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 Shirley Leuszler #GJ-3917-5 heard on November 20, 1998.

Allegations

Allegations

A panel of the discipline committee met on November 20, 1998 at 1000 hours to hear the following allegations, all of which were contained in the Notice of Hearing:

1. You have committed an act of professional misconduct as provided by subsection 85(3)(c) of the Health Disciplines Act, R.S.O. 1990, c. H.4, as amended, and subsection 21(n) of Ontario Regulation 549, R.R.O. 1990 in that during the years 1991 up to and including 1993, while employed as a Health Care Aide at The facility, in Paris, in the Province of Ontario, you engaged in conduct or an act relevant to the performance of nursing services that, having regard to all the circumstances, would reasonably be regarded by members as disgraceful, dishonourable or unprofessional, in that you accepted funds from a client; 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(37) of Ontario Regulation 799/93, in that during the years 1994 up to and including 1997, while employed as a Health Care Aide at The facility, in Paris, 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 you accepted funds from a client.

Ms. Leuszler was present and represented by counsel.

Counsel for the College did not present evidence in relation to allegation #1 in the Notice of Hearing, indicating that allegation #1 occurred prior to the implementation of the Regulated Health Professions Code of the Nursing Act, 1991, S.O. 1991, c.32, as amended.

Agreed Statement of Facts

Agreed Statement of Facts

The panel accepted the agreed statement of facts as follows:

1. Shirley Leuszler ("the Member") has been registered with the College of Nurses of Ontario as a Registered Practical Nurse since 1970.

2. Ms. Leuszler was employed at facility in Paris, Ontario, from 1985 to 1997. She was employed in the capacity of RPN until 1989 and then in the capacity of health care aide until September, 1997 when she was dismissed as a result of the conduct that is the subject of this proceeding.

3. The Client and his wife became residents at facility in or about 1989 when they were both approximately 89 years old. They continued to reside at the facility until the Client's wife died in the fall of 1995. The Client died in the fall of 1997 at approximately 96 years of age. The Client continued to reside at the facility after the death of his wife until he was admitted to the chronic care facility in or about the fall of 1996 and approximately one year before his death.

4. Ms. Leuszler provided care to the Client and his wife while they were residents at the facility. Over time, a strong bond of friendship developed between the Client and Ms. Leuszler, which she characterizes as similar to a father-daughter relationship. The Client had few friends with whom he maintained contact, but his only daughter lived in England and would visit the Client only occasionally.

5. Ms. Leuszler began receiving small gifts of cash from the Client in or about the spring of 1995. The Client provided cash to Ms. Leuszler to make purchases for he and his wife. The Client invited Ms. Leuszler to keep the change from these transactions. According to Ms. Leuszler, the total value of these gifts may not have exceeded $250.

6. Ms. Leuszler commenced a sick leave for physical and emotional upset in September, 1995. She maintained personal contact with the Client while on sick leave both before and after the death of the Client's wife in the fall of 1995. Ms. Leuszler regularly visited the Client at the facility and Hospital and remained in constant contact with him. The Client regularly visited with Ms. Leuszler at her family home. They also spoke to each other frequently by telephone. The Client called her as often as three to four times each day to inquire about her health and to seek companionship in conversations with her.

7. In the course of their friendship, Ms. Leuszler and the Client discussed private matters. Ms. Leuszler informed the Client that she had cancer and needed treatment. The Client expressed his desire to assist Ms. Leuszler financially in view of her difficult personal circumstances and the assistance that she provided to he and his wife. The Client had the financial means to assist Ms. Leuszler without suffering any deprivation himself.

8. During the period between the fall of 1995 and the fall of 1997, the Client provided cheques and cash payments to Ms. Leuszler in the approximate amount of $20,000. These amounted to a steady program of donation of monies to Ms. Leuszler until the Client's death. The payments were made as gifts with no expectation on the Client's part of repayment.

9. The Client changed his Will on August 20, 1997 to include a bequest to Ms. Leuszler in the amount of $60,000. Ms. Leuszler was aware that the Will had been changed to name her as a beneficiary prior to the Client's death.

10. The facility had a written policy regarding acceptance of gifts. The policy prohibited acceptance of personal gifts of any significant monetary value. Minimal token gifts were acceptable, but only with the knowledge and approval of the Administrator. If she testified, Ms. Leuszler would say that she was not aware of the written policy, although she was aware that her conduct in accepting the gifts from the Client was wrong.

11. Ms. Leuszler requested a return to active employment at The facility in August, 1997 but was then advised of the allegations of misconduct for accepting monetary gifts from the Client She was dismissed for misconduct effective September, 1997.

12. Ms. Leuszler acknowledges that she engaged in conduct relevant to the practice of nursing, that, having regard to all of the circumstances, would reasonably be regarded by members as unprofessional when she accepted the funds from the Client as alleged in paragraph 2 of the Notice of Hearing.

The counsel for the defense stated that he would reserve submissions until the penalty phase.

Finding of Professional Misconduct

Finding of Professional Misconduct

The counsel for the College presented into evidence the C.V. for an expert witness, RN, and the panel accepted the opinion of this expert witness as to allegation #2, that Ms. Leuszler's behaviour should be characterized as disgraceful, dishonourable and unprofessional.

The panel deliberated on the agreed statement of facts and unanimously accepted that the document, as presented, warranted a finding of professional misconduct in relation to allegation #2.

Ms. Leuszler admitted to engaging in conduct relevant to the practice of nursing, that having regard to all the circumstances would reasonably be regarded by members of the profession as disgraceful, dishonourable and unprofessional, in that the member accepted funds from a client.

Joint Submission on Penalty

Joint Submission on Penalty

Counsel for the College and Ms. Leuszler presented a joint submission as to penalty directing the Executive Director to:

1. Require Ms. Leuszler to appear before the Panel to be reprimanded;

2. Suspend Ms. Leuszler's Certificate of Registration for a period of twelve months;

3. Impose the following specified terms, conditions and limitations on Ms. Leuszler's Certificate of Registration:

i. she must successfully complete a course at a community college regarding ethics and/or professional boundaries approved by the Director of Investigations and Hearings ("the Director") as soon as possible with proof of successful completion provided to the Director. In the alternative, Ms. Leuszler must complete a counseling program with a member of the College who is recognized as an expert in ethical/boundary issues as approved by the Director; and

ii. for a two-year period in nursing, she must provide to the Director in writing, the names and addresses of all employers and during the period a direct supervisor who is a member of the College must provide written performance appraisals to the Director every six months indicating that she is meeting all standards of practice of the profession, with a specific emphasis on the nurse-client relationship.

Decision

Decision

The panel deliberated and accepted the joint submission on penalty as above.

Reasons

Reasons

Ms. Leuszler has admitted to allegation #2 as set out in the Notice of Hearing. According to the CNO Guidelines for Professional Behaviour (Accepting Gifts):

The nurse must not solicit gifts from clients.

The nurse may choose to accept a gift from a client when:

a. the gift-giving has been initiated by the client, and

b. giving the gift provides therapeutic value to the client.

When choosing to accept a gift, the nurse must consider all of the following factors:

a. the context of the situation in which the gift is offered, and

b. whether the client will expect a difference in the level or nature of care or feel obligated to provide gifts to other members of the health care team.

The panel wished to deliver a strong message to the profession and to assure the public that the type of behaviour that Ms. Leuszler has admitted engaging in will not be tolerated.

The panel delivered the oral reprimand to Ms. Leuszler in camera at the conclusion of the proceedings.