DISCIPLINE COMMITTEE OF THE COLLEGE OF NURSES OF ONTARIO
PANEL: Grace Fox, NP Chairperson Renate Davidson Public Member George Rudanycz, RN Member Margaret Tuomi Public Member Ingrid Wiltshire-Stoby, RN Member
BETWEEN:
COLLEGE OF NURSES OF ONTARIO MEGAN SHORTREED for College of Nurses of Ontario
- and -
PRIYA BASIL JANE LETTON for Registration No. 0417451 Priya Basil
Heard: September 26, 2016
DECISION AND REASONS
This matter came on for hearing before a panel of the Discipline Committee (the “Panel”) on September 26, 2016 at the College of Nurses of Ontario (“the College”) at Toronto.
The Allegations
The allegations against Priya Basil (the “Member”) as stated in the Notice of Hearing dated March 21, 2016 are as follows.
IT IS ALLEGED THAT:
- 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 the Ontario Regulation 799/93, in that while you were a Registered Nurse in a nursing teaching capacity at Modern Tech Nursing Inc. in Toronto, Ontario, you 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 and unprofessional, and in particular:
a) you provided [Applicant A], an applicant seeking a Certificate of Registration with the College of Nurses of Ontario, with a completed Competency Assessment Supplement which you knew or ought to have known was not the applicant’s own original work, in exchange for a payment; and/or
b) you provided [Applicant B], an applicant seeking a Certificate of Registration with the College of Nurses of Ontario, with a completed Competency Assessment Supplement which you knew or ought to have known was not the applicant’s own original work, in exchange for a payment.
Member’s Plea
The Member admitted the allegations set out in paragraph 1 a and 1 b in the Notice of Hearing. The Panel received a written plea inquiry which was signed by the Member. The Panel also conducted an oral plea inquiry and was satisfied that the Member’s admission was voluntary, informed and unequivocal.
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
Priya Basil (the “Member”) obtained a BscN from India in 2001.
The Member registered with the College of Nurses of Ontario (the “College”) as a Registered Nurse (“RN”) in June 2004.
The Member has been and remains the sole owner and operator of ModernTech Nursing Inc. (“ModernTech”) since January 2006.
MODERNTECH
ModernTech is located in Toronto, Ontario.
Through ModernTech, the Member provides RN and Registered Practical Nurse (“RPN”) registration examination study and review aids, as well as teaches RN and RPN review courses.
ModernTech’s programs are primarily directed towards assisting internationally educated nurses, who would like to obtain a certificate of registration from the College and become licensed to practise as a nurse in Ontario.
The Member also acknowledges that at the relevant time ModernTech provides applicants with assistance to complete Competency Assessment Supplements (“CAS”) required in the College registration process for some foreign educated nursing students.
INCIDENTS RELEVANT TO ALLEGATIONS OF PROFESSIONAL MISCONDUCT
Internationally Educated Applicants and Competency Assessments
Internationally educated nurses (“IENs”) who wish to apply for a certificate of registration from the College to allow them to practise nursing in Ontario (“applicant”) must complete a number of requirements before they can be registered at the College.
As the College must evaluate an IEN’s nursing education and/or experience, IENs who have not completed a College pre-approved education program must provide transcripts, course descriptions and syllabi to enable the College to evaluate the nursing program against College standards. If the College identifies competency gaps, the applicant may be required to fill out a CAS, which allows the applicant to express, in his or her own words, how he or she meets the competency gaps. The CAS form contains 121 questions, and requires applicants to demonstrate their competency by setting out personal experiences of how they have dealt with nursing situations and challenges.
The CAS is sent to the applicant with a declaration form that the applicant is expected to sign and submit with the CAS. The declaration form states the following:
The information contained in the Competency Assessment Supplement being submitted by me in support of my application for a Certificate of Registration has been prepared by me, is the result of my own work, accurately reflects my education, training and experience and contains no material previously published or written by another person, except where properly and fully acknowledged.
I have not allowed any other person to copy any portion of my submission.
I will take all reasonable care to ensure that my submission is protected so that no other person will be able to copy or otherwise use my submission for any improper purpose. [emphasis in original]
An applicant is given 45 days to complete and submit their CAS. It is then evaluated by the College, which determines whether the CAS addresses all of the competency gaps identified and whether the applicant can move forward in the registration process. If gaps remain, the applicant is required to undergo additional education and/or training.
Within one month, the College received two completed CAS forms from two different RPN applicants of the College, [Applicant A] and [Applicant B], which were almost identical. Both applicants had purchased the completed CAS forms from the Member.
The CAS submitted by [Applicant A] is attached as Appendix A, and the CAS submitted by [Applicant B] is attached as Appendix B to this Agreed Statement of Facts.
[Applicant B] and [Applicant A] reported that they never met each other, did not speak with anyone besides the Member at Modern Tech, did not use the computers at Modern Tech, and did not share the completed CAS forms they received from the Member with anyone else.
[Applicant A]
[Applicant A] obtained a degree in nursing in India in 2011. She applied for registration with the College in May 2012.
[Applicant A] was asked by the College to submit a CAS.
[Applicant A] did not understand what she was being asked to do in the CAS, so a friend referred her to the Member.
[Applicant A] called the Member and sent her an email in December 2013. The Member advised that she could assist [Applicant A].
[Applicant A]’s first appointment with the Member was on January 7, 2014 at 2:30 p.m. She met the Member in an empty classroom at ModernTech. [Applicant A] reports that the Member advised [Applicant A] that she would prepare all the answers for her CAS, that she had done this for other applicants in the past, and all she needed was [Applicant A]’s course information.
[Applicant A] returned to ModernTech on January 9, 2014 at 3 p.m. and provided the Member with the package she had received from the College, a copy of the syllabus from her education in India and a copy of her certificates.
[Applicant A] reports that the Member advised her that she did not need to do anything else. The Member advised [Applicant A] that she would complete the CAS herself.
[Applicant A] paid the Member $800 in cash at this meeting, as requested by the Member.
A few days later, the Member advised [Applicant A] that her CAS was completed. The Member asked [Applicant A] to return to ModernTech to pick up the answers.
On January 28, 2014 at 2:30 p.m., [Applicant A] met the Member in her office at ModernTech and was given two paper copies of the CAS – one for her own review and one to submit to the College. The Member also asked her receptionist to transfer an electronic copy of the CAS to a USB key [Applicant A] brought with her.
[Applicant A] reports that the Member asked her not to share any information or tell anyone what the Member had done.
[Applicant A] reviewed the CAS, noted that the answers were mostly accurate with respect to her experience, but some were made up. What she sent to the College was exactly as written by the Member.
[Applicant A] signed the declaration on January 28, 2014 and submitted the CAS to the College.
In or about February or March 2014, [Applicant A] received a letter of direction from the College requiring her to pursue additional education. [Applicant A] called the Member to ask why she did not become eligible to register with the College. [Applicant A] was told that the Member was not in the office. [Applicant A] decided to take the additional education.
In May 2014, the Member called [Applicant A] to ask her about the status of her application. [Applicant A] indicated that she was required to enrol in additional education, and did so at George Brown. The Member advised her that she could appeal the College’s decision and suggested enrolling in cheaper and shorter courses compared to those at George Brown. [Applicant A] advised the Member that she intended to complete the courses at George Brown, and did not want to be involved with the Member any further.
When [Applicant A] received a letter from the College dated May 23, 2014 advising that [Applicant A]’s CAS contained similar content to or the exact content of another CAS, [Applicant A] called the Member. [Applicant A] reports that the Member advised her to lie to the College.
[Applicant B]
[Applicant B] obtained a degree in nursing from India in 2008. She applied for registration with the College in September 2012.
[Applicant B] was asked by the College to submit a CAS.
[Applicant B] did not know how to complete the CAS. She was unable to find anyone who could provide her with examples of how to complete the questions in the CAS. As a result, she used the internet to find an institution that could assist her and came across ModernTech.
In early January 2014, [Applicant B] called ModernTech and set up an appointment to speak with the Member. She was told to bring a copy of her transcript from her nursing education in India. [Applicant B] then met with the Member for approximately half an hour.
[Applicant B] returned to ModernTech with her husband to pick up her completed CAS. She was only given a paper copy.
[Applicant B] paid $800 in cash for the completed CAS in two separate instalments, on January 28 and 31, 2014.
[Applicant B] changed some of the answers because the grammar in the document she had picked up from the Member was poor.
[Applicant B] signed the declaration on February 25, 2014 and submitted the completed CAS to the College.
After [Applicant B] received the letter from the College sent in May 2014, advising that her CAS was similar to or an exact copy of another CAS, [Applicant B]’s husband called the Member and the Member refunded [Applicant B]’s money.
UNDERTAKING TO PERMANENTLY RESIGN FROM THE COLLEGE
- The Member has signed an Undertaking with the College, agreeing to permanently resign and not to apply again for membership with the College, as she does not intend to practise nursing in the future. The Undertaking is attached as Appendix C.
ADMISSIONS OF PROFESSIONAL MISCONDUCT
- The Member admits that she provided both [Applicant A] and [Applicant B] with similar or the same completed CAS forms, knowing that neither was their original work, in exchange for payment as described in paragraphs 12 to 40 above, and as alleged in paragraph 1 of the Notice of Hearing. In particular, the Member admits that the conduct is disgraceful, dishonourable and unprofessional.
Decision
The Panel finds that the Member committed acts of professional misconduct as alleged in paragraphs 1 (a) and (b) of the Notice of Hearing. More specifically, the Panel finds that the Member engaged in conduct that would reasonably be considered by members of the profession to be disgraceful, dishonourable and unprofessional.
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 (a) in the Notice of Hearing is supported by paragraphs 12, 13, 14, 18 to 30 and appendix A and B in the Agreed Statement of Facts.
Allegation #1 (b) in the Notice of Hearing is supported by paragraphs 12, 13, 14, 34 to 39 and appendix A and B in the Agreed Statement of Facts.
The Panel finds that the Member’s conduct in providing two foreign nursing applicants with completed Competency Assessment Supplements was unprofessional as it demonstrated a serious and persistent disregard for her professional obligations and falls well below the standards of the profession.
The Panel also finds that the Member’s conduct was dishonourable. It demonstrated an element of dishonesty and deceit through the fact it was cheating the system by preparing forms that the Member knew or ought to have known should have been prepared by the applicants.
Finally, the Panel finds that the Member’s conduct was disgraceful as it shames the Member and by extension the profession. The conduct of completing Competency Assessment Supplements which she knew or ought to have known was not the applicants’ original work, in exchange for payment, shows a moral failing and falls well below the standards of the profession. It casts serious doubt on the Member’s moral fitness and inherent ability to discharge the higher obligations the public expects professionals to meet.
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.
Requiring Ms. Basil to appear before the Panel to be reprimanded within three months of the date that this Order becomes final.
Requiring Ms. Basil to pay a fine in the amount of $2,500 within 12 months of the date of this Order, by delivering a certified cheque or money order made payable to the Minister of Finance for Ontario to the Director, Professional Conduct of the College.
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 the Member has co-operated, made admissions and has voluntarily resigned.
The aggravating factors in this case were the Member took money to complete forms, advised her clients to lie to the College and this was a serious dishonest offense.
The proposed penalty provides for general deterrence through the fine and the reprimand showing the profession that professional misconduct is not taken lightly.
The proposed penalty provides for specific deterrence through the fine and the reprimand and shows the Member that disgraceful, dishonourable and unprofessional conduct will not be tolerated.
Overall, the public is protected because the Member has removed herself from the profession and the penalty imposed makes a statement to the membership of the profession that public protection is paramount.
College Counsel also submitted that Joint Submissions on Order are not entered into lightly, both parties make compromises and consideration is given to fairness for both sides.
The Member’s counsel agreed with the College that this is an appropriate penalty. The Member cannot just walk away, and there will on-going consequences for her actions.
Penalty Decision
The Panel accepts the Joint Submission as to Order and accordingly orders:
Ms. Basil is required to appear before the Panel to be reprimanded within three months of the date that this Order becomes final.
Ms. Basil is required to pay a fine in the amount of $2,500 within 12 months of the date of this Order, by delivering a certified cheque or money order made payable to the Minister of Finance for Ontario to the Director, Professional Conduct of the College.
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 Member has co-operated with the College and, by agreeing to the facts and a proposed penalty, has accepted responsibility. The Panel finds that the penalty of a fine and reprimand satisfies the principles of specific and general deterrence, and the resignation provides public protection.
I, Grace Fox, NP, 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:
Grace Fox, NP, Chairperson
Renate Davidson, Public Member
George Rudanycz, RN
Margaret Tuomi, Public Member
Ingrid Wiltshire-Stoby, RN