How can a dedicated nurse be sacked for handing a patient a Bible?
Sarah worked for the NHS for 15 years. Then one day she was frogmarched out of hospital ...
MaNy of us who know no better might be guilty at times of taking our NHS for granted. It was different for Sarah Kuteh. She’d grown up in Sierra Leone, where disease is rampant and medicines scarce. Preventable death was a sad reality.
Having trained as a secondary school teacher, it was her intention to teach when she arrived in Britain in 1993.
But when she saw first-hand the work of doctors and nurses while working in a care home as she looked for a teaching post, she felt a sense of wonderment. Here, for the first time, she saw how desperately sick patients were given medicines denied to the people in her home country and cured.
From Sarah’s perspective, it seemed incredible. She determined to retrain as a nurse.
and that’s what she did. after qualifying in 2001, she gave 15 years dedicated service to the NHS. Sister Sarah was much loved by many colleagues and the patients she treated at darent Valley Hospital in Kent.
But in June 2016, her association with the NHS came to an abrupt and humiliating end when she was escorted out of the building by a grim-faced matron and dismissed from her post, two months later, for ‘gross misconduct’. What was this ‘gross misconduct’? She had, from time to time, told patients a little about her Christian faith and the comfort it had brought her. Sometimes, she had also offered to say a prayer with them.
and on one occasion, she had given someone a Bible — a well-meaning if, she now knows, illadvised act which ultimately sealed her fate.
Nursing & Midwifery Council (NMC) guidelines prohibit nurses discussing religion, unless it is initiated by a patient. When the case was referred to the NMC earlier this year, Sarah was told she had failed in the expectation for a nurse ‘to understand the importance of, and respect, equality and diversity’.
It imposed conditions of practice on her should she work as a nurse again, including having to work under the close supervision of a superior.
you could be forgiven for thinking that Sarah had committed a grievous crime.
This week, it emerged that the NMC has lifted these restrictions.
Sarah is free to practise as a nurse again without someone constantly looking over her shoulder. But much damage has been done.
after her dismissal, she was forced to sell her home in Bexley, Kent, because she couldn’t pay the mortgage.
For the past year, Sarah and her three daughters (she is separated from her husband) have been living in a one-bedroom flat loaned to her by a friend. The two younger daughters are sleeping on sofas in the living room.
To her friends and family, and surely to many of the patients who have received her unflinchingly dedicated care over the past 15 years, it is an unjust betrayal of Sister Sarah.
T oday, 49- year- old Sarah, a member of the House of God Church, a Pentecostal movement, is by turns reflective and emotional.
She says that she recognises there may have been times when she was ‘ not sensitive enough’, that a patient who may have seemed to be engaging with her may, privately, have felt uncomfortable.
yet she becomes emotional and tearful when she talks about the daily reality of life as a ward sister. For while the NHS does amazing things, sometimes there is nothing more to be done.
‘It’s all very well but they don’t see what I have seen, how much heart you put into it. I’ve seen young mothers who have learned they are dying of cancer.
‘one patient had just been given bad news and he told me he wanted to commit suicide. They come into my office, you try to offer compassion and sympathy.’
She pauses. ‘you know, the heart has gone out of nursing. That makes me very sad.’
She believes — and many may agree — that her punishment was ‘wholly disproportionate’ to her actions.
It’s a bitter twist to her association with the NHS, the organisation which she so admired — and still does, albeit with qualifications — when she came to Britain in 1993 to start a new life.
‘When I started work in the care home, I would see patients being treated and think, “oh my goodness, they’re getting better!” I thought, “Wow, I want to be part of the team.” It’s a buzz that never goes away.’
after qualifying in 2001 having studied for three years at South Bank University, Sarah practised at a number of London hospitals, including Ealing and Hammersmith.
She worked in a&E, children’s wards, maternity and intensive care units.
In 2007, she took a position in the intensive care unit (ICU) of darent Valley Hospital, run by dartford and Gravesham NHS Trust, and in 2012 she was made an Intensive Care Sister.
In 2015, however, she became unwell herself with a condition which required surgery. after five months off work recovering, it was felt it would be best for her to return to a less pressurised environment and so she joined a pre-op assessment ward.
Here, one of Sarah’s duties was to go through an assessment questionnaire with patients.
one of the questions asked whether or not the patients followed a particular religion and, if so, were they practising or non-practising.
‘Someone might say, I’m Church of England but I don’t practise,’ explains Sarah.
In this context, then, you can see how a dialogue about faith might develop, especially with patients facing surgery which some feared they may not wake up from.
Nevertheless, Sarah is adamant she never went about ‘prescribing’ Christianity, maintaining she would only ever tell a patient how her faith had helped her through difficult situations and occasionally offer to say a prayer for them. But there were some patients who evidently felt uncomfortable with this, but did not tell Sister Sarah herself, instead voicing their concern to other nurses on the ward.
In total, eight complaints were made about Sarah, although only one formal complaint was submitted.
S arah was seeing up to 40 patients a week, so the number of complainants was comparatively small. The one formal complaint concerned a man in his 50s whom Sarah describes as appearing very frail.
‘He was very unkempt and when he coughed, he rattled. I felt great sympathy for him.
‘I asked him the question about religion and he said he wasn’t religious but as a boy he was a chorister at a cathedral and he used to sing The Lord Is My Shepherd. He then sang a stanza from it.
‘It was later said that I’d asked him to sing it, but I don’t remember asking him to sing at all.’
on another occasion, Sarah went through the questionnaire with an 18-year-old girl.
‘She said she was interested in spirituality and we talked a bit about this. I mentioned that my own daughter, then 18, had begun to rely on prayer recently. The
subject of the Bible came up and she said she didn’t have one.
‘I said, “I tell you what, I’ve got a Bible in my bag” and I gave it to her.’
The NhS has strict rules forbidding its staff from imposing their religious beliefs upon patients. Yet, in Sarah’s defence, these do seem to be somewhat contradictory.
For while it was strictly forbidden for Sarah to instigate a discussion about religion with a patient, at the same time she was being hauled over the coals by her superiors for crossing this boundary, her face was plastered on posters across the hospital advertising the monthly prayer group in the chapel that she helped to run.
Indeed, she was about to apply for the job of chaplain.
‘This was no secret, everyone knew,’ she says.
In April 2016, Sarah’s manager came into her office and said some patients had complained about her discussing her faith with them.
She reminded her that in future, she must not do so unless a conversation was initiated by the patient, to which Sarah agreed. She was also given a ‘ letter of concern’ which, Sarah says, is not as serious as a formal warning.
As far as she was concerned, she was careful from then on to abide by the rules.
So she was profoundly shocked to be told one Friday two months later to stop work immediately, go home and report back on the Monday for an ‘investigative meeting’.
‘You can imagine my shock,’ says Sarah.
She took a union representative with her and the current chaplain, with whom she had organised the monthly prayer sessions.
She says it was ‘an ambush’.
Before the panel of five, she was asked if she had given a Bible to a patient. She replied readily that yes, she had done so. All hell, as it were, broke loose.
The union rep, realising immediately that such an admission would spell disaster for Sarah, demanded the meeting be halted, took Sarah outside and demanded: ‘Why didn’t you tell me that beforehand?’
Sarah got into a state of panic. ‘I thought, “Oh my goodness, I’ve done something so stupid.” But I had no idea what I’d done wrong, so I didn’t have anything to warn the union rep about.’
The meeting went badly. Sarah was desperately upset to learn that some patients had felt uncomfortable when she talked about her faith and asked if she could apologise to them. This request was refused.
She was informed that she was being suspended. The matron escorted her out of the building in a formal fashion.
A second ‘disciplinary’ meeting was held in August 2016, at which Sarah was told that she was dismissed.
‘I offered to work under supervision, to have a pay freeze, even a demotion,’ says Sarah. ‘But it was no good. They dismissed me. I was deeply shocked, very hurt and humiliated.’
Sarah believed — and still does — that the Trust’s actions were wholly disproportionate and sought legal help.
her case was taken up by Christian Concern, an organisation that defends Christians who find themselves in situations such as Sarah’s, and they enlisted barrister Jonathan Storey. ‘ he was my representative throughout and is a dedicated, passionate for justice barrister’, says Sarah.
But a tribunal last year upheld the Trust’s decision, saying she was correctly dismissed.
Sarah’s legal team are currently waiting to hear whether the Court of Appeal will consider her case.
Finding herself ousted from her position had practical — as well as emotional — ramifications.
Without her £33,000 salary she could not pay the mortgage. Arrears mounted and she had to sell her house and move into the onebedroom flat that she’s currently in.
‘The family has suffered,’ she says. ‘No one considers what will happen when they dismiss you, how you will support your family. I’m a single parent.
‘My daughters should not be sleeping on sofas.’
But it’s typical of Sarah that, even during her darkest hours, when she was relying on the generosity of friends to support her, she refused to feel sorry for herself, instead getting work as a volunteer at her local food bank.
There was one moment of near comedy once when a friend from her local church knocked at her door and asked if she had a spare Bible to hand.
‘I thought, “Of all the people to ask for a Bible!” But I gave it to him.’
In January this year, she attended a hearing of the Nursing & Midwifery Council which ruled she had breached professional standards, saying: ‘ Your misconduct goes to the heart of what is the foremost and indispensable responsibility of a registered nurse.’ It said Sarah posed ‘a risk that you will, in the future, put patients at unwarranted risk of emotional harm, bring the profession into disrepute, and breach a fundamental tenet of the profession.’ harsh words, indeed. Conditions of practice were imposed.
Sarah had held off applying for a new post in the hope she would win her tribunal and clear her name, but when that did not happen, she began looking around for work.
In April this year Sarah was relieved to be taken on at a nursing home within the private sector, albeit in a role that was closely supervised.
Following on from the NMC hearing, Sarah penned a ‘written reflective piece’ to the NMC, about how she should behave as a nurse, and this met with a favourable response.
The NMC said she had demonstrated ‘full remediation and a high level of insight in regard to your failings’. Last month, the restrictions on her were lifted.
She is happy in her new post and understandably wary about going back to the NhS. ‘It seems you get blamed very easily, very quickly,’ she says.
She is cautious, of course, about the future and the way she must reconcile her devout faith with the strict code of practice she must follow.
‘I don’t have a plan as such about it — that would be too preemptive. If there is clear permission from a patient, then I will talk about my faith, with great sensitivity.
‘But I can still be a Christian at work. We can show Christ in the way in which we behave, the way we show compassion, without saying it. And that is what I will continue to do.’