They saved a life, then came the complaint

After treating a patient at an emergency clinic, nurse practitioner Genevieve Brebner received a gift basket and a card saying “thanks for saving my life”.

The response from the very next patient she treated that day was vastly different.

Instead of a thank you note, a relative of the patient - who’d been brought back from the brink of death - laid a complaint against Brebner and five colleagues who’d treated him.

Almost 18 months later, the clinicians are waiting to hear back from the Health and Disability Commissioner, the body that protects people’s healthcare rights and, according to its website, resolves complaints “in a fair, timely and effective way”.

Brebner, however, says the process is “distressing and extremely prolonged”, leaving clinicians in an “awful limbo of ‘guilty until proven innocent’.”

She’s taking the rare step of speaking publicly about a process she believes allows anyone to jeopardise careers “with the click of a keyboard”.

And it’s not just clinicians who are finding the delays stressful - Stuff has been contacted by families who have been waiting up to three years for resolution of complaints about the care of relatives in rest homes.

“What’s the point of even having a complaints facility, if it’s going to take three long years to actually get back to you,” one woman says. “I just find it ridiculous.”

The HDC now has a disclaimer on its website saying, “unfortunately, our response and complaints management may be delayed due to the huge increase in complaints”.

Morag McDowell, the Health and Disability Commissioner, says there has been a 40% jump in complaints over the past four years. In the last financial year, 6210 complaints were received, of which 6028 were closed.

“This has put enormous pressure on our staff and the timeliness in which we can do things.”

McDowell says the HDC has introduced processes to fast-track complaints and is looking for other ways to improve efficiency, but “we are still operating in a very challenging environment”.

“I would like to assure the public that ... our processes are fair and robust.”

Brebner is a nurse practitioner, highly skilled autonomous clinicians who have legal authority to practice beyond the level of a registered nurse.

She trained here and in the US, and has more than a decade’s experience as a sole rural emergency responder, as well as working in general practice and urgent care clinics.

She says she has had a “faultless record of service”.

The patient at the centre of the complaint had critically low blood pressure when he was examined at the Canterbury clinic where Brebner was working at the time.

(Stuff is withholding the name of the clinic to protect the privacy of the patient and the other clinicians.)

The team treating him in a specially-fitted resuscitation room included Brebner, nurses and two doctors.

Several medical interventions were done, including administering adrenalin, throughout which the patient was minimally responsive.

Brebner says he was “severely unwell”.

“We took lifesaving measures and he did survive.

“Those are interventions that we’re trained in and that we employ only under very extreme circumstances where the alternative outcome is likely to be death”.

Brebner can’t go into detail for privacy reasons, but one of the procedures undertaken is only used in critical situations, and she is “very familiar” with it.

She’s required to teach procedures to other staff and in this case taught an experienced registered nurse how to do it.

The patient misconstrued this, Brebner says, assuming the other nurse was a student nurse and therefore beyond her scope of practice.

The patient fully recovered and was discharged from ED within hours.

Brebner says the complaint was laid about a month later by a family member who wasn’t present in the room.

While she understands they were fully within their rights to make a complaint - “I’m sincerely sorry for the distress ... suffered” - she says the HDC process makes it distressing for clinicians, too.

“Since the complaint was lodged, our lives have been up-ended,” she says.

“We had to go through all the CCTV footage ... write our own statements. We’ve all had to spend many hours with our lawyers, preparing our 'defence' by explaining every tiny aspect of our lifesaving care that day.”

They’ve had to disclose that they’re under investigation when applying for jobs or to renew their annual practising certificates.

“While we all continue to work as clinicians, it’s been under a huge shadow of doubt, stress and persistent worry,” Brebner says.

“It’s a huge burden over all our heads knowing that we might lose our licences or have disciplinary action taken against us.”

Despite providing a response to the complaint in March 2023, Brebner says they hadn’t heard anything from the HDC until this week, when her lawyer was told the organisation was experiencing “significant delays” and was still reviewing advice from its independent clinical advisor.

McDowell says she can’t comment in detail about this case, but we “have been corresponding with [Brebner’s] lawyers regularly”.

She acknowledges that being involved in a complaint can be stressful.

“Unfortunately, complaints where multiple parties are involved can be more complex and time consuming,” she says.

“We make every effort to keep everyone involved up-to-date. While it may be unsettling at the time, we would encourage people to focus on the learning that can result from a complaint, not to mention system and process improvements.”

McDowell says the organisation is reviewing its regulations and legislation and people can contribute their views until July 31.

Brebner says she stands by her practice and is confident in her clinical judgement, but the experience has made her wary about teaching other nurses.

“It’s made me question the system by which someone with the stroke of a keyboard can jeopardise the careers of six people.

“We are good people and this is a very bad thing to happen to us.”

- Stuff