An aged care nurse who slammed a dementia patient’s therapy doll on a table and laughed at the distressed patient who believed it was a real baby has been found to have been “callous and deplorable”.
Sudiksha Ahuja was found guilty in August of unsatisfactory professional conduct after being prosecuted by the Health Care Complaints Commission before the New South Wales civil and administrative tribunal, the commission said in a statement on Tuesday. On Monday, the commission cancelled Ahuja’s registration as an enrolled nurse.
According to the tribunal’s decision, the incident occurred in the residential aged care section of Junee hospital shortly after 3pm on 9 December 2021.
At the aged care facility, doll diversion therapy was used to help patients in later stages of dementia to reminisce about when they were mothers, which helped calm them into thinking they were holding and looking after their baby, according to evidence tendered at the hearing.
Although the dolls were used communally in the dining room, an 85-year-old patient known as “Patient A” was especially attached to the dolls, said hello to them every morning and believed they were her “real” babies, the inquiry heard.
The tribunal found Ahuja and another assistant in nursing (AIN) working in the facility – known as AIN-B – were well-acquainted with Patient A and knew she could easily be upset by people disrespecting her view of the dolls as babies.
The tribunal found the two practitioners were “from the outset … bent on getting an agitated reaction from Patient A by mishandling the dolls. They thought it was amusing.”
The tribunal found it was not clear which practitioner initiated the conduct. AIN-B alleged it was Ahuja who “said she was going to do something to prank Patient A”, while another staff member gave evidence to the inquiry alleging she heard AIN-B say to Ahuja “[Patient A] hates it when people mess around with the dolls. Go move the blanket and see.”
After entering the dining room, the tribunal heard, Ahuja removed one of the dolls from the cradle and proceeded to bang the head of the doll on the dining room table in the presence of Patient A. The tribunal heard she “slammed it hard, face first on the table”.
The tribunal heard evidence that Ahuja said “Patient A, Patient A look at this” and Patient A tried to get the two practitioners to stop, but was struggling to get words out.
The tribunal heard evidence “Patient A had tears in her eyes at the time and was showing signs of distress by crying out.”
Ahuja “thought the situation was humorous and was laughing at Patient A’s distress in the circumstances … [and] her own conduct,” the tribunal found. The tribunal did not accept Ahuja’s evidence that the laughter was an attempt to reassure Patient A or lighten her mood.
The tribunal heard that other staff members had to step in to stop Ahuja and AIN-B from engaging in the conduct and they were told to stop by another staff member, another patient and by Patient A herself.
The staff member who asked Ahuja and AIN-B to stop three times gave evidence, saying she wasn’t as forceful as she could have been.
“I was more like, ‘Oh, guys, stop. No, don’t do that.’”
The tribunal also rejected Ahuja’s version of events that she hadn’t banged the doll on the table, but instead put the doll on to the table, with the tribunal saying that was “totally unconvincing”.
Ahuja also provided a demonstration of how she handled the doll. “It was apparent that in her attempts at demonstrating what she was doing with the doll, [Ahuja] became aware of the difficulty she was having in reliably telling the truth and changed the manner in which she was giving the demonstration on a number of occasions,” the tribunal found.
“The conduct was callous and deplorable. It set out to, and did, cause agitation and distress to Patient A.”
Another staff member gave evidence that she found Patient A in her nightie later having uncharacteristically gotten herself out of bed. Patient A explained she was “checking whether the babies are safe”.
A nurse attending to Patient A’s medicine the next morning recorded in a progress note that “Patient A started crying / stated that they should not do that / when I asked Patient A what was the matter she further stated / that the girls were hurting the babies they were hitting [their] heads on the tables and laughing / Patient A was very upset she remained crying and shaking her head.”
The tribunal found “although the conduct, their ‘prank’, occurred only on one day, [Ahuja’s] attempt to collude with AIN-B to avoid responsibility compounds her culpability.”
The tribunal heard that on or about 2 March 2022, after the Murrumbidgee local health district begun investigating her conduct, Ahuja messaged AIN-B on Snapchat, requesting she call her.
AIN-B gave evidence that Ahuja asked her to provide false information about the incident to the investigation, by saying words to the effect of “Can you please tell them that I just dropped it accidentally? And nothing. I didn’t smack it on the table.”
Ahuja cautioned the tribunal against accepting AIN-B’s evidence, saying it was unreliable. The tribunal accepted the need for caution but maintained in their view Ahuja was attempting to collude.
Ahuja’s registration as an enrolled nurse has been cancelled and the tribunal made an order prohibiting Ahuja from providing any health service for 12 months.
The tribunal found Ahuja’s conduct was “the antithesis of what is required of carers in aged care facilities where patients may be frail, and challenged both physically and mentally. The conduct was significantly below the Codes of Practice and Standards by which [she] was required to abide.”
