College of Nurses of Ontario v. Esther Olalere, 2022 CanLII 113314

DISCIPLINE COMMITTEE OF THE COLLEGE OF NURSES OF ONTARIO

PANEL: Susan Roger, RN Chairperson

Andrea Arkell Public Member

Sylvia Douglas Public Member

Ramona Dunn, RN Member

Emilija Stojsavljevic, RPN Member

BETWEEN:

COLLEGE OF NURSES OF ONTARIO ) DENISE COONEY for

) College of Nurses of Ontario

• and - )

ESTHER OLALERE ) JULIA MARTIN for

Registration No. 07310563 ) Esther Olalere

) CHRISTOPHER WIRTH

) Independent Legal Counsel

) Heard: February 1, 2022

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 1, 2022, via videoconference.

The Allegations

The allegations against Esther Olalere (the “Member”) as stated in the Notice of Hearing dated December 21, 2021, 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 you contravened a standard of practice of the profession or failed to meet the standards of practice of the profession, as follows:

a. you provided false and/or misleading information to Victorian Order of Nurses, Toronto York Site in Toronto, Ontario (“VON”) in connection with your application for employment in or about Fall 2016, including but not limited to:

i. you provided false and/or misleading information about your education; and/or

ii. you provided false and/or misleading information about your employment history;

b. you provided false and/or misleading information to Baywoods Place in Hamilton, Ontario (“Baywoods Place”) in connection with your application for employment in or about October 2017, including but not limited to:

i. you provided false and/or misleading information about your education;

ii. you provided false and/or misleading information about your employment history; and/or

iii. you provided false and/or misleading information about individuals who could provide Baywoods Place with references;

c. you provided false and/or misleading information to Sunrise Senior Living (“Sunrise Senior Living”) in connection with your application for employment at its Aurora, Ontario location in or about April 2018, including but not limited to:

i. you provided false and/or misleading information about your education;

ii. you provided false and/or misleading information about your employment history; and/or

iii. you provided false and/or misleading information about individuals who could provide Sunrise Senior Living with references;

d. you provided false and/or misleading information about your professional credentials to Sunrise Senior Living in connection with your application for employment at its Thornhill, Ontario, location in or about Spring 2019, including but not limited to:

i. you provided false and/or misleading information about your education;

ii. you provided false and/or misleading information about your employment history; and/or

iii. you provided false and/or misleading information about individuals who could provide Sunrise Senior Living with references;

e. you provided false and/or incomplete information about your employment information to the College of Nurses of Ontario (“CNO”) on your Annual Member Renewal Forms between 2016 and 2019.

2. You 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(14) of Ontario Regulation 799/93, in that you falsified a record relating to your practice, and in particular:

a. you provided false and/or misleading information to VON in connection with your application for employment in or about Fall 2016, including but not limited to:

i. you provided false and/or misleading information about your education; and/or

ii. you provided false and/or misleading information about your employment history;

b. you provided false and/or misleading information to Baywoods Place in connection with your application for employment in or about October 2017, including but not limited to:

i. you provided false and/or misleading information about your education;

ii. you provided false and/or misleading information about your employment history; and/or

iii. you provided false and/or misleading information about individuals who could provide Baywoods Place with references;

c. you provided false and/or misleading information to Sunrise Senior Living in connection with your application for employment at its Aurora, Ontario location in or about April 2018, including but not limited to:

i. you provided false and/or misleading information about your education;

ii. you provided false and/or misleading information about your employment history; and/or

iii. you provided false and/or misleading information about individuals who could provide Sunrise Senior Living with references;

d. you provided false and/or misleading information about your professional credentials to Sunrise Senior Living in connection with your application for employment at its Thornhill, Ontario, location in or about Spring 2019, including but not limited to:

i. you provided false and/or misleading information about your education;

ii. you provided false and/or misleading information about your employment history; and/or

iii. you provided false and/or misleading information about individuals who could provide Sunrise Senior Living with references;

e. you provided false and/or incomplete information about your employment information to CNO on your Annual Member Renewal Forms between 2016 and 2019.

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 paragraph 1(15) of Ontario Regulation 799/93, in that you signed or issued, in your professional capacity, a document that you knew, or ought to have known contained a false or misleading statement and in particular:

a. you provided false and/or misleading information to VON in connection with your application for employment in or about Fall 2016, including but not limited to:

i. you provided false and/or misleading information about your education; and/or

ii. you provided false and/or misleading information about your employment history;

b. you provided false and/or misleading information to Baywoods Place in connection with your application for employment in or about October 2017, including but not limited to:

i. you provided false and/or misleading information about your education;

ii. you provided false and/or misleading information about your employment history; and/or

iii. you provided false and/or misleading information about individuals who could provide Baywoods Place with references;

c. you provided false and/or misleading information to Sunrise Senior Living in connection with your application for employment at its Aurora, Ontario location in or about April 2018, including but not limited to:

i. you provided false and/or misleading information about your education;

ii. you provided false and/or misleading information about your employment history; and/or

iii. you provided false and/or misleading information about individuals who could provide Baywoods Place with references;

d. you provided false and/or misleading information about your professional credentials to Sunrise Senior Living in connection with your application for employment at its Thornhill, Ontario location, in or about Spring 2019, including but not limited to:

i. you provided false and/or misleading information about your education;

ii. you provided false and/or misleading information about your employment history; and/or

iii. you provided false and/or misleading information about individuals who could provide Sunrise Senior Living with references;

e. you provided false and/or incomplete information about your employment information to CNO on your Annual Member Renewal Forms between 2016 and 2019.

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 relevant to the practice of nursing that would reasonably be regarded by members of the profession as disgraceful, dishonourable or unprofessional, as follows:

a. you provided false and/or misleading information to VON in connection with your application for employment in or about Fall 2016, including but not limited to:

i. you provided false and/or misleading information about your education; and/or

ii. you provided false and/or misleading information about your employment history;

b. you provided false and/or misleading information to Baywoods Place in connection with your application for employment in or about October 2017, including but not limited to:

i. you provided false and/or misleading information about your education;

ii. you provided false and/or misleading information about your employment history; and/or

iii. you provided false and/or misleading information about individuals who could provide Baywoods Place with references;

c. you provided false and/or misleading information to Sunrise Senior Living in connection with your application for employment at its Aurora, Ontario location in or about April 2018, including but not limited to:

i. you provided false and/or misleading information about your education;

ii. you provided false and/or misleading information about your employment history; and/or

iii. you provided false and/or misleading information about individuals who could provide Sunrise Senior Living with references;

d. you provided false and/or misleading information to Sunrise Senior Living as part of your application for employment at its Thornhill, Ontario, location in or about Spring 2019, including but not limited to:

i. you provided false and/or misleading information about your education;

ii. you provided false and/or misleading information about your employment history; and/or

iii. you provided false and/or misleading information about individuals who could provide Sunrise Senior Living with references;

e. you provided false and/or incomplete information about your employment information to CNO on your Annual Member Renewal Forms between 2016 and 2019.

Member’s Plea

The Member admitted the allegations set out in paragraphs 1(a)(i), (ii), (b)(i), (ii), (iii), (c)(i), (ii), (iii), (d)(i), (ii), (iii), (e), 2(a)(i), (ii), (b)(i), (ii), (iii), (c)(i), (ii), (iii), (d)(i), (ii), (iii), (e), 3(a)(i), (ii), (b)(i), (ii), (iii), (c)(i), (ii), (iii), (d)(i), (ii), (iii), (e), 4(a)(i), (ii), (b)(i), (ii), (iii), (c)(i), (ii), (iii), (d)(i), (ii), (iii) and (e) in the Notice of Hearing. The Panel received a written plea inquiry which was signed by the Member. The Panel also conducted an oral plea inquiry and was satisfied that the Member’s admission was voluntary, informed and unequivocal.

Agreed Statement of Facts

College Counsel and the Member’s Counsel advised the Panel that agreement had been reached on the facts and introduced an Agreed Statement of Facts, which as amended reads, unedited and without attachment of Appendix “A” referenced therein, as follows:

THE MEMBER

1. Esther Olalere (the “Member”) obtained a degree in nursing from the University of New Brunswick – Saint John Campus, in 2007. The Member completed a Master of Nursing, Advanced Practice Nurse and Master of Science in Health Informatics from the University of Victoria, located in Victoria, British Columbia, in July 2020.

2. The Member registered with the College of Nurses of Ontario (“CNO”) as a Registered Nurse (“RN”) on May 22, 2007.

3. The Member is currently employed at Kensington Place Retirement Home in Toronto, Ontario.

4. The Member is registered as a director of a company under the Canada Business Corporations Act, Abaster Consulting Inc. (“Abaster”).

PRIOR HISTORY

5. The Member has no prior disciplinary findings with CNO.

INCIDENTS RELEVANT TO ALLEGATIONS OF PROFESSIONAL MISCONDUCT

2016: Misrepresentations on application to Victorian Order of Nurses, Toronto York Site

6. The Member was employed as Senior Manager of the Victorian Order of Nurses, Toronto York Site (“VON”) from November 14, 2016 to April 22, 2017.

7. In or around fall 2016, the Member submitted a résumé to VON as part of her application for employment. In her résumé, the Member made the following representations to VON:

a) The Member had completed a Master of Nursing, Advanced Practice Nurse and Master of Science in Health Informatics, from the University of Victoria in 2016;

b) The Member was the Director of Nursing & Chair of Joint Occupational Health and Safety Committee, with Amica Mature Lifestyles (“Amica”), which operates retirement residences, from February 2012 – September 2014; and

c) The Member was employed as a Clinical Nurse Manager with St. Elizabeth from January 2010 to January 2012.

8. These representations were false and/or misleading. In fact:

a) The Member did not complete her Masters degrees from the University of Victoria until July 2020 (and had not already completed it);

b) The Member was employed with Amica from May 25, 2010 to September 9, 2011 (not January 2010 to February 2012); and

c) The Member was employed as a part-time visiting RN at St. Elizabeth from December 8, 2008 to February 3, 2009 (not as a Clinical Nurse Manager from January 2010 to January 2012).

2017: Misrepresentations on application to Baywoods Place, Hamilton, Ontario

9. The Member was employed at Baywoods Place, in Hamilton, Ontario (“Baywoods Place”) as Director of Care from November 22, 2017 to January 24, 2018.

10. In or around October 2017, the Member submitted a résumé to Baywoods Place as part of her application for employment. In her résumé, the Member made the following representations to Baywoods Place:

a) The Member had completed a Master of Nursing, Advanced Practice Nurse and Master of Science in Health Informatics, from the University of Victoria, in 2017;

b) The Member was employed as a Director of Care for OMNI Health Care (“OMNI”) (which operates multiple retirement residence and long-term care facilities across Ontario), from October 2014 to October 2016;

c) The Member was employed by VON as the Senior Manager/District Executive Director, Clinical Practice and Client Care from November 2016 to the date of the application in October 2017;

d) The Member was employed by Amica as the Director of Nursing & Chair of Joint Occupational Health and Safety Committee, from February 2010 to September 2014; and

e) The Member was employed as a Clinical Nurse Manager for St. Elizabeth from January 2009 to May 2010.

11. These representations were false and/or misleading. In fact:

a) The Member did not complete Masters degrees from the University of Victoria until July 2020 (and had not already completed it);

b) The Member was never employed at OMNI or any OMNI facilities, at any time;

c) The Member’s employment with VON ended on April 22, 2017 (and was not ongoing);

d) The Member was employed with Amica from May 25, 2010 to September 9, 2011 (not from February 2010 to September 2014); and

e) The Member was employed as a part-time visiting RN at St. Elizabeth from December 8, 2008 to February 3, 2009 (not as a Clinical Nurse Manager from January 2009 to May 2010).

12. During her interview at Baywoods Place, the Member made representations about her experience at OMNI. These representations were false and/or misleading, as she was never employed at any OMNI facility.

13. In connection with her application at Baywoods Place, the Member provided names of individuals who could provide her with references. The information she provided was false and/or misleading. In particular, the Member represented that two individuals affiliated with OMNI, named “Sami Martin” and “Joy Martin”, could provide her with reference. Neither individual has ever worked at or been affiliated with any OMNI facility.

2018: Application to Sunrise Senior Living, Aurora, Ontario

14. In April 2018, the Member submitted an online application for the role of Resident Care Director with Sunrise Senior Living, Aurora, Ontario (“Sunrise – Aurora”). In the application, the Member made the following representations to Sunrise - Aurora:

a) She had obtained a Masters in Science – Nursing;

b) She had worked as Director of Nursing for Amica for four years;

c) She worked at Mount Sinai Hospital in Toronto Ontario (“Mount Sinai”) as a Project Coordinator for 1 year;

d) She completed a contract role as Project Coordinator at the Centre for Addiction and Mental Health in Toronto, Ontario (“CAMH”).

15. These representations were false and/or misleading. In fact:

a) The Member did not complete Masters degrees from the University of Victoria until July 2020;

b) The Member had worked at Amica for approximately one year (and not four years);

c) The Member had worked at Mount Sinai in a Temporary Office Support assignment for four months (and not as a Project Coordinator for one year); and

d) The Member had worked at CAMH as a co-op student performing supporting roles (and not as a project coordinator).

16. The Member provided Sunrise – Aurora with the names of individuals who could provide her with references as part of her application. The information she provided was false and/or misleading. In particular, the Member represented that references could be provided by:

a) “Dr. [ ] ” of Amica; however, there was no individual named [ ] who was associated with Amica.

b) “Mr. Joy Arthur” of Abaster; however, there was no such individual.

c) “Mr. Sami Martin” of VON; however, there was no individual named Sami Martin who was associated with VON.

2019: Application to Sunrise Senior Living, Thornhill, Ontario

17. In or around spring 2019, the Member submitted a résumé to Sunrise Senior Living, Thornhill, Ontario (“Sunrise – Thornhill”) in connection with a transition to an Executive Director role at a different Sunrise Senior Living location. In the résumé, the Member made the following representations:

a) The Member completed a Master of Nursing, Advanced Practice Nurse and Master of Science in Health Informatics from the University of Victoria in 2018.

b) The Member was retained by Abaster and CAMH as the “Project Coordinator Optimizing Projects” from January 2016 to June 2016. The Member described the services provided to CAMH, as including, but not limited to the following:

i. Coordinated various concurrent CIS optimization projects and assigned resources, analyzed and developed data sets for clinical workflows for various units within the hospital;

ii. Analyzed daily operational system CIS issues/tickets and monitoring project deadlines through heat maps and KPI reports while assigning required resource;

iii. Collaborated with Team leads, Integration and Foundation, Clinical Applications, as well as Director of Information Privacy and Health Records to assess and develop training tools, such as electronic privacy tool (Lockbox) for protection of patients’ health information;

iv. Actively participated in clinical application change committee meetings to decide approval of in-house change requests as well as SRs; Responsible for coordinating work among a cross-functional team of ten staff; Partnered with EPMO to work with an assigned PM on PANDA and InfoMed projects.

v. Conducted clinical application testing for efficiency to prevent undue workarounds.

vi. Collaborated with Senior Manager, Clinical Applications and Discipline Chief Nursing along with other team members from Professional Practice Office to redesign and implement Downtime policy workflows structured around improved communication and patient safety.

vii. Participated in Physician User Group (PUG) and other interdisciplinary team meetings to address users’ interface issues with CIS.

viii. Designed knowledge Items (KIs) for third party IT support based on analysis of CIS functionalities and common system challenges; Worked with IT/Education in developing training tools for user groups (Physicians, APNs, Nurse Educators, Addiction Therapist, Social Worker, Psychologists).

c) The Member was retained by Abaster and Mount Sinai as “Project Coordinator/Lead Clinical Analyst” from October 2014 to December 2015. The Member described the services provided, as including, but limited to the following:

i. Reported directly to Health Informatics Director with the assigned responsibilities of leading the team of Clinical Analysts on requirements gathering and analysis processes, evidence-based research, project management, work-flow design, development support and deployment of Cerner application; Ensured project was delivered within required time.

ii. Assisted the CIO in an in-depth assessment and analysis of the current paper versus electronic information system within the hospital.

iii. Developed the clinical workflow data sets for ICU nurses; Led and trained team of Clinical Analysts on the “Time and Motion” study and how to gather clinical workflow data required to assess the efficiency of medication ordering process from ordering to Pharmacy verification to delivery to administration by Nurses in the ICU for pre and post-implementation of CPOE.

iv. Worked collaboratively with the team of IT Specialists, Clinical Analysts including other health care Stakeholders (Nurses, Doctors, Patients, Respiratory Therapists, Departmental Managers, Directors and PMO) to design, develop, test and deploy Computerized Physician Order Entry system; Participated in the development and design of a digital Tracking Shell for effective interdisciplinary communication in ICU in conjunction with a Clinical Analyst.

d) The Member was employed as the Director of Nursing & Chair of Joint Occupational Health and Safety Committee for Amica from May 2010 to September 2014.

18. These representations were false and/or misleading. In fact:

a) The Member did not complete Masters degrees from the University of Victoria until July 2020 (rather than having earned it in 2018).

b) The Member participated in a co-op placement at CAMH. CAMH did not retain Abaster. As a student, the Member was not the lead on any of the projects, nor did she have primary responsibility for the projects. She worked in a supporting role for the brief duration of the co-op placement.

c) The Member worked at Mount Sinai from June 1, 2015 to September 4, 2015 in a Temporary Full-Time Office Support assignment with the Mount Sinai Informatics Department. Abaster was not in any way connected with the assignment. The Member’s description of her responsibilities and services were significantly overstated.

d) The Member was employed with Amica from May 25, 2010 to September 9, 2011 (not from May 2010 to September 2014).

2016 to 2019: CNO Annual Member Renewal Forms

19. Each year, members of CNO must renew their membership with CNO to continue practicing as a nurse in Ontario. The renewal process involves answering questions about employment status, areas of practice, and education, as well as paying an annual fee. The annual membership renewal process helps to ensure that everyone practicing as a nurse in Ontario is registered with CNO, and that their information is accurate and up-to-date.

20. CNO Bylaw 44.2.02 specifies that each member is to accurately complete and return the annual membership renewal form with the requested information set out therein.

21. The Member omitted employment information from the Annual Member Renewal Forms (“AMRs”) she submitted to CNO as follows:

a) In her 2016 and 2017 AMRs, the Member did not report her employment with Orchard Villa Long-Term Care Home in Pickering, Ontario (“Orchard Villa”). The Member worked at Orchard Villa from August 29, 2016 to October 18, 2016 as the Director of Care.

b) In her 2016 and 2017 AMRs, the Member did not report her employment with CAMH.

c) In her 2018 and 2019 AMRs, the Member did not report employment with Sunrise – Aurora or with Sunrise – Thornhill.

CNO STANDARDS

22. 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 the profession. Nurses are accountable for conducting themselves in ways that promote respect for the profession.

23. The Professional Standards practice standard sets out an expectation that nurses meet the leadership standard by, among other things, showing integrity and role-modelling professional values, beliefs and attributes.

24. The Ethics practice standard sets out the ethical standards that apply to nurses. One of the ethics standards addresses commitments to the nursing profession, and in particular:

Nurses have a commitment to the nursing profession. Being a member of the profession brings with it the respect and trust of the public. To continue to deserve this respect, nurses have a duty to uphold the standards of the profession, conduct themselves in a manner that reflects well on the profession, and to participate in and promote the growth of the profession.

25. The Member admits and acknowledges that she failed to meet the standards of practice of the profession when she provided false or misleading information to her potential employers regarding her nursing experience and educational qualifications, and employment references, as set out above. She admits that in so doing, she falsified a record relating to her practice, and that she signed or issued documents in her professional capacity that she knew or ought to have known contained a false or misleading statement.

26. Prior to these allegations being referred to the Discipline Committee, the Member engaged in structured coaching and education sessions with Dr. Erika Abner, Professor of Ethics, at the University of Toronto, including readings and a written component. The Member undertook these remediation efforts of her own volition and at her own expense. A letter from Dr. Abner is attached as Appendix “A”.

ADMISSIONS OF PROFESSIONAL MISCONDUCT

27. The Member admits that she committed the acts of professional misconduct as alleged in paragraphs 1 (a) to (e) of the Notice of Hearing, and in particular, she contravened a standard of practice of the profession or failed to meet the standards of practice of the profession, as described in paragraphs 6 – 25 above.

28. The Member admits that she committed the acts of professional misconduct as alleged in paragraphs 2 (a) to (e) of the Notice of Hearing, and in particular she falsified records relating to her practice, as described in paragraphs 6 – 25 above.

29. The Member admits that she committed the acts of professional misconduct as alleged in paragraphs 3 (a) to (e) of the Notice of Hearing, and in particular she signed or issued, in her professional capacity, documents that she knew, or ought to have known contained a false or misleading statement, as described in paragraphs 6 – 25 above.

30. The Member admits that she committed the acts of professional misconduct as alleged in paragraphs 4 (a) to (e), and in particular, that she engaged in conduct relevant to the practice of nursing that would reasonably be regarded by members of the profession as dishonourable and unprofessional, as described in paragraphs 6 – 25 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), (b)(i), (ii), (iii), (c)(i), (ii), (iii), (d)(i), (ii), (iii), (e), 2(a)(i), (ii), (b)(i), (ii), (iii), (c)(i), (ii), (iii), (d)(i), (ii), (iii), (e), 3(a)(i), (ii), (b)(i), (ii), (iii), (c)(i), (ii), (iii), (d)(i), (ii), (iii), (e), 4(a)(i), (ii), (b)(i), (ii), (iii), (c)(i), (ii), (iii), (d)(i), (ii), (iii) and (e) of the Notice of Hearing. As to allegations 4(a)(i), (ii), (b)(i), (ii), (iii), (c)(i), (ii), (iii), (d)(i), (ii), (iii) and (e), 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), (b)(i), (ii), (iii), (c)(i), (ii), (iii), (d)(i), (ii), (iii) and (e) in the Notice of Hearing are supported by paragraphs 6-25 and 27 in the Agreed Statement of Facts. The Panel finds that between 2016 and 2019, the Member provided false and misleading information on employment applications to multiple employers, as described in paragraphs 6-18 in the Agreed Statement of Facts. In that same period, the Member also provided incomplete employment information to the CNO on her Annual Renewal Forms, as described in paragraphs 19-21 in the Agreed Statement of Facts. The Panel finds that these actions of the Member breached Professional Standards by failing to show integrity, and breached Ethics Standards by failing to uphold the standards of the profession and reflect well on the profession. The Member admitted that she committed acts of professional misconduct as alleged in paragraphs 1(a) to (e) of the Notice of Hearing.

Allegations #2(a)(i), (ii), (b)(i), (ii), (iii), (c)(i), (ii), (iii), (d)(i), (ii), (iii) and (e) in the Notice of Hearing are supported by paragraphs 6-25 and 28 in the Agreed Statement of Facts. In particular, the Panel finds that she falsified records relating to her practice, as described in paragraphs 6-25 above. The Member admitted that she committed the acts of professional misconduct as alleged in paragraphs 2(a) to (e) of the Notice of Hearing.

Allegations #3(a)(i), (ii), (b)(i), (ii), (iii), (c)(i), (ii), (iii), (d)(i), (ii), (iii) and (e) in the Notice of Hearing are supported by paragraphs 6-25 and 29 in the Agreed Statement of Facts. The Panel finds that the Member signed or issued, in her professional capacity, documents that she knew or ought to have known contained a false or misleading statement, as described in paragraphs 6-25 above. The Member admitted that she committed the acts of professional misconduct as alleged in paragraphs 3(a) to (e) of the Notice of Hearing.

With respect to allegations #4(a)(i), (ii), (b)(i), (ii), (iii), (c)(i), (ii), (iii), (d)(i), (ii), (iii) and (e), the Panel finds that the Member committed the acts of professional misconduct as alleged in paragraphs 4(a) to (e), and in particular that she engaged in conduct relevant to the practice of nursing that would reasonably be regarded by members of the profession to be dishonourable and unprofessional.

The Panel finds that the Member’s conduct was unprofessional as it demonstrated a serious and persistent disregard for her professional obligations, by providing false or misleading information to potential employers regarding her nursing experience and educational qualifications and employment references. Furthermore, the Member provided incomplete employment information on Annual Member Renewal forms (AMRs) she submitted to the CNO between 2016 and 2019.

Finally, the Panel finds that the Member’s conduct was also dishonourable as she breached the Professional Standards and the Ethics practice standard by falsifying a record relating to her practice and signing or issuing documents that she knew or ought to have known contained a false or misleading statement. In so doing, the Member demonstrated deceit and dishonesty in her applications to several potential employers, over several years. The Member’s conduct brings discredit to the profession. The Member knew or ought to have known that her conduct was unacceptable and fell below the standards of a professional. Moreover, her failure to fulfill her reporting obligations to the CNO in multiple AMRs interfered with the CNO’s ability to effectively regulate the profession.

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:

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

2. Directing the Executive Director to suspend the Member’s certificate of registration for 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.

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

a) The Member will attend a minimum of 1 meeting with a Regulatory Expert (the “Expert”) at her own expense and within 6 months from the date that this Order becomes final. If the Expert determines that a greater number of sessions are required, the Expert will advise the Director of Professional Conduct (the “Director”) regarding the total number of sessions that are required and the length of time required to complete the additional sessions, but in any event, all sessions shall be completed within 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 seven days before the first meeting, the Member provides the Expert with a copy of:

1. the Panel’s Order,

2. the Notice of Hearing,

3. the Agreed Statement of Facts,

4. this Joint Submission on Order, and

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

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

1. Professional Standards;

2. Ethics Standard; and

3. Code of Conduct;

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

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

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

2. the potential consequences of the misconduct to the Member’s 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 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:

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.

College Counsel submitted to the Panel that the Joint Submission on Order is a product of negotiations by experienced counsel. It appropriately reflects the aggravating and mitigating factors, meets the goals of penalty and is consistent with prior cases.

For the aggravating factors, College Counsel noted that there was a pattern of serious and persistent dishonesty and deceit towards nursing employers and multiple misrepresentations to multiple employers over several years. The Member’s behaviour was not a one-time lapse in judgment; there was enough time and opportunity for the Member to reflect on and repair her conduct. Moreover, her misconduct could have potentially impacted employers’ trust in nurses. As well, if members do not fulfill their self reporting obligation, the College cannot effectively regulate.

The mitigating factors included that there were no concerns about patient care by the Member and the Member took full responsibility for her misconduct when contacted by the College. On her own initiative and at her own expense, the Member engaged in learning sessions with a professional regarding her misconduct. Furthermore, she agreed to a resolution with the College by entering into an Agreed Statement of Facts and a Joint Submission on Order.

The goals of penalty include protecting the public and enhancing the College’s ability to regulate the profession through specific deterrence, general deterrence, and rehabilitation and remediation of the Member. The proposed penalty strikes a balance between these goals.

The proposed penalty provides for specific deterrence through the oral reprimand and the 3-month suspension of the Member’s certificate of registration. The reprimand will let the Member see how her actions are perceived by nurses and the public.

The 3-month suspension of the Member’s certificate of registration also provides for general deterrence. It sends a message to the public and nurses that this behaviour will not be tolerated and the public will be protected. The public is also protected by the 18-month period of employer notification.

Remediation and rehabilitation are achieved through a minimum of 1 meeting with a Regulatory Expert, completion of reflective questionnaires, and review of the College’s publications. These actions will help the Member return to ethical practice.

College Counsel submitted three cases to the Panel to demonstrate that the proposed penalty fell within the range of similar cases from this Discipline Committee.

CNO v. Charania (Discipline Committee, 2014): In this case, the member falsified his resume, including fictitious references. In addition, the member had been found guilty of using a computer system fraudulently, contrary to the Criminal Code of Canada. The panel found the member to have engaged in disgraceful, dishonourable and unprofessional conduct. The penalty included an oral reprimand, a four-month suspension of the member’s certificate of registration, two meetings with a Nursing Expert and 24 months of employer notification. College Counsel noted that only one expert meeting is proposed in the case before this Panel because the Member proactively engaged in remediation discussions with an expert.

CNO v. Librado (Discipline Committee, 2014): In this case, while employed at a facility, the member held herself out as a Registered Nurse and used the restricted title Registered Nurse or RN, not Registered Practical Nurse. The member also falsified time records and annual payment cards. The panel found the member behaved in a dishonourable, disgraceful and unprofessional manner. The penalty included an oral reprimand, a four-month suspension of the member’s certificate of registration, three meetings with a Nursing Expert and 12 months of employer notification.

CNO v. Holmgren (Discipline Committee, 2013): This case involves more serious allegations than in the case before this Panel. The member falsified his work history and credentials to multiple prospective employers. He also failed to provide the College with details of the findings of guilt for criminal offences. The panel found the member’s conduct to be disgraceful, dishonorable and unprofessional. The penalty included an oral reprimand, a six-month suspension of the member’s certificate of registration, two meetings with a Nursing Expert and 24 months of employer notification.

Submissions were made by the Member’s Counsel.

The Member’s Counsel made submissions to the Panel on mitigating factors. She noted that the Member had never previously been guilty of misconduct; that the Member was a committed, caring and compassionate nurse; and when the allegations were made, she acknowledged her misconduct, retained counsel to settle the case and also sought out and paid for remediation sessions. The Member’s Counsel submitted that the other cases referred to were more serious, and there was an element of truth to the Member’s misrepresentations on her Master’s degrees in that she has since obtained a degree while working full-time and being a mother of three, demonstrating her commitment to being the best nurse she could be.

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 three months of the date that this Order becomes final.

2. 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.

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 a minimum of 1 meeting with a Regulatory Expert (the “Expert”) at her own expense and within 6 months from the date that this Order becomes final. If the Expert determines that a greater number of sessions are required, the Expert will advise the Director of Professional Conduct (the “Director”) regarding the total number of sessions that are required and the length of time required to complete the additional sessions, but in any event, all sessions shall be completed within 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 seven days before the first meeting, the Member provides the Expert with a copy of:

1. the Panel’s Order,

2. the Notice of Hearing,

3. the Agreed Statement of Facts,

4. this Joint Submission on Order, and

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

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

1. Professional Standards;

2. Ethics Standard; and

3. Code of Conduct;

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

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

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

2. the potential consequences of the misconduct to the Member’s 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 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:

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 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 provides for general deterrence through the 3-month suspension of the Member’s certificate of registration. This sends a message to the membership that these actions fall below the standards of nursing practice and will not be tolerated.

The penalty provides for specific deterrence through an oral reprimand and the 3-month suspension of the Member’s certificate of registration as it demonstrates the seriousness of the conduct to the Member.

The proposed penalty provides for remediation and rehabilitation through attendance and participation in a minimum of 1 meeting with a Regulatory Expert, completion of Reflective Questionnaires and review of the College’s publications. These actions will help the Member return to ethical practice.

Overall, the public is protected by the 3-month suspension of the Member’s certificate of registration and the terms, limitations and conditions on it, including the requirement for employer notification of this decision for 18 months.

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

I, Susan Roger, 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.