personal responsibility for practising safely. 

The Health Care Complaints Commission v Okembunachi [2026] case highlights serious breaches of professional obligations and the consequences of failing to meet Nursing and Midwifery Board of Australia standardsopen_in_new

Read the Tribunal decisionopen_in_new

What happened?

NCAT found that a registered nurse working in an aged care facility:

• slept while on duty as the sole registered nurse on a night shift
• failed to administer prescribed medications on multiple occasions
• inappropriately directed an assistant-in-nursing to administer medication
• failed to assess residents or access clinical systems to monitor patient care.

The Tribunal determined this conduct amounted to unsatisfactory professional conduct and professional misconduct.

Outcome

The nurse’s registration was cancelled, with a nine-month non-review period imposed.

NMBA Standards for Practice breached

NCAT’s findings reflected breaches of multiple Ahpra NMBA Registered Nurse Standards for Practice, including:

• Standard 1 – Thinks critically and analyses nursing practice
• Standard 3 – Maintains the capability for practice
• Standard 4 – Comprehensively conducts assessments
• Standard 6 – Provides safe, appropriate and responsive quality nursing practice.

These standards apply across all settings, including aged care, community, and acute environments.

Central to this decision was the nurse’s failure to remain fit for practice, including alertness and capacity to safely perform professional duties.

Why this matters

This decision reinforces that patient safety, appropriate delegation, fitness for practicve and professional accountability are non-negotiable. Failures in these areas can result in the most serious regulatory outcomes –including loss of registration.

This decision reinforces that being rostered and present is not enough. Nurses must be alert, capable, and safe to practise at all times. Where secondary employment or study impacts performance or fitness for practice, regulatory and employment consequences - including loss of registration - can follow. 

Secondary employment: why disclosure matters

Many nurses undertake secondary employment and/or study. While this is common and often appropriate, nurses must ensure that additional work does not compromise patient safety, performance, or fitness for practice.

Notifying your employer of secondary employment is important because it allows:

• appropriate management of fatigue and safe rostering
• identification and management of conflicts of interest
• assurance that work hours align with work health and safety obligations
• protection for both patients and nurses if concerns arise.

Failure to manage fatigue or disclose secondary employment may place nurses at risk of breaching NMBA standards – particularly where patient care is affected.

Three key takeaways

• Read our recent article on secondary employment
• Reflect on your professional obligations
• Always align your practice with NMBA standards

Take a professional standards refresheropen_in_new