Registered nurse dismissed for refusing to return to work: conduct dismissal upheld
A tribunal has upheld the dismissal of a Band 5 registered nurse who refused to return to work after being removed from clinical duties over patient safety concerns. All claims, including unfair dismissal and disability discrimination, were dismissed.
1 min read · Last updated 18 May 2026
Case details
- #conduct-dismissal
- #unauthorised-absence
- #patient-safety
- #occupational-health-refusal
- #perceived-disability
- #autism
Key facts
- The claimant was employed as a Band 5 Registered Nurse from 27 March 2016 until dismissal on 18 November 2019.
- On 25 March 2018, the claimant left a Level 3 patient's bedside and refused to return due to interactions with staff.
- On 13 June 2018, a patient complained that the claimant caused him pain by moving him without help.
- The claimant was removed from clinical duties on 5 July 2018 due to patient safety concerns.
- The claimant refused to attend Occupational Health appointments and obtained a GP letter confirming no mental illness or learning disability.
- The claimant was absent without leave from 6 August 2018 and admitted there was no medical reason for not returning to work.
Timeline
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Employment started
Claimant began working as a Registered Nurse for the Respondent.
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Moved to Critical Care Unit
Claimant moved to work on the Critical Care Unit due to a breakdown in relationships on Kirton Ward.
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First incident: left patient bedside
Claimant left a Level 3 patient's bedside and refused to return after interactions with staff.
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Meeting with Roz Yale
Roz Yale met with the claimant to discuss the incident and suggested an Occupational Health referral for possible Autism; claimant refused.
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Second incident: patient complaint
A patient complained that the claimant caused him pain by moving him without assistance.
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Decision to remove from clinical duties
Meeting held; decision taken to remove claimant from clinical duties due to patient safety concerns.
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Removed from clinical duties
Claimant verbally informed she was placed on restricted duties with no direct patient contact.
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Refused to return to work
Claimant was required to return to work on non-clinical duties but refused; absence became unauthorised.
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First disciplinary outcome: written warning
First Disciplinary Hearing resulted in a formal written warning and conditions to return to work.
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Fourth disciplinary hearing: dismissal
Fourth Disciplinary Hearing decided to dismiss the claimant for failure to comply with management requests.
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Effective date of termination
Claimant's employment terminated after one month's notice.
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Appeal hearing
Appeal hearing chaired by Mike Mears; dismissal upheld.
The legal issue
The tribunal had to decide whether the nurse was unfairly dismissed for conduct, whether she was directly discriminated against because of a perceived disability (Autism), and whether she was entitled to unpaid wages, holiday pay, and notice pay.
The outcome
The tribunal dismissed all claims. It found that the dismissal was fair by reason of conduct, as the nurse had refused to return to work after being offered non-clinical duties and had no medical justification for her absence. The claim of direct disability discrimination based on a perceived disability also failed, as the tribunal found no evidence that the employer perceived her as disabled. Claims for unpaid wages, holiday pay, and notice pay were also dismissed.
- No compensation awarded as all claims failed.
Lessons & takeaways
- Employees who refuse to follow reasonable management instructions, including attending occupational health, risk dismissal for conduct.
- A claim of perceived disability discrimination requires evidence that the employer actually believed the employee was disabled, not just that they considered a referral.
- Long-term unauthorised absence without a medical reason is likely to be treated as a conduct issue, not a capability issue.
What this case shows in practice
This case highlights the importance of following reasonable management instructions, especially in safety-critical roles like nursing. The registered nurse was removed from clinical duties after two incidents raised patient safety concerns. When offered non-clinical duties, she refused to return to work and also refused to attend occupational health appointments. Her absence became unauthorised, and despite a written warning and multiple disciplinary hearings, she continued to stay away. The tribunal found that the employer acted reasonably in dismissing her for conduct.
What the employer did right
The employer followed a thorough process: it removed the nurse from clinical duties when safety concerns arose, offered alternative work, suggested an occupational health referral, and held multiple disciplinary hearings before deciding to dismiss. The nurse was given every opportunity to return to work but chose not to. The tribunal noted that the employer's actions were within the range of reasonable responses for a conduct dismissal.
Why the result matters
This case is a reminder that employees cannot simply refuse to work and then claim unfair dismissal. It also shows that a perceived disability discrimination claim requires more than just a suspicion—there must be evidence that the employer actually believed the employee was disabled. Here, the employer's suggestion of an autism assessment was not enough to prove discrimination. For employees in similar situations, following reasonable instructions and engaging with occupational health are crucial to protecting their position.
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