A rest home resident with dementia slapped a nurse across the face hard, causing a loud cracking sound. 

The nurse said her “mind went blank” in that moment and she slapped the client back with the same force. 

The woman, whose name is permanently suppressed, immediately admitted that what she did was wrong and was dismissed from the rest home. 

This week, she appeared before the Health Practitioners Disciplinary Tribunal, which found her actions met the threshold for disciplinary sanction. 

Pleas for help 

The teleconference hearing heard the woman had completed an Enrolled Nursing diploma and was registered with the Nursing Council. 

In 2024, she was working a day shift at an Invercargill rest home when she heard the site’s cook yelling “help” and went to investigate. 

She found the cook in the dining room of the home, cornered by one of the residents. 

The agreed facts said the resident, who had a diagnosis of peripheral vascular dementia, had one hand gripped on the cook’s wrist. 

The resident’s other hand was on her walker. 

She was trying to shut the fire doors but was not letting the staff press the button to release them. 

The nurse approached the resident and, according to the agreed facts, said something to the effect of: “Come on darling, let’s go to your room and you can tell me what your issue is.” 

In response, the resident let go of the woman’s wrist and slapped the nurse in a way the cook described as having made “a real crack”. 

It was a “definitely hard” hit, the cook said. 

Seconds later, the nurse slapped the patient back with about the same amount of force. 

She then left the room to consult with her manager over the situation. 

The Health Practitioners Disciplinary Tribunal has made a ruling on the incident in Invercargill. Photo / 123rf 

On her way out, she saw another staff member, whom she told to go and assist the cornered cook and check on the other workers. 

When that staff member went into the dining room, the resident was hitting the cook. 

Reinforcements called 

Other care workers tried to get the resident to stop but she grabbed one of the carer’s arms and rammed her walker into her. 

She then turned back to the cook, grabbed her thumb and bent it back. 

The care workers pried the resident off the cook and pushed a wheelchair under the woman’s legs for her to sit. 

When the nurse told her manager what had happened, the manager advised that they call an ambulance to get the resident out of the home. 

Police had to be called because the resident was unco-operative. 

Three paramedics and four police officers tried to get her into the ambulance, but she slapped two of the officers with a remote control. 

Eventual de-escalation 

Eventually, another carer was called in who was able to calm the woman down. 

The manager later told the Nursing Council that at some point during that time, the nurse confessed to hitting the resident. 

Later, when speaking to a nurse in the emergency department, the manager declared the resident was not allowed to return to the home. 

It was her second paranoid episode, her dementia was progressing and she had assaulted staff, the manager said. 

Despite this, there was an attempt made to return the woman to the rest home, but she refused to go inside. 

Later, the woman was taken into another rest home with dementia-level care. 

The day after the incident, the manager discussed it with the nurse, who acknowledged she should not have assaulted the client. 

She said it was an “instant reaction” and accepted there would be consequences. 

Two days later, she was suspended with full pay pending an investigation. She was later dismissed. 

It was a ‘reaction’ 

The nurse told the disciplinary tribunal she was not claiming to have hit her client in self-defence. 

It was merely a “reaction”, she said. 

“Throughout this whole process, I have been very transparent and I’ve accepted my actions,” she said. 

She realised her behaviour was unprofessional and would bring the nursing profession into disrepute. 

The rest home’s management had not done anything about the client’s aggressive behaviour, she said, and she felt let down by them. 

But she “wholeheartedly” took responsibility for her actions and would take whatever penalties were imposed. 

“I regret what I’ve done,” she said. “My mind was gone. I can only learn from this.” 

She said she knew it wouldn’t happen again because of the effect it had on her life, her family and her job. 

The woman missed nursing, interacting with residents and helping people through “their time of need”. 

Understaffed and missed training 

Before the incident, and despite working at the rest home for some years, the nurse had not completed the home’s de-escalation training. 

She said she had not received the training because of short staffing. 

The woman asked the tribunal to recognise she was not only a nurse, but a care worker who spent more “time on the floor” interacting with residents. 

“This would be the only incident that I’ve had where my mind went blank,” she told the tribunal. 

“I had no reason for it, to be truthful. 

“I just was assaulted and reacted.” 

Since her dismissal, she had completed the de-escalation programme and one year of study to become a registered nurse. 

She was planning to relocate and return to work and studying. 

The tribunal censured the nurse and ordered her to complete a Nursing Council-approved de-escalation programme within six months of resuming work as a nurse. 

On returning to work, she must also be mentored by a council-approved supervisor for six months. 

She was also ordered to pay 10% of the Nursing Council’s costs, an estimate of more than $3000. 

Ella Scott-Fleming has been a journalist for three years and previously worked at the Otago Daily Times, Gore Ensign and Metro Magazine. She has an interest in court and general reporting. She’s currently based in Auckland covering justice related stories.