College of Nurses of Ontario v. Sircar, 2014 ONCNO 87372

DISCIPLINE COMMITTEE OF THE COLLEGE OF NURSES OF ONTARIO

PANEL: Nancy Sears, RN Chairperson

Sarah Corkey, RN Member Ashley Friest, RPN Member Catherine Egerton Public Member

Margaret Tuomi Public Member

BETWEEN:

COLLEGE OF NURSES OF ONTARIO ) MEGAN SHORTREED for ) College of Nurses of Ontario

• and - )

PAPIYA MIA SIRCAR ) MICHELLE GIBBS for Registration No. 9711961 ) Papiya Mia Sircar

) Heard: June 18, 2014

DECISION AND REASONS

This matter came on for hearing before a panel of the Discipline Committee on June 18, 2014, at the College of Nurses of Ontario (“the College”) at Toronto.

The Allegations

The Allegations

Counsel for the College advised the panel that the College was requesting leave to withdraw the allegations set out in paragraphs 2(i) and 3(ii) of the Notice of Hearing dated April 4, 2014. The panel granted this request. The remaining allegations against Papiya Mia Sircar (the “Member”) are as follows.

IT IS ALLEGED THAT:

1. 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, during the period October 14, 2011 – February 2013, you contravened a standard of practice of the profession or failed to meet the standard of practice of the profession, and in particular, you acted in a deceitful manner towards your employer, clients, and to the College of Nurses of Ontario (“CNO”) as set out in one or more of paragraphs 2 - 16 of the attached Appendix “A”.

2. 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(14) of Ontario Regulation 799/93, in that you falsified records relating to your practice, and in particular one or more of:

(i) [Withdrawn]

(ii) [client] records at [the Clinic] in which, during the period October 14, 2011 – March 14, 2012, you indicated you were a registered nurse or a nurse.

3. 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(15) of Ontario Regulation 799/93, in that you signed or issued, in your professional capacity, a document that you knew or ought to have known contained a false or misleading statement, and in particular, one or more of:

(i) the records set out in paragraphs 3, 4, 7, 8, 9, 13, 14, and 16 of Appendix “A”; and

(ii) [Withdrawn]

4. 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(16) of Ontario Regulation 799/93, in that you inappropriately used a term, title or designation in respect of your practice, and in particular:

(i) during the period October 14, 2011 – March 14, 2012, you indicated to [the Clinic] and its clients that you were a registered nurse or a nurse when you were not;

(ii) you signed [client] records at [the Clinic] during the period October 14, 2011 – March 14, 2012, indicating you were a registered nurse or a nurse when you were not; and

(iii) you indicated and/or failed to correct [the Clinic’s] advertising, in which you were identified as having a Masters of Science in Nursing, when you do not.

5. 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(17) of Ontario Regulation 799/93, in that you used a name other than your name, as set out in the register, in the course of providing or offering to provide services within the scope of practice of the profession except where the use of another name is necessary for personal safety and provided the employer and the College have been made aware of the pseudonym and the pseudonym is distinctive, and in particular the records set out in paragraphs 3 and 4 of the attached Appendix “A.”

6. 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(18) of Ontario Regulation 799/93, in that you contravened a term, condition or limitation on your certificate of registration as set out in paragraphs 5, 10, and 11 in the attached Appendix “A”.

7. 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(19) of Ontario Regulation 799/93, in that you contravened a provision of the Nursing Act, the Regulated Health Professions Act, 1991 or the regulations under either of those Acts, and in particular, you contravened the Acts as set out in paragraphs 5 and 6 in the attached Appendix “A”.

8. 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(21) of Ontario Regulation 799/93, in that you failed to comply with an order of a panel of the Discipline Committee as set out in paragraphs 5, 6, 10 and 11 in the attached Appendix “A”.

9. 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 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 as set out in paragraphs 1 - 16 in the attached Appendix “A”.

APPENDIX “A” TO THE NOTICE OF HEARING

Appendix A to the Notice of Hearing

1. Papiya Mia Sircar (“Member”) worked as a Registered Nurse at [the Clinic] from June 23, 2009, to June 5, 2013. Her job included providing nursing care to [clients] before, during and after dental surgery, including initiating intravenous access and the administration and monitoring of IV sedation.

2. According to [the Clinic’s] advertising, the Member had a Master of Science in Nursing. The Member does not have a Master of Science in Nursing. The Member took no steps to correct the information in [the Clinic’s] advertising regarding her education.

3. In October 2011, the Member provided [the Clinic] with a copy of a document purportedly downloaded from the “Find a Nurse” section of the CNO’s website on October 19, 2011 at 10:52:47 am. That document indicates:

(i) the Member’s name is “Papiya Mia Sircar Patterson”;

(ii) her registration # is [90#####];

(iii) she became a member of the CNO in 1990; and

(iv) her business address is [a Hospital].

4. The Member falsified the information on the document purportedly downloaded from the “Find a Nurse” section of the CNO website, and in particular, the last name, registration number, date of registration, and business address belong to another CNO member.

5. On October 14, 2011, the Member was the subject of a Discipline Committee hearing. The Member was found to have committed a number of acts of professional misconduct, and, as a result, the panel of the Discipline Committee ordered, among other things:

(i) a 5-month suspension, beginning October 14, 2011. The term of the suspension was October 14, 2011 – March 14, 2012 (“Period”); and

(ii) terms, conditions and limitations, including the requirement that, for a year after the suspension ended, to notify all employers in nursing of the Discipline Committee Decision, and to notify the CNO’s Director of Professional Conduct in writing of the name and contact information for all employers in nursing within 14 days of resuming or commencing employment in a nursing position (“Condition”).

6. The Member continued to work as a registered nurse at [the Clinic] throughout the Period. Although she was not a member of the CNO during the Period, the Member:

(i) used the titles “nurse” and “Registered Nurse”, contrary to subsection 11.(1) of the Nursing Act, 1991;

(ii) held herself out as a person who was qualified to practise in Ontario as a nurse, contrary to subsection 11.(5) of the Nursing Act,1991;

(iii) performed controlled acts, including performing a prescribed procedure below the dermis, and administering a substance by injection, contrary to subsection 27.(1) of the Regulated Health Professions Act, 1991; and

(iv) treated and advised persons with respect to their health in circumstances where it was reasonably foreseeable that serious physical harm could result from the treatment or advice or from an omission of them, contrary to subsection 30.(1) of the Regulated Health Professions Act, 1991.

7. On her 2012 Registration Renewal Form, which was confirmed December 16, 2011, the Member indicated she was employed on a casual basis in nursing by [an agency].

8. On her 2013 Registration Renewal Form, confirmed November 7, 2012, the Member indicated she was employed on a casual basis in nursing by [the agency], and on a part-time basis at [a coffee shop].

9. The information provided by the Member on her 2012 and 2013 Registration Renewal Forms was false and misleading because the Member did not provide any information about her employment as a registered nurse by [the Clinic].

10. The Member did not notify [the Clinic] of the Discipline Committee Decision in 2011 or 2012, as required by the Condition.

11. The Member did not notify the CNO’s Director of Professional Conduct in writing of the name and contact information for [the Clinic], as required by the Condition.

12. On February 12, 2013, in response to information from the CNO that she had breached the Condition, the Member left six telephone messages for the CNO’s Monitoring Administrator, all of which contained false and misleading information, including that:

(i) she was not currently employed by [the Clinic];

(ii) her employment with [the Clinic] had been terminated in September 2009;

(iii) she had not been practi[s]ing nursing but was returning to active practice in nursing the following week;

(iv) she had recently been hired back by [the Clinic];

(v) she had notified [the Clinic] of the Discipline Committee Decision and Reasons and of the Condition;

(vi) she was within the 14-day window to report a new employer to the CNO; and

(vii) she had provided [the Clinic] with the necessary paperwork to comply with the Condition.

13. On February 12, 2013, the Member wrote a letter to the CNO Monitoring Administrator, which contained the following false and misleading information:

(i) her employment at [the Clinic] had been terminated in September 11, 2011 in anticipation of the outcome of her Discipline Committee hearing;

(ii) she had recently been offered employment at [the Clinic] as a registered nurse; and

(iii) she was scheduled to start work as a registered nurse at [the Clinic] on February 19, 2013.

14. On February 12, 2013, the Member began texting her employer, who was on holiday, indicating he needed to sign a form confirming that he knew of her discipline matter. The Member assured her employer, “It's not as though I’ve been practicing without a license,” which was false and misleading, and indicated the CNO were “bureaucratic assholes.”

15. On February 14, 2013, the Member provided the CNO with a form, indicating her employers were [the agency], [the coffee shop] and [the Clinic]. She also provided a form signed by the Office Manager of [the Clinic], indicating the employer had been provided with the Member’s Discipline Committee record on February 12, 2013.

16. On February 21, 2013, the Member submitted a “Confirmation of Receipt of Discipline Order Documentation” to the CNO which contained false and misleading information, including that her employment start date at [the Clinic] was February 19, 2013.

17. On June 5, 2013, [the Clinic] terminated the Member’s employment.

Member’s Plea

Member’s Plea

The Member admitted the allegations set out in paragraphs 1, 2(ii), 3(i), 4(i), 4(ii), 4(iii), 5, 6, 7, 8 and 10 in the Notice of Hearing. It was noted by College Counsel that there is no allegation 9. The panel conducted an oral plea inquiry and was satisfied that the Member’s admission was voluntary, informed and unequivocal.

Agreed Statement of Facts

Agreed Statement of Facts

Counsel for the College and the Member advised the panel that agreement had been reached on the facts and introduced an Agreed Statement of Facts, which reads as follows.

THE MEMBER

1. Papiya Mia Sircar (the “Member”) obtained a diploma in nursing [ ] in 1996.

2. The Member obtained a Bachelor of Science degree in nursing [ ] in 1999.

3. The Member registered with the College of Nurses of Ontario (the “College”) as a Registered Nurse (“RN”) on February 26, 1997. The Member was suspended by the College’s Discipline Committee between October 14, 2011, and March 14, 2012.

INCIDENT RELEVANT TO ALLEGATIONS OF PROFESSIONAL MISCONDUCT

October 14, 2011 Discipline Committee Hearing

4. On October 14, 2011, the Member was the subject of a Discipline Committee hearing. The hearing proceeded by way of an Agreed Statement of Facts and Joint Submission on Order. The Joint Submission on Order, signed by the Member and ordered by the Discipline Committee (“Order”), included the following:

(i) a five month suspension, from October 14, 2011, to March 14, 2012; and

(ii) terms, conditions and limitations, including the requirement that, for a year after the suspension ended, the Member had to notify all nursing employers of the Discipline Committee’s Order, and to notify the College’s Director of Professional Conduct in writing of the name and contact information for all employers in nursing within 14 days of resuming or commencing employment in a nursing position.

5. Pursuant to the Order, the Member provided the College with a Confirmation of Receipt of Discipline Order Documentation on November 15, 2011, indicating her employer was [the agency].

6. On her 2012 Registration Renewal Form, which was received by the College on December 16, 2011, the Member indicated she was employed on a casual basis in nursing by [the agency].

7. On her 2013 Registration Renewal Form, received by the College on November 7, 2012, the Member indicated she was employed on a casual basis in nursing by [the agency], and on a part-time basis at [the coffee shop].

THE REPORT FROM THE MEMBER’S EMPLOYER

8. On August 19, 2012, the College received a report that the Member had started working at [the Clinic], a private dental surgery clinic (the “Clinic”) in June 2009, and may have worked at the Clinic while suspended.

9. In January 2013, the College contacted [Dr. A], the owner of the Clinic. [Dr. A] confirmed the Member was working at the Clinic as a Registered Nurse, and had been working there as a Registered Nurse since June 2009.

10. On February 6, 2013, the College wrote a letter to the Member indicating it had received information that she may have breached the Order.

11. On February 12, 2013, the Member called the College on six occasions and left messages. In the messages, which were transcribed, the Member indicated:

(i) she was not currently employed by the Clinic;

(ii) her employment with the Clinic had been terminated in September 2009;

(iii) she had not been practising nursing but was returning to active practice in nursing the following week;

(iv) she had recently been hired back by the Clinic;

(v) she had notified the Clinic of the Discipline Committee’s Order;

(vi) she was within the 14-day window to report a new employer to the College; and

(vii) she had provided the Clinic with the necessary paperwork to comply with the Order.

12. On February 12, 2013, the Member wrote a letter to the College’s Monitoring Administrator, which indicated:

(i) she had been hired by [Dr. A] in June 2009 to provide nursing care intra-operatively for [clients] undergoing routine periodontal surgery under conscious sedation at the Clinic;

(ii) her employment at the Clinic had been terminated on September 11, 2011, in anticipation of the outcome of her Discipline Committee hearing;

(iii) she had recently been offered employment at the Clinic to resume the same duties that she had previously performed; and

(iv) she was scheduled to start work at the Clinic on February 19, 2013.

13. On February 21, 2013, the Member submitted a Confirmation of Receipt of Discipline Order Documentation to the College, which contained false and misleading information, including that her employment start date at the Clinic was February 19, 2013. She also submitted a Notification of Employment Form indicating her employers were [the agency], [the coffee shop] and the Clinic.

THE MEMBER’S EMPLOYMENT AT THE CLINIC

14. The Clinic is an independent clinic that provides oral surgery.

15. The Member began working as a Registered Nurse at the Clinic in June 2009 and worked there on a continuous basis until June 5, 2013.

16. The Member provided nursing care to clients undergoing oral surgery, including performing pre-operative assessments, starting IVs, administering IV and oral medications, monitoring clients during surgery, providing post-operative care, and discharging clients.

17. The Clinic’s advertising indicated the Member had a Master of Science in Nursing (“MScN”), although she does not. She does possess a Bachelor of Science in Nursing degree (BscN).

18. In October 2011, the Member provided [Dr. A] with a document that purported to contain the information about her in the “Find a Nurse” section of the College’s website. The Member had altered the information on the document by using the last name, date of registration with the College, registration number and employment history of another College member.

19. [Dr. A] did not know the Member’s certificate of registration had been suspended as a result of the Order.

20. In February 2013, while [Dr. A] was on vacation, the Member sent him a text message asking him to sign a form indicating he was in receipt of a Discipline order. The Member also sent [Dr. A] text messages in which she indicated that she:

(i) had been through “crap” with the College in 2011/2012;

(ii) was supposed to get a form signed by him confirming his acknowledgement of her Discipline Committee hearing and Order;

(iii) did not think she was ever sent the form by the College;

(iv) would put the form on his desk for when he returned;

(v) had to figure out what piece of paperwork the College needs to be happy;

(vi) didn’t know “why their knickers were in such a knot over this. Its [sic] not as though I have been practising without a license…they could have just called and cleared the whole thing up”;

(vii) had been informed that as a condition of her Discipline Committee Order, the paperwork should have been filed within 14 days of starting a job;

(viii) told the College she was not working with him at present, which was technically true since he was on holiday, and that she started next week on Tuesday. She described the College as “Bureaucratic @$$holes”; and

(ix) apologized for the “fib.”

21. [Dr. A] did not have access to the form referred to by the Member but instructed his office manager to sign the form on his behalf, which she did.

22. The form was a Confirmation of Receipt of Discipline Order Documentation. The Member had completed the information section of the form, including the employment start date. The Member wrote on the form that her employment start date was February 19, 2013, even though she had been working at the Clinic since June 2009. The form was submitted to the College by the Member on February 21, 2013.

23. [Dr. A] met with the Member on May 30, 2013. She confessed to him that her certificate of registration had been suspended from October 14, 2011, to March 14, 2012 and that she worked as a nurse throughout the suspension. The Member also admitted that she failed to inform him about the suspension.

24. The Member’s employment with the Clinic was terminated on June 5, 2013.

THE MEMBER’S RESPONSE

25. The Member admits that:

(i) she worked as a Registered Nurse at the Clinic during her suspension;

(ii) while suspended, she used the titles “Nurse” and “Registered Nurse,” held herself out as a person qualified to practise in Ontario as a nurse, performed controlled acts, and treated and advised persons with respect to their health in circumstances where it was reasonably foreseeable that serious physical harm could result from the treatment or advice;

(iii) she breached the Order in that she did not notify the Clinic of the Discipline Committee Decision, and she did not notify the College’s Director of Professional Conduct in writing of the name and contact information for the Clinic within 14 days of resuming or commencing employment in a nursing position;

(iv) she gave information and provided statements to the College that were not true; and

(v) she gave information and provided statements to her employer that were not true.

26. The Member made these admissions early in the process. Because of the Member’s cooperation with the College, the need for a lengthy hearing has been avoided and witnesses have been spared the need to testify.

27. If the Member were to testify, she would express remorse and apologize for the conduct set out above. She would acknowledge the importance of being honest and forthcoming with the College, and in complying with all Discipline Committee orders. She would express how deeply ashamed she was by her actions, that she understood the seriousness of her misconduct, and that she was willing to take responsibility for her misconduct by appearing before a panel of the Discipline Committee to face the consequences of her actions.

28. If the Member were to testify, she would further say that she was under personal and financial stress during the period of suspension, and that her stress contributed to her extremely poor judgment and decision-making.

ADMISSIONS OF PROFESSIONAL MISCONDUCT

29. The Member admits that she committed the acts of professional misconduct as alleged in the Notice of Hearing, dated April 4, 2014, and in particular, she:

(i) contravened a standard of the profession or failed to meet the standard of practice of the profession as alleged in paragraph 1;

(ii) falsified records relating to her practice, as alleged in paragraph 2(ii);

(iii) signed or issued, in her professional capacity, documents that she knew or ought to have known contained false or misleading statements, as alleged in paragraph 3(i);

(iv) inappropriately used a term, title, or designation in respect of her practice as alleged in paragraph 4;

(v) used a name other than her name as set out in the register in the course of providing services within the scope of practice of the profession, as alleged in paragraph 5;

(vi) contravened a term, condition or limitation on her certificate of registration, as alleged in paragraph 6;

(vii) contravened provisions of the Nursing Act and the Regulated Health Professions Act as alleged in paragraph 7;

(viii) failed to comply with an order of the Discipline Committee, as alleged in paragraph 8; and

(ix) 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 as disgraceful, dishonourable and unprofessional, as alleged in paragraph 10.

OTHER

30. With leave of the Panel of the Discipline Committee, the College withdraws the following particulars: paragraph 2(i) and 3(ii).

Decision

Decision

The panel finds that the Member committed acts of professional misconduct as alleged in paragraphs 1, 2(ii), 3(i), 4 (i) (ii) (iii), 5, 6, 7, 8 and 10 of the Notice of Hearing. As to allegation 10, the panel finds that the Member engaged in conduct relevant to the practice of nursing that would reasonably be considered by members to be unprofessional, dishonourable, and disgraceful.

Reasons for Decision

Reasons for Decision

The panel considered the Agreed Statement of Facts and the Member’s plea and finds that this evidence supports findings of professional misconduct as alleged in the Notice of Hearing.

Allegation #1 in the Notice of Hearing is supported by paragraphs 3, 9, 15, 16, 17, 18, 23, and 25 in the Agreed Statement of Facts.

Allegation #2(ii) in the Notice of Hearing is supported by paragraphs 15 and 16 in the Agreed Statement of Facts in that inferences can be drawn that the Member while working as a Registered Nurse in the clinic and providing client care would have, as a matter of normal practice, made documentations in [client] records and that documentation would have included a nursing designation. Counsel for the parties agreed that during the development of the Agreed Statement of Facts, documents supporting this inference had been examined by both parties. Both agreed that in the absence of explicit evidence in the Agreed Statement of Facts, this inference is reasonable.

Allegation #3(i) in the Notice of Hearing is supported by paragraphs 3, 5, 6, 7, 12, 18, 20, and 22 in the Agreed Statement of Facts.

Allegation #4(i) in the Notice of Hearing is supported by paragraphs 15 and 16 in the Agreed Statement of Facts in that inferences can be drawn that while working as a Registered Nurse in the clinic and providing client care she held herself out as a nurse to her employer and its clients. Counsel for the parties agreed that in the context of this case that this inference is reasonable.

Allegation #4(ii) in the Notice of Hearing is supported by paragraphs 15 and 16 in the Agreed Statement of Facts in that inferences can be drawn that the Member while working as a Registered Nurse in the clinic and providing client care would have, as a matter of normal practice, made documentations in [client] records and that documentation would have included a nursing designation. Counsel for the parties agreed that during the development of the Agreed Statement of Facts, documents supporting this inference had been examined by both parties. Both agreed that in the absence of explicit evidence in the Agreed Statement of Facts, this inference is reasonable.

Allegation #4(iii) in the Notice of Hearing is supported by paragraph 17 in the Agreed Statement of Facts.

Allegation #5 in the Notice of Hearing is supported by paragraph 18 in the Agreed Statement of Facts.

Allegation #6 in the Notice of Hearing is supported by paragraphs 4, 13, 19 and 23 in the Agreed Statement of Facts.

Allegation #7 in the Notice of Hearing is supported by paragraphs 9, 15, 16, 23 and 25 in the Agreed Statement of Facts.

Allegation #8 in the Notice of Hearing is supported by paragraphs 9, 12, 13, 15, 16, 19, 23 and 25 in the Agreed Statement of Facts.

With respect to Allegation # 10, the panel finds that the Member’s conduct in not complying with a previous discipline panel order was unprofessional as it demonstrated a serious and persistent disregard for her professional obligations.

The panel also finds that the Member’s conduct was dishonourable. It demonstrated an element of dishonesty and deceit through falsification of documents, not informing her employer of a previous discipline order, and not complying with terms, conditions, and limitations placed on her certificate of registration specifically to protect the public in a previous discipline panel order.

Finally, the panel finds that the Member’s conduct was disgraceful as it shames the Member and by extension the profession. The conduct of repeatedly disregarding the responsibilities and obligations related to self-regulation by continuing to practi[s]e while her certificate of registration was suspended and repeated deceitful acts towards the college and her employer casts serious doubt on the Member’s moral fitness and inherent ability to discharge the higher obligations the public expects professionals to meet.

Penalty

Penalty

Counsel for the College and the Member advised the panel that a Joint Submission on Order had been agreed upon. The Joint Submission requests that this panel make an order as follows.

1. Directing the Executive Director to immediately revoke the Member’s certificate of registration; and

2. Requiring the Member to appear before the Panel to be reprimanded.

Penalty Submissions

Penalty Submissions

Submissions were made by College Counsel. The Member’s Counsel indicated that she agreed with those submissions.

The parties agreed that the mitigating factors in this case were:

• Personal and financial stress of the Member; and

• The Member’s expression of remorse and shame

The aggravating factors in this case were:

• The misconduct involved multiple deceptions;

• A previous order of this Discipline Committee was breached the day after it was made;

• The deceit was repeated when the Member was initially questioned by the College about the Member’s continued practice during suspension and current employers; and

• The complete disregard for the College’s regulatory process.

The proposed penalty provides for general deterrence by focusing on the consequences of ungovernability.

The proposed penalty provides for specific deterrence as it requires the Member to think carefully and reflect on values should she seek reinstatement.

As the Member will no longer practi[s]e as a nurse, there is no need for the proposed penalty to provide for remediation and rehabilitation.

Overall, the public is protected because the Member will not be able to practi[s]e as a nurse.

Counsel submitted five cases to the panel to demonstrate that the proposed penalty fell within the range of similar cases from this and other Discipline Committees.

CNO v. Pontin (Discipline Committee, 2010). The member in this case had been suspended due to non-payment of fees but continued to practi[s]e and represent herself as a nurse. Penalty included revocation of the member’s certificate of registration.

CNO v. Campbell (Discipline Committee, 2012). This member used the protected title of Registered Nurse while her certificate of registration was suspended as a result of a previous decision of the Discipline Committee. The penalty included revocation of the member’s certificate of registration due to ungovernability and the lack of indication that remediation would be of any use.

CNO v. Nahwegahbow (Discipline Committee, 2005). This member was suspended due to non-payment of fees but continued to use the title of Registered Practical Nurse and practi[s]ed as a Registered Practical Nurse while her certificate was suspended. The panel ordered revocation of the member’s certificate of registration.

Law Society of Upper Canada v. Vance (Law Society Hearing Panel, 2010). The member failed to cooperate and communicate with the Law Society and practi[s]ed while suspended as a result of a previous order. The member’s licence to practi[s]e law was revoked.

Ontario College of Pharmacists v. Chin (Discipline Committee, 2011). The member breached a previous discipline panel order and contravened a term, condition or limitation on his certificate of registration. The member’s certificate of registration was revoked.

Penalty Decision

Penalty Decision

The panel accepts the Joint Submission as to Order and accordingly orders:

1. That the Executive Director immediately revoke the Member’s certificate of registration; and

2. That the Member appear before the Panel to be reprimanded

Reasons for Penalty Decision

Reasons for Penalty Decision

The panel understands that the penalty ordered should protect the public and enhance public confidence in the ability of the College to regulate nurses. This is achieved through a penalty that addresses specific deterrence, general deterrence and, where appropriate, rehabilitation and remediation. The panel also considered the penalty in light of the principle that joint submissions should not be interfered with lightly.

The panel concluded that the proposed penalty is reasonable and in the public interest. The panel finds that the oral reprimand and the revocation of the Member’s certificate of registration satisfies the principles of specific and general deterrence, and public protection. The Member has cooperated with the College and, by agreeing to the facts and a proposed penalty, has accepted responsibility. The panel finds that because the Members certificate of registration will be revoked, the goal of rehabilitation and remediation does not apply. The penalty is in line with what has been ordered in previous cases.

I, Nancy Sears, RN, 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

Panel Members:

Sarah Corkey, RN

Ashley Friest, RPN

Catherine Egerton, Public Member

Margaret Tuomi, Public Member