College of Nurses of Ontario v. Ferris, 2017 ONCNO 84898

DISCIPLINE COMMITTEE OF THE COLLEGE OF NURSES OF ONTARIO

PANEL: INGRID WILTSHIRE-STOBY, RN Chairperson LAURA CARAVAGGIO, RPN Member KAREN LAFORET, RN Member MARY MACMILLAN-GILKINSON Public Member ASHLEIGH MOLLOY Public Member

BETWEEN:

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

• and -

BRADLEY FERRIS Reg. No. 09377444 SELF-REPRESENTED

ANDREA GONSALVES Independent Legal Counsel

Heard: JULY 13, 2017

DECISION AND REASONS

[October 25, 2017 Addendum: Following the release of our Decision and Reasons, it was brought to the panel’s attention that we had made two drafting errors. As a result, the panel has made two corrections to this Decision and Reasons to reflect its oral decision and written Order given on July 13, 2017. On page 8, the panel’s decision now reads that the Member’s conduct as to allegation #4(a) (b) (c) and (d) would reasonably be regarded by members of the profession as unprofessional and with respect to allegation #4 (e)) and (f) the panel’s decision now reads that the Member’s conduct would reasonably be regarded by members of the profession as dishonourable and unprofessional. On page 9, paragraphs 6 and 7 now outlines the panel’s reasons for its decision with respect to allegation #4].

This matter came on for hearing before a panel of the Discipline Committee (“the Panel”) on July 13, 2017 at the College of Nurses of Ontario (“the College”) at Toronto.

The Panel ordered a publication ban following a motion brought by College Counsel, pursuant to s. 45 (3) of the Health Professions Procedural Code of the Nursing Act, 1991. The order bans the publication and broadcasting of the identities of the clients referred to in this hearing or any information that could reasonably disclose the client’s identities, including any reference to client names in the allegations in the Notice of Hearing. The Member agreed with the publication ban.

The Allegations

The allegations against Bradley Ferris (the “Member”) as stated in the Notice of Hearing dated June 20, 2017 are as follows.

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 (the “Act”), and defined in subsection 1(1) of Ontario Regulation 799/93, in that, while employed as a Registered Nurse at Southern Ontario Fertility Technologies Inc. in London, Ontario (the “Facility”), you contravened a standard of practice of the profession or failed to meet the standards of practice of the profession, and in particular:

a) for the [Client A], you issued a written referral order under a physician’s name without the physician’s approval, on July 31, 2014 and November 6, 2014; and/or

b) for the [Client B], you issued a written referral order under a physician’s name without the physician’s approval, on August 21, 2014; and/or

c) for the [Client C], you issued a written referral order under a physician’s name without the physician’s approval, on September 4, 2014; and/or

d) for the [Client D], you issued a written referral order under a physician’s name without the physician’s approval, on September 24, 2014; and/or

2. You have committed an act of professional misconduct as provided by subsection 51(1)(c) of the Health Professions Procedural Code of the Act, and defined in subsection 1(8) of Ontario Regulation 799/93, in that, while employed as a Registered Nurse at the Facility, you misappropriated property from a client or work place, and in particular:

a) between October 6 and November 16, 2014, you falsified payroll records relating to yourself and your sister and colleague, Meagan Golem, in order to pay her for time that she did not work, and in doing so, caused your employer to pay for hours never worked by any employee; and/or

3. You have committed an act of professional misconduct as provided by subsection 51(1)(c) of the Health Professions Procedural Code of the Act, and defined in subsection 1(28) of Ontario Regulation 799/93, in that, while employed as a Registered Nurse at the Facility, you submitted an account or charge for services that you knew was false or misleading, and in particular:

a) between October 6 and November 16, 2014, you falsified payroll records relating to yourself and your sister and colleague, Meagan Golem, in order to pay her for time that she did not work; and/or

4. You have committed an act of professional misconduct as provided by subsection 51(1)(c) of the Health Professions Procedural Code of the Act, and defined in subsection 1(37) of Ontario Regulation 799/93, in that, while employed as a Registered Nurse at the Facility, 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, and in particular:

a) For the [Client A], you issued a written referral order under a physician’s name without the physician’s approval, on July 31, 2014 and November 6, 2014; and/or

b) For the [Client B], you issued a written referral order under a physician’s name without the physician’s approval, on August 21, 2014; and/or

c) For the [Client C], you issued a written referral order under a physician’s name without the physician’s approval, on September 4, 2014; and/or

d) For the [Client D], you issued a written referral order under a physician’s name without the physician’s approval, on September 24, 2014; and/or

e) between October 6 and November 16, 2014, you falsified payroll records relating to yourself and your sister and colleague, Meagan Golem, in order to pay her for time that she did not work, for the purposes of defrauding the government’s Employment Insurance scheme; and/or

f) on or about November 21, 2014, you input information into Meagan Golem’s Record of Employment which you knew or ought to have known was false, for the purposes of defrauding the government’s Employment Insurance scheme.

Member’s Plea

The Member admitted the allegations set out in paragraphs 1 (a), (b), (c), (d), 2 (a), 3 (a), and 4 (a), (b), (c), (d), (e,) and (f,) 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

1. Bradley Ferris (the “Member”) obtained a degree in nursing from Western University in 2009.

2. The Member registered with the College of Nurses of Ontario (the “College”) as a Registered Nurse (“RN”) on May 5, 2009.

3. The Member was employed at Southern Ontario Fertility Technologies Inc. (the “Clinic”) from January 12, 2010 to November 22, 2014, when his employment was terminated as a result of the incidents below.

THE CLINIC

4. The Clinic is located in London, Ontario.

5. The Clinic is a fertility clinic owned by [Doctor A] and [Doctor B], who are husband and wife.

6. The Member worked at the Clinic as a full-time nurse and Business Manager. As Business Manager, the Member was in charge of the business and financial aspects of the Clinic’s practice.

7. The Member’s sister, Meagan Golem, was the In-Vitro Fertilization Coordinator at the Clinic. She was also an RN. Her duties included managing the In-Vitro Fertilization (“IVF”) cycles and monitoring.

INCIDENTS RELEVANT TO ALLEGATIONS OF PROFESSIONAL MISCONDUCT

Falsifying Payroll Records

8. On October 3, 2014, Ms. Golem went on her second maternity leave. She was pregnant with twins and was ordered to go off work early on bed rest because it was a high risk pregnancy.

9. At the time, Ms. Golem did not have enough hours to qualify for Employment Insurance (“EI”) benefits because she had only returned to work from her first maternity leave in July 2014. She was approximately 200 hours short of qualifying for EI benefits.

10. The Member proposed to [Doctor A] that he could transfer some of his hours worked to Ms. Golem, who was not working, so she could be eligible for EI. If the Member were to testify, he would say that [Doctor A] approved. If [Doctor A] were to testify, she would say that she told the Member the Clinic would have nothing to do with the EI scheme. If Ms. Golem were to testify, she would say the Member came up with the EI scheme on his own and told her he received approval from [Doctor A] to credit some of his hours to her. In any event, the Member admits that his proposal to submit a record of hours not worked by his sister to the federal government constituted a plan to defraud the EI program.

11. At the beginning of October 2014, the Member was responsible for the Clinic’s payroll. Between October and November 2014, the Member falsified the payroll records and arranged for Ms. Golem to be paid for hours she did not work, as follows:

• October 6-19, 2014 – 74 hours

• October 20-November 2, 2014 – 79.50 hours

• November 3-16, 2014 – 40 hours

12. In order to make payments to Ms. Golem, the Member allocated hours he worked to Ms. Golem, for most but not all of the hours credited to her. The Member arranged for the Clinic to pay Ms. Golem for nine more hours than he actually deducted from his own pay. The Clinic therefore suffered a financial loss as a result of the EI scheme.

13. If the Member were to testify, he would say the overpayment of nine hours was an oversight and an inadvertent miscalculation on his part. He would further say that did not intend to pay Ms. Golem for hours he did not deduct from his own pay. In any case, the Member admits that he submitted an account or charge that he knew was false or misleading when he submitted the altered payroll records. He also admits that he misappropriated property from the Clinic with respect to causing the employer to pay for nine hours not worked by any employee.

14. The Member later requested Ms. Golem’s Record of Employment (“ROE”) from the payroll company. It was based on the false payroll records he had submitted, and so reflected hours Ms. Golem did not in fact work. The ROE indicated that Ms. Golem’s last day of work was November 16, 2014 when it was October 3, 2014. The Member submitted the false ROE to [Doctor B] for signature. [Doctor B] noticed the false information and did not sign it. It was never submitted to the government.

Issuing Written Referral Orders without Documenting Physician Approval

15. The Clinic had a professional association with Create, a fertility clinic in Toronto, and referred clients there for IVF beginning July 1, 2014.

16. If [Doctor A] were to testify, she would say that the only person at the Clinic who could refer a client for IVF was the referring physician.

17. While the Member would testify that he sought a physician’s approval in each of the following cases, he admits that his progress notes in the patients’ charts do not reflect his seeking or obtaining an order from a physician. Further, in each case, there was an opportunity for a physician to review and sign the referral in person.

Client A

18. On July 31, 2014 and November 6, 2014, the Member wrote referrals for Client A and applied the physician’s stamp to the referrals without documenting any verbal or telephone order by the physician.

19. The first document is dated July 31, 2014. The request is a consultation sent to [Doctor C] at Create. The reason for the consult is listed as “IVF, recurrent loss.” The information section states:

3 miscarriages prior to successful twin pregnancy in IUI. Another loss now. Hx of PCOS. Would appreciate your feedback on IVF +/- PGS and orders.

20. The Member handwrote the document and applied [Doctor A’s] stamp in lieu of her signature.

21. The second document is dated November 6, 2014. The request is directed to [Doctor D]. The reason for consultation is listed as “second opinion”:

PT c PCOS, recurrent loss and set of twins conceived c femora and IUI. PT requesting opinion on PCOS and IVF.

22. The referral is in the Member’s handwriting and again [Doctor A’s] stamp was applied in lieu of a signature. The schedules from the Clinic show that [Doctor A] was at the Clinic and saw clients on both July 31, 2014 and November 6, 2014.

Client B

23. On August 21, 2014, the Member wrote a referral for Client B and applied the physician’s stamp without documenting any verbal or telephone order by the physician. The referral is for Client B to see [Doctor C] at Create for IVF. The referral is in the Member’s handwriting and [Doctor A’s] stamp was applied in lieu of her signature.

24. According to the Facility’s schedules, [Doctor A] saw clients on August 21, 2014 from 11:30 to 14:15. Client B was not listed as a client on [Doctor A’s] schedule, but she would have been available to sign a referral.

Client C

25. On September 4, 2014, the Member wrote a referral for Client C to see a physician for IVF and applied the physician’s stamp without documenting any verbal or telephone order by the physician. The referral is in the Member’s handwriting.

26. The progress note [for] Client C on September 3, 2014 was written by the Member. It notes:

We had a long discussion on PGS testing in IVF and the options presented by that. I recommend an appointment with [Doctor C] to discuss their options, including an IVF and PGS and egg donation.

27. The Member did not document any verbal or telephone order from [Doctor A] to make a referral order in her name. According to the Clinic’s schedules, [Doctor A] saw clients on September 4, 2014 from 10:00 to 13:00.

Client D

28. On September 24, 2014, the Member wrote a referral for Client D and applied [Doctor A’s] stamp without documenting any verbal or telephone order by the physician. A request for a consultation was filled out by the Member as follows:

Pt completed donor oocyte IVF in 2013; miscarriage. Would like to complete FET @ ISIS c you as MRP. Pt would like to monitor cycle at SOFT.

29. If [Doctor A] were to testify, she would say that this referral should have only been made after she discussed the options with Client D during a visit and a written order was made by a physician. No such visit occurred with Client D.

30. According to the Facility’s schedules, [Doctor A] saw clients on September 24, 2014 from 10:30 am to 12:00, but Client D was not listed as a client on her schedule. Therefore, she did not consult with Client D, but was available to sign a referral.

COLLEGE STANDARDS

31. The College’s practice guideline Directives states that an “order” is broader than just medication, and includes “a prescription for a procedure, treatment, drug or intervention.” The College’s Authorizing Mechanisms practice guideline dictates that verbal orders should only be used in emergency situations, or when the physician is unable to document the order.

32. The standards require a nurse to document an order if the order was obtained verbally (e.g., over the phone). Moreover, the College’s Documentation standard contains requirements that nurses ensure that “documentation is a complete record of nursing care provided and reflects all aspects of the nursing process, including … intervention (independent and collaborative)” and to document “significant communication with …other care providers”.

33. Further, the College’s Guidelines on Telepractice state:

When telecommunication technologies are used to seek or provide advice and/or information to another health care provider concerning a client’s care, a consistent method of collecting and recording the information should be employed. Nurses’ documentation of provider-to-provider interactions is expected to include:

• date and time of the interaction;

• name of the providers involved;

• name of the client being discussed (when applicable);

• reason for the interaction;

• information provided/received;

• client information provided/received;

• advice or information given/received;

• any follow-up required/provided;

• any agreement/consensus about the plan of care; and

• the documenting nurse’s signature and designation.

ADMISSIONS OF PROFESSIONAL MISCONDUCT

34. The Member admits that he committed the acts of professional misconduct as alleged in paragraphs 1(a), (b), (c) and (d) of the Notice of Hearing, as described in paragraphs 15 to 33 above, in that he breached the standards of practice of the profession on obtaining and documenting verbal or telephone orders, and thereby issued written referral orders under a physician’s name without appropriate approval.

35. The Member admits that he committed the act of professional misconduct as alleged in paragraph 2(a) of the Notice of Hearing, as described in paragraphs 8 to 14 above, in that he misappropriated property from his work place when he falsified payroll records relating to himself and Meagan Golem in order to pay her for time that she did not work, and in doing so, caused his employer to pay for nine hours never worked by any employee.

36. The Member admits that he committed the act of professional misconduct as alleged in paragraph 3(a) of the Notice of Hearing, as described in paragraphs 8 to 14 above, in that he submitted an account or charge for services that he knew was false or misleading when he falsified payroll records for himself and Meagan Golem, in order to pay her for time she did not work.

37. The Member admits that he committed the acts of professional misconduct as alleged in paragraphs 4(a), (b), (c) and (d) of the Notice of Hearing, in that his conduct would reasonably be regarded by members of the profession as unprofessional, and in paragraphs 4(e) and (f) of the Notice of Hearing, in that his conduct would reasonably be regarded by members of the profession as dishonourable and unprofessional, as described in paragraphs 8 to 33 above.

Decision

The Panel finds that the Member committed acts of professional misconduct as alleged in paragraphs 1 (a), (b), (c), (d), 2 (a) and 3 (a) of the Notice of Hearing. As to allegation #4 (a), (b), (c) and (d) of the Notice of Hearing, the Panel finds that the Member engaged in conduct that would reasonably be considered by members of the profession as unprofessional and in paragraphs 4(e) and (f) of the Notice of Hearing, the panel finds that the Member’s conduct would reasonably be regarded by members of the profession as 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 in the Notice of Hearing is supported by paragraphs 15-33 in the Agreed Statement of Facts.

The Member acknowledges that he contravened the College’s practice guideline directives, the College’s Authorizing Mechanisms practice guidelines as well as the College’s Documentation standard when he issued a written referral order for four clients to receive IVF without documenting the physician’s approval. If the Member were to testify, he would state that he did seek out the doctor’s approval but admits his progress notes do not reflect this. If the doctor were to testify, she would state that the physician is the only one who can refer a client for IVF. The Member acknowledges that he handwrote the referrals and applied the doctor’s stamp in lieu of her signature. In all cases, the physician was in the Clinic on the days that the referrals were made and was available to sign them in person.

Allegation #2 in the Notice of Hearing is supported by paragraphs 8 - 14 in the Agreed Statement of Facts.

The Member acknowledges that he misappropriated property from his workplace when he falsified payroll records. He was attempting to ensure that his sister, Meagan Golem, had the required number of hours to qualify for employment insurance. She had been unexpectedly ordered off work due to a high risk pregnancy. The Member transferred the hours he worked between October 6 and November 16, 2014 to his sister, Meagan Golem. In so doing, he allocated more hours to his sister than he had actually deducted from his own pay. This caused their employer to pay for nine hours not worked by any either of them or any employee. If the Member were to testify he would say that this was an oversight and a miscalculation. However, it did occur.

Allegation #3 in the Notice of Hearing is supported by paragraphs 8 – 14 in the Agreed Statement of Facts.

The Member acknowledges that he knowingly submitted payroll records that were false or misleading. As a result of transferring hours worked from himself to his sister, Meagan Golem’s Record of Employment was wrongly stated as November 16, 2014 instead of October 3, 2014. It is fortunate that [Doctor B] noticed the incorrect information and refused to sign the Record of Employment. Otherwise, the federal government would have been defrauded.

With respect to Allegation # 4 (a), (b), (c) and (d), the Panel finds that the Member’s conduct was unprofessional as it demonstrated a serious and persistent disregard for his professional obligations. The Member was placed in a position of trust by his employer. Yet, he intentionally disregarded his professional responsibilities and showed a lack of good judgement when he made written referrals under a physician’s name without obtaining signed consent. He did not live up to the standards expected of him.

With respect to allegation #4(e) and (f), the Panel finds that the Member’s conduct was dishonourable and unprofessional. By falsifying payroll records in an attempt to help his sister obtain Employment Insurance, the Member engaged in conduct that was deceitful and dishonest. His actions were also unprofessional in that he showed a lack of moral integrity and a lack of the good judgement and responsibility that are required of those privileged to practice the profession of nursing. The Member ought to have known that his conduct was unacceptable.

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. Requiring the Member to appear before the Panel to be reprimanded within three months of the date that this Order becomes final.

2. Directing the Executive Director to suspend the Member’s certificate of registration for three months. This suspension shall take effect from the date that this Order becomes final and shall continue to run without interruption as long as the Member remains in the practising class.

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

a) The Member will attend a minimum of two meetings with a Nursing Expert (the “Expert”) at his own expense and within six months from the date of this Order. If the Expert determines that a greater number of sessions are required, the Expert will advise the Director of Professional Conduct (the “Director”) regarding the total number of sessions that are required and the length of time required to complete the additional sessions, but in any event, all sessions shall be completed within one year from the date of this Order. To comply, the Member is required to ensure that:

i. The Expert has expertise in nursing regulation and has been approved by the Director of Professional Conduct (the “Director”) in advance of the meetings;

ii. At least seven days before the first meeting, the Member provides the Expert with a copy of:

1. the Panel’s Order,

2. the Notice of Hearing,

3. the Agreed Statement of Facts,

4. this Joint Submission on Order, and

5. if available, a copy of the Panel’s Decision and Reasons;

iii. Before the first meeting, the Member reviews the following College publications and completes the associated Reflective Questionnaires, online learning modules and online participation forms (where applicable):

1. Professional Standards,

2. Documentation,

3. Authorizing Mechanisms,

iv. At least seven days before the first meeting, the Member provides the Expert with a copy of the completed Reflective Questionnaires, and online participation forms;

v. The subject of the sessions with the Expert will include:

1. the acts or omissions for which the Member was found to have committed professional misconduct,

2. the potential consequences of the misconduct to the Member’s clients, colleagues, profession and self,

3. strategies for preventing the misconduct from recurring,

4. the publications, questionnaires and modules set out above, and

5. the development of a learning plan in collaboration with the Expert;

vi. Within 30 days after the Member has completed the last session, the Member will confirm that the Expert forwards his/her report to the Director, in which the Expert will confirm:

1. the dates the Member attended the sessions,

2. that the Expert received the required documents from the Member,

3. that the Expert reviewed the required documents and subjects with the Member, and

4. the Expert’s assessment of the Member’s insight into his behaviour;

vii. If the Member does not comply with any one or more of the requirements above, the Expert may cancel any session scheduled, even if that results in the Member breaching a term, condition or limitation on his certificate of registration;

b) For a period of 12 months from the date the Member returns to the practice of nursing, the Member will notify his employers of the decision. To comply, the Member is required to:

i. Ensure that the Director is notified of the name, address, and telephone number of all employer(s) within 14 days of commencing or resuming employment in any nursing position;

ii. Provide his employer(s) with a copy of:

1. the Panel’s Order,

2. the Notice of Hearing,

3. the Agreed Statement of Facts,

4. this Joint Submission on Order, and

5. a copy of the Panel’s Decision and Reasons, once available;

iii. Ensure that within 14 days of the commencement or resumption of the Member’s employment in any nursing position, the employer(s) forward(s) a report to the Director, in which it will confirm:

1. that they received a copy of the required documents, and

2. that they agree to notify the Director immediately upon receipt of any information that the Member has breached the standards of practice of the profession; and

3. All documents delivered by the Member to the College, the Expert or the employer(s) will be delivered by verifiable method, the proof of which the Member will retain.

Penalty Submissions

Submissions were made by College Counsel. The Member indicated that he agreed with those submissions.

The parties agreed that the mitigating factors in this case were that the Member had no prior disciplinary history with the College. He cooperated with the College and admitted his wrongdoing. A contested hearing, which would have involved additional costs and delays, was avoided. The Member spoke to the Panel and took responsibility for his actions and made no excuses. He apologized to the profession at large. On June 28, 2017 he issued a cheque payable to his employer in the amount of $279.00 as restitution for the nine hours he misappropriated. He has stated that he wants to improve his practice.

The aggravating factors in this case were the Member’s actions when he issued false and misleading accounts which resulted in the misappropriation of funds from his work place. If his plan had been successful, he would have defrauded the government. This speaks to a lack of honesty and integrity.

The proposed penalty provides for general deterrence through the three month suspension and the terms, conditions and limitations.

The proposed penalty provides for specific deterrence through the suspension, the reprimand and the terms, conditions and limitations.

The proposed penalty provides for remediation and rehabilitation through the reprimand and the minimum of two meetings with a Nursing Expert.

Overall, the public is protected because the Member will have the opportunity to reflect on his conduct, gain insight into his actions and improve on his practice.

Counsel submitted that the proposed penalty fell within the range of similar cases from this Discipline Committee.

The College submitted the case of CNO v. Sharisa Mohamed (Discipline Committee, 2008). This case was more serious as it involved a number of circumstances where the member lied. In this case, the member falsified her medical records in order to receive sick leave benefits and/or modified work. It took considerable time for the member to acknowledge her deceit. The Facility sustained a financial loss of $16,581.12. The member was given a 4 month suspension, a minimum of 6 sessions with a Counsellor and was fined.

The College submitted the case of CNO v. Barbara Cecilioni (Discipline Committee, 2013). In this case, the member performed a controlled act without a doctor’s order and without a doctor’s assessment. The member did not document her interactions with the Client. She also failed to abide by a previous undertaking given by the College. She was given a four month suspension and 12 month employer notification.

Penalty Decision

The Panel accepts the Joint Submission as to Order and accordingly makes the following order:

1. Requiring the Member to appear before the Panel to be reprimanded within three months of the date that this Order becomes final.

2. Directing the Executive Director to suspend the Member’s certificate of registration for three months. This suspension shall take effect from the date that this Order becomes final and shall continue to run without interruption as long as the Member remains in the practising class.

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

a) The Member will attend a minimum of two meetings with a Nursing Expert (the “Expert”) at his own expense and within six months from the date of this Order. If the Expert determines that a greater number of sessions are required, the Expert will advise the Director of Professional Conduct (the “Director”) regarding the total number of sessions that are required and the length of time required to complete the additional sessions, but in any event, all sessions shall be completed within one year from the date of this Order. To comply, the Member is required to ensure that:

i. The Expert has expertise in nursing regulation and has been approved by the Director of Professional Conduct (the “Director”) in advance of the meetings;

ii. At least seven days before the first meeting, the Member provides the Expert with a copy of:

1. the Panel’s Order,

2. the Notice of Hearing,

3. the Agreed Statement of Facts,

4. this Joint Submission on Order, and

5. if available, a copy of the Panel’s Decision and Reasons;

iii. Before the first meeting, the Member reviews the following College publications and completes the associated Reflective Questionnaires, online learning modules and online participation forms (where applicable):

1. Professional Standards,

2. Documentation,

3. Authorizing Mechanisms,

iv. At least seven days before the first meeting, the Member provides the Expert with a copy of the completed Reflective Questionnaires, and online participation forms;

v. The subject of the sessions with the Expert will include:

1. the acts or omissions for which the Member was found to have committed professional misconduct,

2. the potential consequences of the misconduct to the Member’s clients, colleagues, profession and self,

3. strategies for preventing the misconduct from recurring,

4. the publications, questionnaires and modules set out above, and

5. the development of a learning plan in collaboration with the Expert;

vi. Within 30 days after the Member has completed the last session, the Member will confirm that the Expert forwards his/her report to the Director, in which the Expert will confirm:

1. the dates the Member attended the sessions,

2. that the Expert received the required documents from the Member,

3. that the Expert reviewed the required documents and subjects with the Member, and

4. the Expert’s assessment of the Member’s insight into his behaviour;

vii. If the Member does not comply with any one or more of the requirements above, the Expert may cancel any session scheduled, even if that results in the Member breaching a term, condition or limitation on his certificate of registration;

b) For a period of 12 months from the date the Member returns to the practice of nursing, the Member will notify his employers of the decision. To comply, the Member is required to:

i. Ensure that the Director is notified of the name, address, and telephone number of all employer(s) within 14 days of commencing or resuming employment in any nursing position;

ii. Provide his employer(s) with a copy of:

1. the Panel’s Order,

2. the Notice of Hearing,

3. the Agreed Statement of Facts,

4. this Joint Submission on Order, and

5. a copy of the Panel’s Decision and Reasons, once available;

iii. Ensure that within 14 days of the commencement or resumption of the Member’s employment in any nursing position, the employer(s) forward(s) a report to the Director, in which it will confirm:

1. that they received a copy of the required documents, and

2. that they agree to notify the Director immediately upon receipt of any information that the Member has breached the standards of practice of the profession; and

3. All documents delivered by the Member to the College, the Expert or the employer(s) will be delivered by verifiable method, the proof of which the Member will retain.

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 satisfies the principles of specific and general deterrence, rehabilitation and remediation, and public protection. It sends a strong message to the membership that there are consequences when a member fails to maintain professional standards. Actions such as falsifying documents and failing to document will be taken seriously, will not be tolerated and will result in disciplinary actions.

The penalty is in line with what has been ordered in previous cases.

I, Ingrid Wiltshire-Stoby, sign this decision and reasons for the decision as Chairperson of this Discipline panel and on behalf of the members of the Discipline panel.

Chairperson Date