VICTORIAN CIVIL AND ADMINISTRATIVE TRIBUNAL
administrative DIVISION
REVIEW AND REGULATION LIST	vcat reference No. Z445/2023
	
CATCHWORDS	
Review and Regulation List – Allegations of professional misconduct by a nurse under the Health Practitioner Regulation National Law Act 2009 (Vic) (National Law) – allegations of misappropriation and self-administration of drugs and of practising under the influence of drugs – criminal charges but no conviction – whether professional misconduct under paragraphs (a), (b) or (c) of the definition of professional misconduct in section 5 of the National Law – section 196 of the National Law – whether nurse should be reprimanded – whether registration should be cancelled or suspended – whether conditions should be imposed if suspended – whether nurse should be prohibited from providing any health service – period of review for conditions.	

APPLICANT	Nursing and Midwifery Board of Australia	
RESPONDENT	Trina Brown	
WHERE HELD	Melbourne	
BEFORE	E. de Zilwa, Presiding Member
M. Archibald PSM, Member
M. Bylhouwer, Member	
HEARING TYPE	Hearing	
DATE OF HEARING	13 December 2024	
DATE OF orders	16 and 19 December 2024	
DATE OF REASONS	6 June 2025	
CITATION	Nursing and Midwifery Board of Australia v Brown (Review and Regulation) [2025] VCAT 488	

Orders
Findings
1	In respect of Allegation 1 of the Amended Notice of Allegations, the Tribunal finds the conduct of the respondent constitutes professional misconduct within the meaning of paragraphs (a) and (c) of the definition of professional misconduct in section 5 of the Health Practitioner Regulation National Law Act 2009 (Vic) (‘National Law’).
2	In respect of Allegation 2 of the Amended Notice of Allegations, the Tribunal finds the conduct of the respondent constitutes professional misconduct within the meaning of paragraphs (a) and (c) of the definition of professional misconduct in section 5 of the National Law.
3	In respect of Allegation 3 of the Amended Notice of Allegations, the Tribunal finds the conduct of the respondent constitutes professional misconduct within the meaning of paragraphs (a) and (c) of the definition of professional misconduct in section 5 of the National Law. 
Determinations
4	Under section 196(2)(a) of the National Law, the respondent is reprimanded.
5	Under section 196(2)(d) of the National Law the respondent's registration is suspended for six months from the date of the Tribunal's orders (being until 18 June 2025).
6	Under section 196(2)(b) of the National Law the respondent's registration at the end of the suspension will be subject to the conditions in the form set out in the attached Schedule A.
7	Under section 196(3) of the National Law review period on the conditions of 6 months is imposed.
SCHEDULE A
Limitations on practice
1	The Practitioner may practise only in place(s) of practice approved by the Board/Ahpra.
For the purposes of this condition, 'practise' is defined as any role, whether remunerated or not, in which the individual uses their skills and knowledge as a nurse in their profession. It is not restricted to the provision of direct clinical care and includes using the knowledge and skills of a nurse in a direct non-clinical relationship with a client, working in management, administration, education, research, advisory, regulatory or policy development roles and any other roles that impact on safe, effective delivery of services in the nursing profession. 
For the purposes of this condition, the following practice locations have been approved: none yet approved. 
2	The Practitioner must only practise as an Enrolled Nurse when supervised by a Registered Nurse (the supervisor).
For the purposes of this condition, ‘supervised' is defined as: The Practitioner must consult with the supervisor who is always physically present in the workplace and available to observe and discuss the management of patients and/or performance of the Practitioner when necessary and otherwise at weekly intervals. 
3	The Practitioner must not practise between 11:00pm and 6:00am. 
4	The Practitioner must not exceed 24 hours of practice a week. 
5	Within 7 days of the notice of imposition of these conditions, the Practitioner must, on the approved form (HPN10), nominate a primary supervisor and at least one alternate supervisor to be approved by the Board/Ahpra. The Practitioner must ensure that each nomination is accompanied by an acknowledgement, on the approved form (HPNA10), from each nominated supervisor that they are willing to undertake the role of supervisor and are aware that Ahpra will seek reports from them. 
6	In the event that no approved supervisor is willing or able to provide the supervision required the Practitioner must cease practice immediately and must not resume practice until a new supervisor has been nominated by the Practitioner and approved by the Board/Ahpra.
7	Within 7 days of the notice of the imposition of these conditions, the Practitioner is to provide to Ahpra, on the approved form (HP10) acknowledgement that Ahpra may: 
(a)	obtain information from relevant authorities (such as but not limited to Medicare) 
(b)	obtain information and/or a report from the senior person at each place of practice on a monthly basis, and 
(c)	obtain a report from the approved supervisor on a monthly basis. 
8	Within 7 days of the notice of the imposition of these conditions, the Practitioner is to provide to Ahpra on the approved form (HPS10), acknowledgement from the senior person at each place of practice that Ahpra may seek reports from them. 
9	Within 21 days of the notice of the imposition of these conditions the Practitioner must provide to Ahpra, on the approved form (HPC), the contact details of a senior person, such as the Director of Nursing, or equivalent (the senior person) at each current place of practice. In providing this form, the practitioner acknowledges that Ahpra will contact the senior person and provide them with a copy of the conditions on the practitioner’s registration or confirm that the senior person has received a copy of the conditions from the practitioner. The practitioner will be required to provide the same form: 
(a)	within seven days of the commencement of practice at each subsequent place of practice, and 
(b)	within seven days of each and every notice of any subsequent alteration of these conditions. 
Undertake urine and hair drug screening 
10	The Practitioner must only take substances prescribed, approved, or administered by a nominated treating practitioner(s) and such nominated treating practitioner(s) must not be a relative, friend, professional colleague or in a contractual or financial relationship with the Practitioner. 
For the purposes of this condition 'substance' is defined as any illicit substance as well as any pharmacist only, prescription only and any controlled drug medication as contained in Schedule 3, 4, 8 or 11 in the Standard for the Uniform Scheduling of Medications and Poisons (the SUSMP) as amended from time to time and as published at https://www.tga.gov.au/publication/poisons-standard-susmp. 
11	No less than 14 days prior to commencing practise in accordance with condition 1, the Practitioner must commence random urine drug screening (UDS) and hair analysis for drug screening (hair analysis) in accordance with Ahpra’s protocol for UDS and hair analysis (the protocol) in force at the date these conditions are imposed and then amended from time to time. 
12	The Practitioner must commence UDS and hair analysis at Group Two frequency or as otherwise advised by Ahpra and must continue to attend at this frequency until the Board approves otherwise. 
13	Within 7 days of the notice of the imposition of these conditions, the Practitioner must provide to Ahpra: 
(a)	Confirmation, on the approved form (HP6), that they understand the requirements of the protocol as it pertains to urine and hair drug screening and they are aware of Ahpra’s monitoring of this condition. 
(b)	The details, on the approved form (HPF6), of all current substances that have been prescribed or administered to or approved for them, along with the contact information of all prescribing practitioners who have, or are likely to, prescribe, approve or administer substances. 
Attend treating practitioner(s) 
14	The Practitioner must undertake treatment with:
(a)	a general practitioner; and 
(b)	a psychologist or counsellor with expertise in drug and alcohol misuse and general psychological counselling 
(the treating practitioners) and attend at a frequency determined by the treating practitioners.  
15	Within 14 days of the notice of the imposition of these conditions, the Practitioner must provide the following to Ahpra: 
(a)	The contact details, on the approved form (HPF3), of all treating practitioners. 
(b)	Acknowledgement, on the approved form (HPF3), from the Practitioner that Ahpra may seek reports from the treating practitioner(s) on a monthly basis. 
(c)	Confirmation, on the approved form (HPNA3), from the treating practitioner(s) that they have seen a copy of the conditions on the Practitioner’s registration and are aware Ahpra may contact them to seek reports. 
16	Within 7 days of the notice of the imposition of these conditions the Practitioner must provide to Ahpra, on the approved form (HPC), the contact details of a senior person, such as the Director of Nursing/Senior Manager/other as appropriate (a senior person) at each current place of practice. In providing this form, the practitioner acknowledges that Ahpra will contact the senior person and provide them with a copy of the conditions on the practitioner’s registration or confirm that the senior person has received a copy of the conditions from the practitioner. The practitioner will be required to provide the same form: 
(a)	within seven days of the commencement of practice at each subsequent place of practice, and 
(b)	within seven days of each and every notice of any subsequent alteration of these conditions. 
17	All costs associated with compliance with the conditions on their registration are at the Practitioner’s own expense. 

E. de Zilwa
Presiding Member	M. Archibald PSM
Health Practitioner Member	M. Bylhouwer
Health Practitioner Member	

APPEARANCES:		
For the applicant 	Mr S Dawson of Counsel	
For the respondent 	Ms K Ottrey of Counsel	

Reasons
1	On 8 June 2023 the Nursing and Midwifery Board of Australia (‘the Board’) referred four allegations concerning Ms Trina Brown to the Tribunal. The referral was made under the Health Practitioner Regulation National Law (Victoria) Act 2009 (‘the National Law’) and was accompanied by a Notice of Allegations, later amended.
2	The Tribunal held a hearing in this matter on 13 December 2024. At the hearing the applicant was represented by Mr S Dawson of Counsel and the respondent was represented by Ms K Ottrey of Counsel.
3	On 16 December 2024 the Tribunal found that in respect of Allegations 1, 2 and 3 of the Amended Notice, the conduct of Ms Brown constitutes professional misconduct within the meaning of paragraphs (a) and (c) of the definition of professional misconduct in section 5 of the National Law.
4	On 19 December 2024 the Tribunal made orders that:
•	the respondent be reprimanded; 
•	that her registration is suspended for six months until 18 June 2025;
•	that her registration at the end of the suspension be subject to conditions; and
•	there be a six-month review period on those conditions.
5	Our reasons which were to follow, are now provided.
The Allegations
6	As the parties agreed, the misconduct at Lyndoch Living (‘Lyndoch’) occurred between 1 January and 30 June 2020. Lyndoch was a residential aged care facility in Warrnambool.
7	A notification about Ms Brown’s conduct had been made by a representative of Lyndoch to the Australian Health Practitioner Regulation Agency (‘Ahpra’) on 15 July 2020. 
8	In summary, the three allegations against Ms Brown were that she engaged in professional misconduct and/or unprofessional conduct in that:
•	between 1 January 2020 and 30 June 2020, she misappropriated:
o	Midazolam, a Schedule 4 drug of dependence which is a prescription only medication;
o	Morphine, which is a Schedule 8 drug of dependence known as a controlled drug; and 
o	consumables being needles and syringes, while working as an enrolled nurse at Lyndoch;
•	Between 1 January 2020 and 30 June 2020, she self-administered Midazolam and morphine in circumstances where the medications had not been prescribed for her; and
•	Between 1 January 2020 and 30 June 2020, she practised under the influence of Schedule 4 and Schedule 8 drugs of dependence.
Findings of fact
Misappropriation of Drugs and Consumables
9	On 30 June 2020 a medication count was undertaken at Lyndoch. The count showed that five 5 ml ampoules of Midazolam were missing. The drugs had been prescribed for a deceased resident and recorded in the drug register on 29 June 2020 as having been returned to the pharmacy when that resident died.
10	Ms Brown had co-signed the 29 June 2020 entry in the drug register to record the return of the five ampoules. They were not returned to the pharmacy. She later admitted she self-administered two ampoules at work that same day and took the remaining three ampoules home.
11	On 30 June 2020 Ms Brown was told by a colleague about an investigation into the missing Midazolam. On that same day, Ms Brown told the associate nurse unit manager at Lyndoch by a text message, that she had returned the Midazolam ampoules to the pharmacy and commented that she would be ‘horrified if it’s gone missing’.
12	On 3 July 2020 Ms Brown sent an email to a colleague at Lyndoch denying that she had misappropriated the drugs.
13	On 7 and 8 July 2020 Ms Brown was interviewed by representatives of Lyndoch. During the interviews Ms Brown admitted misappropriating and self administering the Midazolam.
14	Ms Brown also admitted that between 1 January 2020 and 30 June 2020 she misappropriated Midazolam and Morphine ampoules which had been discarded into a sharps container at Lyndoch. Over the same period Ms Brown misappropriated needles and syringes from Lyndoch to self-administer the misappropriated ampoules.
15	Between about 1 January 2020 and 30 June 2020 Ms Brown self-administered the drugs of dependence while working her shifts at Lyndoch. Ms Brown would self-administer the drugs of dependence in the staff toilets at Lyndoch. On 23 June 2020 she self-administered the drugs of dependence in a unisex toilet in the main foyer of Lyndoch.
16	Because of her self-administration of these drugs, Ms Brown would often sleep during her meal breaks at work and on one occasion fell asleep at the nurses’ desk.
17	On 10 July 2020, Victoria Police interviewed Ms Brown at the Warrnambool police station. She admitted to the misappropriation and self-administration of the drugs.
18	On 13 July 2020, Ms Brown emailed Lyndoch to resign her position. She apologised and stated that she was seeking help and took full responsibility for her actions.
19	On 29 July 2020, Victoria Police charged Ms Brown with several offences. These included theft of Midazolam and Morphine between 1 January 2020 and 28 June 2020; theft of five ampoules of Midazolam on 29 June 2020; unauthorised use of Morphine between 1 January 2020 and 28 June 2020; and unauthorised use of Midazolam between 1 January 2020 and 2 July 2020.
20	On 4 October 2021, Ms Brown appeared in the Magistrates’ Court at Warrnambool and accepted responsibility for the offences. The proceedings were adjourned to 4 April 2022 so Ms Brown could undertake a diversion program (‘diversion plan’). She was ordered to donate $300 to the Salvation Army; be of good behaviour until 4 April 2022; and to maintain scheduled contact with her drug and alcohol counsellor until 4 April 2022.
21	Ms Brown completed the diversion plan. On 4 April 2022 she was discharged without any finding of guilt.
Self-administration of Drugs
22	Ms Brown admitted the facts underlying Allegation 2. She admits self-administering Midazolam and Morphine, which are prescription only medications, in circumstances where these drugs had not been prescribed for her.
Practising Under the Influence of Drugs
23	Ms Brown also admitted the facts underlying Allegation 3. She admitted practising as a nurse under the influence of drugs of dependence, namely Midazolam and Morphine, between 1 January 2020 and 30 June 2020.
Findings under the National Law
24	Once we find the facts proven, we are required to decide, relevantly here, whether the conduct is to be characterised as professional misconduct or unprofessional conduct. These terms are defined by the National Law. 
25	The National Law provides three definitions of professional misconduct:
(a) 	unprofessional conduct by the practitioner that amounts to conduct that is substantially below the standard reasonably expected of a registered health practitioner of an equivalent level of training or experience; and 
(b) 	more than one instance of unprofessional conduct that, when considered together, amounts to conduct that is substantially below the standard reasonably expected of a registered health practitioner of an equivalent level of training or experience; and 
(c) 	conduct of the practitioner, whether occurring in connection with the practice of the health practitioners profession or not, that is inconsistent with the practitioner being a fit and proper person to hold registration in the profession.
26	The National Law’s definition of unprofessional conduct is ‘professional conduct that is of a lesser standard than that which might reasonably be expected of the health practitioner by the public or the practitioner’s professional peers’. This includes contravention by the practitioner of the National Law and conviction of the practitioner for an offence under another Act.
27	In an Agreed Statement of Facts Findings and Determinations dated 19 August 2024, the parties provided joint submissions concerning characterisation, with which we agree.
28	Ms Brown’s conduct constitutes professional misconduct as defined in paragraphs (a) and (c) of definition of professional misconduct in section 5.
29	Her conduct was below that which would be expected by reasonable members of the public and by nurses of similar standing in the nursing profession. Her behaviour involved repeated instances of behaviour which were unlawful. 
30	Ms Brown’s conduct from January to late June 2020 was professional misconduct such that it made Ms Brown not a fit and proper person to be a member of the nursing profession at the time she committed the criminal offences.
31	Ms Brown engaged in criminal behaviour which led to her being charged with criminal offences and she acknowledged her guilt for those offences in court. Importantly she was not convicted of those offences by the court. 
32	The finding of not being a fit and proper person applies to her conduct at that time. It is not a finding about her conduct at the time of the VCAT hearing.
33	Ms Brown’s conduct at the time she offended rendered her an unfit person, but that does not prevent her from subsequently becoming a fit and proper person.
34	Ms Brown’s misconduct clearly fits within paragraphs (a) and (c) of the definition of professional misconduct.
Determinations under the National Law 
35	Once findings of fact and findings of characterisation under the National Law have been made, the next step for the Tribunal to take is to make determinations.
36	While the parties agreed that the Tribunal should reprimand Ms Brown, that was where their agreement ended.
37	The Board submitted that the Tribunal should cancel Ms Brown’s registration as a nurse and prohibit her from practising in health-related areas until she regains her registration.
38	Ms Brown submitted that her registration should not be cancelled, and she should not be disqualified from practice, but that her registration should be suspended. It was also submitted there should be conditions imposed on her registration as recommend by Dr Dore, a consultant psychiatrist and specialist in addiction medicine, who had examined and reported on Ms Brown.
The Board’s Submissions
39	In support of cancellation of registration, the Board in summary submitted:
•	general deterrence was a most important factor;
•	her misconduct was a serious departure from professional standards;
•	her behaviour was criminal;
•	she was not a fit and proper person to be registered as a nurse;
•	the misconduct was undertaken secretly;
•	she used these drugs at work;
•	consequently there was no prescriber supervision when she was using the drugs; and
•	this meant she placed herself and her patients at risk.
40	We were told that Ms Brown should have known of the risks she exposed herself to and that she was risking the care of others. As an Enrolled Nurse, she should have known she could seek help and where she could get it. See Paramedicine Board of Australia v Graham (‘Graham’s case’). 
41	The nature of Ms Brown’s conduct was escalating over the relevant period. She initially denied wrongdoing and obfuscated. Her misconduct was said to be overt but deceptive. For example, she had been filmed on CCTV cameras entering and leaving a toilet.  A cleaner entered the same toilet immediately after Ms Brown left and found a syringe and bloodstained needle on the floor of the same toilet.
42	It was emphasised that she had privileged access to drugs and syringes. The public confidence in the nursing profession could be undermined by Ms Brown’s conduct. She represented a significant risk to the public. 
43	It was submitted that cancellation of Ms Brown’s registration is necessary to maintain public confidence in the nursing profession.
44	We were referred to parts of the decision in Graham’s case to emphasise the propositions that:
•	health practitioners should obtain professional help and advice; 
•	health professionals have better access than many people to support and treatment options; and
•	they have a particular responsibility to ensure they do not practice when their capacity to meet their professional duties is impaired.
45	In other words, it was said to us that cancellation of registration in this instance was necessary for general deterrence and can even encourage other practitioners who may have similar problems to seek help.
46	The conclusion was that, given the obvious questions about Ms Brown’s fitness to practice, cancellation of her registration was an appropriate determination.
47	It was said to us that general deterrence was more important than specific deterrence in this instance. Part of the reason for this was that Ms Brown had shown insight into her misconduct. This was demonstrated by the evidence she gave to the Tribunal about her poor health and situations of stress that she had been under.
48	The Board was not asking that Ms Brown be prohibited for a time from applying for registration. The Board’s position recognised the hard work undertaken by Ms Brown in overcoming her addictions. However, cancellation would send an appropriate message to the public in a way that would not be achieved if Ms Brown’s registration was suspended. The community and the nursing profession need to know that practitioners are not able to abuse their position in the way done by Ms Brown.
49	The Board noted that Ms Brown had given an undertaking not to practice and she had abided by that undertaking, not practising since July 2020.
50	The Board also submitted that, given the gravity of her conduct, an order under section 196(4)(b) prohibiting Ms Brown from providing health services should be made.
51	Such a prohibition order would prevent Ms Brown from providing an extensive range of health services, while she did not hold registration.
52	Prohibition, it was said, would give effect to the paramount purpose of the National Law, which was protecting the public. A prohibition order would be necessary to prevent Ms Brown from working in a related healthcare field until she regained her nursing registration.
Submissions for Ms Brown
53	Ms Ottrey submitted on behalf of Ms Brown:
•	Ms Brown’s registration should not be cancelled and there should be no prohibition order;
•	Ms Brown has worked in the healthcare and disability sectors and has an interest in doing so again;
•	the prohibition order sought by the Board is too broad given that Ms Brown’s misconduct was narrow by comparison; and
•	if Ms Brown chose not to reregister, the prohibition order that the Board sought could effectively continue for ever and prevent her from working in the health system in any capacity.
54	We were told Ms Brown is not a risk to the community. She had been a risk to patients under her care when she misappropriated medication, but the Board has not identified any risk that she continues to pose to the community.
55	In oral submissions about the facts of this proceeding, Ms Ottrey submitted:
•	the misconduct was very grave; 
•	it involved working under the influence of drugs which can be a risk to patient care; 
•	Ms Brown did not divert medication from the residents of Lyndoch; 
•	there were no adverse consequences for the residents of Lyndoch; 
•	her misconduct was an unplanned event and there was no evidence of calculation on her part;
•	the allegations relate to a limited period of six months; and
•	the investigative processes undertaken by Lyndoch are in the Tribunal Book and show how suspicion fell on Ms Brown.
56	In relation to the criminal prosecutions against her, we were reminded that:
•	these were based on her own admissions; 
•	the interview contains all the admissions she made; 
•	there was no objective evidence that forced her admissions; and
•	she had shown candour and integrity.
57	In her favour, we were told Ms Brown had shown remorse, contrition and insight. She accepted responsibility for her misconduct. At the time of the first interview at Lyndoch she was physically unwell. Ms Brown resigned her employment promptly and apologised to her employer. This was before the complaints against her were referred to Ahpra. It was conceded that the early denials made by Ms Brown were troubling but there is evidence that she subsequently showed remorse. 
58	Ms Brown organised her own residential rehabilitation and consulted her general practitioner. She sought counselling, spoke to her brother and followed up on Dr Dore’s recommendations.
59	She persisted in seeking treatment for her back problems. This led to her having two hip replacements and therefore she is no longer in the chronic pain that she previously suffered from, and which was recognised as part of the reason she self-medicated.
60	In relation to the allegations against Ms Brown, it was conceded that:
•	the seriousness of her conduct did amount to an abuse of trust; 
•	her misappropriation of medication occurred over six months; 
•	she only appropriated discarded medication or medication which had been intended for use by a deceased resident; 
•	for most of the period of her offending up until 29 June 2020, Ms Brown’s misappropriation of medication related to residual medication;
•	on 29 June 2020 Ms Brown misappropriated unopened ampoules of medication;
•	Ms Brown’s conduct in misappropriating medication was unsophisticated and not part of a carefully contrived plan;
•	although there are no known adverse consequences for the residents who were treated by Ms Brown while she was under the influence of medication, there was a clear risk that those residents could have suffered adverse health consequences; and
•	Ms Brown did not profit from her unlawful conduct.
61	We were told that Ms Brown will be fit to resume practice under certain conditions and that she is not permanently unfit to practice as an Enrolled Nurse. This means that it is appropriate to suspend her registration, but not to cancel her registration. It was noted that the reports from Dr Dore (and an earlier report from Dr Prior, also a psychiatrist) made clear that Ms Brown is not permanently and indefinitely unfit to resume practice as an enrolled nurse.
62	Dr Dore recommended that conditions be imposed on Ms Brown’s return to practice.
63	It was submitted that there has been delay of more than four years between Ms Brown’s misconduct being discovered and this hearing taking place. The Allegations relate to the period between January and the end of June 2020. 
64	In the intervening time, among other things, Ms Brown:
•	was the subject of an enquiry by her former employers; 
•	resigned her employment and apologised for her misconduct; 
•	was interviewed and charged by Victoria Police;
•	appeared in court, admitted her guilt and was placed on a diversion plan; 
•	successfully completed that programme and was discharged by the court without a conviction; 
•	underwent counselling and therapy; 
•	had surgery to replace both her hips; and 
•	has participated in voluntary work to help disabled people.
65	Ms Ottrey submitted that the delay had served the need for general deterrence in respect of the profession and the requirements of specific deterrence for Ms Brown.
66	The delay enabled Ms Brown to show the Tribunal that she has not abused medication over the period of the delay and that she has been rehabilitated. Sanctions designed to protect the community from Ms Brown are no longer necessary. The risks and stressors which caused her misconduct are no longer present in Ms Brown’s life.
67	The need for general deterrence can now be met by a reprimand and a suspension of her registration with conditions.
68	The need for specific deterrence has been moderated. This is shown by Ms Brown’s expressions of remorse and her demonstrated insight into her misconduct. She no longer has access to Schedule 4 medication. There have been no other notifications about her to Ahpra or the Board.
Ms Brown’s Evidence
69	Ms Brown gave evidence, including that she was born, lived and was educated in rural Victoria; 
•	she is the youngest of four children, having three older brothers;
•	she grew up on a farm; 
•	her father died when she was 11 years old; 
•	she successfully completed her secondary education but did not immediately pursue tertiary education; 
•	in the year 2000 Ms Brown undertook music studies; and
•	Ms Brown travelled overseas and lived in London for four months but became homesick and returned to Australia. 
70	Ms Brown has worked in a wide range of areas, including working at a nursing home as a personal care assistant, factory work, working in a band, working as an artificial insemination technician, farm work and hospitality work. Some of this work was physically demanding. 
71	She completed TAFE studies in 2010 and was first registered as an Enrolled Nurse on 20 November 2011. Ms Brown commenced work at Lyndoch in Warrnambool on a casual basis. From 2012 Ms Brown’s work at Lyndoch became regular nightshift work, being six nightshifts per fortnight.
72	Ms Brown had a history of misusing alcohol and drugs before she commenced work at Lyndoch. In part, this was her way of coping with physical injuries she had sustained during her working life before starting at Lyndoch. 
73	She told us she:
•	had worked in aged care from 1997 to 1999; 
•	when she completed her nurse training in 2010 she started working in 2011 at Lyndoch; 
•	from 2012 she was put on a contract at Lyndoch; 
•	she worked the night shift which was supposed to be 48 hours per fortnight; 
•	she always put in more time than was expected; 
•	she worked in the dementia ward and with high care residents; 
•	Lyndoch was always short staffed; 
•	she loved working in aged care and loved working with elderly people; 
•	she did not enjoy the stress of that work; 
•	she felt that the conditions of work meant that she could not work safely; 
•	the residents were not safe and did not get appropriate care; 
•	the Covid pandemic made it harder to work at Lyndoch; 
•	she could not afford to resign from her position; 
•	she was in physical pain when working at Lyndoch; 
•	with hindsight she knows now she should have resigned but she was under financial stress as she was trying to pay off two mortgages; and
•	her relationship had broken down and she was on her own.
74	In relation to the events of 29 June 2020 surrounding the missing ampoules of medication, Ms Brown said she was shocked at what she had done and was fearful of the consequences when she sent the text messages in response to concerns about the missing ampoules.
75	As to her physical and mental condition, Ms Brown gave evidence that she had started to suffer back problems in 2015. Scans of her back, ordered by her general practitioner, showed no evidence of back problems. She continued to suffer back pain and was treated by a chiropractor and undertook walking as exercise.  Her general practitioner prescribed panadeine forte and anti-inflammatory medication. 
76	Ultimately Ms Brown was diagnosed with severe hip damage. It appears this had been the cause of her back pain. She had surgery to replace both her hips. The first hip replacement operation was April 2022. The second operation was in May 2024. She had to take opioids after the hip operations but has not used them since then. She said that she now takes panadol and meloxicam only as needed. She does rehabilitation exercises, swims and walks daily. 
77	In relation to her mental health history, Ms Bown said her mental health was good before she started working at Lyndoch. By 2020, she said her mental health had deteriorated. She reported physical pain, the breakdown of her relationship, the fact that her mother was unwell, and the difficulties of dealing with the Covid pandemic. To deal with these problems she consulted her general practitioner who prescribed antidepressant medication. She started using this medication while working at Lyndoch. She only told her general practitioner about her wrongdoing after it was discovered. Her doctor knew about the stress she was under. Ms Brown stated that she has now learned to communicate and will not try to do everything alone. 
78	As noted above, in mid-July 2020, after the internal investigation at Lyndoch, Ms Brown resigned from her employment and apologised to her employer for her misconduct. 
79	Ms Ottrey reminded us that Lyndoch notified Ahpra. Subsequently, in a telephone call with Ahpra, Ms Brown asked to ‘self-suspend’ her registration. The Board proposed immediate action to suspend Ms Brown’s registration on 29 July 2020. On that same day, Ms Brown was charged by Victoria Police. On 31 July Ms Brown notified Ahpra that she had been charged and offered an undertaking not to practice as a nurse. This undertaking was accepted on 5 August 2020.
80	Ms Brown’s evidence was that she did not keep a stockpile of drugs at her home. After leaving her employment at Lyndoch she began to experience withdrawal symptoms. She spoke to her general practitioner and commenced a 28-day residential addictive behaviours program at the Geelong Clinic. She successfully completed this program and was discharged from the clinic. Her evidence was that her stay at the clinic taught her about pain management. She received help in planning her next steps of recovery from addiction. She decided to return home to live with her mother. From July to October 2024, she undertook drug and alcohol counselling at Odyssey House. She explained that this was quicker than seeing a psychologist or a psychiatrist. She no longer uses drugs and does not have an alcohol over-use problem. She has developed strategies about how to deal with stress.
Dr Prior’s Report
81	Ahpra obtained a report from Dr Nigel Prior, a consultant psychiatrist, concerning Ms Brown, referred to above. Among other things, Dr Prior was given the results of a hair drug screen test conducted in April 2021. He interviewed Ms Brown by Skype in May 2021. His conclusion was that Ms Brown was fit to return to work but with some conditions imposed on her. These included treatment for substance abuse, with the treater providing reports to the Board; drug and alcohol testing; supervised employment, initially part-time and not night shifts; and any employment to exclude some drug handling, such as restricted Schedule 4 or Schedule 8 medications.
82	In her evidence, Ms Brown said that at the time of Dr Prior’s report she did not feel ready to return to work as an Enrolled Nurse. She had tried counselling as he recommended, but was focused on moving home at the time, and was having difficulty in dealing with her physical pain.
83	When she finished working at Lyndoch, Ms Brown worked in Warrnambool and then returned to Colac. Her work has mainly been in the hotel and hospitality industry. She still works at a hotel.
84	In the future, Ms Brown said she would like to work in disability care as a support worker. She currently helps with a program for riding for the disabled. She does this once every week. She would like to become a riding coach. She already has a Working with Children card.
85	She realises that if the Tribunal made a prohibition order this would prevent her from working with disabled people.
86	She said that her life has changed since leaving Lyndoch. She no longer endures physical pain. She does not face the same financial pressures. She no longer uses drugs. She lives independently with her mother, whose health has improved. She pays her share of the household expenses such as food and utility bills.
87	She explained that the delay in the hearing has not been easy to deal with. Her misconduct was not what she would normally do, and she doesn’t like herself for having done the things she did. Her judgment was badly affected by the drugs she misused. She realises that she could have hurt somebody else or herself. She said that she is unsure about returning to the nursing profession, but she would like to be able to make that choice for herself. If she did, she is aware that she would have to choose employment that did not hurt her own body. She understands that after a period of 5 years away from the profession she would have to retrain. If she did re-enter the profession, she is aware of the issues she would face. 
Determinations
88	We have already found that the facts as outlined above constitute professional misconduct. We are satisfied that Ms Brown’s conduct was inconsistent with her being a fit and proper person to hold registration as an Enrolled Nurse. 
89	A range of sanctions is available to the Tribunal under section 196(2) of the National Law. We can:
(a) 	caution or reprimand the practitioner;
(b)	Impose a condition on the practitioner’s registration, including, for example—
(i) 		a condition requiring the practitioner to complete specified further education or training, or to undergo counselling, within a specified period; or 
(ii) 	a condition requiring the practitioner to undertake a specified period of supervised practice; or
(iii) 	a condition requiring the practitioner to do, or refrain from doing, something in connection with the practitioner’s practice; or 
(iv) 	a condition requiring the practitioner to manage the practitioners practice in a specified way; or 
(v) 	a condition requiring the practitioner to report to a specified person at specified times about the practitioner’s practice; or 
(vi) 	a condition requiring the practitioner not to employ, engage or recommend a specified person, or class of persons, 
(c) 	require the practitioner to pay a fine of not more than $30,000 to the national board that registers the practitioner; 
(d) 	suspend the practitioner’s registration for a specified period;
(e) 	cancel the practitioner’s registration.
90	In making our decisions we relied on the Tribunal Book and other documents given to us at the hearing, including a letter from Odyssey House.
Reprimand
91	We have decided that Ms Brown must be reprimanded under section 196 (2)(a) of the National Law. The misconduct admitted by Ms Brown requires a serious censure. To reprimand her is to impose a serious censure for that misconduct.
Suspension of Registration
92	We decided to suspend Ms Brown’s registration for six months under section 196(2)(d) of the National Law. 
93	Given all the circumstances surrounding Miss Brown’s misconduct and how she has acted in the time leading up to this hearing, cancellation of Ms Brown’s registration is not warranted. 
94	We are satisfied that Ms Brown no longer poses the same risk to potential patients or the public that she did at the time of her misconduct in 2020. We accept that part of the reason for her misconduct at the time was that she was suffering physical pain. We note that Miss Brown had a total right hip replacement in April 2022 and a total left hip replacement in May 2024. The evidence is that her physical pain has largely been resolved by the hip replacements.
95	Her chronic pain led her to abuse medications. The cause of her pain having been removed has been a significant factor in her rehabilitation. 
96	Another significant part of her rehabilitation was that she recognised the extremely serious nature of her misconduct, and she took steps to rehabilitate herself. This was evident from her successful participation in drug addiction therapies and has been generally confirmed by the two reports referred to above, one from Dr Prior in May 2021 and the other from Dr Dore in February 2024. 
97	Her professional misconduct was totally unacceptable behaviour by an Enrolled Nurse. It was inconsistent with her being a fit and proper person to hold registration as an Enrolled Nurse. However, the fact that she undertook drug rehabilitation on her own initiative demonstrates appropriate insight into the gravity of her own misconduct. Ms Brown is clearly remorseful for her misconduct. The time that has passed since her misconduct in June 2020 and the hearing before the Tribunal in December 2024, combined with her rehabilitation, works in her favour.
98	As noted above, one of the events during the period of rehabilitation was the fact that she was charged with criminal offences by the police, that she acknowledged her guilt for those offences and that the court placed her in a diversion plan which she successfully completed. Subsequently, the court discharged her without a conviction. Given those circumstances, the community expectations of general deterrence will be met by our orders.
99	Similarly, her insight into the harm she may have caused those for whom she was supposed to be caring, coupled with the genuine remorse that she expressed, must be considered with her subsequent behaviour since her discharge by the Magistrates’ Court. Ms Brown voluntarily undertook to cease practice as an Enrolled Nurse, quite soon after resigning from her employment, in August 2020. In all the circumstances, we are satisfied that the needs of specific deterrence will also be met by our orders.
100	For these reasons to cancel her registration would be excessive and serve no good purpose. 
101	By contrast, to suspend her registration is a fair, effective and proportionate way of condemning her professional misconduct. 
102	In the event Ms Brown chooses to return to nursing, because of the time that has passed since her voluntarily ceasing to practice, she would have to undertake re-entry to practice training. 
Conditions on Registration
103	Ms Brown should not be allowed to resume practice as an Enrolled Nurse without conditions being imposed upon her registration. It is appropriate that the conditions suggested by Dr Dore in her report of February 2024 be in place to support Ms Brown if she returns to practice after the period of suspension concludes. The Tribunal imposes those conditions under section 196(2)(d) of the National Law. Our orders of 19 December 2024 contain those conditions. 
104	Section 196(3) of the National Law requires that, as we have determined that conditions be imposed upon any registration of Ms Brown, it is necessary for us to decide a review period for the conditions we impose. We fix a review period of 6 months for those conditions.

105	The Board also sought a prohibition order under section 196(4)(b) of the National Law to prohibit Ms Brown from providing a health service. Such an order can only be made if the Tribunal decides to cancel Ms Brown’s registration. As we have decided not to cancel her registration, we will not make the order sought by the Board under section 196(4)(b). 

E. de Zilwa
Presiding Member	M. Archibald PSM
Health Practitioner Member	M. Bylhouwer
Health Practitioner Member