College of Nurses of Ontario v. Donna G. Jamandre, 2020 ONCNO 119447

DISCIPLINE COMMITTEE OF THE COLLEGE OF NURSES OF ONTARIO

PANEL: Heather Stevanka, RN Chairperson Andrea Arkell Public Member Carly Hourigan Public Member Karen Laforet, RN Member Josee Wright, RPN Member

BETWEEN:

COLLEGE OF NURSES OF ONTARIO ) JESSICA LATIMER for ) College of Nurses of Ontario

• and - )

DONNA G. JAMANDRE ) NO REPRESENTATION for Registration No. 0111666/IC14105 ) Donna G. Jamandre ) CHRISTOPHER WIRTH ) Independent Legal Counsel ) Heard: December 17, 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 December 17, 2020, via videoconference.

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 names of the patients, or any information that could disclose the identities of the patients referred to orally or in any documents presented in the Discipline hearing of Donna G. Jamandre.

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 names of the patients, or any information that could disclose the identities of the patients referred to orally or in any documents presented in the Discipline hearing of Donna G. Jamandre.

The Allegations

College Counsel advised the Panel that the College was requesting leave to withdraw the allegations set out in paragraphs 1(a), 2 and 4(a) of the Notice of Hearing dated August 13, 2020. The Panel granted this request. The remaining allegations against Donna G. Jamandre (the “Member”) are as follows:

IT IS ALLEGED THAT:

1. You have committed an act of professional misconduct as provided by subsection 51(1)(c) of the Health Professions Procedural Code of the Nursing Act, 1991, S.O. 1991, c. 32, as amended, and defined in subsection 1(1) of Ontario Regulation 799/93, in that, while practicing as a Registered Nurse at Caressant Care McLaughlin in Lindsay, Ontario (the “Facility”), you contravened a standard of practice of the profession or failed to meet the standards of practice of the profession, in or around October to November 2018, by:

(a) [Withdrawn]; and/or

(b) Failing to dispose of medication appropriately.

2. [Withdrawn].

3. You have committed an act of professional misconduct as provided by subsection 51(1)(c) of the Health Professions Procedural Code of the Nursing Act, 1991, S.O. 1991, c. 32, as amended, and defined in subsection 1(18) of Ontario Regulation 799/93, in that, in or around November 2018, you contravened a term, condition or limitation on your certificate of registration, imposed pursuant to s. 1.5(1)1. (ii) of Ontario Regulation 275/94, in that you failed to report charges relating to any offence to the Executive Director of the College of Nurses of Ontario (“CNO”), and in particular, that you were charged with the following offences on or around November 21, 2018:

(a) Between the 13^th^ day of November in the year 2018 and the 21^st^ day of November in the year 2018 at the City of Kawartha Lakes in the said Region, did steal property, the property of [Patient A] of a value not exceeding five thousand dollars, contrary to Section 334 (b) of the Criminal Code; and/or

(b) Between the 13^th^ day of November in the year 2018 and the 21^st^ of November in the year 2018 at the City of Kawartha Lakes in the said Region, did have in her possession property to wit: medication, of a value not exceeding five thousand dollars, knowing that all of the property was obtained by the commission in Canada of an offence punishable by indictment, contrary to Section 354(1) (a) of the Criminal Code.

4. You have committed an act of professional misconduct as provided by subsection 51(1)(c) of the Health Professions Procedural Code of the Nursing Act, 1991, S.O. 1991, c. 32, as amended, and defined in subsection 1(37) of Ontario Regulation 799/93, in that you engaged in conduct or performed an act, relevant to the practice of nursing, that, having regard to all the circumstances, would reasonably be regarded by members of the profession as disgraceful, dishonourable or unprofessional in particular, in or around October to November 2018, you:

(a) [Withdrawn]; and/or

(b) Failed to dispose of medication appropriately; and/or

(c) Failed to report to the Executive Director of CNO that you were charged with the following offences on or around November 21, 2018:

i. Between the 13^th^ day of November in the year 2018 and the 21^st^ day of November in the year 2018 at the City of Kawartha Lakes in the said Region, did steal property, the property of [Patient A] of a value not exceeding five thousand dollars, contrary to Section 334 (b) of the Criminal Code; and/or

ii. Between the 13^th^ day of November in the year 2018 and the 21^st^ of November in the year 2018 at the City of Kawartha Lakes in the said Region, did have in her possession property to wit: medication, of a value not exceeding five thousand dollars, knowing that all of the property was obtained by the commission in Canada of an offence punishable by indictment, contrary to Section 354(1) (a) of the Criminal Code.

Member’s Plea

The Member admitted the allegations set out in paragraphs 1(b), 3(a), 3(b), 4(b), 4(c)(i) and 4(c)(ii) 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 advised the Panel that agreement had been reached on the facts and introduced an Agreed Statement of Facts, which as amended reads, unedited, as follows:

THE MEMBER

1. Donna G. Jamandre (the “Member”) obtained a diploma in nursing from Humber College in May 2001.

2. The Member registered with the College of Nurses of Ontario (“CNO”) as a Registered Practical Nurse (“RPN”) on June 25, 1993, and as a Registered Nurse (“RN”) on August 10, 2001.

3. The Member was suspended for non-payment of fees relating to her RPN Certificate of Registration from May 3, 2002, until February 1, 2013, at which time she resigned her RPN designation. The Member continues to maintain her RN status and is entitled to practice nursing without restrictions.

4. The Member was employed as a full-time RN at Caressant Care McLaughlin (the “Facility”) from November 28, 2017 to her resignation from the Facility on November 21, 2018 in relation to the incidents below.

THE FACILITY

5. The Facility is a two-storey long-term care residence located in Lindsay, Ontario, with a complement of 96 beds and a 1:32 nurse-residents ratio across three specialized care units.

THE PATIENTS

[Patient A]

6. [Patient A] was a 99-year-old patient.

7. In response to an infection, [Patient A] was prescribed the antibiotic Clavulin, which was filled and dispensed by the pharmacy as Amoxi Clav, on October 13, 2018. The full course of the antibiotic was five days, three times per day. Therefore, the course of antibiotics was scheduled to end on October 17, 2018.

8. The Member charted administering Amoxi Clav to [Patient A] on October 15, 2018.

9. On October 16, 2018, [Patient A] was briefly hospitalized.

10. Upon her return to the Facility later that day, [Patient A]’s Amoxi Clav prescription was discontinued. Instead, [Patient A]’s prescription changed to a 7-day course of Amoxicillin. According to her chart, [Patient A] received her first dosage of Amoxicillin on October 17, 2018 and her final dosage on October 24, 2018.

[Patient B]

11. [Patient B] was a 93-year-old patient.

12. The Member was responsible for administering and charting [Patient B]’s medications, including Tylenol for arthritis.

INCIDENTS RELEVANT TO ALLEGATIONS OF PROFESSIONAL MISCONDUCT

Improper Disposal of Medications

13. In or around November 2018, the Member was renting a room in the home of [the PSW], a Personal Support Worker (“PSW”) at the Facility.

14. On November 18, 2018, [the PSW] entered the Member’s room and saw pill bottles on the Member’s dresser with [Patient A]’s and [Patient B]’s names on the labels.

15. [The PSW] observed other pill bottles on the Member’s dresser, but patient names were indiscernible because they had been written over with black permanent marker.

16. [The PSW] also saw a plastic bag on the floor of the Member’s room containing additional pill bottles.

17. Using her cell phone, [the PSW] took photos of the pill bottles in the Member’s room because she was concerned about the number of pill bottles in the Member’s room, along with the fact that patients’ names were on the bottles and pills were clearly visible inside several bottles.

18. On November 19, 2018, [the PSW] texted the Member asking why she had patients’ pill bottles in her room. The Member did not respond.

19. On November 20, 2018, [the PSW] reported to the Facility’s Director of Care, [the Director], that she had found pill bottles with patients’ names on them in the Member’s room.

20. On November 21, 2018, [the Director] was scheduled to meet with the Member to discuss what [the PSW] had reported. The Member did not attend the meeting. Instead, the Member resigned her employment, effective immediately and did not provide an explanation to the Facility as to why patients’ pills and pill bottles were improperly disposed of.

21. The Facility’s medication disposal procedure requires staff to dispose of medication bottles on-site and ensure patient personal health information is removed or destroyed prior to disposal. There are no exceptions that permit repurposing of patient medication vials, bottles or packs for off-site purposes.

22. If the Member were to testify, she would state that she removed patients’ empty pill bottles from the Facility for “domestic use” as storage containers for household items, such as pins, needles, vitamins and her own medications. Nevertheless, the Member admits that her actions were contrary to Facility policy and that she failed to protect patient privacy.

23. Specifically, the Member also admits that she removed pill bottles with patients’ names from the Facility, including bottles belonging to [Patient A] and [Patient B], in or around October and November 2018. The Member fully acknowledges and accepts she failed to appropriately dispose of medication in this regard. Moreover, by removing patients’ pill bottles from the Facility and repurposing them without taking measures to protect patient identities, she risked exposing personal health information that she had no authority to disseminate. The Member fully understands both why and how her actions contravened the standards of practice of the profession.

Failure to Report Criminal Charges to CNO Executive Director

24. At approximately 1700 hours on November 21, 2018, [the Director] reported the Member’s conduct to the Kawartha Lakes Police Service.

25. At approximately 0310 hours on November 22, 2018, the Member voluntarily surrendered to the Kawartha Lakes Police Service. The Member was charged with theft under $5,000, contrary to subsection 334 (b) of the Criminal Code of Canada, as well as possession of property obtained by crime, contrary to paragraph 354(1) (a) of the Criminal Code of Canada.

26. In her statement to police, the Member claimed that she threw the pill bottles into the garbage. The Member was released from custody at approximately 0351 hours on a promise to appear at the Ontario Court of Justice.

27. On June 13, 2019, the charges were withdrawn in exchange for the Member entering into a peace bond.

28. The Member admits that she did not report either of the criminal charges to CNO.

CNO STANDARDS OF PRACTICE

29. CNO publishes nursing standards to set out the expectations for the practice of nursing. CNO’s standards inform nurses of their accountabilities and apply to all nurses regardless of their role, job description, or area of practice.

Medication Standard

30. CNO’s Medication standard describes nurses’ accountabilities when engaging in medication practices, such as administering, dispensing, storing and disposal.

31. To ensure patient safety, nurses must be well-informed about proper drug disposal protocols and have a strong understanding of the impact of improper disposal as a means of safeguarding against drug diversion, privacy breaches, dosage errors and/or inadvertent physical harm to others.

Confidentiality and Privacy – Personal Health Information

32. CNO’s Confidentiality and Privacy standard explains that nurses are expected to protect the privacy and confidentiality of any identifying information about patients (“personal health information”). This includes maintaining confidentiality of patient personal health information even after a professional relationship has ended, safeguarding the security of patient personal health information against unauthorized access or use, and ensuring that personal health information is destroyed in a way that protects the confidentiality of that information.

Professional Standards

33. CNO’s Professional Standards provides that each nurse is accountable to the public and responsible for ensuring her or his practice and conduct meets the legislative requirements and the standard of practice of the profession. A nurse demonstrates this standard by taking appropriate action to maintain patient safety and taking responsibility for errors when they occur.

ADMISSIONS OF PROFESSIONAL MISCONDUCT

34. The Member acknowledges that her failure to appropriately dispose of medication was a breach of the standards of practice as set out in CNO’s Professional Standards, Confidentiality and Privacy and Medication standards.

35. As such, the Member admits that she committed the acts of professional misconduct as alleged in paragraphs 1(b) and 4(b) of the Notice of Hearing, as described in paragraphs 13-23 above, and that her conduct was unprofessional.

36. The Member acknowledges that she was under an obligation to report criminal charges to the Executive Director of CNO as a condition of her certificate of registration, pursuant to s. 1.5(1)1.(ii) of Ontario Regulation 275/94 of the Nursing Act, 1991, and that her failure to report criminal charges for the two offences that occurred on or around November 21, 2018 contravened a term, condition or limitation on her certificate of registration and constituted a breach of CNO’s Professional Standards.

37. As such, the Member admits that she committed the acts of professional misconduct as alleged in paragraphs 3(a), 3(b), 4(c)(i) and 4(c)(ii) in the Notice of Hearing, as described in paragraphs 24-28 above, and that her conduct was unprofessional.

38. CNO seeks leave of the Discipline Committee to withdraw the allegations of professional misconduct in paragraphs 1(a), 2 and 4(a) of the Notice of Hearing.

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(b), 3(a), 3(b), 4(b), 4(c)(i) and 4(c)(ii) of the Notice of Hearing. As to allegations 4(b), 4(c)(i) and 4(c)(ii), the Panel finds that the Member engaged in conduct that would reasonably be regarded by members of the profession to be unprofessional.

Reasons for Decision

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

Allegations #1(b) and #4(b) in the Notice of Hearing are supported by paragraphs 13-23 and 30-35 in the Agreed Statement of Facts. The Panel relied on paragraphs 6-21 for context. The Member removed patients’ empty pill bottles from the Facility and completely disregarded the Facility’s medication disposal procedure. The Member acknowledged that the pill bottles had patients’ personal health information and personal information on the labels. If the Member were to testify, she would state that the empty pill bottles removed from the Facility were for “domestic use” as storage containers for household items (e.g., pins, needles, her own medication). The Member acknowledges that her actions were in violation of the Facility’s policy, that she failed to protect patient privacy, and she contravened the College’s standards of nursing with respect to the Confidentiality and Privacy Standard, the Professional Standards and the Medication Standard.

Allegations #3(a), 3(b), 4(c)(i) and 4(c)(ii) in the Notice of Hearing are supported by paragraphs 24-28, 33, 36 and 37 in the Agreed Statement of Facts. The Member acknowledges that she was obligated to report criminal charges to the Executive Director of the College pursuant to s. 1.5 (1)1. (ii) of Ontario Regulation 275/94 of the Nursing Act, 1991. The College’s Professional Standards state that each nurse is accountable for ensuring their practice and conduct meets the legislative requirements and the standard of practice for the profession. The Member contravened a term, condition, or limitation on her certificate of registration when she failed to report criminal changes for two offences that occurred on or around November 21, 2018.

The Member’s conduct specific to allegation #4(b) was unprofessional as it shows a disregard for her professional obligation to protect clients’ personal health information and falls below the standards of nursing with respect to the Confidentiality and Privacy Standard, the Professional Standards and the Medication Standard. With respect to allegations 4(c)(i) and 4(c)(ii), the Member’s conduct was also found to be unprofessional as she knew or ought to have known that her conduct, specifically the failure to report criminal charges as she was required to do, was unacceptable and fell below the standards expected of a professional.

Penalty

College Counsel and the Member 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:

1. Requiring the Member to appear before the Panel to be reprimanded within 3 months of the date that this Order becomes final.

2. Directing the Executive Director to suspend the Member’s certificate of registration for 2 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 a practicing 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 2 meetings with a Regulatory Expert (the “Expert”), at her own expense and within 6 months from the date of 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:

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 CNO publications and completes the associated Reflective Questionnaires, online learning modules, decision tools and online participation forms (where applicable):

1. Code of Conduct,

2. Confidentiality and Privacy – Personal Health Information,

3. Medication,

4. Professional Standards, and

5. Mandatory Reporting: A Process Guide for Employers, Facility Operators and Nurses;

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:

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 patients, 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 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 12 months from the date this Order becomes final, 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:

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.

3. 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 Joint Submission on Order was appropriate as the proposed penalty meets the objectives of penalty with respect to the interests of the public, the profession and the Member.

The aggravating factors in this case were:

• The seriousness of the Member’s conduct which harmed the College’s regulatory function;
• The Member’s conduct brought discredit to the profession.

The mitigating factors in this case were:

• The Member had no prior disciplinary history with the College;
• The Member has accepted responsibility for her conduct by agreeing to the Agreed Statement of Facts and the Joint Submission on Order and by doing so has eliminated the need for a longer hearing;
• The Member participated in the process and attended the hearing despite being on sick-leave.

The proposed penalty provides for general deterrence through:

• The two-month suspension and oral reprimand which demonstrates to the public and the membership that this conduct will not be tolerated;
• The penalty package demonstrates to all members that the College takes this type of conduct very seriously.

The proposed penalty provides for specific deterrence through:

• The 12-month employer notification;
• The oral reprimand;
• The two-month suspension.

The proposed penalty provides for remediation and rehabilitation through:

• The terms, conditions and limitations on the Member’s certificate of registration including two meetings with a Regulatory Expert to review the standards of practice;
• The Member will also complete Reflective Questionnaires to ensure more insight and learning regarding the nursing standards and the expectations of the profession.

Public protection and public confidence in the self-regulation of the profession, as well as goals of general deterrence and specific deterrence are met with the Member’s two-month suspension of her certificate of registration. The Member will have the opportunity to update her knowledge of the College’s Professional Standards and reflect on how she may apply this knowledge to her practice through the educational and expert meetings. For 12 months, the Member’s employers will be aware of this decision and will have the opportunity to monitor her conduct to ensure compliance with the College’s practice standards. The penalty submission in its entirety addresses the seriousness of the misconduct and the College’s unwillingness to tolerate unprofessional behaviour.

College Counsel submitted three cases to the Panel to demonstrate that the proposed penalty is appropriate and fell within the range of similar cases from this Discipline Committee while acknowledging that there is not a case exactly like the Member’s.

CNO v. MacLeod (Discipline Committee, 2013). The member was found guilty of professional misconduct when she failed to meet the standards of practice in the control, storage, access, security and/or monitoring of narcotics of which she took custody. In addition, the member breached client confidentiality and privacy. The penalty included a reprimand, a four-month suspension, reflective questionnaires, review and completion of various College publications, online learning modules, two meetings with a Nursing Expert, a 12-month employer notification and no independent practice.

CNO v. McLellan (Discipline Committee, 2017). The member was found to have breached the College’s Professional Standards and Medication Standard when she failed to maintain appropriate narcotic safeguards. The penalty included a reprimand, a two-month suspension, reflective questionnaires, review and completion of various College publications, online learning modules, two meetings with a Nursing Expert and an 18-month employer notification.

CNO v. Noseworthy-Gondermann (Discipline Committee, 2018). The member was found to have committed professional misconduct by failing to notify the College’s Executive Director of criminal charges and convictions. In this case, the member’s disregard for personal and professional integrity and her failure to participate in the process demonstrated her inability to be governed by the College. Due to the member’s actions and inactions and lack of governability her registration was revoked in order to meet the over-riding goal of protection of the public.

College Counsel submitted that the Member’s proposed two-month suspension falls within the range of penalties set out in the cases presented and that the penalty is proportionate and equivalent to the misconduct found. College Counsel also submitted that the Joint Submission on Order was carefully negotiated and that it balances both mitigating and aggravating factors.

Penalty Decision

The Panel accepts the Joint Submission on Order and accordingly orders:

1. The Member is required to appear before the Panel to be reprimanded within 3 months of the date that this Order becomes final.

2. The Executive Director is directed to suspend the Member’s certificate of registration for 2 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 a practicing class.

3. 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 of 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:

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 CNO publications and completes the associated Reflective Questionnaires, online learning modules, decision tools and online participation forms (where applicable):

1. Code of Conduct,

2. Confidentiality and Privacy – Personal Health Information,

3. Medication,

4. Professional Standards, and

5. Mandatory Reporting: A Process Guide for Employers, Facility Operators and Nurses;

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:

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 patients, 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 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 12 months from the date this Order becomes final, 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:

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.

3. 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 Member has co-operated with the College and, by agreeing to the facts and the proposed penalty, has accepted responsibility.

The Panel finds that the penalty satisfies the principles of specific and general deterrence, rehabilitation, remediation and public protection. As noted above, specific and general deterrence is achieved through the suspension and oral reprimand. Rehabilitation and remediation is satisfied with the proposed meetings with a regulatory expert. The public is protected through employer notification and through the reflective questions geared to insightful learning specific to the nursing standards and expectations of the profession.

The Panel concluded that the proposed penalty meets the goals of protecting the public interest, general and specific deterrence as well as rehabilitation and remediation opportunities for the Member.

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

I, Heather Stevanka, 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.