College of Nurses of Ontario v. Punchard, 2022 ONCNO 135436

DISCIPLINE COMMITTEE OF THE COLLEGE OF NURSES OF ONTARIO

PANEL: Michael Hogard, RPN Chairperson Mary MacNeil, RN Member Sharon Moore, RN Member Lalitha Poonasamy Public Member

BETWEEN:

COLLEGE OF NURSES OF ONTARIO ) DENISE COONEY for ) College of Nurses of Ontario

• and - )

KAREN PUNCHARD ) CHRISTOPHER BRYDEN for Registration No. 9880865 ) Karen Punchard ) CHRISTOPHER WIRTH ) Independent Legal Counsel

) Heard: September 26, 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 September 26, 2022, via videoconference.

The Allegations

The allegations against Karen Punchard (the “Member”) as stated in the Notice of Hearing dated May 26, 2022 are as follows:

IT IS ALLEGED THAT:

1. You have committed an act of professional misconduct as provided by subsection 51(1)(c) of the Health Professions Procedural Code of the Nursing Act, 1991, S.O. 1991, c. 32, as amended, and defined in subsection 1(1) of Ontario Regulation 799/93, in that while working as a Registered Nurse at Toronto Western Hospital in Toronto, Ontario (the “Facility”), you contravened a standard of practice of the profession or failed to meet the standards of practice of the profession, and in particular, in or around 2016, you submitted false claims under the Facility’s employee group benefit plan (the “Benefit Plan”).

2. 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(8) of Ontario Regulation 799/93, in that while working as a Registered Nurse at the Facility, you misappropriated property from a client or workplace, and in particular, in or around 2016, you submitted false claims under the Benefit Plan.

3. 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 while working as a Registered Nurse at the Facility, you falsified a record relating to your practice, and in particular, in or around 2016, you submitted false claims under the Benefit Plan.

4. 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(15) of Ontario Regulation 799/93, in that while working as a Registered Nurse at the Facility, 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, in or around 2016, you submitted false claims under the Benefit Plan.

5. You have committed an act of professional misconduct as provided by subsection 51(1)(c) of the Health Professions Procedural Code of the Nursing Act, 1991, S.O. 1991, c. 32, as amended, and defined in subsection 1(37) of Ontario Regulation 799/93, in that while working as a Registered Nurse at the Facility, you engaged in conduct or performed an act, relevant to the practice of nursing, that, having regard to all the circumstances, would reasonably be regarded by members as disgraceful, dishonourable or unprofessional, and in particular, in or around 2016, you submitted false claims under the Benefit Plan.

Member’s Plea

The Member admitted the allegations set out in paragraphs 1, 2, 3, 4 and 5 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:

MEMBER

1. Karen Punchard (the “Member”) registered with the College of Nurses of Ontario (“CNO”) as a Registered Nurse (“RN”) on May 8, 1998.

2. The Member has been employed as an RN at Toronto Western Hospital (the “Facility”), located in Toronto, Ontario since 2007.

BENEFIT PLAN

3. The Facility’s employee benefit plan (the “Benefit Plan”) is a group insurance policy which provides coverage for extended health care, dental, and other insurance benefits. The Facility is the Plan Sponsor for the Benefit Plan and funds the cost of claims paid out under the plan. SunLife Insurance (“Sun Life”) administers the Benefit Plan on behalf of the Facility. Employees contribute to the cost of the Benefit Plan as set out in their employment agreement and/or collective agreement, and based on their election for individual or family coverage.

4. In order to submit a claim online, plan members must confirm that the information submitted is accurate and true, and agree, if requested, to provide original receipts and/or supporting documents.

INCIDENTS RELEVANT TO ALLEGATIONS OF PROFESSIONAL MISCONDUCT

5. Between May to December 2016, the Member submitted five false claims for massage therapy under the Benefit Plan, totalling $473.

6. The Member was chosen as part of a random audit by Sun Life. On March 14, 2017, a Sun Life analyst sent the Member an email requesting receipts for the massage therapy claims. The Member did not provide the requested documentation. Sun Life concluded that the above-mentioned claims for massage therapy were improper.

7. The Member admitted to the Facility that she submitted false claims. The Member made restitution and reimbursed the amounts with respect to the false claims.

BENEFIT FRAUD CASES

8. To date, a total of 75 benefit fraud cases involving substantially similar schemes as the one identified in this case, involving either cash or products not covered by the benefit plan, have been referred to the Discipline Committee. The dollar amounts of the false claims involved range from under $500 to over $45,000.

CNO STANDARDS

Professional Standards

9. CNO’s Professional Standards provides an overall framework for the practice of nursing and a link with other standards, guidelines and competencies developed by CNO. It includes seven broad standard statements pertaining to accountability, continuing competence, ethics, knowledge, knowledge application, leadership and relationships.

10. CNO’s Professional Standards provides, in relation to the accountability standard, that nurses are accountable to the public and responsible for ensuring their practice and conduct meets the legislative requirements and the standards of the profession. Nurses are responsible for their actions and the consequences of those actions as well as for conducting themselves in ways that promote respect for the profession. Nurses demonstrate this standard by actions such as ensuring their practice is consistent with CNO’s standards of practice and guidelines as well as legislation.

11. CNO’s Professional Standards provides, in relation to the leadership standard, that leadership requires self-knowledge (understanding one’s beliefs and values and being aware of how one’s behaviour affects others), respect, trust, integrity, shared vision, learning, participation, good communication techniques and the ability to be a change facilitator. The leadership expectation is not limited to nurses in formal leadership positions and all nurses, regardless of their position, have opportunities for leadership. Nurses demonstrate this standard by actions such as role-modelling professional values, beliefs and attributes.

Ethics

12. CNO’s Ethics Standard describes ethical values that are important to the nursing profession in Ontario including patient well-being, patient choice, privacy and confidentiality, respect for life, maintaining commitments, truthfulness and fairness.

13. CNO’s Ethics Standard provides, in relation to maintaining commitments, that nurses have a commitment to the nursing profession and 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.

14. CNO’s Ethics Standard also provides, in relation to truthfulness, that truthfulness means speaking and acting without intending to deceive.

15. The Member admits and acknowledges that she contravened CNO’s Professional Standards and Ethics Standard when she submitted false claims under the Benefit Plan.

ADMISSIONS OF PROFESSIONAL MISCONDUCT

16. The Member admits that she committed the acts of professional misconduct as alleged in paragraph 1 of the Notice of Hearing in that she contravened a standard of practice of the profession or failed to meet the standards of practice of the profession, as described in paragraphs 5 to 7 and 9 to 15 above.

17. The Member admits that she committed the acts of professional misconduct as alleged in paragraph 2 of the Notice of Hearing in that she misappropriated property from a workplace, as described in paragraphs 5 to 7 above.

18. The Member admits that she committed the acts of professional misconduct as alleged in paragraph 3 of the Notice of Hearing in that she falsified a record relating to her practice, as described in paragraphs 5 to 7 above.

19. The Member admits that she committed the acts of professional misconduct as alleged in paragraph 4 of the Notice of Hearing in that she signed or issued, in her professional capacity, a document that she knew or ought to have known contained a false or misleading statement, as described in paragraphs 5 to 7 above.

20. The Member admits that she committed the acts of professional misconduct as alleged in paragraph 5 of the Notice of Hearing, and in particular her conduct was dishonourable and unprofessional, as described in paragraphs 5 to 7 and 9 to 15 above.

Submissions on liability were made by College Counsel.

College Counsel asked the Panel to accept the Agreed Statement of Facts and the admissions made by the Member, and make findings of professional misconduct with respect to all five allegations. With respect to allegation #1, the Agreed Statement of Facts provides the relevant College standards and the Member’s admission that these standards were breached. College Counsel submitted that based on this, the Panel has a basis to make a finding with regard to a breach of the standards.

With regard to allegation #5, College Counsel submitted that the Member’s conduct was relevant to the practice of nursing and would reasonably be regarded by members of the profession to be unprofessional and dishonourable. The Member’s conduct and admission of submitting false claims to the Toronto Western Hospital’s (the “Facility”) employee benefit plan (the “Benefit Plan”) totalling $473.00 are clearly relevant to the practice of nursing as the claims were submitted as part of her employment with the Facility. Having regard to the circumstances, members of the profession would regard this behaviour as being unprofessional due to a serious disregard for the standards to act with integrity, honesty and in an ethical manner. Dishonourable conduct involves deceit and lying which applies to the Member’s conduct in that she submitted five false claims over seven months. The amount at issue in this case is small, being $473.00, and the quantum in the benefit fraud cases referred to the Discipline Committee to date, ranges from under $500 to over $45,000 but fraud is fraud. This is the conduct that brings discredit and dishonor to the profession. College Counsel asked the Panel to make findings of professional misconduct with respect to all allegations.

Submissions on liability were made by the Member’s Counsel.

The Member’s Counsel submitted that the Member admitted to her conduct as set out in the Agreed Statement of Facts. The Member admitted to submitting the false claims when confronted by her employer and reimbursed the money. The Member was initially terminated from her employment and then reinstated three months later. As a result, she incurred three months without pay. The Member’s Counsel submitted that the Member is remorseful, contrite and is committed to not repeating this conduct again.

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, 2, 3, 4 and 5 of the Notice of Hearing. As to allegation #5, the Panel finds that the Member engaged in conduct that would reasonably be regarded by members of the profession to be unprofessional and dishonourable.

Reasons for Decision

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

Allegation #1 in the Notice of Hearing is supported by paragraphs 5 to 7 and 9 to 16 in the Agreed Statement of Facts. As a result of her employment, the Member had access to the Facility’s Benefit Plan. In order to submit a benefit claim, plan members had to confirm that the information they submitted in the claim was accurate and true and agree, if requested, to provide original receipts and/or supporting documents. In March 2017, the Member was chosen as part of a random audit by the administrator of the Benefit Plan and was asked to submit receipts for massage therapy claims. The Member did not provide the requested documentation and admitted to the Facility that she had submitted five false claims between May to December 2016, totalling $473.00. The Member contravened the College’s Professional Standards and the Ethics Standard when she submitted the false claims under the Benefit Plan. The College’s Professional Standards require nurses to be truthful, act with integrity and be accountable for conducting themselves in ways that promote respect for the profession. The Ethics Standard also requires nurses to be truthful and act without intending to deceive. The Member was not honest or truthful and intended to deceive when she submitted the false claims between May to December 2016..

Allegation #2 in the Notice of Hearing is supported by paragraphs 5 to 7 and 17 in the Agreed Statement of Facts. The Member admitted to misappropriating property from the Facility by submitting five false claims to the Benefit Plan between May to December 2016 and to receiving $473.00 in relation to those false claims. Receiving money with respect to false benefit claims constitutes misappropriation of property.

Allegation #3 in the Notice of Hearing is supported by paragraphs 5 to 7 and 18 in the Agreed Statement of Facts. As a Registered Nurse (“RN”) employed at the Facility, the Member had access to the Benefit Plan. The Member admitted to falsifying a record relating to her practice by submitting false claims to the Benefit Plan between May to December 2016. The Member would not have been able to submit the false claims without confirming the information she submitted was true and accurate. By completing and submitting the false claims, the Member falsified a record relating to her practice, as she had access to the Benefit Plan in the context of her employment as an RN at the Facility.

Allegation #4 in the Notice of Hearing is supported by paragraphs 5 to 7 and 19 in the Agreed Statement of Facts. The Member admitted to signing, in her professional capacity, a document that she knew or ought to have known contained a false or misleading statement by submitting five false benefit claims between May and December 2016. In order to do this, the Member had to submit an online form and indicate the information she submitted was accurate and true. The Member admitted that she did this fraudulently. When the Member confirmed in the online claim form that the information she submitted was accurate and true, she was providing a false or misleading statement in her professional capacity as she had access to the Benefit Plan by virtue of being an RN employee of the Facility. Accordingly, the facts support the allegation that the Member signed, in her professional capacity, a document that she knew contained a false or misleading statement.

Allegation #5 in the Notice of Hearing is supported by paragraphs 5 to 7, 9 to 15 and 20 in the Agreed Statement of Facts. The Panel finds that the Member’s conduct in submitting false claims to the Facility’s Benefit Plan was clearly relevant to the practice of nursing and was unprofessional. The Member breached the College’s Professional Standards and the Ethics Standard when she submitted five false benefit claims between May to December 2016, thereby demonstrating a serious and persistent disregard for her professional obligations.

The Panel also finds that the Member’s conduct was dishonourable. It demonstrated an element of dishonesty and deceit. The Member knowingly submitted five false benefit claims over a seven-month period in 2016 and she did not come forward to take accountability for this. Her conduct was only revealed through a random audit being conducted by the administrator of the Benefit Plan. The Member’s conduct showed an element of moral failing. The Member knew or ought to have known that her 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:

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

2. Directing the Executive Director to suspend the Member’s certificate of registration for 2 months. This suspension shall take effect from the date that this Order becomes final and shall continue to run without interruption as long as the Member remains in a practicing class.

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

a) The Member will attend 2 meetings with a Regulatory Expert (the “Expert”), at 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:

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 and decision tools (where applicable):

1. Code of Conduct,

2. Professional Standards, and

3. 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:

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 their report to CNO, 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 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 employer(s) 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:

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 CNO, in which it will confirm:

1. that they received a copy of the required documents, and

2. that they agree to notify CNO 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 CNO, the Expert or the Member’s 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 reminded the Panel that it is obligated to accept a Joint Submission on Order unless to do so would bring the administration of justice into disrepute or would not be in the public interest. A Joint Submission on Order also needs to appropriately reflect aggravating and mitigating factors of the case.

The aggravating factors in this case were:

• The Member engaged in repeated dishonesty and deceit at the expense of the employer funded benefit plan;

• The employer is a public institution which means the public purse was funding the claims;

• The Member participated in five instances of submitting false claims over seven months;

• The Member had a chance to reconsider, but instead she repeated the conduct; and

• The Member’s conduct was an abuse and breach of the trust and confidence placed in her by the Facility, the benefit provider and the public, that she would only use the Benefit Plan for authorized purposes.

The mitigating factors in this case were:

• The total amount of the Member’s false claims was $473.00 which is at the lower end of the benefit fraud being reported to the College;

• The Member took responsibility before her employer and made restitution;

• The Member accepted responsibility with the College by admitting to the allegations and entering into an Agreed Statement of Facts and a Joint Submission on Order with the College; and

• The Member has no prior discipline history with the College.

College Counsel submitted that the Joint Submission on Order meets the goals of penalty which are to protect the public, maintain high professional standards and enhance public confidence in the College’s ability to regulate nurses. A penalty also needs to address specific deterrence which is to deter the Member from participating in similar misconduct, and general deterrence which is to deter the membership of the College at large from engaging in similar conduct. The penalty must also address rehabilitation and remediation of the Member. College Counsel submitted that the penalty strikes the correct balance between these goals.

Specific deterrence is met through the oral reprimand and the 2-month suspension of the Member’s certificate of registration. The oral reprimand will assist the Member in gaining a greater understanding of how her actions are perceived by her peers and by members of the profession and the public. The oral reprimand and suspension also sends a strong signal to the Member that this behavior is unacceptable and is intended to ensure that it is not repeated.

General deterrence is met through the 2-month suspension of the Member’s certificate of registration, which sends a message to members of the profession that this type of conduct is unacceptable. With regard to general deterrence, seventy-five cases of benefit fraud referred to the Discipline Committee clearly indicate a significant problem in the profession. Over two dozen decisions have been made to date regarding similar conduct and a clear message is needed that regardless how small, benefit fraud is not acceptable.

The elements of remediation and rehabilitation are met through the 2 meetings with a Regulatory Expert and review of the College’s publications. These activities will prepare the Member to return to an ethical practice that meets the standards expected of nurses. The public is protected through the 12 months of employer notification which ensures employer oversight once the Member returns to practice.

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. Verde-Balayo (Discipline Committee, 2021): This was the first case to be decided regarding benefit fraud. The amount of the benefit fraud in this case was $7,982.50 and restitution was not made. The penalty included an oral reprimand, a 4-month suspension of the member’s certificate of registration, 2 meetings with a Regulatory Expert, a review of the College’s publications and 12 months of employer notification. The two differences between the cases are that the case before this Panel involves a smaller amount of benefit fraud, under $500.00 and the Member has made restitution.

CNO v. Vallega (Discipline Committee, 2022): In this case, the benefit fraud is a smaller amount of $575.00, which is similar in amount to the case before this Panel. The penalty included an oral reprimand, a 2-month suspension of the member’s certificate of registration, 2 meetings with a Regulatory Expert, a review of the College’s publications and 12 months of employer notification.

College Counsel submitted that the Joint Submission on Order is within a reasonable range.

Submissions were made by the Member’s Counsel.

The Member’s Counsel submitted that the Member is remorseful and contrite and asked the Panel to accept the Joint Submission on Order.

Penalty Decision

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

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

2. The Executive Director is directed to suspend the Member’s certificate of registration for 2 months. This suspension shall take effect from the date that this Order becomes final and shall continue to run without interruption as long as the Member remains in a practicing class.

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

a) The Member will attend 2 meetings with a Regulatory Expert (the “Expert”), at 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:

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 and decision tools (where applicable):

1. Code of Conduct,

2. Professional Standards, and

3. 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:

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 their report to CNO, 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 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 employer(s) 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:

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 CNO, in which it will confirm:

1. that they received a copy of the required documents, and

2. that they agree to notify CNO 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 CNO, the Expert or the Member’s 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. Specifically, the oral reprimand and the 2-month suspension of the Member’s certificate of registration provides for specific deterrence. The 2-month suspension of the Member’s certificate of registration also provides for general deterrence. The 2 meetings with a Regulatory Expert will allow for rehabilitation and remediation and the 12 months of employer notification will ensure the public is protected.

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

I, Michael Hogard, 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.