Full Text For: Judith Meyer, RN #71-6332-2

DISCIPLINE COMMITTEE OF THE COLLEGE OF NURSES OF ONTARIO

The following is a public record of the hearing between College of Nurses of Ontario and Judith Meyer #71-6332-2 heard on December 15, 1998.

DECISION AND REASONS

Decision and Reasons

On December 15, 1998 a panel of the Discipline Committee met to hear allegations against Judith Meyer, R.N.

Counsel for the College entered into evidence the Notice of Hearing, which contained the following allegations:

ALLEGATIONS

Allegations

1. You have committed an act of professional misconduct as provided by subsection 51(1)(c) of the Health Professions Procedural Code of the Nursing Act, 1991, S.O. 1991, c.32, as amended, and defined in subsection 1(1) of Ontario Regulation 799/93, in that during the month of March, 1997 while working as a Registered Nurse at Kristus Darzs Latvian Home in Woodbridge, in the Province of Ontario, you contravened a standard of practice of the profession or failed to meet the standards of practice of the profession with respect to one or more clients, by:

a. failing to administer medications as ordered; and/or

b. discarding residents’ medications; and/or

c. falsifying medication administration records; and/or

2. You have committed an act of professional misconduct as provided by subsection 51(1)(c) of the Health Professions Procedural Code of the Nursing Act, 1991, S.O. 1991, c.32, as amended, and defined in subsection 1(14) of Ontario Regulation 799/93, in that during the month of March, 1997 while working as a Registered Nurse at Kristus Darzs Latvian Home in Woodbridge, in the Province of Ontario, you falsified a record relating to your practice in that you falsified medication administration records with respect to one or more clients; and/or

3. You have committed an act of professional misconduct as provided by subsection 51(1)(c) of the Health Professions Procedural Code of the Nursing Act, 1991, S.O. 1991, c.32, as amended, and defined in subsection 1(37) of Ontario Regulation 799/93, in that during the month of March, 1997 while working as a Registered Nurse at Kristus Darzs Latvian Home in Woodbridge, in the Province of Ontario, you engaged in conduct or performed an act, relevant to the practice of nursing, that, having regard to all the circumstances, would reasonably be regarded by members as disgraceful, dishonourable or unprofessional, in that, with respect to one or more clients, you:

a. failed to administer medications as ordered; and/or

b. discarded residents’ medications; and/or

c. falsified medication administration records.

The panel was informed by counsel for the College that an Agreed Statement of Facts had been entered into by counsel for the College and counsel for the Member, as well as the Member herself.

AGREED STATEMENT OF FACTS

Agreed Statement of Facts

1. The Member graduated from the Toronto East General School of Nursing in 1971.

2. The Member was employed as a Registered Nurse between 1988 and 1997 with Kristus Darz (“the Facility”), a home for the aged located in Woodbridge, Ontario.

3. The facility includes three floors, with the first floor being designated for those residents requiring complete or almost complete care. Virtually all of the residents on the first floor were severely cognitively and physically impaired.

4. Between 1993 and April, 1997, the Member obtained a position on permanent days on the Facility’s first floor.

5. In March, 1997, the staffing complement on the first floor of the facility on the day shift included one Registered Nurse and three Registered Practical Nurses.

6. The care routine on the first floor unit was extremely heavy. As well, the medications routine and, in particular, the morning medication round, was very heavy. Almost all of the residents on this unit required assistance and supervision with medications.

7. On the first floor, medications were usually prepared in a medication room. The medications were often crushed, mixed in apple sauce with a tongue depressor that was labelled with the resident’s name. The depressor was left in the cup containing the crushed medications in apple sauce. The depressor was used to give medications to the residents. The practice was to give the medications to the residents immediately. The medications were signed for as they were prepared. There was a photograph of the resident which preceded the Medication Administration Reports (“MARs”) for each specific resident.

8. On each of March 11th, 22nd, 23rd and 25th, 1997, the Member failed to administer medications as ordered, discarded residents’ medications outside of generally accepted nursing standards, and she falsified the MARs by indicating that she had dispensed and administered the medications that had been ordered.

9. The Member was terminated from her employment on April 2nd, 1997 following an internal investigation conducted by the Facility.

10. The Member agrees that her conduct as set out above amounts to professional misconduct. Accordingly, the Member admits to the allegations of professional misconduct as set out in allegations 1(a), (b), (c) and 2 of the Notice of Hearing.

Counsel for the College then noted that the Member agreed with allegations 1 (a), (b), (c), and allegation 2, and that the College withdrew allegation 3.

In order to ensure that the Member’s admission of professional misconduct was made freely and voluntarily, the panel asked the Member the five questions put to members on uncontested hearings. The questions were as follows:

1. Do you understand the nature of the allegations that have been made against you?

2. Do you understand that by admitting the allegations, you are waving the right to require the prosecution to prove the case against you and the right to have a hearing?

3. Do you understand the consequences of admitting to the allegations made against you?

4. Did you voluntarily decide to admit the allegations against you?

5. Do you understand that the agreement between the prosecution and defence counsel with respect to the penalty imposed does not bind the Discipline panel?

The Member answered in the affirmative to each of the above five (5) questions.

The panel then adjourned to deliberate the allegations and the Agreed Statement of Facts.

The panel reconvened and informed counsel for the College and counsel for the Member that it accepted the Agreed Statement of Fact noting that it was based on allegations 1 and 2, and that the College withdrew allegation 3.

Counsel for the College presented the panel with the Joint Submission on Penalty, and indicated that counsel for the Member would provide an additional document titled Performance Appraisal of the

Member (from Regional Nursing Services). This document was presented to the panel.

Counsel for the College reviewed the Joint Submission on Penalty, asking that Item No. 2, Recommendation of Suspension, commence January 2nd, 1999. This joint submission provided as follows:

JOINT SUBMISSION ON PENALTY

Joint Submission on Penalty

The College and the Member jointly submit that the panel of the Discipline Committee should make an order directing the Executive Director as follows:

1. Require the Member to appear before the panel to be reprimanded;

2. Suspend the Member’s Certificate of Registration for a period of 4 months;

3. Impose specified terms, conditions and limitations on the Member’s Certificate of Registration that:

a. The Member complete two (2), two (2) hour educational sessions (“sessions”) with a nursing practice advisor from the College of Nurses;

b. Before the first session, the Member will review the following standards/documents from the College:

i. Medication Administration Standards;

ii. Documentation Standards;

iii. Guidelines for Professional Behaviour and, more specifically, Section One: “The Ethical Framework for Nursing in Ontario”, and Section Three: “Explanation of Professional Misconduct”.

c. After the sessions, the Member will complete a reflective practice piece, as directed by the nursing practice advisor. The reflective practice piece, such as an essay, will be written on the basis of the sessions as well as two courses which the Member has already completed, the RPN refresher course and an ethics course.

d. For a two year period of employment in nursing (the “period”), the Member must provide the Director, Investigations and Hearings (the “Director”) in writing with the names and addresses of all employers.

e. During the period, the Member will provide performance appraisals to the Director every four months for the first year of employment in nursing and semi-annually thereafter for a total of five performance appraisals.

f. For the first six-month period of employment in nursing following the suspension, the Member will enter into a preceptor-type arrangement with a nursing practice advisor from the College and the Member will be in telephone contact with the nursing practice advisor bi-weekly for the first three months and once a month thereafter, provided that the nursing practice advisor is of the opinion that there is no need for the continuation of bi-weekly telephone calls.

In reviewing the Joint Submission on Penalty, the panel queried counsel for the Member as to why the Member had chosen an RPN Refresher course when she is an RN. Counsel for the Member replied indicating the Member was anxious to rehabilitate herself “sooner, rather than later”, and the RPN course, therefore, was the only course available at that point in time. Having no further questions or comments, the panel recessed to discuss the Joint Submission on Penalty.

The panel reconvened and accepted the Joint Submission on Penalty, with an order that the 4-month suspension begins on January 2, 1999.

The panel asked the Member if she was willing to sign a waiver with the College in the event she would like to receive her oral reprimand forthwith, or to have it scheduled at a future date. After consulting with her counsel, the Member agreed that she would sign the waiver and have her oral reprimand administered at the conclusion of proceedings on December 15, 1998.

College staff and counsel for the College as well as counsel for the Member, were excused from the proceedings.

The panel members recessed to discuss the oral reprimand, and reconvened with the Member at 11:00

a.m. December 15, 1998, to deliver the oral reprimand.

REASONS FOR FINDING

Reasons for Finding

The member admitted the allegations, and was co-operative in the investigative proceedings. She had taken steps for her remediation prior to being ordered to do so. The Member also has a very positive performance appraisal from her current place of work, where she started after the allegations were laid.

Taking all of these facts into consideration, the panel finds that the Joint Submission on Penalty is in keeping with the College’s mandate of protecting the public interest while maintaining the Member’s rights.