College of Nurses of Ontario v. The Member, 2000 ONCNO 50770

Panel:

Chairperson, RN

Member, RN

Member, RPN

Public Representative

BETWEEN

COLLEGE OF NURSES OF ONTARIO

COUNSEL for College of Nurses of Ontario

and -

The Member

COUNSEL for the Member

Heard: June 9, 2000

REASONS FOR DECISION

A panel of the Discipline Committee met on June 9, 2000 to hear allegations against the Member, as outlined below in the 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(8) of Ontario Regulation 799/93, in that during the period from November 1997 to November 1998 both dates inclusive, in the Province of Ontario, you misappropriated property from a client or workplace by making some or all of the following withdrawals of funds from the accounts of clients at the Facility:

(a) Client #1

(i) September 1, 1998

$ 40.00

(b) Client #2

(i) December 5, 1997 (ii) January 14, 1998 (iii) July 6, 1998 (iv) July 21, 1998 (v) August 26, 1998 (vi) November 5, 1998

$ 15.00 $ 20.00 $ 10.00 $ 40.00 $ 30.00 $ 45.00

(i) January 16, 1998 (ii) November 17, 1998

$ 15.00 $ 40.00

(d) Client #4

(i) January 9, 1998

$ 45.00

(e) Client #5

(i) November 20, 1997 (ii) March 13, 1998 (iii) June 24, 1998 (iv) July 6, 1998 (v) July 21, 1998 (vi) September 17, 1998 (vii) September 25, 1998 (viii) October 22, 1998 (ix) November 5, 1998

$ 25.00 $ 25.00 $ 15.00 $ 30.00 $ 30.00 $ 25.00 $ 35.00 $ 15.00 $ 35.00

(f) Client #6

(i) January 6, 1998 (ii) January 9, 1998 (iii) January 19, 1998 (iv) January 21, 1998 (v) March 13, 1998

$ 50.00 $ 35.00 $ 45.00 $450.00 $ 40.00

(g) Client #7

(i) April 14, 1998 (ii) November 17, 1998

$ 75.00 $ 40.00

(h) Client #8

(i) November 7, 1997 (ii) November 25, 1997 (iii) May 25, 1998

$ 25.00 $ 50.00 $ 20.00

(i) Client #9

(i) November 7, 1997 (ii) November 11, 1997 (iii) November 20, 1997 (iv) November 25, 1997 (v) December 5, 1997 (vi) January 5, 1998 (vii) January 16, 1998 (viii) February 13, 1998 (ix) March 5, 1998 (x) March 25, 1998 (xi) May 20, 1998 (xii) May 25, 1998 (xiii) June 24, 1998 (xiv) July 6, 1998 (xv) July 21, 1998 (xvi) August 25, 1998 (xvii) September 17, 1998 (xviii) September 28, 1998 (ixx) October 16, 1998 (xx) October 22, 1998 (xxi) November 5, 1998 (xxii) November 17, 1998

$ 15.00 $ 45.00 $ 45.00 $ 35.00 $ 40.00 $ 45.00 $ 25.00 $ 30.00 $ 40.00 $ 25.00 $ 25.00 $ 25.00 $ 20.00 $ 25.00 $ 35.00 $ 30.00 $ 35.00 $ 40.00 $ 40.00 $ 15.00 $ 40.00 $ 45.00

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 period from November 1997 to November 1998 both dates inclusive, 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 made some or all of the following withdrawals of funds from the accounts of clients at the Facility:

(a) Client #1

(i) September 1, 1998

$ 40.00

(b) Client #2

(i) December 5, 1997 (ii) January 14, 1998 (iii) July 6, 1998 (iv) July 21, 1998 (v) August 26, 1998 (vi) November 5, 1998

$ 15.00 $ 20.00 $ 10.00 $ 40.00 $ 30.00 $ 45.00

(i) January 16, 1998 (ii) November 17, 1998

$ 15.00 $ 40.00

(d) Client #4

(i) January 9, 1998

$ 45.00

(e) Client #5

(i) November 20, 1997 (ii) March 13, 1998 (iii) June 24, 1998 (iv) July 6, 1998 (v) July 21, 1998 (vi) September 17, 1998 (vii) September 25, 1998 (viii) October 22, 1998 (ix) November 5, 1998

$ 25.00 $ 25.00 $ 15.00 $ 30.00 $ 30.00 $ 25.00 $ 35.00 $ 15.00 $ 35.00

(f) Client #6

(i) January 6, 1998 (ii) January 9, 1998 (iii) January 19, 1998 (iv) January 21, 1998 (v) March 13, 1998

$ 50.00 $ 35.00 $ 45.00 $450.00 $ 40.00

(g) Client #7

(i) April 14, 1998 (ii) November 17, 1998

$ 75.00 $ 40.00

(h) Client #8

(i) November 7, 1997 (ii) November 25, 1997 (iii) May 25, 1998

$ 25.00 $ 50.00 $ 20.00

(i) Client #9

$ 15.00 $ 45.00 $ 45.00 $ 35.00 $ 40.00 $ 45.00 $ 25.00 $ 30.00 $ 40.00 $ 25.00 $ 25.00 $ 25.00 $ 20.00 $ 25.00 $ 35.00 $ 30.00 $ 35.00 $ 40.00 $ 40.00 $ 15.00 $ 40.00 $ 45.00

Counsel for the College informed the panel that the College was not submitting any evidence on allegation #1, in its entirety, and allegation #2(a) through 2(e), and allegation #2(h) and 2(i).

PLEA

When called upon to indicate whether she admitted or denied the allegations the Member admitted to allegations #2(f)(iv) and #2(g)(i).

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 FACTS

Council for the College tendered an Agreed Statement of Fact (exhibit #2), as follows:

AGREED STATEMENT OF FACT

The Member:

The Member received her nursing education at college, successfully completing the RPN course and the Medications course in 1991.
The Member has been employed with the Facility since October 1991.

The Facility and the Unit

The Facility is a provincial psychiatric hospital.
The Unit treats clients who suffer from both psychiatric illnesses and brain damage due to injuries.
Each client is assigned a primary nurse as well as an alternate nurse. Although primary nurses are not necessarily assigned to their clients on each shift they work, the primary nurse is responsible for the client's care plan and attending to any needs that the client may have, including the purchase of clothing or other personal items when necessary.
Most of the clients on the Unit have been deemed to be financially incapable under the Mental Health Act. In particular, the clients who are the subject of the specified allegations, Client #6 and Client #7, were both deemed to be incapable of managing their own property.
Clients who are deemed incapable have their financial affairs overseen by the Office of the Public Guardian and Trustee (the Public Trustee). The social worker on the Unit was the assigned liaison between the Unit and the Public Trustee at the time of the events which are described in the following paragraph.
Clients receive a monthly personal needs allowance of $112.00 from the government which is deposited into individual money accounts, held in the hospital's business office.

Procedure for Withdrawing Money from Client Money Accounts

Money accounts are accessed to provide clients with money for canteen items as well as to allow them to purchase clothing and other personal items.
During the year 1998, money from clients' money accounts could be obtained from the business office upon presentation of a requisition slip. The requisition slip could be provided either directly by the client, when appropriate, or by Unit staff on behalf of a client. Requisition slips that were pre-authorized by the Unit Nursing Manager were kept on the Unit in an unlocked drawer at the nursing station.
The usual practice of nurses on the Unit was to inform the Unit clerk that a client required money and request that a requisition slip be completed by the Unit clerk. The requisition slip was then signed by the client, if able, or signed by the nurse on behalf of the client. Either the nurse or the Unit clerk would present the requisition to the Business Office and sign for the money received.
Requests for funds over $50.00 required pre-approval by the Unit's social worker and the subsequent submission of receipts for purchases made with the funds.
Clothing or other personal item purchases made by nursing staff were to be documented in the client's nursing notes and in the client's clothing record.

Allegation 1: Misappropriation of Property from a Client

The College tenders no evidence with respect to this allegation.

Allegations 2(f)(iv) and 2(g)(i): Disgraceful, Dishonourable and Unprofessional Conduct in relation to Client #1 and Client #2

The Member made the following withdrawals from the accounts of clients on the Unit:
- Withdrawal of $450.00 from Client #1's account on January 21, 1998; and
- Withdrawal of $75.00 from Client #2's account on April 14, 1998.
The Member made these withdrawals by completing a requisition slip on her own. In addition, the Member did not request or receive approval for the withdrawals from the social worker.
Despite the Unit expectation that purchases made for clients by nurses would be documented in the nursing notes and on the client's clothing list, the Member did not document the fact that money had been withdrawn on behalf of the clients, that she had in fact received the funds, and that she had made purchases for the clients with the funds.
In addition, the Member failed to provide receipts for the purchases made, as required by the Business Office.
The Member admits that her conduct constitutes an act of professional misconduct in that she 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 2(f)(iv) and 2(g)(i) of the Notice of Hearing in that she failed to obtain the required authorization to withdraw the monies and failed to accurately and completely document the withdrawals from clients accounts and the subsequent purchases made for the clients.
The College tenders no further evidence with respect to the remainder of allegation 2.

DECISION

The panel found that the Member's conduct, as set out in allegations #2(f)(iv) and @2(g)(i ) of the Notice of Hearing, constituted an act of professional misconduct that having regard to all the circumstances, would reasonably be regarded by members as disgraceful, dishonourable, and unprofessional.

JOINT SUBMISSION ON PENALTY

The panel was presented with a Joint Submission with respect to penalty 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 within three months of the date the order becomes final; and Requiring the Member to meet with a Nursing Practice Consultant to review the standards of practice in relation to managing client funds.

DECISION

The panel accepted the Joint Submission on Penalty and recommended the meeting with the practice adviser of the College and the Member to review the Standards of Practice in relation to managing client funds at the earliest possible convenience of the College.

Accordingly, the Discipline panel orders that:

The Member appear before the panel to be reprimanded at a date to be arranged, but in any event, within three months of the date this order becomes final; and
The Member meet with a nursing practice consultant to review the standards of practice in relation to managing client funds at the earliest possible convenience of the College.

REASONS FOR DECISION

The panel took into consideration the Member's unblemished record and willingness to admit to the allegations of professional misconduct. The panel also noted the Member's remorse and that she realised that she had been lax in regards to the procedure in handling client's personal funds. The penalty should serve to inform the members of the profession that this type of behaviour is not to be tolerated and will provide protection for the public.

This order is effective June 9, 2000.

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 [ ]