DISCIPLINE COMMITTEE OF THE COLLEGE OF NURSES OF ONTARIO
PANEL: Tanya Dion, RN Chairperson Margarita Cleghorne, RPN Member Karen Goldenberg Public Member Neil Hillier, RPN Member Lalitha Poonasamy Public Member
BETWEEN:
COLLEGE OF NURSES OF ONTARIO (EMILY LAWRENCE for College of Nurses of Ontario)
- and -
LOUIS MORAN Registration No. 0410753 (SOPHIA RUDDOCK for Louis Moran) (CHRISTOPHER WIRTH Independent Legal Counsel)
Heard: February 26, 2021
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 February 26, 2021, via videoconference.
Publication Ban
The Member’s Counsel brought a motion pursuant to s.45(3) of the Health Professions Procedural Code of the Nursing Act, 1991, for an order preventing the public disclosure and banning the publication or broadcasting of the Member’s health information and health restrictions referred to orally or in any documents presented in the Discipline hearing of Louis Moran.
The Panel considered the submissions of the parties and decided that there be an order preventing public disclosure and banning the publication or broadcasting of the Member’s health information and health restrictions referred to orally or in any documents presented in the Discipline hearing of Louis Moran.
The Allegations
The allegations against Louis Moran (the “Member”) as stated in the Notice of Hearing dated January 18, 2021 are as follows:
IT IS ALLEGED THAT:
- You have committed an act of professional misconduct as provided by sub-section 51(1)(c) of the Health Professions Procedural Code of the Nursing Act, 1991, S.O. 1991, c. 32, as amended, and defined in paragraph 1(24) of Ontario Regulation 799/93 in that, while registered as a Registered Nurse, you failed to abide by a written undertaking given by yourself to the College of Nurses of Ontario (“CNO”) or failed to carry out an agreement entered into with CNO in that:
a. between on or about April 2018 to June 2018, you accepted employment with Dynamic Endoscopy and failed to abide by the requirements of the Undertaking and Acknowledgement to CNO dated July 24, 2017 (the “Undertaking”), including that:
i. you failed to inform Dynamic Endoscopy that you provided the Undertaking to CNO and/or provide a summary of the Undertaking to Dynamic Endoscopy;
ii. you failed to arrange workplace monitoring of your practice at Dynamic Endoscopy; and/or
iii. you failed to advise CNO that you obtained employment at Dynamic Endoscopy and/or the name of your immediate supervisor at Dynamic Endoscopy;
b. between on or about July 2018 to August 2018, you accepted employment with In Home Assistance Living, a staffing agency, and failed to abide by the requirements of the Undertaking in that:
i. you accepted employment with a staffing agency;
ii. you failed to inform In Home Assistance Living that you provided the Undertaking to CNO and/or provide a summary of the Undertaking to In Home Assistance Living; and/or
iii. you failed to advise CNO that you obtained employment at In Home Assistance Living;
c. between on or about July 2018 to August 2018, you were assigned by In Home Assistance Living to practice at St. Joseph’s Health Centre and failed to abide by the requirements of the Undertaking in that:
i. you failed to inform St. Joseph’s Health Centre that you provided the Undertaking to CNO and/or provide a summary of the Undertaking to St. Joseph’s Health Centre;
ii. you failed to arrange workplace monitoring of your practice at St. Joseph’s Health Centre; and/or
iii. you failed to advise CNO that you were assigned to practice at St. Joseph’s Health Centre and/or the name of your immediate supervisor at St. Joseph’s Health Centre;
d. between on or about August 2018 to September 2018, you accepted employment with SE Health Staffing Solutions, a staffing agency, and failed to abide by the requirements of the Undertaking in that:
i. you accepted employment with a staffing agency;
ii. you failed to inform SE Health Staffing Solutions that you provided the Undertaking to CNO and/or provide a summary of the Undertaking to SE Health Staffing Solutions; and/or
iii. you failed to advise CNO that you obtained employment at SE Health Staffing Solutions; and/or
- You have committed an act or acts 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 paragraph 1(37) of Ontario Regulation 799/93, in that, while registered as a Registered Nurse, you engaged in conduct, relevant to the practice of nursing, that, having regard to all the circumstances, would reasonably be regarded by members as disgraceful, dishonourable or unprofessional, in that:
a. between on or about April 2018 to June 2018, you accepted employment with Dynamic Endoscopy and failed to abide by the requirements of the Undertaking, including that:
i. you failed to inform Dynamic Endoscopy that you provided the Undertaking to CNO and/or provide a summary of the Undertaking to Dynamic Endoscopy;
ii. you failed to arrange workplace monitoring of your practice at Dynamic Endoscopy; and/or
iii. you failed to advise CNO that you obtained employment at Dynamic Endoscopy and/or the name of your immediate supervisor at Dynamic Endoscopy;
b. between on or about July 2018 to August 2018, you accepted employment with In Home Assistance Living, a staffing agency, and failed to abide by the requirements of the Undertaking in that:
i. you accepted employment with a staffing agency;
ii. you failed to inform In Home Assistance Living that you provided the Undertaking to CNO and/or provide a summary of the Undertaking to In Home Assistance Living; and/or
iii. you failed to advise CNO that you obtained employment at In Home Assistance Living;
c. between on or about July 2018 to August 2018, you were assigned by In Home Assistance Living to practice at St. Joseph’s Health Centre and failed to abide by the requirements of the Undertaking in that:
i. you failed to inform St. Joseph’s Health Centre that you provided the Undertaking to CNO and/or provide a summary of the Undertaking to St. Joseph’s Health Centre;
ii. you failed to arrange workplace monitoring of your practice at St. Joseph’s Health Centre; and/or
iii. you failed to advise CNO that you were assigned to practice at St. Joseph’s Health Centre and/or the name of your immediate supervisor at St. Joseph’s Health Centre;
d. between on or about August 2018 to September 2018, you accepted employment with SE Health Staffing Solutions, a staffing agency, and failed to abide by the requirements of the Undertaking in that:
i. you accepted employment with a staffing agency;
ii. you failed to inform SE Health Staffing Solutions that you provided the Undertaking to CNO and/or provide a summary of the Undertaking to SE Health Staffing Solutions; and/or
iii. you failed to advise CNO that you obtained employment at SE Health Staffing Solutions.
Member’s Plea
The Member admitted the allegations set out in paragraphs 1(a)(i), (ii), (iii), 1(b)(i), (ii), (iii), 1(c)(i), (ii), (iii), 1(d)(i), (ii), (iii), 2(a)(i), (ii), (iii), 2(b)(i), (ii), (iii), 2(c)(i), (ii), (iii), 2(d)(i), (ii) and (iii) 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 reads, unedited, as follows:
THE MEMBER
Louis Moran (the “Member”) obtained a diploma in nursing from George Brown College in 2003.
The Member initially registered with the College of Nurses of Ontario (“CNO”) as a Registered Nurse on March 2004. From November 2014 to August 2015, the Member was suspended by the Inquiries, Complaints and Reports Committee (“ICRC”). He voluntarily surrendered his certification of registration from August 2015 to August 2017. The Member has been current in the General Class since August 2017 and is entitled to practice with voluntary restrictions.
CNO UNDERTAKING
- An inquiry was initiated by the Executive Director and the result of that inquiry was reviewed by the ICRC. The ICRC referred the Member’s matter to the Fitness to Practise Committee (“FTPC”) on October 22, 2014 (“Referral”).
4. The Member voluntarily surrendered his certificate of registration pursuant to a Memorandum of Agreement approved by the FTPC on August 10, 2015 (“Surrender Agreement”) and a decision on consent was issued by the FTPC dated August 10, 2015 [ ].
The Surrender Agreement anticipated the Member being able to return to nursing practice once certain criteria had been met by the Member [ ].
In 2017, the Member was ready to return to practice. He provided an undertaking and agreement to CNO dated July 24, 2017 (“Undertaking”). Pursuant to the terms of the Undertaking, the Member agreed to certain workplace practice restrictions [ ].
The length of the Undertaking is until the later of June 25, 2021 or the date on which the Director of Professional Conduct at CNO (“Director”) has confirmed receipt and approval of reports [ ].
The Member also provided a Memorandum of Agreement and a Memorandum of Understanding both signed by the Member on July 24, 2017. The Memorandum of Understanding specifies what information will be posted on the public portion of CNO’s register. The Memorandum of Understanding stated that for the duration of the Undertaking (unless otherwise varied or removed by the Director or the FTPC), CNO’s register will indicate the following under “Other Information”:
"The member voluntarily entered into an Undertaking agreeing to certain restrictions. The member shall not engage in the independent practice of nursing or through an agency. The member shall advise his Employer(s) of his workplace restrictions.”
As a result of the Member’s execution of Undertaking, a Decision on Consent was issued by the FTPC dated August 8, 2017, whereby the FTPC disposed of the Referral without making any finding [ ].
In the Undertaking, the Member acknowledged and agreed [ ] it is in the public interest that his practice be subject to certain restrictions [ ].
The Undertaking includes, but is not limited to, the following practice restrictions:
No independent practice of nursing, meaning the Member cannot obtain any employment in home care and he would work only in a setting where his practice, performance and/or behaviour can be directly observed at any given time. For clarity, this term includes no self-employed nursing or employment through an agency;
Employer notification, in that the Member is required inform any nursing employer of the Undertaking prior to commencing employment;
Workplace monitoring, in that the Member’s practice is to be monitored at each nursing employer by a regulated healthcare practitioner, and a Workplace Supervisor who would complete a supervision agreement, acting as the point of contact with CNO;
Provision to the Member’s employers of a document called a Nursing Practice Undertaking which contains the practice-related terms of the Undertaking; and
CNO notification, in that the Member is required to inform CNO of the names and addresses of all of his employers upon obtaining nursing employment and of the name of his workplace supervisor.
The Undertaking permits the Member to seek a variance of the terms of the Undertaking from the Director or the FTPC. The Member did not seek any variance of the Undertaking.
In the Undertaking, the Member confirmed that he was responsible for ensuring that he complied with the terms of the Undertaking and failure to comply will constitute a breach of the Undertaking and any breach of the Undertaking may amount to an act of professional misconduct.
INCIDENTS RELEVANT TO ALLEGATIONS OF PROFESSIONAL MISCONDUCT
Dynamic Endoscopy
Following the Member’s execution of the Undertaking in July 2017 and the disposal of the Fitness to Practise matter in August 2017, the Member worked ten shifts from April 7 to June 23, 2018 with Dynamic Endoscopy. The first eight were unpaid, as an observer. The last two were paid. Thereafter, the Member stated that he wouldn’t accept more shifts, as his mother was ill.
The Member did not disclose the practice restrictions to which he was subject in the Undertaking to Dynamic Endoscopy, or arrange workplace monitoring as required by the Undertaking, nor did he advise CNO that he had accepted employment with Dynamic Endoscopy. Dynamic Endoscopy did not check CNO’s register which contained the reference to the Undertaking.
In Home Nursing Agency and St. Joseph’s Health Centre
Between approximately July 2018 and August 2018, the Member accepted employment with In Home Assistance Living, a nursing staffing agency, also referred to as In Home Nursing Agency (“In Home”).
The Member was prohibited by the terms of the Undertaking from accepting employment with staffing agencies.
In Home placed the Member to work at St. Joseph’s Health Centre (“St. Joseph’s”) in the ICU. In Home did not check CNO’s register at hire or prior to his assignment to St. Joseph’s.
The Member worked shifts in the ICU at St. Joseph’s on July 4, 5, 6, 7, 8, 9, 12, 13, 15, 16, 17, 18, 21, 22, 23, 27, 28, 29, August 3, 4, and 8, 2018. He performed head-to-toe assessments, administered medication, implemented and reported on nursing interventions, participated in rounds, and completed clinical documentation.
The Member did not disclose his practice restrictions to either In Home or St. Joseph’s, nor did he advise CNO that he was working for In Home or St. Joseph’s, despite having undertaken to do so in the Undertaking. The Member also did not secure a workplace monitor at St. Joseph’s, another requirement of the Undertaking, although there was a charge nurse or team leader on each shift he worked.
At some point prior to August 10, 2018, the Member applied for a permanent position in the ICU at St. Joseph’s. Staff at St. Joseph’s then determined that the Member was subject to the Undertaking, and in breach of his voluntary restrictions. St. Joseph’s advised In Home and cancelled the Member’s shifts.
On August 10, 2018, In Home asked the Member for confirmation of his practice restrictions and cancelled all shifts at St. Joseph’s. The Member told In Home that he had intended to disclose his restrictions if he got an interview with St. Joseph’s, and that he had previously applied for many positions without success as a result of the restrictions.
St. Joseph’s Health Centre advised the CNO of the Member’s conduct, by letter received on August 14, 2018.
On August 15, 2018, the Member emailed the manager at St. Joseph’s to apologize for his transgression and asked for an opportunity to explain his situation. The manager declined.
In November 2018, the Member wrote again to the manager and stated “… I really enjoyed working [at St. Joseph’s] … Unfortunately my understanding of my nursing restriction, as stipulated by the CNO was in breach. I have since rectified the matter and am presently employed [elsewhere] … I have signed an undertaking with the CNO which highlights my restrictions and would be willing to discuss this with you, …” The manager also reported to CNO that, at some point, the Member had advised her that he was not aware of his restrictions.
SE Health
SE Health Staffing Solutions is a department of SE Health. It provides relief staff to other organizations such as hospitals and long-term care facilities. SE Health employed the Member from August 13 to September 10, 2018 as a casual employee, although he was not assigned and did not work any shifts through SE Health.
On September 6, 2018, SE Health discovered that the Member was subject to restrictions. He had not disclosed the restrictions to SE Health, or arranged workplace monitoring as required by the Undertaking, nor had he advised CNO that he had accepted employment with SE Health. On September 24, 2018, CNO received a report from SE Health.
The Member admits and acknowledges that he breached the terms of the Undertaking when he failed to provide accurate and complete information to his employers regarding workplace restrictions, failed to put in place workplace monitoring as required by the Undertaking, failed to fulfil his reporting obligations and provide information to CNO pursuant the Undertaking, and accepted employment with staffing agencies when prohibited from doing so, as described above.
The Member also admits that he was aware of the terms of the Undertaking and consciously failed to comply with those terms, which he acknowledges was dishonorable and unprofessional.
If the Member were to testify he would say that he had tremendous difficulties in securing employment as a nurse since his return to practice in 2017. He would further state that he spent seven months applying for positions and not getting jobs when he disclosed his Undertaking. He would further state that under financial strain, he accepted offers of employment without disclosing the terms of his Undertaking. The Member continued to comply with the terms of his Undertaking with respect to his health. However, the Member acknowledges and admits that regardless of the financial burden that may result from compliance with the Undertaking, the workplace practice restrictions he breached are a necessary and important component of the Undertaking that cannot justifiably be unilaterally disregarded because of financial strain. He further acknowledges and admits that he exercised poor judgment when he made a unilateral decision to not comply with all of the terms of his Undertaking.
ADMISSIONS OF PROFESSIONAL MISCONDUCT
The Member admits that he committed the acts of professional misconduct as alleged in paragraphs 1(a), (b), (c) and (d) including all subparagraphs thereto of the Notice of Hearing in that he failed to abide by a written undertaking given by him to CNO, as described in paragraphs 14 to 30 above.
The Member admits that he committed the acts of professional misconduct as alleged in paragraphs 2 (a), (b), (c) and (d) including all subparagraphs thereto of the Notice of Hearing, and in particular his conduct was dishonourable and unprofessional, as described in paragraphs 14 to 30 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(a)(i), (ii), (iii), 1(b)(i), (ii), (iii), 1(c)(i), (ii), (iii), 1(d)(i), (ii), (iii), 2(a)(i), (ii), (iii), 2(b)(i), (ii), (iii), 2(c)(i), (ii), (iii), 2(d)(i), (ii) and (iii) of the Notice of Hearing. As to allegations #2(a)(i), (ii), (iii), 2(b)(i), (ii), (iii), 2(c)(i), (ii), (iii), 2(d)(i), (ii) and (iii), the Panel finds that the Member engaged in conduct that would reasonably be regarded by members of the profession 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.
Allegations #1(a)(i), (ii) and (iii), #1(b)(i), (ii) and (iii), #1(c)(i), (ii) and (iii), #1(d)(i), (ii) and (iii) in the Notice of Hearing are supported by paragraphs 6 to 31 in the Agreed Statement of Facts.
The Member accepted employment with three different employers, two of whom were staffing agencies even though his Undertaking with the CNO placed a restriction on him practicing nursing independently and specifically restricted self-employed nursing or employment through a nursing agency. The Member did not inform any of his employers or the facility where he was assigned to work about the Undertaking nor did he provide them with a summary of the Undertaking. The Member did not arrange for workplace monitoring as required by the terms of the Undertaking. Lastly, the Member failed to inform CNO that he had obtained employment or been assigned to practice at a facility, nor did he provide CNO with the names of his immediate supervisors as required under the terms of the Undertaking. The Member’s failure to abide by his written Undertaking is clearly professional misconduct as defined in the legislation.
Allegations #2(a)(i), (ii) and (iii), #2(b)(i), (ii) and (iii), #2(c)(i), (ii) and (iii), #2(d)(i), (ii) and (iii) in the Notice of Hearing are supported by paragraphs 6 to 32 in the Agreed Statement of Facts.
The Panel finds that the Member’s conduct in disregarding and failing to abide by his Undertaking, was unprofessional as it demonstrated a serious and persistent disregard for his professional obligations.
The Panel also finds that the Member’s conduct was dishonourable as the Member knew or ought to have known that his conduct was unacceptable and fell below the standards of a professional. It also demonstrated an element of dishonesty and deceit through not being truthful with his employers and by not following the limitations set out in his Undertaking.
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 3 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.
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 his 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, and
Code of Conduct;
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 his behaviour;
vii. If the Member does not comply with any one or more of the requirements above, the Expert may cancel any session scheduled, even if that results in the Member breaching a term, condition or limitation on his certificate of registration;
b) For a period of 18 months from the date the Member returns to the practice of nursing, the Member will notify his employers of the decision. To comply, the Member is required to:
i. Ensure that the Director is notified of the name, address, and telephone number of all employer(s) within 14 days of commencing or resuming employment in any nursing position;
ii. Provide his employer(s) with a copy of:
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 Member’s behaviour was deliberate and intentional;
The Member returned to practice without completing his Undertaking and his conduct persisted over three employers since April 2018;
The Member’s behaviour persisted and continued after concerns were raised.
The mitigating factors in this case were:
The Member has no prior findings in respect to discipline;
The Member cooperated to reach a resolution;
The Member’s cooperation avoided the need for a contested hearing and thereby saved resources;
The Member has cooperated with the College and by agreeing to the Agreed Statement of Facts and the Joint Submission on Order, has accepted accountability and responsibility for his conduct;
Furthermore, College Counsel noted:
The impact on the Member’s finances can provide context for the breach but is not a mitigating factor.
The proposed penalty provides for general and specific deterrence through the reprimand and the three-month suspension and sends a clear message to the membership as a whole of the importance of complying with an agreement made with the College and sends a clear message that an agreement with the College cannot be breached or ignored.
The proposed penalty provides for remediation and rehabilitation through:
The meetings with a Regulatory Expert and the opportunity for the Member to reflect on his actions and gain insight;
Transparency about the Member’s employment and restrictions.
Overall, the public is protected as the proposed penalty:
Ensures that regulatory governance is respected;
Demonstrates that adherence to the College’s regulatory authority is a bedrock of the profession and its ability to self-regulate;
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. Fitzpatrick (Discipline Committee, 2010). This case has similar facts. The member entered into an undertaking with the College which was breached when the member obtained employment at two facilities and there were documentation and medication errors. The member was found to have committed professional misconduct. The penalty was a reprimand with terms, conditions and limitations on her certificate of registration which provided for a remedial program which needed to be completed before the member could practice independently and for 24 months of employer notification. College Counsel commented that this case is dated and is not the current practice for serious breaches and the need to send a clear message is more important in 2021 than was the case in 2010.
CNO v. Fabro (Discipline Committee, 2014). The member failed to comply with a Resolution Agreement. In this case, the member received an oral reprimand, terms, conditions and limitations which included two meetings with a Regulatory Expert and a two-month suspension.
CNO v Shier (Discipline Committee, 2019). The member failed to appear before the ICRC to be cautioned and failed to complete an education program ordered by the ICRC. The penalty imposed included an oral reprimand, two meetings with a Nursing Expert and a four-month suspension.
The Member’s Counsel submitted that she agreed with College Counsel as to why the Joint Submission on Order should be accepted and that with respect to mitigation, the Member has practised for 15 years and has no discipline history and has acknowledged and taken responsibility for his actions.
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 3 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.
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 his 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, and
Code of Conduct;
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 his behaviour;
vii. If the Member does not comply with any one or more of the requirements above, the Expert may cancel any session scheduled, even if that results in the Member breaching a term, condition or limitation on his certificate of registration;
b) For a period of 18 months from the date the Member returns to the practice of nursing, the Member will notify his employers of the decision. To comply, the Member is required to:
i. Ensure that the Director is notified of the name, address, and telephone number of all employer(s) within 14 days of commencing or resuming employment in any nursing position;
ii. Provide his employer(s) with a copy of:
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. Governance must be respected and adherence to the College authority is paramount for the profession to self-regulate. The penalty is in line with what has been ordered in previous cases.
I, Tanya Dion, 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.