PUBLISHED JUNE 2002

DISCIPLINE COMMITTEE OF THE COLLEGE OF NURSES OF ONTARIO

FULL-TEXT DECISION

Note: This is the full text of the decision of the Discipline panel in this matter. Any information identifying clients, witnesses or facilities has been removed [ ]. The member’s name is omitted if the allegations have been dismissed or if the results are not placed on the public portion of the Register.

Panel:

Gabrielle Bridle, RPN Chairperson Christine Barber, RPN Member Janise Johnson, RN Member

Bill Weichel Public Representative

Tom Clifford Public Representative

BETWEEN

COLLEGE OF NURSES OF ONTARIO Nick Coleman for College of Nurses of Ontario

• and -

D. Lynne Myers #GA-1105-7

REASONS FOR DECISION

Michelle Brodey for D. Lynne Myers

Heard: 7th day of September, 2001

This matter came on for hearing before a panel of the Discipline Committee on September 7th, 2001, at the College of Nurses of Ontario at Toronto. The Member was present and represented by legal counsel.

The Allegations against D. Lynne Myers as stated in the Notice of Hearing (Exhibit #1), dated July 18, 2001 are as follows:

The Allegations

IT IS ALLEGED THAT:

1. You have committed an act of professional misconduct as provided by subsection 51(c) of the Health Professions Procedural Code of the Nursing Act, 1991, S.O. 1991, c.32, as amended, and subsection 1(1) of Ontario Regulation 799/93 in that, while employed as a Registered Practical Nurse at [the Health Centre], 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 of clients and/or your communications with clients and/or family Members of clients with respect to one or more of the clients on or about the dates specified below:

a. [Client A] on or about February 9, 2000

b. [Client B] on or about September 27, 1999

c. [Client B] in or about the week of September 27, 1999

d. [Client C] on or about August 6, 1999

e. [Client D] on or about August 6, 1999

f. [Client E] on or about August 6, 1999

g. [Client F] on or about August 6, 1999

h. [Client B] in or about January, 1999

i. [Client G] in or about January, 1999

j. [Client H] in or about November, 1998

k. [Client I] in or about May-June 1997

l. [Client I] in or about July-August 1997.

2. You have committed an act of professional misconduct as provided by subsection 51(c) of the Health Professions Procedural Code of the Nursing Act, 1991, S.O. 1991, c. 32, as amended, and subsection 1(7) of Ontario Regulation 799/93 in that, while employed as a Registered Practical Nurse at [the Health Centre], you abused a client verbally, physically or emotionally with respect to one or more of the clients on or about the dates specified below:

a. [Client A] on or about February 9, 2000

b. [Client B] on or about September 27, 1999

c. [Client B] in or about the week of September 27, 1999

d. [Client C] on or about August 6, 1999

e. [Client D] on or about August 6, 1999

f. [Client E] on or about August 6, 1999

g. [Client F] on or about August 6, 1999

h. [Client B] in or about January, 1999

i. [Client G] in or about January, 1999

j. [Client H] in or about November, 1998

k. [Client I] in or about May-June 1997

l. [Client I] in or about July-August 1997.

3. You have committed an act of professional misconduct as provided by subsection 51(c) of the Health Professions Procedural Code of the Nursing Act 1991, S.O. 1991, c. 32, as amended, and subsection 1(37) of Ontario Regulation 799/93 in that, while employed as a Registered Practical Nurse at [the Health Centre], 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 of clients and/or your communications with clients and/or family Members of clients with respect to one or more of the clients on or about the dates specified below:

a. [Client A] on or about February 9, 2000

b. [Client B] on or about September 27, 1999

c. [Client B] in or about the week of September 27, 1999

d. [Client C] on or about August 6, 1999

e. [Client D] on or about August 6, 1999

f. [Client E] on or about August 6, 1999

g. [Client F] on or about August 6, 1999

h. [Client B] in or about January, 1999

i. [Client G] in or about January, 1999

j. [Client H] in or about November, 1998

k. [Client I] in or about May-June 1997

l. [Client I] in or about July-August 1997.

In summary then, the allegations in the Notice of Hearing are:

1. Contravened a standard of practice of the profession with respect to care of and or communications with clients and or family Members as specified in Allegation #1a,b,c,d,e,f,g,h,i,j,k,l. in the Notice of Hearing (Exhibit #1)

2. Abuse a client verbally, physically or emotionally as specified in Allegation #2 a,b,c,d,e,f,g,h,i,j,k,l. in the Notice of Hearing

3. Conduct regarded by Members of the profession to be disgraceful, dishonourable or unprofessional as specified in Allegation #3 a,b,c,d,e,f,g,h,i,j,k,l. in the Notice of Hearing

Counsel for the College informed the panel that Allegation #1 e,f,g, Allegation #2 e,f,g, Allegation #3 e,f,g of the Notice of Hearing (Exhibit #1) are being withdrawn by the College and that no evidence will be presented with respect to Allegation #2 c,d,k,l of the Notice of Hearing.

Member’s Plea

D. Lynne Myers admitted the Allegations set out in paragraph #1 a,b,c,d, h, i, j, k, l, paragraph #2 a, b, h, i, j and paragraph #3 a, b,c, d, h, i, j, k, l in the Notice of Hearing.

The Chairperson conducted a plea inquiry which satisfied the panel that the Member’s admission was voluntary, informed and unequivocal.

Agreed Statement of Facts

Counsel for the College advised the panel that agreement had been reached on the facts and introduced an Agreed Statement of Facts (Exhibit # 2) which provided as follows:

BACKGROUND

1. D. Lynne Myers, R.P.N., # GA-1105-7 (“the Member”) has been registered as a Registered Practical Nurse with the College of Nurse of Ontario (“the College”) since 1971.

2. The Member was employed as a Registered Practical Nurse at [the Health Centre] from April, 1995 to February, 2000 where the incidents that are the subject of the Allegations occurred. She was terminated from that employment in February, 2000, as described below. Since May, 2000, the Member has worked as a home-care nurse for [employer B].

3. The [Health Centre] is a 450-bed long-term in-patient care facility for [ ], located in [ ].

INCIDENTS INVOLVING [CLIENT I]

4. At the time of the incidents, [client I] was a 75-year old man with non-insulin dependent diabetes mellitus, peripheral vascular disease and seizure disorder, with cognitive and memory impairment. The Nursing Care Plan noted that he required total assistance with dressing himself and considerable assistance with toileting himself. The Nursing Care Plan also indicated that [client I] was “very sensitive to staff attitude” and that he should be approached in a “friendly, kind manner.” When this need was not met, [client I] could be difficult to reason with and inflexible.

5. The family Members of [client I] reported various incidents involving the Member in May – June, 1997. [Client I’s] daughter, [ ], reported finding her father upset and crying with a sweater half on, half off. He complained that the Member had refused to help him get dressed. If [the daughter] were to testify, she would state that when she approached the Member regarding this incident, the Member stated that it was not her job to dress [client I]. The Member then turned and walked away, declining to discuss the matter any further.

6. On another occasion in May – June, 1997, [Client I’s] wife, [ ], asked the Member to assist at

lunch to cut his meat for him. If [the wife] were to testify, she would say the Member replied, “Cut it yourself, I don’t have time.” When [the wife] asked the Member to ensure that [client I’s] bib was loosened when he finished his meals, the Member responded, “I can’t do everything.”

7. On another occasion in May – June, 1997, [the wife] came in one evening and found [client I] on the toilet, unable to get up. [Client I] told her that the Member had placed him on the toilet and that he had rung the callbell for assistance, without response. [The wife] called the Member for help, but the Member refused, walking away.

8. On August 12, 1997, [the wife] arrived early in the morning while [client I] was taking his diabetes medications. She noticed a pill on the floor. [Client I] explained that the pill had fallen because the Member placed his pills on the table but would not assist him to take the pills. [Client I] had had a stroke which affected his hands. He had difficulty retrieving the medications from the table and had dropped some to the floor. [The wife] brought this matter to the attention of the Member, but she continued to refuse to assist [client I] with the medications. Subsequently, the Member explained that she was attempting to make [client I] more independent. She acknowledged to her supervisor that her conduct was not consistent with the Nursing Care Plan for [client I].

9. The family Members also complained that the Member gave them “the silent treatment” in July – August, 1997, after the other incidents involving the Member and [client I]. The Member responded that she had purposefully avoided and ignored them because of their complaints about her rudeness, in order to avoid any further confrontations.

10. If the Member were to testify, she would say that the family did not agree with what she would describe as her approach to assist [client I] in becoming more independent. Having said that, she would acknowledge that there was a breakdown in communications and that she was insensitive in her approach and communications with [client I] and his family.

11. The Member received a verbal warning from her supervisor regarding her conduct with respect to the incidents in May – August, 1997 described in paragraphs 5 – 9.

INCIDENT INVOLVING [CLIENT H]

12. At the time of the incident, [client H] was an elderly woman with a psychotic disorder and atrial fibrillation. The Nursing Care Plan indicated that she frequently needed total care. Staff were advised to approach her with patience because she hated to be rushed.

13. On November 8, 1998, [client H] complained to [an RN] that the Member was forcing her to take her pills too quickly without any regard for her comfort. The pills were getting stuck in her throat. When [client H] asked the Member to stop doing this, the Member stated that she would report that [client H] had refused her pills. The Member also stated that she did not have time for [client H] and that [client H] would be moved to another unit. These comments were upsetting to [client H].

INCIDENT INVOLVING [CLIENT G]

14. At the time of the incident, [client G] was a 78-year old man with chronic obstructive pulmonary disease, atrial fibrillation and renal cancer. He was independent and continent, but was expected to ask for help if needed.

15. On a morning in January, 1999, [client G] had returned from his breakfast and was sitting in his wheelchair by the door to his room. He requested assistance from the Member to use the bathroom. The Member was overheard by a colleague to say, “You have a diaper on so use it.”

INCIDENT INVOLVING [CLIENT C]

16. At the time of the incident, [client C] was an 86-year old man suffering from chronic obstructive pulmonary disease, congestive heart failure, and atrial fibrillation. He required intermittent supervision. He was continent but needed assistance with toileting.

17. On August 6, 1999, the Member was asked to respond to [client C’s] callbell which had been ringing for at least five minutes. The Member took no steps to respond, stating, “He’s been doing that all day.” Another Registered Nurse then found [client C] in his room sitting with his pants around his ankles, wanting to be toileted. He was very anxious and his breathing was distressed because his portable oxygen tank was empty.

18. If the Member were to testify, she would say that responsibility for checking the oxygen tank was shared with the HCA. However, she acknowledges that it was the Member’s primary responsibility and she regrets any discomfort or anxiety caused by the incident.

INCIDENTS INVOLVING [CLIENT B]

19. At the time of the incidents, [client B] was an 85-year-old man who had cognitive and psychological deficits, including dementia, and impaired mobility. He was also identified as being at risk for choking. His Nursing Care Plan required that he receive constant supervision while eating and that he be encouraged to eat slowly. His Nursing Care Plan also identified that [client B’s] wife, [ ], was having difficulty coping with [client B’s] deteriorating condition, and specified that she should be encouraged to take her husband for walks and activities when visiting, that any changes in her husband’s care be discussed with her before being initiated, and that she be allowed to make decisions where reasonable. The Nursing Care Plan also indicated that [client B] was at high risk for falls and injury to himself, with an expected outcome identified as to reduce or prevent falls and injury.

20. In January, 1999, the Member was being assisted by [an RPN] to move [client B] from his bed for breakfast. [Client B] had injured himself in a fall a few days earlier. If [the RPN] were to testify, she would say that she spoke to [client B] about their intentions. She placed her knee on the bed and her arms under the arms of [client B], commencing to count, “one-two-three.” [The RPN] expected that she and the Member would lift [client B] out of bed, with his cooperation. However, the Member just grabbed [client B] by the wrist and pulled him out of bed. [Client B] shouted at the Member that she was too rough and he swore at her.

21. If the Member were to testify, she would say that she has no recollection of pulling [client B] by the wrists and knows that patients should not be transferred in this fashion. However, she regrets if her actions were perceived as rough by her fellow nurse and by [client B].

22. On or about September 27, 1999, [the wife] went to her husband’s room to visit. She observed the Member attempting to force two pills into [client B’s] mouth and saying, “You swallow! You swallow!” in a loud voice. [Client B] looked panicked and was shaking his arms with clenched fists. The Member eventually ceased her efforts and left [client B’s] room.

23. The same day, [the wife] was about to take her husband outside in his wheelchair, as was their usual practice. If [the wife] were to testify, she would say when she informed the Member of her intention, the Member replied in a rude and loud manner, “I decide that”, and “No, no. He has to stay in bed. He’s sick.” After [the wife] and the Member assisted [client B] back into bed, the Member pointed at the outside bedrail and rudely stated to [the wife], “And you put that up!”

24. As a result of the incidents on September 27, 1999, the Member was suspended for five days without pay, was required to meet with [ ], the Education Co-ordinator at the Health Centre, to discuss abuse. Pursuant to that meeting and after viewing the College’s abuse prevention video, One is One Too Many, the Member prepared a written report defining the various types of abuse, and outlining how she would behave differently in situations such as the ones involving [client B] and his wife, [ ].

25. According to [the Education Co-ordinator], the Member was quite remorseful during the meeting. The Member acknowledged that she had made a mistake regarding her conduct with respect to [client B] and that she felt badly about what had occurred. She explained that her actions were the result of her being rushed and busy, and wanted to make amends to the client.

26. With respect to the incidents on September 27, 1999, the Member was warned that any further incident of abuse would result in the termination of her employment.

INCIDENT INVOLVING [CLIENT A]

27. At the time of the incident, [client A] was a 93-year old man who had had a bowel resection, was dysphagic and received nutrition through a feeding tube inserted in his abdomen. [Client A] also had pernicious anemia. He required total care. [Client A] had been recently transferred back to the Health Centre in unstable condition and required deep suctioning every 15 minutes to prevent him from aspirating mucous. [Client A] was described as a gentle, quiet, frail man.

28. On February 9, 2000, at about 11:00 a.m., the Member asked [the RN] to perform deep suctioning on [client A]. At the Health Centre only R.N.s are permitted to perform deep suctioning. [The RN] attended [client A] with the Member and found him to be responsive but in extreme distress, so she explained what she was going to do before she began the suctioning process.

29. At the time, [client A’s] feeding tube was not inserted and [client A’s] arm was lying over the insertion site in his abdomen. If [the RN] were to testify, she would say that while she was preparing the suctioning machine, the Member, without speaking to [client A], grabbed his wrist and roughly flung his arm off the insertion site, pulled his bedclothes down to his feet, lifted up his night shirt and hooked up the feeding tube. The Member then walked out of the client’s room.

30. If the Member were to testify, she would say that she has no recollection of the specific tube change on February 9, 2000, but that she regrets if her actions were perceived as rough and if she did not appropriately communicate her intentions to [client A] about the tube change.

31. [Client A] was visibly upset by the Member’s actions, and [the RN] stayed with him to calm him down and to finish the suctioning. When [the RN] later raised the incident with the Member, the Member’s response was, “Well, he was unconscious.”

32. The Member’s employment at the Health Centre was terminated following the incident involving [client A] on February 9, 2000.

PROFESSIONAL MISCONDUCT

33. The Member admits that she committed acts of professional misconduct as alleged in the Notice of Hearing. In particular, the Member acknowledges that she contravened or failed to meet the standards of practice of the profession with respect to the following incidents identified in the Allegations:

Allegation 1(a), in that she failed to communicate appropriately with [client A] regarding her intention to hook up the feeding tube on February 9, 2000;

Allegation 1(b) and 1(c), in that she failed to communicate appropriately regarding the administration of medications to [client B] and with his wife regarding [client B’s] confinement to bed on September 27, 1999;

Allegation 1(d), in that she failed to respond to [client C’s] request for assistance regardless of his needs on August 6, 1999;

Allegation 1(h), in that she failed to take sufficient care while assisting [client B] to move from his bed with respect to the incident on January, 1999;

Allegation 1(i), in that she failed to respond to [client G’s] request for assistance to toilet in January, 1999;

Allegation 1(j), in that she pressured [client H] to take her medications too quickly for [client H’s] comfort on November 8, 1998; and

Allegation 1(k) and 1(l), in that she failed to assist [client I] with his medications, dressing and toileting, and regarding her communications with family Members, in May – August, 1997.

34. The Member also acknowledges that she verbally, physically and emotionally abused clients with respect to the following incidents identified in the Allegations:

Allegation 2(a), in that she treated [client A] roughly, without otherwise communicating with him, while removing his arm from his bed clothes before inserting the feeding tube; Allegation 2(b), in that she attempted to force [client B] to take his medications despite his resistance on September 27, 1999;

Allegation 2(h), in that she used force to pull [client B] out of bed against his wishes in January, 1999;

Allegation 2(i), in that she stated to [client G] that he should toilet in his diaper rather than be assisted to the bathroom; and

Allegation 2(j), in that she pressured [client H] to take her medications more quickly than [client H] wished and threatened to report

that she had refused to take her medications and to have her moved to another unit in retaliation for [client H’s] resistance to taking the medications.

35. The Member also acknowledges that she engaged in conduct relevant to the practice of nursing, that, having regard to the circumstances, would reasonably be regarded by Members as disgraceful, dishonourable or unprofessional with respect to the incidents identified in Allegations 3(a), (b), (c), (d), (h), (i), (j), (k) and (l) in that she was aware at the time of the incidents that her conduct was inappropriate.

36. The College presents no evidence with respect to Allegations 1(e), (f) and (g); Allegations 2(e),

(f) and (g), and Allegations 3(e), (f) and (g).

Decision

The panel considered the Agreed Statement of Facts and finds that the facts support a finding of professional misconduct and, in particular, finds that the Member committed an act of professional misconduct as alleged in paragraphs #1 a,b,c,d,h,i,j,k,l, #2 a,b,h,i,j, and #3 a,b,c,d,h,i.j,k,l of the Notice of Hearing in that the Member contravened a standard of practice of the profession or failed to meet the standards of practice of the profession with respect to her care of clients and/or her communications with clients and/or family Members of clients with respect to the clients on or about the dates specified. The Member abused clients verbally, physically or emotionally with respect to one or more of the clients on or about the dates specified. The Member engaged in conduct or performed an act relevant to the practice of nursing, that, having regard to all circumstances, would reasonably be regarded by Members as disgraceful, dishonourable or unprofessional with respect to her care of clients and/or her communications with clients and/or family Members of clients, with respect to one or more clients on or about the dates specified.

Reasons for Decision

Counsel for the College addressed the issue of public interest as well as the Member’s personal circumstance. Counsel for the College pointed out that this was a pattern of abusive conduct with elderly residents over a period of three years. During that time period the employer attempted rehabilitation by giving the Member a verbal warning, by suspending her for a five day period and by requiring the Member to meet with the Education Co-ordinator at the Health Centre to discuss abuse. Pursuant to that meeting and after viewing the College’s video, “One is One Too Many” the Member was required to prepare a written report defining the various types of abuse, outlining how she would modify her behaviour in similar situations. According to the Education Co-ordinator, the Member was quite remorseful and acknowledged that she had made a mistake. The Member explained that her actions were the result of her being rushed and busy. The Member was warned that any further incidents of abuse would result in termination of her employment. The Member did engage in further abusive behaviours and was subsequently terminated.

Penalty

Counsel for the College advised the panel that a Joint Submission as to Penalty had been agreed upon. The Joint Submission as to Penalty provides as follows:

D. Lynne Myers # GA-1105-7 (“the Member”) and the College of Nurses of Ontario (“the College”)

jointly submit that, in view of the professional misconduct admitted to by the Member in the Agreed Statement of Fact, and the circumstances set out in the Agreed Statement of Fact, the panel of the Discipline Committee should make an order doing the following, which order is to become effective when the order becomes final:

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

2. Directing the Executive Director of the College to suspend the Member’s certificate of registration for three months, commencing on October 7, 2001.

3. Directing the Executive Director to impose the following terms, conditions and limitations on the Member’s certificate of registration:

a. For the next two years of the Member’s nursing practice, beginning the day the order becomes final, the Member must provide the Director of the Investigations and Hearings program (“the Director”) with the names, addresses and telephone numbers of every employer or contracting agency (“employer”) for whom she practices nursing, in the case of her current employer(s), within fourteen days from the date the order becomes final, or in the case of new employment or service (“employment”), within fourteen days from the date of commencing the new employment.

b. The Member may only practice in a facility where her employer writes to the Director within fourteen days of the commencement of the Member’s employment advising the Director:

i. of the date the Member commenced employment;

ii. that the employer has received a copy of the Agreed Statement of Facts and the panel’s penalty order, or, if available, the decision and reasons of the panel in this matter;

iii. that the employer agrees to arrange for a supervisor who is a Member of the College and employed at the facility to monitor the Member’s practice such that her practice will be monitored for two years of her practice from the date the order becomes final, to ensure that her interaction with clients and their families is at all times professional, appropriate, and adheres to the standards of practice of the profession. Monitoring is to include random checks with the Member’s clients, and/or the families/significant others of clients as required, at least once every three months,

iv. agrees to notify the Director immediately upon receipt of any reasonable information that the Member has not behaved professionally or appropriately, or has not adhered the standards of the profession, in her interaction with her clients or the families/significant others of her clients.

c. The Member may only practice in the community where her current employer writes to the Director within fourteen business days from the date this order becomes final, or in the case of a new employer, within fourteen days from the commencement of the employment, advising the Director:

i. of the date the Member commenced employment,

ii. that the employer has received a copy of the Agreed Statement of Facts and the panel’s penalty order, or if available, a copy of the panel’s decision and reasons in this matter.

iii. that the employer agrees to arrange for a supervisor who is a Member of the College to monitor the Member’s practice such that her practice will be monitored for two years of practice from the date the order becomes final, to ensure that her interaction with clients and/or their families/significant others is at all times professional, appropriate, and adheres to the standards of practice of the profession. Monitoring is to include random checks with the Member’s clients, and/or the families/significant others of her clients as required, at least once every month.

iv. that the employer agrees to notify the Director immediately upon receipt of any reasonable information that the Member has not behaved professionally or appropriately, or has not adhered the standards of the profession, in her interaction with her clients or the families/significant others of her clients.

d. The Member must retain, at her own expense, a Member of the College who has expertise in the prevention of abuse, and who is acceptable to the College, for the purpose of meeting with the Member as a preceptor to assist her in ensuring that her conduct toward clients, and their families/significant others, is at all times professional, appropriate and consistent with the standards of the profession, subject to the following terms:

i. The Member must provide the name, address phone number, and resume of the expert to [ ], Practice Consultant at the College, so that [the Practice Consultant] or her delegated Practice Consultant, may determine whether the expert is acceptable as a preceptor to the College.

ii. By October 8, 2001, or such further time as is approved by the Director in advance, [the Practice Consultant] or her delegate, must have an initial consultation with the agreed-upon preceptor. The preceptor must receive a copy of the Agreed Statement of Facts and the panel’s penalty order prior to this consultation.

iii. The Member must participate in a subsequent consultation with [the Practice Consultant], or her delegate, and the preceptor by telephone or in person to discuss the goals for the Member’s meetings with the preceptor, as set out above in paragraph “d”, and the process by which those goals will be achieved.

iv. The Member must meet for counselling with the preceptor in person on at least six occasions, at intervals of approximately one month, the last meeting to occur by or before May 31, 2002, or such later date as is approved in advance by the Director. At these meetings, the Member is to discuss with the preceptor current and past examples of her interactions with clients, and/or their families/significant others, for the purposes of improving her therapeutic communication and ensuring that her conduct toward them is at all times professional, appropriate and consistent with the standards of the profession. In this endeavour, the Member and the preceptor are to use as a reference the College publication Standard for the Therapeutic Nurse-Client Relationship.

v. The preceptor must prepare a final report to [the Practice Consultant] advising if the Member attended and participated adequately in the counselling sessions as stipulated, and summarizing the topics discussed during the counselling sessions.

Penalty Decision

The panel unanimously accepts the Joint Submission as to Penalty (Exhibit # 3) and accordingly orders:

1. Reprimand

2. Three month suspension

3. Terms, conditions and limitations as specified in the Joint Submission on Penalty

Counsel for the College addressed the issue of public interest as well as the Member’s personal circumstances when determining penalty.

College counsel submitted that the need to ensure that the penalty provides a specific deterrent to the Member from repeating the conduct is achieved through the oral reprimand and a three-month suspension. Further, intensive work monitoring for a period of two years and intensive counselling with a College approved preceptor also assures that the Member is assisted in her rehabilitation. This sends a strong message that this kind of conduct will not be condoned by Members of the profession. The panel strongly supported the preceptor component in rehabilitation of this Member’s practice, it would give the Member opportunity to reflect on her practice.

Defense Counsel agreed that the monitoring aspect of the penalty is appropriate for protection of the public and will assist the Member in her nursing practice. Defense also agreed that the preceptorship will accomplish the goal of appropriate conduct and communication. The penalty also sends a loud and

clear message to the Membership that this behaviour will not be tolerated. The penalty also puts a significant financial hardship on the Member with the three-month suspension and potential personal expense of the preceptor.

Defense pointed out that the Member admitted to her conduct and therefore has greater likelihood for rehabilitation. The Member has accepted responsibility for her actions and has avoided unnecessary expense to the College and unnecessary pain for her clients, their families and her co-workers.

The panel concluded that the proposed penalty is reasonable and in the public interest. The Member has co-operated with the College and, by agreeing to the facts and a proposed penalty, has accepted responsibility for her actions.

, Chairperson Date Gabrielle Bridle, RPN, Chairperson, Discipline Panel

Christine Barber, RPN Member Janise Johnson, RN Member

Bill Weichel Public Representative Tom Clifford Public Representative