DISCIPLINE COMMITTEE OF THE COLLEGE OF NURSES OF ONTARIO
PANEL: Dawn Cutler, RN Chairperson
Sylvia Douglas Public Member Carly Gilchrist, RPN Member Carly Hourigan Public Member
Jane Mathews, RN Member
BETWEEN:
COLLEGE OF NURSES OF ONTARIO ) GLYNNIS HAWE for
) College of Nurses of Ontario
- and - )
BRENDA LEE LACROIX ) MANPRIT SINGH for Registration No.: 8200453 ) Brenda Lee Lacroix
) CHRISTOPHER WIRTH
) Independent Legal Counsel
) Heard: September 25, 2020
DECISION AND REASONS
This matter came on for hearing before a panel of the Discipline Committee (the “Panel”) of the College of Nurses of Ontario (the “College”) on September 25, 2020, via videoconference.
The Allegations
The allegations against Brenda Lee Lacroix (the “Member”) as stated in the Notice of Hearing dated August 18, 2020, are as follows:
IT IS ALLEGED THAT:
You have committed an act of professional misconduct as provided by subsection 51(1)(a) of the Health Professions Procedural Code of the Nursing Act, 1991, S.O. 1991, c. 32, as amended, in that, on May 13, 2014, you were found guilty of an offence relevant to your suitability to practise, and in particular, in the Ontario Court of Justice, in Pembroke, Ontario, you were found guilty of driving a motor vehicle while your ability to operate the vehicle was impaired by alcohol or a drug, contrary to s. 253(1)(a) of the Criminal Code of Canada (“Criminal Code”).
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, between 2014 and 2019, you contravened a term, condition or limitation of your certificate of registration, imposed pursuant to s. 1.5(1)1.(ii) of Ontario Regulation 275/94 of the Nursing Act, 1991, in that you failed to report charges arising in any jurisdiction relating to any offence to the Executive Director of the College of Nurses (“CNO”), as follows:
(a) On March 24, 2014, in Pembroke, Ontario, you were charged with the following offences, which you did not report:
a) Driving while ability impaired, contrary to s. 253(1)(a) of the Criminal Code; and
b) Fail or refuse to provide sample, contrary to ss. 254(3) and 254(5) of the Criminal Code;
(b) On June 3, 2014, in Pembroke, Ontario, you were charged with the following offences, which you did not report:
a) Assault, contrary to s. 266 of the Criminal Code;
b) Assault with a weapon, contrary to s. 267(a) of the Criminal Code; and
c) Criminal harassment, contrary to s. 264(2)(c) of the Criminal Code; and
(c) On April 5, 2019, in Pembroke, Ontario, you were charged with assault, contrary to s. 266 of the Criminal Code, which you did not report.
- 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, in May 2014, you contravened a term, condition or limitation of your certificate of registration, imposed pursuant to s. 1.5(1)1.i. of Ontario Regulation 275/94 of the Nursing Act, 1991, in that you failed to report a finding of guilt arising in any jurisdiction relating to any offence to the Executive Director of CNO, as follows:
(a) On May 24, 2014, in the Ontario Court of Justice, in Pembroke, Ontario, you were found guilty of driving a motor vehicle while your ability to operate the vehicle was impaired by alcohol or a drug, contrary to s. 253(1)(a) of the Criminal Code, which you did not report.
- 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, in April 2019, you contravened a provision of the Nursing Act, 1991, the Regulated Health Professions Act, 1991, or the regulations under either of those Acts, and in particular, s. 85.6.4 of the Health Professions Procedural Code, in that you failed to report being charged with an offence and/or information about any bail condition or other restriction imposed on, or agreed to, in connection with a charge to the Registrar of CNO, as follows:
(a) On April 5, 2019, in Pembroke, Ontario, you were charged with assault, contrary to s. 266 of the Criminal Code, which you did not report; and
(b) On April 5, 2019, in Pembroke, Ontario, you agreed to conditions in order to be released from custody, in relation to the charge of assault, which you did not report.
- 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, in May 2014, you contravened a provision of the Nursing Act, 1991, the Regulated Health Professions Act, 1991, or the regulations under either of those Acts, and in particular, s. 85.6.1 of the Health Professions Procedural Code, in that you failed to report a finding of guilt of an offence to the Registrar of CNO, as follows:
(a) On May 24, 2014, in the Ontario Court of Justice, in Pembroke, Ontario, you were found guilty of driving a motor vehicle while your ability to operate the vehicle was impaired by alcohol or a drug, contrary to s. 253(1)(a) of the Criminal Code, which you did not report.
- 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, between 2014 and 2019, 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, you failed to report charges and/or bail conditions and/or findings of guilt to the Executive Director of CNO, as follows:
(a) On March 24, 2014, in Pembroke, Ontario, you were charged with the following offences, which you did not report:
a) Driving while ability impaired, contrary to s. 253(1)(a) of the Criminal Code; and
b) Fail or refuse to provide sample, contrary to ss. 254(3) and 254(5) of the Criminal Code;
(b) On June 3, 2014, in Pembroke, Ontario, you were charged with the following offences, which you did not report:
a) Assault, contrary to s. 266 of the Criminal Code;
b) Assault with a weapon, contrary to s. 267(a) of the Criminal Code; and
c) Criminal harassment, contrary to s. 264(2)(c) of the Criminal Code;
(c) On April 5, 2019, in Pembroke, Ontario, you were charged with Assault, contrary to s. 266 of the Criminal Code, which you did not report;
(d) On April 5, 2019, in Pembroke, Ontario, you agreed to conditions in order to be released from custody, in relation to the charge of assault, which you did not report; and
(e) On May 24, 2014, in the Ontario Court of Justice, in Pembroke, Ontario, you were found guilty of driving a motor vehicle while your ability to operate the vehicle was impaired by alcohol or a drug, contrary to s. 253(1)(a) of the Criminal Code, which you did not report.
Member’s Plea
The Member admitted the allegations set out in paragraphs 1, 2(a) a), 2(a) b), 2(b) a), 2(b) b), 2(b) c), 2(c), 3(a), 4(a), 4(b), 5(a), 6(a) a), 6(a) b), 6(b) a), 6(b) b), 6(b) c), 6(c), 6(d) and 6(e) 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
College Counsel and the Member’s Counsel advised the Panel that agreement had been reached on the facts and introduced an Agreed Statement of Facts, which reads, unedited, as follows:
THE MEMBER
Brenda Lee Lacroix (the “Member”) obtained a diploma in nursing from Algonquin College in 1981.
The Member initially registered with the College of Nurses of Ontario (“CNO”) as a Registered Nurse (“RN”) on August 6, 1981.
PRIOR HISTORY
- The Member has previous findings against her made by CNO’s Discipline Committee. On June 14, 2007, the Discipline Committee found the Member committed professional misconduct in that she:
was found guilty of the criminal offences of break and enter contrary to section 348(1)(b) of the Criminal Code of Canada (“Criminal Code”), breach of a recognizance contrary to section 145(3) of the Criminal Code and mischief contrary to section 430(4) of the Criminal Code, which were relevant to her suitability to practice nursing; and
engaged in conduct considered to be disgraceful, dishonorable and unprofessional by breaking into a private home, physically assaulting a person in the home using a weapon, driving a motor vehicle while impaired by alcohol and drugs, and communicating with persons in circumstances where she was the subject of a recognizance which required her to refrain from communicating with them.
- The order imposed for the above-noted professional misconduct was: an oral reprimand; a 5-month suspension of her certificate of registration; and terms, conditions or limitations placed on her certificate of registration requiring her health to be monitored by her treating health care professionals, employer notification and reporting obligations, and a restriction from practicing independently.
INCIDENTS RELEVANT TO ALLEGATIONS OF PROFESSIONAL MISCONDUCT
Reporting Obligations
- Between 2014 and 2019, the Member was obligated to self-report criminal charges and findings of guilt to CNO, as follows:
Throughout the entire time period, the Member was under an obligation to report any finding of guilt to the Executive Director of CNO, both as a condition of her certificate, in accordance with section 1.5(1)(i) of Ontario Regulation 275/94, made under the Nursing Act, 1991, as well as being required by statute, under section 85.6.1(1) of the Health Professions Procedural Code.
Throughout the entire time period, the Member was under an obligation to report any charge arising in any jurisdiction relating to any offence to the Executive Director of CNO, as a condition of her certificate, in accordance with section 1.5(1)(ii) of Ontario Regulation 275/94, made under the Nursing Act, 1991.
As of May 1, 2018, the Member was under an obligation to report if she had been charged with an offence, as well as information about every bail condition or other restriction imposed on, or agreed to, by the Member in connection with the charge, in accordance with s. 85.6.4(1) of the Health Professions Procedural Code.
Criminal Charges and Finding of Guilt
March 2014 Charges
- On March 24, 2014, the Member was charged with:
impaired driving, contrary to section 253(1)(a) of the Criminal Code; and
refusing to provide a breath sample, contrary to sections 254(3) and 254(5) of the Criminal Code.
The Member failed to report the criminal charges to CNO.
On May 13, 2014, the Member pled guilty to, and was found guilty of, impaired driving contrary to section 253(1)(a) of the Criminal Code. The other charge was withdrawn.
The Member failed to report the finding of guilt to CNO.
The Member acknowledges that the conviction for impaired driving is relevant to her suitability to practice as it involved conduct that causes or risks harm to others.
June 2014 Charges
- On June 3, 2014, the Member was charged with:
assault, contrary to section 266 of the Criminal Code;
assault with a weapon, contrary to section 267(a) of the Criminal Code; and
criminal harassment, contrary to section 264(2)(c) of the Criminal Code.
The Member failed to report the criminal charges to CNO.
The charges were withdrawn on August 12, 2014.
If the Member were to testify regarding the 2014 incidents, she would say that she was going through an extremely difficult time during this period and was on sick leave from May 2012 to September 2014. It was during this time that Ontario Regulation 275/94, made under the Nursing Act, 1991, was amended to require nurses to report criminal charges to CNO. The Member would testify that she was overwhelmed with her personal and health situation and was unable to prioritize her professional obligations in the way she should have. The Member takes responsibility for this and regrets her inaction.
April 2019 Charge
On April 5, 2019, the Member was charged with assault, contrary to section 266 of the Criminal Code.
The Member was granted bail on the basis of certain conditions, including that she not communicate with identified individuals and abstain from consuming alcohol or other intoxicating substances.
The Member again failed to report the criminal charge to CNO. She also failed to report the conditions she agreed to in order to obtain bail.
The charge was withdrawn on August 6, 2020.
If the Member were to testify, she would say that she was under a misapprehension during this time that only convictions had to be reported to CNO. The Member admits that she was obligated to be aware of the amendments made to Ontario Regulation 275/94, requiring the reporting of criminal charges, and that she should have reported the charges.
ADMISSIONS OF PROFESSIONAL MISCONDUCT
The Member admits that she committed the acts of professional misconduct as alleged in paragraph 1 of the Notice of Hearing, in that she was found guilty of an offence relevant to her suitability to practice, and in particular, driving a motor vehicle while her ability to operate the vehicle was impaired by alcohol or a drug, contrary to s. 253(1)(a) of the Criminal Code, as described in paragraphs 5 to 10 above.
The Member admits that she committed the acts of professional misconduct as alleged in paragraphs 2(a), (b) and (c) of the Notice of Hearing, in that she failed to report charges arising in any jurisdiction relating to any offence to the Executive Director of CNO, as described in paragraphs 5 to 19 above.
The Member admits that she committed the acts of professional misconduct as alleged in paragraph 3(a) of the Notice of Hearing, in that she failed to report a finding of guilt arising in any jurisdiction relating to any offence to the Executive Director of CNO, as described in paragraphs 5 to 10 above.
The Member admits that she committed the acts of professional misconduct as alleged in paragraphs 4(a) and (b) of the Notice of Hearing in that she failed to report being charged with an offence and information about any bail condition or other restriction imposed on, or agreed to, in connection with a charge to the Registrar (being the Executive Director) of CNO, as described in paragraphs 5 to 19 above.
The Member admits that she committed the acts of professional misconduct as alleged in paragraph 5(a) of the Notice of Hearing in that she failed to report a finding of guilt of an offence to the Registrar (being the Executive Director) of CNO, as described in paragraphs 5 to 10 above.
The Member admits that she committed the acts of professional misconduct as alleged in paragraphs 6 (a), (b), (c), (d) and (e) of the Notice of Hearing, and in particular her conduct was dishonourable and unprofessional, as described in paragraphs 5 to 19 above.
Decision
The College bears the onus of proving the allegations in accordance with the standard of proof, that being the balance of probabilities based upon clear, cogent and convincing evidence.
Having considered the evidence and the onus and standard of proof, the Panel finds that the Member committed acts of professional misconduct as alleged in paragraphs 1, 2(a) a), 2(a) b), 2(b) a), 2(b) b), 2(b) c), 2(c), 3(a), 4(a), 4(b) and 5(a) of the Notice of Hearing. As to allegations 6(a) a), 6(a) b), 6(b) a), 6(b) b), 6(b) c), 6(c), 6(d) and 6(e), the Panel finds that the Member engaged in conduct that would reasonably be regarded by members to be 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 5 to 10 and 20 in the Agreed Statement of Facts. Between 2014 and 2019 the Member was obligated to self-report criminal charges and findings of guilt to the College as a condition of her certificate. On May 13, 2014, the Member pled guilty to and was found guilty of impaired driving contrary to section 253(1)(a) of the Criminal Code. The Member admits that she committed the act of professional misconduct as alleged in paragraph 1 of the Notice of Hearing, in that she was found guilty of an offence relevant to her suitability to practice, and in particular, driving a motor vehicle while her ability to operate the vehicle was impaired by alcohol or a drug. The Member acknowledged that this conviction is relevant to her suitability to practice as it involved conduct that causes or risks harm to others.
Allegation #2(a) a) in the Notice of Hearing is supported by paragraphs 5, 6, 7 and 21 in the Agreed Statement of Facts. On March 24, 2014, the Member was charged with impaired driving contrary to section 253(1)(a) of the Criminal Code. Throughout the entire time period, the Member was under an obligation to report any charge arising in any jurisdiction relating to any offence to the Executive Director of the College, as a condition of her certificate, in accordance with section 1.5(1)1.(ii) of Ontario Regulation 275/94, made under the Nursing Act, 1991. The Member failed to report this criminal charge to the Executive Director of the College. The Member admits that she committed acts of professional misconduct as alleged in the Notice of Hearing, in that she failed to report charges arising in any jurisdiction relating to any offence to the Executive Director of the College.
Allegation #2(a) b) in the Notice of Hearing is supported by paragraphs 5, 6, 7 and 21 in the Agreed Statements of Facts. On March 24, 2014, the Member was charged with refusing to provide a breath sample, contrary to sections 254(3) and 254(5) of the Criminal Code. Throughout the entire time period, the Member was under an obligation to report any charge arising in any jurisdiction relating to any offence to the Executive Director of the College, as a condition of her certificate, in accordance with section 1.5(1)1.(ii) of Ontario Regulation 275/94, made under the Nursing Act, 1991. The Member failed to report this criminal charge to the Executive Director of the College. The Member admits that she committed acts of professional misconduct as alleged in the Notice of Hearing, in that she failed to report charges arising in any jurisdiction relating to any offence to the Executive Director of the College.
Allegation #2(b) a) in the Notice of Hearing is supported by paragraphs 5, 11, 12, 13, 14 and 21 in the Agreed Statement of Facts. The Member admits that she committed acts of professional misconduct as alleged in the Notice of Hearing. Between 2014 and 2019, the Member was obligated to self-report criminal charges against her. On June 3, 2014, the Member was charged with assault, contrary to section 266 of the Criminal Code. The Member failed to report this criminal charge to the Executive Director of the College. The criminal charges were withdrawn on August 12, 2014. The Panel accepts that if the Member were to testify regarding the 2014 incidents, she would say that she was going through an extremely difficult time during this period and was on sick leave from May 2012 to September 2014. It was during this time that Ontario Regulation 275/94, made under the Nursing Act, 1991, was amended to require nurses to report criminal charges to the College. The Panel also accepts that if the Member would testify she would say that she was overwhelmed with her personal and health situation and was unable to prioritize her professional obligations in the way she should have. The Panel notes that the Member takes responsibility for this and regrets her inaction.
Allegation #2(b) b) in the Notice of Hearing is supported by paragraphs 5, 11, 12, 13, 14 and 21 in the Agreed Statement of Facts. The Member admits that she committed acts of professional misconduct as alleged in the Notice of Hearing. Between 2014 and 2019, the Member was obligated to self-report criminal charges against her. On June 3, 2014, the Member was charged with assault with a weapon, contrary to section 267(a) of the Criminal Code. The Member failed to report this criminal charge to the Executive Director of the College. The criminal charges were withdrawn on August 12, 2014. The Panel accepts that if the Member were to testify regarding the 2014 incidents, she would say that she was going through an extremely difficult time during this period and was on sick leave from May 2012 to September 2014. It was during this time that Ontario Regulation 275/94, made under the Nursing Act, 1991, was amended to require nurses to report criminal charges to the College. The Panel also accepts that if the Member would testify, she would say that she was overwhelmed with her personal and health situation and was unable to prioritize her professional obligations in the way she should have. The Panel notes that the Member takes responsibility for this and regrets her inaction.
Allegation #2(b) c) in the Notice of Hearing is supported by paragraphs 5, 11, 12, 13, 14 and 21 in the Agreed Statement of Facts. The Member admits that she committed acts of professional misconduct as alleged in the Notice of Hearing. Between 2014 and 2019, the Member was obligated to self-report criminal charges. On June 3, 2014, the Member was charged with criminal harassment, contrary to section 264(2)(c) of the Criminal Code. The Member failed to report this criminal charge to the Executive Director of the College. The criminal charges were withdrawn on August 12, 2014. If the Member were to testify regarding the 2014 incidents, she would say that she was going through an extremely difficult time during this period and was on sick leave from May 2012 to September 2014. It was during this time that Ontario Regulation 275/94, made under the Nursing Act, 1991, was amended to require nurses to report criminal charges to the College. The Panel accepts that if the Member would testify, she would say that she was overwhelmed with her personal and health situation and was unable to prioritize her professional obligations in the way she should have. The Panels notes that the Member takes responsibility for this and regrets her inaction.
Allegation #2(c) in the Notice of Hearing is supported by paragraphs 5, 14, 15, 16, 17, 18, 19 and 21 in the Agreed Statement of Facts. The Member admits that she committed the acts of professional misconduct as alleged in the Notice of Hearing. On April 5, 2019, the Member was charged with assault, contrary to section 266 of the Criminal Code. The Member again failed to report the criminal charge to the Executive Director of the College. The charge was withdrawn on August 6, 2020. If the Member were to testify, she would say that she was under a misapprehension during this time that only convictions had to be reported to the College. The Member admits that she was obligated to be aware of the amendments made to Ontario Regulation 275/94, requiring the reporting of criminal charges, and that she should have reported the charges to the Executive Director of the College.
Allegation #3(a) in the Notice of Hearing is supported by paragraphs 5, 14 and 22 in the Agreed Statement of Facts. The Member admits that she committed the acts of professional misconduct as alleged in the Notice of Hearing when she was found guilty on May 13, 2014 of driving a motor vehicle while her ability to operate the vehicle was impaired by alcohol or a drug, contrary to section 253(1)(a) of the Criminal Code and did not report it to the Executive Director of the College. The Member was under an obligation to report any finding of guilt to the Executive Director of the College, as a condition of her certificate, in accordance with section 1.5(1)1.(i) of Ontario Regulation 275/94, made under the Nursing Act, 1991. The Panel accepts that if the Member were to testify regarding the 2014 incidents, she would say that she was going through an extremely difficult time during this period and was on sick leave from May 2012 to September 2014. It was during this time that Ontario Regulation 275/94, made under the Nursing Act, 1991, was amended to require nurses to report criminal charges to the College. The Panel also accepts that if the Member would testify, she would say that she was overwhelmed with her personal and health situation and was unable to prioritize her professional obligations in the way she should have. The Panel notes that the Member takes responsibility for this and regrets her inaction.
Allegation #4(a) in the Notice of Hearing is supported by paragraphs 5, 15, 16, 17, 18, 19 and 23 in the Agreed Statement of Facts. The Member admits that she committed the acts of professional misconduct as alleged in the Notice of Hearing. On April 5, 2019, the Member was charged with assault, contrary to section 266 of the Criminal Code. The Member again failed to report the criminal charge to the College as required by statute, under section 85.6.4 of the Health Professions Procedural Code. The charge was withdrawn on August 6, 2020.
Allegation #4(b) in the Notice of Hearing is supported by paragraphs 5, 15, 16, 17, 18, 19 and 23 in the Agreed Statement of Facts. The Member admits that she committed the acts of professional misconduct as alleged in the Notice of Hearing. On April 5, 2019, the Member was charged with assault, contrary to section 266 of the Criminal Code. The Member was granted bail on the basis of certain conditions, including that she not communicate with identified individuals and abstain from consuming alcohol or other intoxicating substances. The Member failed to report on the conditions she agreed to in order to obtain bail. The charge was withdrawn on August 6, 2020.
Allegation #5(a) in the Notice of Hearing is supported by paragraphs 5, 14 and 24 in the Agreed Statement of Facts. The Member admits that she committed the acts of professional misconduct as alleged in the Notice of Hearing. The Member was obligated to self-report findings of guilt to the Executive Director of the College as required by statute, under section 85.6.4 of the Health Professions Procedural Code.
With respect to Allegation #6(a) a), #6(a) b), #6(b) a), #6(b) b), #6(b) c), #6(c), #6(d) and #6(e), the Panel finds that the Member’s conduct in failing to report criminal charges and findings of guilt to the College was unprofessional as it demonstrated a serious and persistent disregard for her professional obligations. The Member ought to have known her professional obligations in regard to mandatory reporting. The Panel also finds that the Member’s conduct was dishonourable. It demonstrated an element of dishonesty and deceit through repeatedly failing to report her numerous criminal charges, bail conditions and findings of guilt to the College. As such, the Member’s conduct was unacceptable and fell well below the standards of a professional.
Penalty
College Counsel and the Member’s Counsel advised the Panel that a Joint Submission on Order had been agreed upon. The Joint Submission on Order requests that this Panel make an order as follows:
Requiring the Member to appear before the Panel to be reprimanded within 3 months of the date that this Order becomes final.
Directing the Executive Director to suspend the Member’s certificate of registration for 4 months. This 4-month suspension shall take effect from March 25, 2021 and shall continue to run without interruption as long as the Member remains in a practicing class.
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 2 meetings with a Regulatory Expert (the “Expert”) at her own expense and within 6 months from the date that this Order becomes final. 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 12 months from the date that this Order becomes final. 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 7 days before the first meeting, the Member provides the Expert with a copy of:
the Panel’s Order,
the Notice of Hearing,
the Agreed Statement of Facts,
this Joint Submission on Order, and
if available, a copy of the Panel’s Decision and Reasons;
iii. Before the first meeting, the Member reviews the following CNO publications and completes the associated Reflective Questionnaires, online learning modules, decision tools and online participation forms (where applicable):
Professional Standards,
Code of Conduct, and
Reporting Guide;
iv. At least 7 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:
the acts or omissions for which the Member was found to have committed professional misconduct,
the potential consequences of the misconduct to the Member’s patients, colleagues, profession and self,
strategies for preventing the misconduct from recurring,
the publications, questionnaires and modules set out above, and
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:
the dates the Member attended the sessions,
that the Expert received the required documents from the Member,
that the Expert reviewed the required documents and subjects with the Member, and
the Expert’s assessment of the Member’s insight into her 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 her certificate of registration;
b) For a period of 18 months from the date this Order becomes final during which the Member is engaged continuously in the practice of nursing (i.e. not including the period during which the Member’s certificate of registration is suspended), the Member will notify her 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 her employer(s) with a copy of:
the Panel’s Order,
the Notice of Hearing,
the Agreed Statement of Facts,
this Joint Submission on Order, and
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:
that they received a copy of the required documents, and
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.
All documents delivered by the Member to the CNO, 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.
College Counsel submitted to the Panel that it is expected that panels will accept a joint submission on order unless it falls so far outside the range of reasonable penalties as to be clearly contrary to the public interest or calls the administration of justice at the College into disrepute.
The Member’s four-month suspension, as proposed in the Joint Submission on Order, is not to begin until March 25, 2021, as the Member was currently employed at a Long-Term Care Centre in a remote First Nation and this facility needs her and it would be a hardship to it and create a risk of harm to patients if it was not given time to find a replacement for her.
The aggravating factors in this case were:
The Member’s conduct was serious. The Member posed harm to the members of the public;
The Member’s conduct brings discredit to the profession;
The Member has a disregard for her professional obligations;
The Member has a serious disciplinary history with the College.
The mitigating factors in this case were:
The Member does not pose a risk of harm to patients;
The Member’s discipline history does not demonstrate a history of conduct that poses harm to patients;
The Member has cooperated with the College;
The Member has admitted to the allegations and accepted responsibility.
The proposed penalty provides for general deterrence through a reprimand and a four-month suspension. It sends a strong notice to the public and the profession that this behaviour is not tolerated by the College or the profession. It demonstrates to the profession and the public that the College takes these allegations seriously and will enforce statutory requirements against its members.
The proposed penalty provides for specific deterrence through the suspension of the Member and an oral reprimand which will assist the Member in understanding the actions are taken seriously by the College and other members of the profession and make clear how they are perceived by the Member’s colleagues and the public.
The proposed penalty provides for remediation and rehabilitation through the terms, conditions and limitations imposed on the Member’s certificate of registration including two meetings with a Nursing Expert to review the standards of practice. This will help deepen the Member’s understanding of her conduct and help to ensure that the conduct is not repeated.
Overall, the public is protected because the Member is required to advise her employer(s) of this decision for 18 months. This penalty also sends a clear message to the profession about the seriousness of this type of behaviour.
College Counsel reviewed three prior decisions of the Discipline Committee to demonstrate that the proposed penalty fell within a reasonable range.
CNO v. Toth (Discipline Committee, 2019). The member did not participate in the hearing. The allegations are similar. It was alleged that the member was found guilty of offences relevant to her suitability to practice which included disorderly conduct and resisting or obstructing an officer. The member was charged with offences which she did not report, including driving under the influence. The charges arose in Florida. The member failed to report findings of guilt related to disorderly conduct, resisting an officer and a careless driving charge. The penalty received was an oral reprimand, a 5-month suspension, two meetings with a Nursing Expert and an 18-month employer notification.
CNO v. Scott (Discipline Committee, 2017). This case was uncontested and the member agreed to an Agreed Statement of Facts. The allegations are similar. The member was charged with driving under the influence and failing to provide a breath sample. She was found guilty of driving under the influence and failed to report findings of guilt to the College. There were additional allegations for falsifying her application for registration by failing to report a guilty offence. The penalty received was an oral reprimand, a 3-month suspension, one meeting with a Nursing Expert and a 12-month employer notification.
CNO v. Sharp (Discipline Committee, 2012). This case was uncontested. The allegations were similar. There were a number of offences that the member was found guilty of relevant to his suitability to practice including assault, possession of illegal substances, impaired driving and breach of probation, recognizance, and possession of a dangerous weapon. The member failed to disclose these convictions upon his initial application to the College and on his membership renewal form. These convictions predated his application to the College. The penalty received was an oral reprimand, a 4-month suspension, a number of meetings with a Nursing Expert and a 12–month employer notification.
The Member’s Counsel advised the Panel that she agreed with the College’s submissions and that the Joint Submission on Order was appropriate.
Penalty Decision
The Panel accepts the Joint Submission on Order and accordingly orders:
The Member is required to appear before the Panel to be reprimanded within 3 months of the date that this Order becomes final.
The Executive Director is directed to suspend the Member’s certificate of registration for 4 months. This 4-month suspension shall take effect from March 25, 2021 and shall continue to run without interruption as long as the Member remains in a practicing class.
The Executive Director is directed to impose the following terms, conditions and limitations on the Member’s certificate of registration:
a) The Member will attend a minimum of 2 meetings with a Regulatory Expert (the “Expert”) at her own expense and within 6 months from the date that this Order becomes final. 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 12 months from the date that this Order becomes final. 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 7 days before the first meeting, the Member provides the Expert with a copy of:
the Panel’s Order,
the Notice of Hearing,
the Agreed Statement of Facts,
this Joint Submission on Order, and
if available, a copy of the Panel’s Decision and Reasons;
iii. Before the first meeting, the Member reviews the following CNO publications and completes the associated Reflective Questionnaires, online learning modules, decision tools and online participation forms (where applicable):
Professional Standards,
Code of Conduct, and
Reporting Guide;
iv. At least 7 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:
the acts or omissions for which the Member was found to have committed professional misconduct,
the potential consequences of the misconduct to the Member’s patients, colleagues, profession and self,
strategies for preventing the misconduct from recurring,
the publications, questionnaires and modules set out above, and
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:
the dates the Member attended the sessions,
that the Expert received the required documents from the Member,
that the Expert reviewed the required documents and subjects with the Member, and
the Expert’s assessment of the Member’s insight into her 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 her certificate of registration;
b) For a period of 18 months from the date this Order becomes final during which the Member is engaged continuously in the practice of nursing (i.e. not including the period during which the Member’s certificate of registration is suspended), the Member will notify her 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 her employer(s) with a copy of:
the Panel’s Order,
the Notice of Hearing,
the Agreed Statement of Facts,
this Joint Submission on Order, and
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:
that they received a copy of the required documents, and
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.
All documents delivered by the Member to the CNO, 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.
The penalty is in line with what has been ordered in previous cases.
The Panel also took notice of the current COVID-19 pandemic and concluded that it would reduce the risk of harm to patients and was therefore reasonable and in the public interest, for the commencement of the Member’s suspension to be delayed until March 25, 2021 in order to permit the Long-Term Care facility where she was employed to have sufficient time to find a replacement for her.
I, Dawn Cutler, 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.