DISCIPLINE COMMITTEE OF THE COLLEGE OF NURSES OF ONTARIO
PANEL: Dawn Cutler, RN Chairperson Sylvia Douglas Public Member Carly Gilchrist, RPN Member Carolyn Kargiannakis, RN Member Lalitha Poonasamy Public Member
BETWEEN:
COLLEGE OF NURSES OF ONTARIO MEGAN SHORTREED for College of Nurses of Ontario
- and -
AMANDA HOHBAN Registration No.: 17307763 PETER ENGELMANN for Amanda Hohban
PATRICIA HARPER Independent Legal Counsel
Heard: June 30, 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 June 30, 2020, via teleconference.
Publication Ban
College Counsel brought a motion pursuant to s.45(3) of the Health Professions Procedural Code of the Nursing Act, 1991, for an order preventing public disclosure and banning publication or broadcasting of the name, or any information that could disclose the identity, of the patient referred to orally or in any documents presented in the Discipline hearing of Amanda Hohban.
The Panel considered the submissions of the parties and decided that there be an order preventing public disclosure and banning publication or broadcasting of the name, or any information that could disclose the identity, of the patient referred to orally or in any documents presented in the Discipline hearing of Amanda Hohban.
The Allegations
The allegations against Amanda Hohban (the “Member”) as stated in the Notice of Hearing dated June 3, 2020 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(1) of Ontario Regulation 799/93, in that while working as a Registered Nurse at an Ottawa Public Health Supervised Consumption Site in Ottawa, Ontario (the “Facility”), you contravened a standard of practice of the profession or failed to meet the standards of practice of the profession, as follows:
a. in or about February to May 2019, you failed to maintain the boundaries of the therapeutic nurse-client relationship in respect of a patient or former patient, [ ]; and/or
b. in or about February to May 2019, you sexually abused [the Patient] by engaging in touching of a sexual nature and/or behavior or remarks of a sexual nature with him; and/or
You have committed an act of professional misconduct as provided by subsection 51(1)(b.1) of the Health Professions Procedural Code of the Nursing Act, 1991, S.O. 1991, c. 32, as amended, in that while working as a Registered Nurse at the Facility, you sexually abused [the Patient], and in particular, in or about February to May 2019, you engaged in touching of a sexual nature and/or behavior or remarks of a sexual nature with him; and/or
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 while working 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, as follows:
a. in or about February to May 2019, you failed to maintain the boundaries of the therapeutic nurse-client relationship in respect of a patient or former patient, [ ]; and/or
b. in or about February to May 2019, you sexually abused [the Patient] by engaging in touching of a sexual nature and/or behavior or remarks of a sexual nature with him.
Member’s Plea
The Member admitted the allegations set out in paragraphs 1(a), (b), 2 and 3(a), (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
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, as amended at the hearing reads, unedited, as follows:
THE MEMBER
Amanda Hohban (the “Member”) obtained a degree in nursing from the University of Ottawa in 2017.
The Member registered with the College of Nurses of Ontario (“CNO”) as a Registered Nurse (“RN”) on November 1, 2017.
At the time of the incidents, the Member was employed in her first job at the Ottawa Public Health Supervised Consumption Site (the “Facility”).
The Member worked at the Facility as a casual RN. The Member’s employment was terminated on May 29, 2019, following the Facility’s investigation into the incidents described below.
INCIDENTS RELEVANT TO ALLEGATIONS OF PROFESSIONAL MISCONDUCT
Breach of Boundaries and Sexual Abuse
-
(“the Patient”) was a patient of the Facility and suffered from addiction issues. The Member was in a therapeutic nurse-patient relationship with the Patient between the fall of 2018 and on or about January 20, 2019.
In or around late February 2019, the Member and the Patient began a personal and romantic relationship which lasted until in or around late April 2019.
Starting around late February and throughout March 2019, the Member and the Patient began a personal and romantic relationship while the Member was on vacation overseas. In or around April 2019, the Member and the Patient began to meet in person outside of the therapeutic nurse-patient relationship.
During the personal and romantic relationship, the Member and the Patient communicated via Facebook, text messages and phone. The Member sent the Patient text messages such as:
“I just want you to be the happiest version of you. I can’t wait for that day to come. I was thinking about the last few times we’ve hung out, specifically Sunday morning and it made me realize that I could seriously do that forever with you. My heart is so into this [ ]. Complicated or not I’m always here. Just wanted to remind you of that ”
- The Member also gave the Patient a birthday card dated April 15, 2019 in which she wrote:
“Happy Birthday [ ]! I hope 31 is the year you finally see how special you really are. I feel really lucky knowing I’ll be a part of this scary but exciting year for you. It’s crazy to think some of your bad days is what brought us together. It just means there’s nothing but good days ahead. ”
On another occasion, the Member texted the Patient about a phone she obtained for him. In this portion of the text exchange, the Member wrote “I have a phone for you, it’s an iPhone. You just need the SIM card. Go get a new SIM card today with a new number. ”. In response, the Patient wrote: “no way”, “your honestly the best” and “i dont deserve someone like you” [sic].
On or about April 17, 2019, the Member travelled to Montreal with the Patient and they stayed together overnight in a hotel.
On the trip, the Member and the Patient drank alcohol together. The Member and the Patient also kissed on April 17, 2019 at 1:36 am, which is documented in a photograph.
In late April 2019, the Patient’s ex-partner filed a complaint about the Member with CNO. After she was notified of the complaint, the Member terminated the relationship with the Patient, and told her employer about the relationship.
Termination of Employment
In early May 2019, the Member advised the Facility of the CNO complaint and her relationship with the Patient. The Facility then placed the Member on investigative leave and during an investigative meeting with the Facility on May 13, 2019, the Member admitted that she engaged in a personal relationship with the Patient. The Member also admitted that she kissed the Patient.
On May 29, 2019, the Facility terminated the Member’s employment for failure to comply with CNO standards and the City of Ottawa Code of Conduct. The Member did not challenge her dismissal.
Since her termination, the Member has been cooperative with CNO’s investigation. If the Member were to testify, she would say that she has taken CNO online learning modules on ethical values, the therapeutic nurse-client relationship, maintaining commitments, and working through ethical situations. The Member received and provided to CNO a number of reference letters including at least two from supervisors to whom she had disclosed her misconduct, and would show the Member has gained insight into her misconduct.
CNO STANDARDS
CNO’s Professional Standards provides that each nurse is accountable to the public and responsible for ensuring her or his practice and conduct meets legislative requirements and the standards of practice of the profession. Nurses are accountable for conducting themselves in ways that promote respect for the profession.
CNO’s Professional Standards further provides, in relation to the Ethics standard, that ethical nursing includes acting with integrity, honesty and professionalism in all dealings with the patient and other health care team members.
CNO’s Therapeutic Nurse-Client Relationship Standard (“TNCR Standard”) places the responsibility for establishing and maintaining the limits and boundaries in the therapeutic nurse-patient relationship on the nurse. The TNCR Standard provides that:
[c]rossing a boundary means that the care provider is misusing the power in the relationship to meet his/her personal needs, rather than the needs of the [patient], or behaving in an unprofessional manner with the [patient].
- With respect to maintaining boundaries, a nurse demonstrates having met the TNCR Standard by actions such as:
setting and maintaining the appropriate boundaries within the relationship, and helping [patients] understand when their requests are beyond the limits of the therapeutic relationship;
abstaining from disclosing personal information, unless it meets an articulated therapeutic need of the [patient];
continually clarifying her/his role in the therapeutic relationship, especially in situations in which the [patient] may become unclear about the boundaries and limits of the relationship;
consulting with colleagues and/or the manager in any situation in which it is unclear whether a behaviour may cross a boundary of the therapeutic relationship; and
documenting [patient]-specific information in the [patient’s] record regarding instances in which it was necessary to consult with a colleague/manager about an uncertain situation.
- CNO’s TNCR Standard also requires nurses to protect the patient from harm by ensuring that abuse is prevented or stopped and reported. With respect to protecting the patient from abuse, a nurse demonstrates having met the TNCR Standard by actions such as:
not entering a friendship, or a romantic, sexual or other personal relationship with a [patient] when a therapeutic relationship exists;
ensuring that after the nurse-[patient] relationship has been terminated, the nurse:
o must not engage in a personal friendship, romantic relationship or sexual relationship with the [patient] or the [patient’s] significant other for one year following the termination of the therapeutic relationship; and
- not engaging in behaviours with a [patient] or making remarks that may reasonably be perceived by other nurses and/or others to be romantic, sexually suggestive, exploitive and/or sexually abusive.
In addition, the TNCR Standard further provides that sexual abuse includes touching of a sexual nature or touching that may be perceived by the patient or others to be sexual. The Member admits that she breached the TNCR Standard.
For the purposes of defining sexual abuse, s. 1(6) of the Health Professions Procedural Code to the Regulated Health Professions Act, 1991 defines “patient” to include an individual who was a member’s patient within one year from the date on which the individual ceased to be the member’s patient. Section 1(3) defines “sexual abuse” to include touching, of a sexual nature, of the patient by the member, or behaviour or remarks of a sexual nature by the member towards the patient. The Member admits that she committed sexual abuse by engaging in behaviour or remarks of a sexual nature, and touching of a sexual nature by kissing the Patient.
If the Member were to testify, she would state that she was unaware that she was not permitted to enter a personal, sexual or romantic relationship with a patient for one year following the termination of the therapeutic relationship. The Member would further testify that she is remorseful, has learned from her mistake and has engaged in proactive remediation by reviewing CNO online resources.
ADMISSIONS OF PROFESSIONAL MISCONDUCT
The Member admits that she committed the acts of professional misconduct as alleged in paragraphs 1 (a) and (b) of the Notice of Hearing in that she contravened a standard of practice of the profession or failed to meet the standards of practice of the profession, as described in paragraphs 5 to 23 above.
The Member admits that she committed the acts of professional misconduct as alleged in paragraph 2 of the Notice of Hearing in that she sexually abused the Patient, as described in paragraphs 5 to 23 above.
The Member admits that she committed the acts of professional misconduct as alleged in paragraphs 3 (a) and (b) of the Notice of Hearing, and in particular her conduct was disgraceful, dishonourable and unprofessional, as described in paragraphs 5 to 23 above. The conduct not only violated the professional standards required of nurses, the Member knew or ought to have known that it was wrong and would bring shame on the profession.
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 paragraph 1(a), (b) and 2 of the Notice of Hearing. As to allegations 3(a) and (b), the Panel finds that the Member engaged in conduct that would reasonably be considered by members 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 5-23 and 25 in the Agreed Statement of Facts. The Member admitted that she committed acts of professional misconduct as alleged in the Notice of Hearing. The Patient suffered from addiction issues and was a patient of the Facility where the Member was employed. A therapeutic nurse-client relationship began between the Member and the Patient in the Fall of 2018 and lasted until January 2019.
In late February 2019, the Member and the Patient began a personal/romantic relationship. In April 2019, the Member and the Patient met in person outside the therapeutic nurse-client relationship. The Member and Patient would communicate via Facebook, text message and phone. Messages included “my heart is so into this [Patient]”. A birthday card read “it’s crazy to think some of your bad days brought us together”. The Member purchased a cellphone for the Patient. On or about April 17, 2019 the Member travelled to Montreal with the Patient and stayed together overnight in a hotel. Both parties consumed alcohol and kissed one another which was documented in a photograph. During an investigative meeting with her employer in May 2019, the Member admitted that she engaged in a personal relationship with the Patient. The Member also admitted to kissing the patient.
Although the Member was no longer treating the Patient after January 2019, the TNCR continues to apply for one year following.
Allegation #1(b) in the Notice of Hearing is supported by paragraphs 5- 23 and 25 in the Agreed Statement of Facts. The Member admitted that she committed acts of professional misconduct as alleged in the Notice of Hearing. On or about April 17, 2019 the Member and Patient travelled to Montreal and stayed in a hotel together. On the trip the Member and Patient consumed alcohol together. The Member and Patient kissed. This interaction was documented through a photograph. During the investigation meeting with her employer, the Member admitted she engaged in a personal relationship with the Patient. The Member also admitted that she kissed the Patient.
Allegation #2 in the Notice of Hearing is supported by paragraphs 5-23 and 26 in the Agreed Statement of Facts. The Member admitted that she committed acts of professional misconduct as alleged in the Notice of Hearing. Section 1(6) of the Health Professions Procedural Code to the Regulated Health Professions Act, 1991 defines “patient” to include an individual who is a member’s patient within one year from the date on which the individual ceased to be the member’s patient. Section 1(3) defines “sexual abuse” to include touching, of a sexual nature, of the patient by the member, or behaviour or remarks of a sexual nature by the member towards the patient. The Member admits that she committed sexual abuse by engaging in behaviour or remarks of a sexual nature, and touching of a sexual nature by kissing the Patient. This conduct occurred between February and April, which was four months after the professional relationship ended.
With respect to Allegations # 3(a) and (b), the Panel finds that the Member’s conduct in breaching the boundaries of the therapeutic nurse-client relationship through exchanging messages via Facebook and text messages was unprofessional as it demonstrated a serious and persistent disregard for her professional obligations. The Panel also finds that the Member’s conduct was dishonourable. It demonstrated an element of moral failing through conduct that breached the boundaries in the therapeutic nurse-client relationship, as well as sexually abusing a Patient by engaging in touching of a sexual nature and engaging in behaviour or remarks of a sexual nature. Finally, the Panel finds that the Member’s conduct was disgraceful as it shames the Member and by extension the profession. The conduct casts serious doubt on the Member’s moral fitness and inherent ability to discharge the higher obligations the public expects professionals to meet.
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 6 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 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 2 meetings with a Regulatory Expert (the “Expert”), at her own expense and within 6 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,
Therapeutic Nurse-Client Relationship, and
Code of Conduct;
iv. Before the first meeting, the Member reviews and completes the CNO’s self-directed learning package, One is One Too Many, at her own expense, including the self-directed Nurses’ Workbook;
v. At least 7 days before the first meeting, the Member provides the Expert with a copy of the completed Reflective Questionnaires, online participation forms and Nurses’ Workbook;
vi. 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;
vii. 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;
viii. 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 the Member returns to the practice of nursing, 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.
The aggravating factors in this case were:
The Patient was a vulnerable individual with addiction issues who was seeking treatment in a supervised consumption site;
The text messages grew out of the nurse-client relationship which included comments such as “it’s crazy to think some of your bad days is what brought us together”;
There was a sexual relationship within months of a therapeutic nurse-client relationship;
The relationship extended over a period of months;
The Member and the Patient had an overnight trip to Montreal during which they consumed alcohol.
The mitigating factors in this case were:
The Member is remorseful;
The Member has cooperated with the Employer and the College;
The Member admits to professional misconduct which avoids need of a contested hearing engaging witnesses and the patient;
The Member was a relatively new nurse and it was her first job.
The proposed penalty provides for general deterrence through all aspects of the order. It sends a clear message to the membership about the importance of maintaining therapeutic nurse-client boundaries.
The proposed penalty provides for specific deterrence through the oral reprimand, lengthy suspension and the imposition of terms, conditions and limitations on the Member’s Certificate.
The proposed penalty provides for remediation and rehabilitation through the reprimand, the two meetings with a nursing expert, a review of three publications relevant to the conduct of this case, and the terms, conditions and limitations on the Member’s Certificate. The Member will return to practice with a greater understanding of her professional obligations.
Overall, the public is protected through the 18-month employer notification which provides for the Member’s conduct to be monitored after meeting with the Regulatory Expert. This will ensure that the Member has learned from her mistakes and has made the needed changes to her practice.
College Counsel reminded the Panel of Statutory provisions related to orders of findings of sexual abuse. Under the Code section 51(5) if the Panel has found a member guilty of acts of professional misconduct by sexually abusing a patient the Panel shall do the following 1) reprimand the member and 2) suspend the certificate of registration if sexual abuse does not consist or include conduct in paragraph 51(5)3 and the Panel has not otherwise revoked the member’s certificate of registration. College Counsel reviewed with the Panel six frank acts of sexual abuse. None of these acts occurred with this case.
There are a number of factors to weigh when determining how best to meet the objective and overriding goal of public protection, including the seriousness of the conduct. In this case the conduct was serious. There was a breach of standards, findings of sexual abuse, and findings of disgraceful, dishonourable and unprofessional conduct. There were no frank acts of sexual abuse, but there was a clear romantic relationship and sexual act of kissing.
College Counsel submitted cases to the Panel to demonstrate that the proposed penalty fell within the range of similar cases from this Discipline Committee.
CNO v Cosgrove (Discipline Committee, 2019). This case involved a psychiatric nurse breaching the therapeutic nurse-client relationship. The patient involved had numerous psychiatric admissions. The member failed to meet standards of practice, failed to maintain a therapeutic nurse-client relationship, and engaged in sexual comments and gestures (i.e. a kiss). The member and patient would communicate via text messages, disclose personal life information and exchange gifts. The member in this case also disclosed personal health information of another patient on Facebook. The penalty was an oral reprimand, an 8-month suspension of her certificate, a 12-month employer notification requirement and 2 meetings with a regulatory expert.
CNO v O’Connell (Discipline Committee, 2019). This case involved a community outreach nurse providing counselling and psychotherapeutic support in the community. The member breached the therapeutic nurse-client relationship. The patient was suffering from substance misuse issues and the member engaged in multiple text messages and hours of telephone conversations as part of a personal relationship with her patient for over a three-month time period. The penalty was an oral reprimand, a 5-month suspension of her certificate, a 12-month employer notification requirement and 2 meetings with a regulatory expert.
CNO v Franklin (Discipline Committee, 2020). The member did not attend the discipline hearing. This case involved similar circumstances. While under a therapeutic nurse-client relationship the member kissed the patient, bought the patient a cellphone, drove the patient in the member’s vehicle, allowed the patient to stay overnight at the member’s home and stayed with the patient in a hotel room. Photographs were taken of both individuals. A finding of sexual abuse was made. The penalty was an oral reprimand, and a revocation of the member’s certificate.
The agreement in this case is a 6-month suspension which falls in between the range of the above stated cases. Due to the Member’s youth, her expressed insight and her desire and ability to be remediated, College Counsel submitted that the proposed penalty would permit the Member to be remediated and rehabilitated. Revocation in this case would not be appropriate, whereas the 6-month suspension is still a serious penalty.
The Member’s Counsel submitted that he agreed with the Joint Submission on Order. He also reinforced that the order meets the goals of penalty which includes general deterrence, specific deterrence and rehabilitation and remediation.
The Member’s Counsel reinforced that the Member is remorseful and was cooperative with the employer investigation. The Member was terminated because of the incident. The mitigating factors of this case were that the Member proactively took online modules from the College on Ethical Values, therapeutic nurse-client relationship, maintaining commitments, and working through ethical situations. The Member has obtained numerous character references from colleagues and supervisors. The Member’s Counsel submitted two as exhibits. The Panel reviewed these letters of reference. The Member’s Counsel submitted that these letters indicate that both remediation and rehabilitation are possible and 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 6 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 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 2 meetings with a Regulatory Expert (the “Expert”), at her own expense and within 6 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,
Therapeutic Nurse-Client Relationship, and
Code of Conduct;
iv. Before the first meeting, the Member reviews and completes the CNO’s self-directed learning package, One is One Too Many, at her own expense, including the self-directed Nurses’ Workbook;
v. At least 7 days before the first meeting, the Member provides the Expert with a copy of the completed Reflective Questionnaires, online participation forms and Nurses’ Workbook;
vi. 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;
vii. 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;
viii. 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 the Member returns to the practice of nursing, 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.
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.