DISCIPLINE COMMITTEE OF THE COLLEGE OF NURSES OF ONTARIO
PANEL: Carly Gilchrist, RPN Chairperson Andrea Arkell Public Member Morgan Krauter, NP Member Michael Schroder, NP Member
BETWEEN:
COLLEGE OF NURSES OF ONTARIO ) HAILEY BRUCKNER for ) College of Nurses of Ontario
- and - ) JEAN CONRAD GERARD VENTENILLA ) MAE J. NAM for Registration No. 14036731/JI729948 ) Jean Conrad Gerard Ventenilla ) CHRISTOPHER WIRTH ) Independent Legal Counsel ) Heard: August 4, 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 August 4, 2022, 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 the publication or broadcasting of the names of the patients, or any information that could disclose their identities, referred to orally or in any documents presented at the Discipline hearing of Jean Conrad Gerard Ventenilla.
The Panel considered the submissions of College Counsel and the Member’s Counsel and decided that there be an order preventing public disclosure and banning the publication or broadcasting of the names of the patients, or any information that could disclose their identities, referred to orally or in any documents presented at the Discipline hearing of Jean Conrad Gerard Ventenilla.
The Allegations
The allegations against Jean Conrad Gerard Ventenilla (the “Member”) as stated in the Notice of Hearing dated May 11, 2022 are as follows:
IT IS ALLEGED THAT:
- You have committed an act of professional misconduct as provided by subsection 51(1)(c) of the Health Professions Procedural Code of the Nursing Act, 1991, S.O. 1991, c. 32, as amended and defined in subsection 1(1) of Ontario Regulation 799/93, in that, while employed as a Registered Nurse at ParaMed Home Health in Burlington, Ontario (the “Facility”), you contravened a standard of practice of the profession or failed to meet the standards of practice of the profession as follows:
(a) Between July and September 2020, you documented visits to provide home care to [the Patient] that you never attended, and in doing so, caused the Facility to bill the Local Health Integration Network for nursing services you did not provide and pay you for hours you never worked in respect of home care visits on or about the following dates:
(i) July 2, 2020;
(ii) July 10, 2020;
(iii) July 18, 2020;
(iv) July 23, 2020;
(v) July 30, 2020;
(vi) August 6, 2020;
(vii) August 13, 2020;
(viii) August 20, 2020;
(ix) August 27, 2020;
(x) August 31, 2020;
(xi) September 7, 2020;
(xii) September 14, 2020; and/or
(xiii) September 21, 2020; and/or
- You have committed an act of professional misconduct as provided by subsection 51(1)(c) the Health Professions Procedural Code of the Nursing Act, 1991, S.O. 1991, c. 32, as amended and defined in subsection 1(8) of Ontario Regulation 799/93, in that, while employed as a Registered Nurse at ParaMed Home Health in Burlington, Ontario (the “Facility”), you misappropriated property from a client or workplace, as follows:
(a) Between July and September 2020, you documented visits to provide home care to [the Patient] that you never attended, and in doing so, caused the Facility to bill the Local Health Integration Network for nursing services you did not provide and pay you for hours you never worked in respect of home care visits on or about the following dates:
(i) July 2, 2020;
(ii) July 10, 2020;
(iii) July 18, 2020;
(iv) July 23, 2020;
(v) July 30, 2020;
(vi) August 6, 2020;
(vii) August 13, 2020;
(viii) August 20, 2020;
(ix) August 27, 2020;
(x) August 31, 2020;
(xi) September 7, 2020;
(xii) September 14, 2020; and/or
(xiii) September 21, 2020; and/or
- You have committed an act of professional misconduct as provided by subsection 51(1)(c) 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, while employed as a Registered Nurse at ParaMed Home Health in Burlington, Ontario, you falsified a record relating to your practice, as follows:
(a) Between July and September 2020, you documented visits to provide home care to [the Patient] that you never attended, on or about the following dates:
(i) July 2, 2020;
(ii) July 10, 2020;
(iii) July 18, 2020;
(iv) July 23, 2020;
(v) July 30, 2020;
(vi) August 6, 2020;
(vii) August 13, 2020;
(viii) August 20, 2020;
(ix) August 27, 2020;
(x) August 31, 2020;
(xi) September 7, 2020;
(xii) September 14, 2020; and/or
(xiii) September 21, 2020; and/or
- You have committed an act of professional misconduct as provided by subsection 51(1)(c) the Health Professions Procedural Code of the Nursing Act, 1991, S.O. 1991, c. 32, as amended and defined in subsection 1(15) of Ontario Regulation 799/93, in that, while employed as a Registered Nurse at ParaMed Home Health in Burlington, Ontario, you signed or issued, in your professional capacity, a document that you knew or ought to know contains a false or misleading statement, as follows:
(a) Between July and September 2020, you documented visits to provide home care to [the Patient] that you never attended, on or about the following dates:
(i) July 2, 2020;
(ii) July 10, 2020;
(iii) July 18, 2020;
(iv) July 23, 2020;
(v) July 30, 2020;
(vi) August 6, 2020;
(vii) August 13, 2020;
(viii) August 20, 2020;
(ix) August 27, 2020;
(x) August 31, 2020;
(xi) September 7, 2020;
(xii) September 14, 2020; and/or
(xiii) September 21, 2020; and/or
- You have committed an act of professional misconduct as provided by subsection 51(1)(c) the Health Professions Procedural Code of the Nursing Act, 1991, S.O. 1991, c. 32, as amended and defined in subsection 1(37) of Ontario Regulation 799/93, in that, while employed as a Registered Nurse at ParaMed Home Health in Burlington, Ontario (the “Facility”), you engaged in conduct or performed an act, relevant to the practice of nursing, that, having regard to all the circumstances, would reasonably be regarded by members of the profession as disgraceful, dishonourable or unprofessional, as follows:
(a) Between July and September 2020, you documented visits to provide home care to [the Patient] that you never attended, and in doing so, caused the Facility to bill the Local Health Integration Network for nursing services you did not provide and pay you for hours you never worked in respect of home care visits on or about the following dates:
(i) July 2, 2020;
(ii) July 10, 2020;
(iii) July 18, 2020;
(iv) July 23, 2020;
(v) July 30, 2020;
(vi) August 6, 2020;
(vii) August 13, 2020;
(viii) August 20, 2020;
(ix) August 27, 2020;
(x) August 31, 2020;
(xi) September 7, 2020;
(xii) September 14, 2020; and/or
(xiii) September 21, 2020.
Member’s Plea
The Member admitted the allegations set out in paragraphs 1(a)(i), (ii), (iii), (iv), (v), (vi), (vii), (viii), (ix), (x), (xi), (xii), (xiii), 2(a)(i), (ii), (iii), (iv), (v), (vi), (vii), (viii), (ix), (x), (xi), (xii), (xiii), 3(a)(i), (ii), (iii), (iv), (v), (vi), (vii), (viii), (ix), (x), (xi), (xii), (xiii), 4(a)(i), (ii), (iii), (iv), (v), (vi), (vii), (viii), (ix), (x), (xi), (xii), (xiii), 5(a)(i), (ii), (iii), (iv), (v), (vi), (vii), (viii), (ix), (x), (xi), (xii) and (xiii) in the Notice of Hearing. The Panel received a written plea inquiry which was signed by the Member. The Panel also conducted an oral plea inquiry and was satisfied that the Member’s admission was voluntary, informed and unequivocal.
Agreed Statement of Facts
College Counsel and the Member’s Counsel advised the Panel that agreement had been reached on the facts and introduced an Agreed Statement of Facts, which reads, unedited, as follows:
THE MEMBER
Jean Conrad Gerard Ventenilla (the “Member”) obtained a baccalaureate degree in nursing from the Philippine Women’s University in 2007. In 2013, the Member graduated from York University with a Bachelor of Science in Nursing.
The Member registered with the College of Nurses of Ontario (“CNO”) as a Registered Nurse (“RN”) on March 27, 2014. The Member is currently entitled to practice with no restrictions.
The Member had previously registered as a Registered Practical Nurse (“RPN”) on April 15, 2009.
At all relevant times, the Member was employed by ParaMed Home Health in Burlington, Ontario (the “Agency”). On October 7, 2020, his employment with the Agency was terminated in connection with the incidents described below.
The Member has been employed as a full-time RN at the Hamilton Health Sciences – Hamilton General Hospital since May 1, 2014. He has been employed with Acclaim Health on a part-time basis since January 1, 2021.
PRIOR HISTORY
The Member has no prior disciplinary findings with CNO.
On May 1, 2017, the Member was directed by the [Inquiries] Complaints and Reports Committee (ICRC) to complete remedial activities with respect to the following standards and/or guidelines: Professional Standards, Documentation, and Ethics. He completed these activities on July 31, 2017.
THE AGENCY
- The Agency provides at home nursing support and personal services to clients in the community. Their primary funder is the Local Health Integration Network (“LHIN”).
THE PATIENT
[The Patient] was receiving in-home care services from the Agency through the LHIN. [The Patient] has progressive multiple sclerosis and required nursing services for his catheter.
The Member began providing nursing services to [the Patient] on June 5, 2020.
INCIDENTS RELEVANT TO ALLEGATIONS OF PROFESSIONAL MISCONDUCT
The Member documented, and received payment for, nursing services provided to [the Patient] on 13 occasions from July to September 2020. The Member did not provide care to [the Patient] on any of these occasions.
On July 1, 2020, [the Patient] went to Poland for vacation and did not return home until September 20, 2020.
While [the Patient] was on vacation [outside of Canada], the Member continued to verify, and receive payment for, home care visits with the patient through the Agency’s online scheduling and appointment tracking system. The Member verified that he provided nursing care to [the Patient] on 12 separate occasions:
i. July 2, 2020;
ii. July 10, 2020;
iii. July 18, 2020;
iv. July 23, 2020;
v. July 30, 2020;
vi. August 6, 2020;
vii. August 13, 2020;
viii. August 20, 2020;
ix. August 27, 2020;
x. August 31, 2020;
xi. September 7, 2020; and
xii. September 14, 2020.
The Member did not provide nursing care to [the Patient] on any of these 12 occasions, as the patient was travelling outside of Canada from July 1, 2020 to September 20, 2020.
The Member also falsely verified a visit with [the Patient] on September 21, 2020 – the day after [the Patient] returned from vacation. As set out below, the Member did not provide care to [the Patient] on September 21, 2020.
The Agency billed the LHIN for all 13 reported home care visits, and the Member received payment for each of the 13 home care visits that he never attended.
On September 24, 2020, [the Patient] called the LHIN to report that he was home from his vacation and wanted his nursing services to resume.
On September 30, 2020, the LHIN called the Agency to report that 12 client visits had been submitted for billing while the client was on vacation.
The Care & Service Manager at the Agency went to visit [the Patient] after receiving the call from LHIN on September 30, 2020. During this visit, [the Patient] advised the Care & Service Manager that he had not received any nursing services from the Member while he was away. The Patient further confirmed that he did not receive any nursing services from the Member on September 21, 2020.
The Agency conducted an internal investigation. When questioned by the Agency, the Member admitted that he did not provide nursing services to [the Patient] on any of the 13 dates in question. Instead, he parked outside of [the Patient]’s home and logged in and out of the Facility’s online scheduling and appointment tracking system to verify these visits.
The Member did not make any clinical notes or other entries in [the Patient]’s chart during the time [the Patient] was on vacation; the last entry the Member made in [the Patient]’s chart was on June 18, 2020.
On October 7, 2020, the Agency terminated the Member’s employment. The Agency obtained the Member’s written consent to deduct $425.25 from his final pay cheque; this was equal to the compensation the Member received for nursing services he documented but did not provide to [the Patient]. The Agency then reimbursed LHIN with this money.
If the Member were to testify, he would state that he takes responsibility for what occurred and apologizes for his actions. The Member would state that he falsely reported nursing services because he was worried that the Patient would lose in-home services because the Patient was going on vacation overseas during the Covid-19 pandemic. The Member acknowledges that he should not have falsely reported performing nursing services and receiving payment for 13 home care visits that he did not attend. The Member was honest and forthcoming with the Agency and CNO when the incident was investigated.
CNO STANDARDS
CNO’s nursing standards set out 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.
CNO’s Professional Standards provide that each nurse is accountable to the public and responsible for ensuring that their 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.
The Professional Standards require that each nurse understands, upholds and promotes the values and beliefs described in CNO’s Ethics practice standard. Ethical nursing care means promoting the values of patient well-being, respecting patient choice, assuring privacy and confidentiality, respecting the sanctity and quality of life, maintaining commitments, respecting truthfulness and ensuring fairness in the use of resources. It also includes acting with integrity, honesty and professionalism in all dealings with the patient and other health care team members.
In accordance with CNO’s Documentation standard, nurses must ensure that documentation presents an accurate, clear and comprehensive picture of the patient’s needs, the nurse’s interventions and the patient’s outcomes.
The Documentation standard is met when a nurse ensures that documentation is a complete record of nursing care provided and reflects all aspects of the nursing process, including assessment, planning, intervention and evaluation.
ADMISSIONS OF PROFESSIONAL MISCONDUCT
The Member admits that he committed the acts of professional misconduct as alleged in paragraph 1 (a) of the Notice of Hearing, in that he contravened a standard of practice of the profession or failed to meet the standards of practice of the profession as described in paragraphs 11 – 28 above.
The Member admits that he committed the acts of professional misconduct as alleged in paragraph 2 (a) of the Notice of Hearing, in that he misappropriated property from a client or workplace as described in paragraphs 11 – 28 above.
The Member admits that he committed the acts of professional misconduct as alleged in paragraph 3 (a) of the Notice of Hearing, in that he falsified a record relating to his practice as described in paragraphs 11 – 28 above.
The Member admits that he committed the acts of professional misconduct as alleged in paragraph 4 (a) of the Notice of Hearing, in that he signed or issued, in his professional capacity, a document that he knew or ought to have known contained a false or misleading statement as described in paragraphs 11 – 28 above.
The Member admits that he committed the acts of professional misconduct as alleged in paragraph 5 (a) of the Notice of Hearing, in that, he 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 dishonourable and unprofessional as described in paragraphs 11 – 28 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), (iv), (v), (vi), (vii), (viii), (ix), (x), (xi), (xii), (xiii), 2(a)(i), (ii), (iii), (iv), (v), (vi), (vii), (viii), (ix), (x), (xi),(xii), (xiii), 3(a)(i), (ii), (iii), (iv), (v), (vi), (vii), (viii), (ix), (x), (xi), (xii), (xiii), 4(a)(i), (ii), (iii), (iv), (v), (vi), (vii), (viii), (ix), (x), (xi), (xii), (xiii), 5(a)(i), (ii), (iii), (iv), (v), (vi), (vii), (viii), (ix), (x), (xi), (xii) and (xiii) of the Notice of Hearing. As to allegations #5(a)(i), (ii), (iii), (iv), (v), (vi), (vii), (viii), (ix), (x), (xi), (xii) and (xiii), 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), (iii), (iv), (v), (vi), (vii), (viii), (ix), (x), (xi), (xii) and (xiii) in the Notice of Hearing are supported by paragraphs 11-29 in the Agreed Statement of Facts. While employed as a Registered Nurse at ParaMed Home Health (the “Facility”), the Member did not provide nursing services to [the Patient] for 13 scheduled visits as [the Patient] was out of the country or had just returned from being out of the country. The Member logged in and out of the Facility’s online tracking system to verify that the visits had been completed. The Member did not document any notes in the electronic chart for these visits. The Member breached the Documentation Standard by indicating that 13 visits for nursing care for [the Patient] had occurred when in fact, these visits for nursing care did not occur. The College’s Professional Standards states “Nurses are accountable for conducting themselves in ways that promote respect for the profession”. The Member demonstrated a lack of respect for the profession by verifying nursing visits that did not occur which caused the Facility to bill the Local Health Integration Network (“LHIN”) for nursing services that were not rendered. The Member also violated the College’s Ethics Standard as he demonstrated a lack of integrity and honesty through accepting payment for nursing services that did not occur.
Allegations #2(a)(i), (ii), (iii), (iv), (v), (vi), (vii), (viii), (ix), (x), (xi), (xii) and (xiii) in the Notice of Hearing are supported by paragraphs 11-28 and 30 in the Agreed Statement of Facts. The Member misappropriated property from the Facility when he documented for 13 home care visits to [the Patient] between July and September 2020 that were not attended and received a total of $425.25 from the Facility as payment for nursing services that were not provided. Receiving money with respect to nursing services the Member falsely claimed he provided constitutes misappropriation of property.
Allegations #3(a)(i), (ii), (iii), (iv), (v), (vi), (vii), (viii), (ix), (x), (xi), (xii) and (xiii) in the Notice of Hearing are supported by paragraphs 11-28 and 31 in the Agreed Statement of Facts. The Member falsified a record relating to his practice when he documented 13 home care visits between July and September 2020 which did not occur as [the Patient] was out of the country on vacation. The Member would verify these visits by logging in and out of the Facility’s online scheduling and appointment tracking system while he was parked outside of [the Patient]’s residence. Accordingly, the facts support the allegation that the Member falsified a record related to his practice.
Allegations #4(a)(i), (ii), (iii), (iv), (v), (vi), (vii), (viii), (ix), (x), (xi), (xii) and (xiii) in the Notice of Hearing are supported by paragraphs 11-28 and 32 in the Agreed Statement of Facts. The Member signed or issued, in his professional capacity, a document that he knew or ought to have known contained a false or misleading statement when he documented 13 home care visits between July and September 2020 in the Facility’s electronic scheduling and appointment tracking system which did not occur as [the Patient] was out of the country on vacation. The Member intentionally did this by way of parking outside the residence of [the Patient] 13 separate times so that his geolocation would be verified in the Facility’s online scheduling and appointment tracking system. Accordingly, the facts support the allegation that the Member signed or issued, in his professional capacity, a document which contained a false or misleading statement.
Allegations #5(a)(i), (ii), (iii), (iv), (v), (vi), (vii), (viii), (ix), (x), (xi), (xii), (xiii) in the Notice of Hearing are supported by paragraphs 11-28 and 33 in the Agreed Statement of Facts. The Panel finds that the Member’s conduct was clearly relevant to the practice of nursing. Documenting for 13 home care visits that were not attended 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. It demonstrated an element of deceit through parking outside [the Patient]’s house in order to verify, through the Facility’s online scheduling and appointment tracking system, that the home visits had been completed. It demonstrated an element of dishonesty through accepting, for his own personal gain, payment for nursing services that were not rendered. The Member also knew or ought to have known that his conduct was unacceptable and fell below the standards of a professional.
Penalty
College Counsel and the Member’s Counsel advised the Panel that a Joint Submission on Order had been agreed upon. The Joint Submission on Order requests that this Panel make an order as follows:
Requiring the Member to appear before the Panel to be reprimanded within 3 months of the date that this Order becomes final.
Directing the Executive Director to suspend the Member’s certificate of registration for 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 the Member’s 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 CNO in advance of the meetings;
ii. At least 5 days before the first meeting, or within another timeframe approved by the Expert, 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 and decision tools (where applicable):
Code of Conduct,
Professional Standards,
Documentation, and
Ethics;
iv. At least 5 days before the first meeting, or within another timeframe approved by the Expert, the Member provides the Expert with a copy of the completed Reflective Questionnaires;
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 their report to CNO, 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 the Member’s 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 the Member’s certificate of registration;
b) For a period of 12 months from the date the Member returns to the practice of nursing, the Member will notify the Member’s employers of the decision. To comply, the Member is required to:
i. Ensure that CNO 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 the Member’s 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 CNO, in which it will confirm:
that they received a copy of the required documents, and
that they agree to notify CNO immediately upon receipt of any information that the Member has breached the standards of practice of the profession.
c) The Member shall not practice independently in the community for a period of 6 months from the date the Member returns to the practice of nursing.
- All documents delivered by the Member to 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 misconduct was serious;
The Member’s conduct demonstrated a persistent disregard for his professional obligations as the conduct was repeated on 13 separate occasions;
The Member falsely verified 13 home care visits that he did not attend;
The Member accepted $425.25 as payment for 13 visits for nursing care that he did not provide;
The Member’s conduct involved dishonesty and a breach of trust; and
The Member’s conduct was intentional and for his own personal gain.
The mitigating factors in the case were:
The Member has taken responsibility for his actions and has cooperated with the Facility’s internal investigation and the College’s investigation;
The Member admitted to the allegations made against him by entering into an Agreed Statement of Facts and a Joint Submission on Order with the College; and
The Member has no prior discipline findings with the College.
The proposed penalty provides for general deterrence through the 3-month suspension of the Member’s certificate of registration. The suspension will send a strong signal to members of the profession that there are serious consequences for engaging in similar misconduct.
The proposed penalty provides for specific deterrence through the oral reprimand and the 3-month suspension of the Member’s certificate of registration. The oral reprimand will provide the Member with a greater understanding into how his actions are perceived by members of the profession and the public. The 3-month suspension will send a strong signal to the Member that this misconduct is not acceptable and it will deter the conduct from being repeated.
The proposed penalty provides for remediation and rehabilitation through the 2 meetings with a Regulatory Expert. The Member will have an opportunity to review the College’s standards to allow the Member to learn from his mistakes and gain insight into his conduct. This will assist the Member to return to nursing practice with a greater understanding of the standards that nurses are expected to adhere to.
The public is protected through the 12 months of employer notification provision and the 6 months of prohibition on independent practice. This will ensure greater oversight on the Member’s practice by his employer on his return to nursing.
College Counsel submitted the following cases to the Panel to demonstrate that the proposed penalty fell within the range of similar cases from this Discipline Committee:
CNO v. Ferris (Discipline Committee, 2017): This case is very similar to the case before this Panel. The member worked as an office manager in a clinic. The member’s sister worked as a nurse in the same clinic. The member falsely verified his sister’s payroll records to show that she worked 193.5 hours that she did not work. He transferred 184.5 hours of his own hours to his sister. The clinic paid his sister 9 hours that had not been worked by any nurse. This was for the purpose of the member’s sister being able to qualify for maternity leave benefits. The member falsified his sister’s record of employment by stating an incorrect last day worked. The penalty included an oral reprimand, a three-month suspension of the member’s certificate of registration, a minimum of two meetings with a Nursing Expert and an employer notification period of 12 months. This case differs from the case before this Panel in that it did not include any prohibition on independent practice. As the Member works independently in the community, the case before this Panel includes a 6-month prohibition on independent practice.
CNO v. Visca (Discipline Committee, 2017): This case proceeded by way of a contested hearing as the member did not attend the hearing. The member was alleged to have stolen money from two separate patients. The panel found that the allegations related to one of the patients was proven. The member entered the client’s home when she knew the client would not be home and stole $20.00-$30.00 from the client. The member was charged criminally and admitted her guilt of theft in court. The penalty included an oral reprimand, a five-month suspension of the member’s certificate of registration, two meetings with a Nursing Expert, an employer notification period of 24 months and an independent practice prohibition of 18 months. The case before this Panel includes a lower suspension period and employer notification period as the Member accepted responsibility for his conduct and cooperated with the College.
The Member’s Counsel did not make any submissions on penalty.
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 the Member’s 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 CNO in advance of the meetings;
ii. At least 5 days before the first meeting, or within another timeframe approved by the Expert, 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 and decision tools (where applicable):
Code of Conduct,
Professional Standards,
Documentation, and
Ethics;
iv. At least 5 days before the first meeting, or within another timeframe approved by the Expert, the Member provides the Expert with a copy of the completed Reflective Questionnaires;
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 their report to CNO, 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 the Member’s 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 the Member’s certificate of registration;
b) For a period of 12 months from the date the Member returns to the practice of nursing, the Member will notify the Member’s employers of the decision. To comply, the Member is required to:
i. Ensure that CNO 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 the Member’s 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 CNO, in which it will confirm:
that they received a copy of the required documents, and
that they agree to notify CNO immediately upon receipt of any information that the Member has breached the standards of practice of the profession.
c) The Member shall not practice independently in the community for a period of 6 months from the date the Member returns to the practice of nursing.
- All documents delivered by the Member to 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. Specific deterrence is met through the oral reprimand and the 3-month suspension of the Member’s certificate of registration. The oral reprimand will allow the Member to gain insight to his misconduct from the perspectives of both the public and fellow nurses. General deterrence is met through the 3-month suspension of the Member’s certificate of registration which will send a message to the membership at large that there are serious consequences for engaging in this type of misconduct. Rehabilitation and remediation are met through the 2 meetings with the Regulatory Expert which will afford the Member an opportunity to reflect on the misconduct using relevant College standards. The public is protected through the 12 months of employer notification and 6 months of prohibition on independent practice as there will be greater oversight from the Member’s employer(s) on his return to nursing practice.
This penalty demonstrates that dishonest and deceptive behaviour will not be tolerated and will result in serious consequences.
The penalty is also in line with what has been ordered in previous cases in similar circumstances.
I, Carly Gilchrist, RPN, sign this decision and reasons for the decision as Chairperson of this Discipline Panel and on behalf of the members of the Discipline Panel.