DISCIPLINE COMMITTEE OF THE COLLEGE OF NURSES OF ONTARIO

Panel:

• Chairperson, RPN
• Member, RN
• Public Representative

BETWEEN

COLLEGE OF NURSES OF ONTARIO COUNSEL for College of Nurses of Ontario

• and -

Katherine A. Kartisch #85-2388-8

REASONS FOR DECISION

COUNSEL for Katherine Anne Kartisch

Heard: April 25, 2000

A panel of the Discipline Committee was convened on April 25, 2000 to hear allegations against Katherine A. Kartisch, the "Member", as outlined below in the Notice of Hearing.

NOTICE OF HEARING

1. You have committed an act of professional misconduct as provided by clause 51(1)(c) of the Health Professions Procedural Code and defined in paragraph 1.8 of Ontario Regulation 799/93, in that during the period February 8, 1998 to February 5, 1999, while employed as a Registered Nurse at the Toronto Hospital in the City of Toronto, you misappropriated property from a workplace, the particulars of which are set out in Appendix A.

You have committed an act of professional misconduct as provided by clause 51(1)(c) of the Health Professions Procedural Code and defined in paragraph 1.37 of Ontario Regulation 799/93, in that during the period February 8, 1998 to February 5, 1999, while employed as a Registered Nurse at the Toronto Hospital in the City of Toronto, you engaged in conduct or performed an act or acts relevant to the practice of nursing, that, having regard to all of circumstances, would reasonably be regarded by members as disgraceful, dishonourable or unprofessional, the particulars of which are set out in Appendix A.

APPENDIX A

Re: KATHERINE ANNE KARTISCH, Ontario Registration No. 85-2388-8 Particulars to Specified Allegations

1. During the period from February 8, 1998 to February 5, 1999, you made false entries on the time scheduling sheets of the coronary intensive care unit of the Toronto Hospital, for the purpose of receiving payment from the Toronto Hospital for hours that you had not worked, on one or more of the dates below:

February 8, 1998,

April 5, 1998,

April 16, 1998,

July 18, 1998,

October 14, 1998,

October 29, 1998,

November 21, 1998,

November 28, 1998,

December 3, 1998,

December 9, 1998,

January 6, 1999,

January 19, 1999,

January 26, 1999

2. During the period from February 8, 1998 until February 5, 1999, you accepted payment from the Toronto Hospital for shifts on one or more of the dates below when you knew or ought to have known that you were not entitled to receive the payment:

February 8, 1998,

April 5, 1998,

April 16, 1998,

July 18, 1998,

October 14, 1998,

October 29, 1998,

November 21, 1998,

November 28, 1998,

December 3, 1998,

December 9, 1998,

January 6, 1999,

January 19, 1999,

January 26, 1999

THE PLEA

When called upon to indicate whether she admitted or denied the allegations, the Member admitted to Allegation #1 and Allegation #2.

PLEA INQUIRY

The Chairperson conducted a plea inquiry in the form set out in Appendix "A" to ensure that the Member's admission was informed, voluntarily made and implications of doing so were understood. The Member's responses to the questions asked during the plea inquiry satisfied the panel that the Member's admission was voluntary, informed and unequivocal.

AGREED STATEMENT OF FACT

Counsel for the College tendered an Agreed Statement of Fact (Exhibit #2) as follows:

THE MEMBER

1. Katherine A. Kartisch , ("the Member") has been registered with the College of Nurses of Ontario ("the College") as a Registered Nurse since 1985. The Member was, at all relevant times, employed as a nurse at the Toronto Hospital ("the Hospital").

2. Beginning May 21, 1991, the Member was employed in the Coronary ICU as a full-time Registered Nurse (RN) In 1996, the Member was laid off, and was moved to a position in the Cardiovascular ICU. The Member returned from maternity leave in October of 1997 and was again employed with the Coronary ICU, on a regular part-time basis. The Member remained employed with the Coronary ICU until February 9, 1999, when her employment ended as a result of the events described below.

3. Prior to the events described below, the Member had not been the subject of a complaint or report to the College of Nurses of Ontario.

Staff Scheduling

4. At the times of the events described below, the Coronary ICU of the Hospital employed a self- scheduling system. Nursing staff entered their proposed shifts for a six-week period into a spreadsheet program, adhering to baseline nurse staffing requirements and the collective agreement. Capital letters (i.e., "N" or "D") denoted an 11.25-hour shift, and lower case letters (i.e., "n" or "d") denoted a 7.5-hour shift. Once staff had entered their proposed shifts, the spreadsheet, now referred to as the "Time Sheet", was printed and retained in the unit. Any subsequent changes to the Time Sheet (e.g. shift trades) were made by hand.

5. The Coronary ICU Charge Nurse used the Time Sheet to prepare the Unit's daily Assignment Sheets. Assignment Sheets indicated the date and times of each nurse's shift, and his or her assigned clients. Assignment Sheets could be altered as staffing needs changed and were the most accurate record of shifts actually worked by each nurse on any given date. Time Sheets should have been updated periodically by ward clerks to reflect a nurse’s actual schedule, but this was not a consistent practice.

6. Ward clerks in the Hospital entered information about nurses' shifts into the GRASP Nursing Workload Measurement System, which, among other functions, calculated nurses' payroll. The ward clerks on the Coronary ICU entered shift information from the Time Sheet rather than from the Assignment Sheets. This created an opportunity for shifts that were not actually worked to be entered into the GRASP system and included in the calculation of a nurse's pay.

Pay Received for Time Not Worked

7. On February 8, 1998, the Member worked a 7.5-hour shift. However, the Time Sheet indicated that she was scheduled for an 11.25-hour shift on that date. As a result, she was paid for an 11.25- hour shift.

8. On April 5, 1998, the Member worked a 7.5-hour shift. However, the Time Sheet indicated that she was scheduled for an 11.25-hour shift on that date. As a result, she was paid for an 11.25-hour shift.

9. On April 16, 1998, the Member did not work. The Member nonetheless made a false hand-written entry on the Time Sheet suggesting that she had worked an 11.25-hour shift on that date. As a result, the Member was paid for an 11.25-hour shift.

10. On July 18, 1998, the Member did not work. The Member nonetheless made a false hand-written entry on the Time Sheet suggesting that she had worked an 11.25-hour shift on that date. As a result, the Member was paid for an 11.25-hour shift.

11. On October 14, 1998, the Member did not work. The Member nonetheless made a false hand- written entry on the Time Sheet suggesting that she had worked an 11.25-hour shift on that date.

As a result, the Member was paid for the 11.25-hour shift.

12. On October 29, 1998, the Member did not work. The Member nonetheless made a false hand- written entry on the Time Sheet suggesting that she had worked an 11.25-hour shift on that date. As a result, the Member was paid for an 11.25-hour shift.

13. The Assignment Sheet indicates that the Member was scheduled to work a 7.5-hour shift on November 21, 1998, but did not work because of illness. Nonetheless, she made a hand-written entry on the Time Sheet suggesting that she had worked an 11.25-hour shift on that date. As a result, the Member was paid for an 11.25-hour shift.

14. On November 28, 1998, the Member did not work. Nonetheless, the Member made a false hand- written entry on the Time Sheet suggesting that she had worked an 11.25-hour shift on that date. As a result, the Member was paid for an 11.25-hour shift.

15. On December 3, 1998, the Member worked a 7.5-hour shift as Charge Nurse. Nonetheless, the Member made a false hand-written entry on the Time Sheet suggesting that she had worked an 11.25-hour shift on that date. As a result, the Member was paid for an 11.25-hour shift, plus a premium for having worked as a Charge Nurse.

16. On December 9, 1998, the Member did not work. Nonetheless, the Member made a false hand- written entry on the Time Sheet suggesting that she had worked an 11.25-hours shift on that date. The Member was therefore paid for an 11.25-hour shift.

17. On January 6, 1999, the Member did not work. Nonetheless, the Member made a false hand- written entry on the Time Sheet suggesting that she had worked an 11.25-hour shift on that date. The Member was therefore paid for an 11.25-hour shift.

18. On January 19, 1999, the Member did not work. Nonetheless, the Member made a false hand- written entry on the Time Sheet suggesting that she had worked an 11.25-hour shift on that date. The Member was therefore paid for an 11.25-hour shift.

19. On January 26, 1999, the Member did not work. The Member nonetheless made a false hand- written entry on the Time Sheet suggesting that she had worked an 11.25-hour shift on that date. The Member was therefore paid for an 11.25-hour shift.

20. In summary, on three occasions, the Member was scheduled for and worked a 7.5-hour shift, but was paid for an 11.25-hour shift; on 10 occasions, the Member did not work at all, but was paid for an 11.25-hour shift. Attached as Exhibit "A" are copies of the relevant Time Sheets. Attached as Exhibit "B" are copies of the relevant Assignment Sheets. Attached as Exhibit C are copies of the Payroll Register, which show the amount the Member was paid for each shift.

21. As a result of the foregoing, the Hospital paid the Member a total of $2,158.00, for 123.75 hours that she had not worked.

Discovery of Incident

22. While reviewing the Time Sheets, two members of the Coronary ICU staff noticed that there were two shifts marked in by hand for the Member: one on January 19, 1999, and one on January 26, 1999. One of the staff members was on duty during one of those shifts and recalled that the Member had not worked at that time. The Time Sheet was then cross-referenced with the Assignment Sheets. On both occasions, the Member did not appear on the Assignment Sheets, and therefore had not worked. This matter was brought to the attention of the charge nurse.

23. Upon further investigation, the other instances described in paragraphs 7 to 19, above, were discovered.

Hospital's Actions

23. On February 5, 1999, the Nurse Manager Coronary ICU, met with the Member to discuss the irregularities between the Time Sheets and the hours she actually worked. It was brought to the attention of the Member that she had been paid for several shifts that she did not work.

24. The Nurse Manager Coronary ICU showed the Member that several shifts had been added in pen next to her name. The Member did not have an explanation for this discrepancy. She was

informed that an investigation would ensue.

25. On February 8, 1999, the Member called the Nurse Manager Coronary ICU and admitted to adding extra shifts to the Time Sheets in order to receive pay for shifts she had not worked.

26. On February 9, 1999, the Hospital informed the Member that her employment with the Hospital was terminated for the theft of paid time. A copy of the discharge letter is attached as Exhibit "D".

27. Subsequent to discussions between the Member, the Member's union, and the Hospital, the Member was permitted to resign her employment with the Hospital, effective February 9, 1999.

Member's Admissions

29. The Member admits that she knowingly made false entries on the Time Sheets so that it incorrectly appeared that she was scheduled to work on the following dates: April 16, 1998, July 18, 1998, October 14, 1998, October 29, 1998, November 28, 1998, December 9, 1998, and January 6, 1999. She further admits that she made these false entries on the Time Sheet with the intention of being paid for shifts that she did not work, and that she knowingly accepted such payment.

30. The Member denies that she made false entries on the Time Sheets with respect to her shifts on February 8, 1998, April 5, 1998, November 21, 1998 and December 3, 1998. She admits however, that she knowingly accepted payment for more time (3.75, 3.75, 7.5 and 11.25 hours, respectively) than she actually worked on those dates.

31. The Member neither confirms nor denies that she falsified the Time Sheet for January 19 and 26, 1999.

32. The Member admits that by the means described in paragraphs 29 and 30 above, she knowingly accepted $2,158.95 in pay from the Hospital to which she was not entitled.

33. The Member admits that by making false entries on the Time Sheets for the purpose of receiving payment to which she was not entitled, as described in paragraph 29, above, and by accepting payment for shifts to which she knew she was not entitled, as described in paragraphs 29 and 30, above, she has committed professional misconduct as follows:

a. as set out in paragraph 1 of the Notice of Hearing, she misappropriated property from a workplace, and as set out in paragraph 2 of the Notice of Hearing, she engaged in conduct or performed acts, 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 or unprofessional.

Mitigating Considerations

34. The Member and the College agree that the following are mitigating considerations in this case:

a. Subsequent to being questioned about the schedule irregularities by her Manager, the Member requested and, on February 9, 1999, had a telephone conversation with her Manager during which she admitted that she had added extra shifts to the Time Sheets in order to receive pay for shifts she had not worked.

b. Subsequent to her resignation from the Hospital, the Member requested and, on February 10, 1999, had a meeting with a Hospital representative to arrange for repayment of the funds. She has submitted, and the hospital accepted, 15 post-dated cheques for $143.93 each to the Hospital for the purpose of making full restitution of the monies owed to it.

Other Evidence

35. The Parties reserve the right to adduce such other evidence as may be required.

Prior to the Panel making a decision, counsel for the Member entered into evidence Exhibit #3. This contained the Member's resume, letters of reference and performance appraisals.

DECISION

The panel deliberated, accepted the Agreed Statement of Fact and found the Member to have committed professional misconduct as outlined in Allegation #1 and Allegation #2. The Panel reviewed Exhibit #3 as presented, taking into consideration that it was not sworn evidence and mainly related to the Member's nursing skills and personal relationships.

JOINT SUBMISSION ON PENALTY

The panel was presented with a Joint Submission with respect to Penalty as follows:

Katherine A. Kartisch ("the Member") and the College of Nurses of Ontario ("the College") jointly submit that the appropriate penalty to be imposed by the panel of the Discipline Committee in this case would consist of an order as follows:

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

2. Directing the Registrar to suspend the Member's certificate of registration, such suspension to commence on the day this order becomes final and to run without interruption for sixty days;

3. Directing the Registrar to impose the following terms, limitations or conditions on the Member's certificate of registration:

The Member must provide proof to the Director of the College's Investigations and Hearings Department ("the Director"), in a form satisfactory to the Director, that she has repaid the Toronto Hospital ("the Hospital") the full amount she improperly accepted from the Hospital ($2,158.00), by or before July 31, 2000.

The Member must successfully complete a Community College or University course in ethics and health care that has been approved by the Director, and must provide proof of successful completion to the Director by or before April 25, 2001. Successful completion of the course may be proven by providing the Director with a copy or an original of an official transcript for the course.

DECISION ON PENALTY

The panel accepted the proposed Joint submission on Penalty.

REASONS FOR DECISION

Due to the Member's previously unblemished record and her willingness to admit the professional misconduct alleged, the panel regarded the penalty to be suitable and equitable.

The imposed penalty should serve as a deterrent to the members of the profession. The Member showed remorse for her deliberate misconduct, which had lasted for more than a year, and had taken steps to repay her former employer.

The panel accepted that the conditions imposed would improve the Member's ethical behaviour and at the same time provide for protection of the public.

The Member signed a waiver of appeal at that time. Consequently, the panel's order became final at that time. The panel then orally administered the reprimand called for by paragraph 1 of the Joint Submission.

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, RN

Public Representative