Reasons for Decision

A panel of the Discipline Committee of the College of Nurses of Ontario ("the College") convened on January 19, 2000 to hear the following allegations against Danielle Metellus (the "Member") set out in the Amended Notice of Hearing (Exhibit #1) dated November 22, 1999. The Notice of Hearing was amended to correct the dates of the hearing on page 2 of the Amended Notice of Hearing.

The Member was not present but was represented by her legal counsel. The Member asked to proceed with the Agreed Summary of Facts, indicating that the hearing would be uncontested. The Chairperson was unable to proceed with the Plea Inquiry due to the Member's absence.

The Notice of Hearing contained the following allegations:

NOTICE OF HEARING

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 on or about [date] , 1998, while working as a Registered Nurse at Montfort Hospital in the City of Ottawa, 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 your care and treatment of the Client, and in particular, you struck the Client in the left arm and/or left rib area.
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 on or about [date], 1998, while working as a Registered Nurse at Montfort Hospital in the City of Ottawa, in the Province of

Ontario, you abused a client verbally, physically or emotionally, and in particular, you struck the Client in the left arm and/or left rib area.

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 on or about [date], 1998, while working as a Registered Nurse at Montfort Hospital in the City of Ottawa, 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 your care and treatment of the Client, and in particular, you struck the Client in the left arm and/or left rib area.

AGREED SUMMARY OF FACTS

Agreed Summary of Facts

An Agreed Summary of Facts which contained the Member's admission was submitted as Exhibit #2 (with a French translation as Exhibit #3). Counsel for the College submitted a statement [from a translation company] dated January 17, 2000, confirming that all translations English to French and French to English were an accurate and true eqivalent of the documents submitted to them for translation. The Agreed Summary of Facts provides as follows:

Danielle J. Metellus, (The "Member") is a Registered Nurse and has been registered with the College since 1986.
The Member was employed as an full time R.N. with the Montfort Hospital (the "Hospital") in Ottawa, Ontario, since July, 1987. Initially, she worked in the Psychiatric Unit, where she acted as the night shift supervisor and subsequently a team leader. In July 1996, the Member was transferred to the Active Care Unit where she worked both day and night shifts. This Unit provides nursing care to approximately 22 clients suffering from a variety of medical problems, including respiratory, circulatory and cardiac conditions.
The Member worked the night shift on [date], 1998. At approximately 01:00 hours, the Member was engaged in administering an IV medication to her client (the Client). An RPN, was assisting her. Both the Member and the RPN were aware that the Client was very confused and aggressive.
Both the Member and the RPN positioned themselves on the client's right side of the bed. The RPN held the client's right arm down by placing her right hand on the client's forearm and her left arm on the client's right shoulder. The Member was positioned immediately next to the RPN.
The Member attempted to administer medication through a saline lock which the Client had in place on her right arm. The Client was fighting the procedure and was able to free her right arm. The Client slapped at the Member as her arm became free. She hit the Member on the left side of the face.
Within seconds of the Client hitting the Member, the Member struck the Client once in the left arm between the shoulder and the elbow and once in the left lower rib area.
When the Client was assessed approximately 30 minutes later, the Client had a reddened area on her left arm between the shoulder and the elbow. There was no redness in the left lower rib area. The Client did not require further medical attention.
The incident was immediately reported to the night supervisor by both the RPN and the Member. In explaining her behaviour after the incident, the Member noted that she had been struck on several recent occasions by clients of the Hospital and was finding it difficult to continue to work under such conditions.
As a result of the incident, the Member resigned her employment with the Hospital.
The Member has not worked as a nurse since she left her employment at the Hospital. Recent medical assessment of the Member has confirmed that she suffers from a liver condition, severe rheumatoid arthritis and severe depression and does not intend, nor is she physically well enough, to resume her career in nursing in the foreseeable future. Attached is a copy of a report from her physician dated January 5, 2000.
The Member acknowledges that she is guilty of professional misconduct as set out in paragraphs

1, 2 and 3 of the Notice of Hearing.

The panel unanimously accepted the Agreed Summary of Facts and found on the basis of the facts contained in it that the Member engaged in the professional misconduct alleged in paragraphs 1, 2 and 3 of the Notice of Hearing.

JOINT SUBMISSION ON PENALTY

Joint Submission on Penalty

The Joint Submission on Penalty was submitted to the panel as Exhibit #5 (a French translation was submitted as Exhibit #6) as follows:

THE MEMBER AND THE COLLEGE JOINTLY SUBMIT that the appropriate penalty in this case is for the Discipline Committee to make the following Order:

requiring the Member to appear before the Panel of the Discipline Committee to be reprimanded, at a date to be arranged, but in any event, prior to seeking any employment in nursing;
directing the Executive Director to suspend the Member's Certificate of Registration for a period of three months. The suspension shall commence to run on the date on which the Order becomes final and shall run without interruption;
directing the Executive Director to impose the following terms, conditions and limitations on the Member's Certificate of Registration, namely, the Member:

a. prior to seeking any employment in nursing, shall purchase and complete - "One Is One Too Many", a self-directed learning package and meet with a CNO Nursing Practice Consultant to review the learning package;

b. prior to seeking any employment in nursing, shall complete a brief paper outlining what she learned as a result of completing paragraph

c. which demonstrates a sufficient understanding of the issues relating to prevention of abuse of clients;

d. for a one-year period following the date upon which the Member resumes her nursing career (the "Period") the Member shall:

i. notify the Director in writing of the names and addresses of all Employers;

ii. provide in writing to the Director, written evaluations of the Member's performance from a College member in a supervisory position every four months indicating that the Member is meeting the standards of practice of the profession;

iii. restrict her nursing practice during the Period to work in a facility or facilities where she will have ongoing supervision by another member or members of the College.

Counsel for the College and the Member's Counsel acknowledged extraordinary circumstances arose in the present case and submitted that the Joint Submission on Penalty reflects these circumstances. A statement was provided to the panel reflecting the Member's state of health. In accepting the Joint Submission on Penalty, the panel also recognized that the Member had been in good standing with the College since registration. The Joint Submission on Penalty addresses the need for public protection and at the same time, allows the Member to be rehabilitated and return to the profession.

I, [chairperson], 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, RN

Member, RN

Public Representative Public Representative

College of Nurses of Ontario v. Danielle Metellus, 2000 ONCNO 50741

Case Summary