DISCIPLINE COMMITTEE OF THE COLLEGE OF NURSES OF ONTARIO
Panel:
Chairperson, RPN
Member, RN
Member, RN
Public Representative
Public Representative
BETWEEN
COLLEGE OF NURSES OF ONTARIO COUNSEL for College of Nurses of Ontario
- and -
Bruce T. Hayashi # GD-0071-6
DECISION AND REASONS
COUNSEL for Bruce T. Hayashi
Heard: May 23, 2000
A panel of the Discipline Committee of the College of Nurses of Ontario was convened on May 23, 2000 at the Prince Arthur Hotel in Thunder Bay to hear allegations against the Member, Bruce T. Hayashi. The Member was present as was his defense counsel. Counsel for the College reviewed the Notice of Hearing for the panel and then advised the panel of various amendments and deletions which were agreed to by defense counsel. The panel was advised that the hearing would proceed by way of Agreed Statement of Facts.
Notice of Hearing
- 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 from May 1997 through to February 1999, while working as a Registered Practical Nurse at a mental health centre in Thunder Bay, 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 the following incidents:
a. You telephoned the Client, (a client of the mental health centre), at her home; and/or
b. You visited the Client, (a client of the mental health centre), at her home; and/or
c. You offered to take the Client, (a client of the mental health centre), fishing; and/or
d. You disclosed personal information about yourself to the Client, (a client of the mental health centre), including:
i. Information about the illness and death of your father and brother; and/or
ii. Information about your relationship with your stepson, including that you wanted to
choke him; and/or
e. You made inappropriate comments to the Client, (a client of the mental health centre), including:
i. Words to the effect that she should be home when she said she would be there; and/or
ii. Asking whether she had a boyfriend; and/or
iii. Words to the effect that she had a perfect pear shaped rear end; and/or
iv. Words to the effect that she was a "big suck" for going to bed early; and/or
v. Words to the effect that when there was an extra car in her driveway you should not come into her residence; and/or
f. You had inappropriate physical contact with the Client, (a client of the mental health centre), including:
i. You hugged her while visiting her at her home; and/or
ii. You tweaked her ear lobe; and/or
iii. You sat on her hospital bed while she was in the bed; and/or
iv. You wiggled her foot while she was in bed; and/or
v. You were alone with her in the medication room with the door closed.
- 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(7) of Ontario Regulation 799/93, in that from May 1997 through to February 1999, while working as a Registered Practical Nurse at a mental health centre in Thunder Bay, in the Province of Ontario, you abused a client verbally, and/or physically, and/or emotionally with respect to the following incidents:
a. You telephoned the Client, (a client of the mental health centre), at her home; and/or
b. You visited the Client, (a client of the mental health centre), at her home; and/or
c. You offered to take the Client, (a client of the mental health centre), fishing; and/or
d. You disclosed personal information about yourself to the Client, (a client of the mental health centre), including:
i. Information about the illness and death of your father and brother; and/or
ii. Information about your relationship with your stepson, including that you wanted to choke him; and/or
e. You made inappropriate comments to the Client, (a client of the mental health centre), including:
i. Words to the effect that she should be home when she said she would be there; and/or
ii. Asking whether she had a boyfriend; and/or
iii. Words to the effect that she had a perfect pear shaped rear end; and/or
iv. Words to the effect that she was a "big suck" for going to bed early; and/or
v. Words to the effect that when there was an extra car in her driveway you should not come into her residence; and/or
f. You had inappropriate physical contact with the Client, (a client of the mental health centre), including
i. You hugged her while visiting her at her home; and/or
ii. You tweaked her ear lobe; and/or
iii. You sat on her hospital bed while she was in the bed; and/or
iv. You wiggled her foot while she was in bed; and/or
v. You were alone with her in the medication room with the door closed.
- You have committed an act of professional misconduct as provided by subsection 51(1)(b.1) of the Health Professions Procedural Code of the Nursing Act, 1991, S.O. 1991, c.32, as amended, in that from May 1997 through to February 16, 1999 while working as a Registered Practical Nurse at the mental health centre in Thunder Bay, in the Province of Ontario, you sexually abused a client, (the Client), with respect to the following incidents:
a. You hugged the Client while visiting her at her home; and/or
b. You told the Client words to the effect that she had a perfect pear shaped rear end; and/or
c. You tweaked the Client's earlobe; and/or
d. You sat on her hospital bed while she was in the bed; and/or
e. You wiggled her foot while she was in bed; and/or
f. You were alone with her in the medication room with the door closed.
- 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 from May 1997 through to February 1999 while working as a Registered Practical Nurse at a mental health centre in Thunder Bay, 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 with respect to the following incidents:
a. You telephoned the Client, (a client of the mental health centre), at her home, and/or
b. You visited the Client, (a client of the mental health centre), at her home; and/or
c. You offered to take the Client, (a client of the mental health centre), fishing; and/or
d. You disclosed personal information about yourself to the Client, (a client of the mental health centre), including:
i. Information about the illness and death of your father and brother; and/or
ii. Information about your relationship with your stepson, including that you wanted to choke him; and/or
e. You made inappropriate comments to the Client, (a client of the mental health centre), including:
i. Words to the effect that she should be home when she said she would be there; and/or
ii. Asking whether she had a boyfriend; and/or
iii. Words to the effect that she had a perfect pear shaped rear end; and/or
iv. Words to the effect that she was a "big suck" for going to bed early; and/or
v. Words to the effect that when there was an extra car in her driveway you should not come into her residence; and/or
f. You had inappropriate physical contact with the Client, (a client of the mental health centre), including:
i. You hugged her while visiting her at her home; and/or
ii. You tweaked her ear lobe; and/or
iii. You sat on her hospital bed while she was in the bed; and/or
iv. You wiggled her foot while she was in bed; and/or
v. You were alone with her in the medication room with the door closed. The Notice of Hearing was amended and accepted with the following changes:
a. 1(c) : Change "offered to take" to "discussed taking";
b. 1(d)(ii) : Delete "including that you wanted to choke him";
c. 1(e)(iii): Change "pear" to "heart";
d. 1(e)(v) : Delete entire sentence;
e. 1(f)(v) : Delete "with the door closed";
f. 4(c) : Change "offered to take" to "discussed taking";
g. 4(d)(ii) : Delete "including that you wanted to choke him";
h. 4(e)(iii): Change "pear" to "heart";
i. 4(e)(v) : Delete entire sentence; and
j. 4(f)(v) : Delete "with the door closed".
Counsel for the College submitted to the panel that the College will tender no evidence with respect to Allegations #2 and #3.
Member's Plea
The Member admitted to the allegations #1 and #4 as set out in the Amended Notice of Hearing.
Plea Inquiry
The chairperson conducted the usual Plea Inquiry in which the Member affirmed that he was aware of and voluntarily admitted Allegations #1 and #4. The Member's responses to the Plea Inquiry indicated he was not pressured or offered any inducement to do so and that he understood that the agreement reached between himself and the College was not binding on this panel.
The panel was satisfied that the Client's admission of professional misconduct was informed and voluntarily made.
Agreed Statement of Facts
The panel accepted the Agreed Statement of Facts presented as follows:
The Member
The Member completed his RPN training at the in Thunder Bay in 1973 and became a member of the College in 1973.
The Member has been employed with (the Centre) in Thunder Bay since 1972.
The Facility and the Unit
The Centre
Common diagnoses of clients
At the time of the incidents specified in the allegations, the
The Client
The Client was a
The Client was
Over the next , the Client was
The Client attended the
The Nurse-Client Relationship
- The Member met the Client for the first time during . The Member was assigned to care for the Client on a frequent basis .
Allegations 1 and 4: Failure to meet the standards of practice and disgraceful, dishonourable and unprofessional conduct
Allegations 1(a) and 4(a) Telephone calls to Client
- , the Member called (the Client) several times at her home and left messages for her. The Member obtained her unlisted phone number and her address from her health record.
Allegations 1(b) and 4(b) Visiting the Client at home
- On a day when the Client was at home , the Member called the Client and asked
her if he could come by her home and show her his fishing rod. The Client said that it would be okay. The Member drove by the Client's home and parked in her driveway. The Client did not open the door for him. The Member then drove away.
On another occasion, the Member stopped by the Client's house when she was outside washing her car. The Member told the Client that he happened to be driving by her home.
On a third occasion, the Client was living in .
. The Member knocked on the door to her apartment. The Client opened the door and was surprised to find the Member there. The Client let the Member into her house but felt very uncomfortable. The Member told the Client that he was there for her if she needed him. The Member believed that the Client was uncomfortable and hugged the Client for a brief second and then left.
Allegations 1(c) and 4(c) Offer to take Client fishing
- During a conversation with the Client while she was in at the “centre” , the Member and the Client discussed going fishing at a later point in time.
Allegations 1(d) and 4(d) Disclosure of personal information to Client
During the Client's , the Member disclosed to the Client that his father was dying and that he was experiencing fatigue from caring for him. The Member told the Client that he had to feed and bathe his father. On another occasion, the Member talked about the fact that his brother was dying.
During this time, the client’s was dying. The Client found it stressful and burdensome to hear about the Member's personal situation. The Client's died in 19
While the Client was at the “centre”, the Member told the Client that he was having difficulties in his relationship with his stepson.
Allegations 1(e) and 4(e) Inappropriate comments
After the Member's visit to the Client's home described in paragraph 13, the Member questioned the Client as to why she was not home when she had said she would be.
The Member asked the Client whether she had a boyfriend. The Client told him that she did.
On one occasion in the Hospital, the Client was sitting in the breakfast area. She was wearing a
. The Member called the Client over and said to her something to the effect of, "even in that you have a perfect heart shaped rear end."
- On another occasion, the Client had gone to bed early. The Member came into the Client's room and said to her something to the effect of, "you are a big suck." The Member inquired about why she was going to bed so early and told her to come and play cards.
Allegations 1(f) and 4(f) Inappropriate physical contact with Client
On the visit to the Client's home described in paragraph 15, the Member hugged the Client for a brief second.
On several occasions while the Client was at the “centre”, the Member tweaked the Client's earlobe while talking with her.
On other occasions, the Member came into the Client's room and sat on the edge of her bed. The Member wiggled the Client's foot while she was lying in her bed.
On one occasion, the Member and the Client were alone in the medication room.
The Member admits that his conduct, as described above, constitutes an act of professional misconduct in that he failed to meet the standards of practice of the profession and that he engaged in conduct or performed an act that, having regard to all the circumstances, would
reasonably be regarded by members as disgraceful, dishonourable and unprofessional as set out in allegations 1 and 4 of the Notice of Hearing.
Allegation 2: Verbal, physical and/or emotional abuse
- The College tenders no evidence with respect to this allegation.
Allegation 3: Remarks and behaviour of a sexual nature
- The College tenders no evidence with respect to this allegation.
Investigation and discipline by the Hospital
- The Hospital investigated the Client's complaint about the Member's behaviour and administered the following discipline to the Member:
A four week unpaid suspension; Assignment to the day shift for one year;
Close monitoring including weekly meetings with the (supervisor) ; A directive not to have any contact with the Client; and
Completion of the One is One Too Many program in the company of the Acting Director of Education.
- Although the Member had the right to grieve the discipline imposed by the “centre” under the terms of the collective agreement covering his employment, he declined to pursue this right and accepted the “centre's” response. The Member has fully adhered to the “centre’s” conditions; has completed the abuse prevention program with the Director of Education; and has maintained satisfactory performance.
Finding of Professional Misconduct
The panel finds that the Member committed an act of Professional Misconduct as set out in the Amended Notice of Hearing.
Joint Submission on Penalty
The Member and the College jointly submitted the following penalty:
Requiring the Member to appear before the panel to be reprimanded;
Directing the Executive Director to suspend the Member's certificate of registration for a period of three months beginning on June 8, 2000;
Directing the Executive Director to impose the following specified terms, conditions and limitations on the Member's certificate of registration:
a. That he enrol in and successfully complete a psychiatric nursing course at Confederation College beginning in the fall of 2000, or such other course as approved by the Director of Investigations and Hearings; and
b. For the next twelve months from the date of this order, the Member shall submit performance appraisals of employment in nursing with the current employer or any subsequent employer, to be completed at six-month intervals by a supervisor who is a member of the College.
Penalty Decision
The panel deliberated and decided to accept the Joint Submission on Penalty with the following additional requirements. These variations were agreed to by counsel for the College and counsel for the Member.
The Member is to review the Therapeutic Nurse Client Relationship and be prepared to review this standard with a Practice Advisor from the College of Nurses either by telephone or in writing. The panel feels that it is in the best interest of the Member that he be enrolled in the recommended psychiatric nursing course at a local facility, to ensure that the Member has the opportunity for class interaction and exchange of learning outcome with other health care professionals. He is to be enrolled in the course no later than the Winter Session 2001.
The panel recognizes that there may not be access to a local psychiatric nursing course. If that is the case, the panel agrees to a correspondence course with the proviso that the Member discuss his learning outcomes with the Nurse Educator from the “centre” and a Practice Advisor from the College of Nurses.
Reasons for Decision
The panel found that the Member had blatantly crossed the boundaries of the Nurse/Client relationship. He took advantage of a vulnerable client. The Member's misconduct had occurred on a number of occasions over a period of 20 months. He has many years experience in the psychiatric setting and should have known the boundaries that have to be observed in the therapeutic nursing relationship. The Member is in a position to set an example for less experienced nurses. The Member had already met the requirements of his employers disciplinary measures which demonstrated his capability of complying with remedial measures. The Member through his counsel conveyed his deep regret to the panel for his actions. He spared the client any further distress of having to participate in a lengthy hearing.
Defense counsel pointed out that the penalty incorporates the principles of specific and general deterrence to the Member and the membership, thereby, serving the Colleges mandate to protect the public interest. The penalty also demonstrates that the type of conduct exhibited by the Member will not be tolerated by the profession and carries serious consequences.
At the conclusion of the hearing , an oral reprimand was administered.
I, , RPN, sign this decision and reasons for the decision as Chairperson of this Discipline Panel and on behalf of the members of the Discipline Panel as listed below:
, Chairperson Date Member, RPN
Member, RN
Public Representative Public Representative