Discipline Committee of the College of Nurses of Ontario
DISCIPLINE COMMITTEE OF THE COLLEGE
OF NURSES OF ONTARIO
PANEL: Jane Mathews, RN Chairperson
Ramona Dunn, RN Member
Sandra Larmour Public Member
Michael Schroder, NP Member
BETWEEN:
COLLEGE OF NURSES OF ONTARIO ) JOSEPH BERGER for
) College of Nurses of Ontario
- and - )
JENNIFER LY ) NO REPRESENTATION for
Registration No. 8917163 ) Jennifer Ly
) CHRISTOPHER WIRTH
) Independent Legal Counsel
) Heard: April 24, 2023
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 April 24, 2023, via videoconference.
The Allegations
The allegations against Jennifer Ly (the “Member”) as stated in the Notice of Hearing dated January 24, 2023 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 working as a Registered Nurse at Toronto General 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 2015 to 2016:
a. You submitted and/or accepted payment for false claims under the Facility’s employee group benefit plan; and/or
b. You submitted to the Facility’s employee group benefit plan prescriptions issued using a physician’s stamp, without the physician’s knowledge, permission and/or authorization.
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 Toronto General Hospital in Toronto, Ontario (the “Facility”), you misappropriated property from a client or workplace, and in particular, in or around 2015 to 2016, you submitted and/or accepted payment for false claims under the Facility’s employee group benefit plan.
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 Toronto General Hospital in Toronto, Ontario (the “Facility”), you falsified a record relating to your practice, and in particular, in or around 2015 to 2016, you submitted and/or accepted payment for false claims under the Facility’s employee group benefit plan.
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 Toronto General Hospital in Toronto, Ontario (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 2015 to 2016:
a. You submitted and/or accepted payment for false claims under the Facility’s employee group benefit plan; and/or
b. You submitted to the Facility’s employee group benefit plan prescriptions issued using a physician’s stamp, without the physician’s knowledge, permission and/or authorization.
- 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 Toronto General Hospital in Toronto, 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 as disgraceful, dishonourable or unprofessional, and in particular, in or around 2015 to 2016:
a. You submitted and/or accepted payment for false claims under the Facility’s employee group benefit plan; and/or
b. You submitted to the Facility’s employee group benefit plan prescriptions issued using a physician’s stamp, without the physician’s knowledge, permission and/or authorization.
Member’s Plea
The Member admitted the allegations set out in paragraphs 1(a), (b), 2, 3, 4(a), (b), and 5(a) and (b) in the Notice of Hearing. The Panel received a written plea inquiry which was signed by the Member. The Panel also conducted an oral plea inquiry and was satisfied that the Member’s admission was voluntary, informed and unequivocal.
Agreed Statement of Facts
College Counsel and the Member advised the Panel that agreement had been reached on the facts and introduced an Agreed Statement of Facts, which reads, unedited, as follows:
MEMBER
Jennifer Ly (the “Member”) registered with the College of Nurses of Ontario (“CNO”) as a Registered Nurse (“RN”) in the General Class on January 19, 1989.
At the time of the incidents described below, the Member was employed at Toronto General Hospital in Toronto, Ontario (the “Facility”), which is part of the University Health Network (“UHN”) in the Ambulatory Transplant Unit. The Member’s employment at the Facility was terminated on May 16, 2018, as result of the incidents described below.
BENEFIT PLAN
The Facility offers its employees a self-insured group insurance policy by which the Facility provides coverage to employees for extended health care, dental, and other insurance benefits (the “Benefit Plan”). Sun Life Financial (“Sun Life”) administers the Benefit Plan on behalf of the Facility. The Facility, however, is the plan sponsor for the Benefit Plan, and therefore funds the cost of claims paid out to employees under the plan.
To submit a benefit claim, members of the Benefit Plan were required to complete a medical expense claim form provided by Sun Life. The medical expense claim form requires certain information, including information on the plan member, any dependents, and the nature of the claim. The plan member must certify that all goods or services were received as claimed and that “the information provided for this claim is true and complete”, and then sign.
INCIDENTS RELEVANT TO ALLEGATIONS OF PROFESSIONAL MISCONDUCT
Between November 2015 and May 2016, the Member submitted claims totaling $2,280 to the Benefit Plan.
In support of these claims, the Member submitted prescriptions for orthopaedic footwear and compression stockings from a physician who works at the Facility in nephrology and renal transplantation. The Member was not the physician’s patient. The Member submitted claims using the physician’s stamp without their knowledge or authorization.
On May 7, 2018, the Facility interviewed the Member about her claims. The Member admitted to having submitted claims with the physician’s stamp without their authorization to create fraudulent prescriptions to support the claims submitted to the Benefit Plan.
Following the Facility’s investigation, the Member’s employment was terminated.
The Member made full restitution with respect to the improper claims.
If the Member were to testify, she would apologize and say she takes responsibility for her conduct.
BENEFIT FRAUD CASES
- To date, at least 82 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
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.
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.
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
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.
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.
CNO’s Ethics Standard also provides, in relation to truthfulness, that truthfulness means speaking and acting without intending to deceive.
The Member admits and acknowledges that she contravened CNO’s Professional Standards and Ethics Standard.
ADMISSIONS OF PROFESSIONAL MISCONDUCT
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 9 and 12 to 18 above.
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 9 above.
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 9 above.
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 9 above.
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 9 and 12 to 18 above.
Submissions on liability were made by College Counsel.
College Counsel asked the Panel to accept the Agreed Statement of Facts, as well as the Member’s admissions to all the allegations as set out in paragraphs 19 to 23 of the Agreed Statement of Facts and, on the basis of those facts and admissions, make findings of professional misconduct with respect to the allegations in the Notice of Hearing. College Counsel submitted that the Panel has taken the Member’s plea and confirmed the plea was voluntary and informed through a written and verbal plea inquiry. College Counsel submitted that based on the Agreed Statement of Facts, which specifically describes the facts in relation to the allegations, the Panel has enough evidence to find that the Member committed professional misconduct as set out in all the allegations in the Notice of Hearing.
College Counsel reviewed the following allegations with the Panel: allegations #1(a), (b), and #5(a) and (b). With regard to allegations #1(a) and (b), College Counsel submitted that these allegations are supported by the Agreed Statement of Facts, which contained evidence of the relevant College standards of the profession, as well as the Member’s admission that those standards were breached.
With regard to allegations #5(a) and (b), College Counsel submitted that the parties agreed that the Member’s conduct is relevant to the practice of nursing and is dishonourable and unprofessional. College Counsel submitted that this agreement is part of a resolution reached between the College and the Member.
The conduct at issue, which is that the Member submitted false claims in the amount of $2,280.00 through the Toronto General Hospital’s (the “Facility”) employee group benefit plan (the “Benefit Plan”) between November 2015 and May 2016, is relevant to the practice of nursing as claims were submitted as part of her nursing employment at the Facility.
College Counsel submitted that having regard to all of the circumstances, members of the profession would consider the Member’s conduct to be unprofessional and dishonourable. The Member’s conduct is unprofessional as submitting false claims to the Benefit Plan constitutes a serious and persistent disregard for her professional obligations to act with the honesty and integrity required of a nurse. The Member’s conduct is dishonourable as it involved lying, deceit and dishonesty. The Member failed to act with the integrity which the public expects from the nursing profession, and by doing so has brought shame upon the entire profession.
Submissions on liability were made by the Member.
The Member submitted that she did not intend to deceive but used poor judgment in her actions including using a physician’s stamp without authorization.
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), (b), 2, 3, 4(a), (b) and 5(a) and (b) of the Notice of Hearing. As to allegations #5(a) and (b), 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.
Allegations #1(a) and (b) in the Notice of Hearing are supported by paragraphs 5-9 and 12-19 in the Agreed Statement of Facts. The Member admitted to submitting false claims through the Facility’s Benefit Plan between November 2015 and May 2016 in the amount of $2,280.00. In support of the false claims, the Member submitted prescriptions for orthopaedic footwear and compression stockings from a physician who works at the Facility by means of utilizing a physician’s stamp without their authorization. The College’s Ethics Standard outlines that truthfulness is an important ethical value in the nursing profession. The Member breached the Ethics Standard by purposely attempting to deceive the Benefit Plan which her employer provided when she submitted false claims. The Member also breached the College’s Professional Standards when she demonstrated a lack of integrity through using the physician’s stamp without their knowledge in an attempt to support the false claims.
Allegation #2 in the Notice of Hearing is supported by paragraphs 5-9 and 20 in the Agreed Statement of Facts. The Member admitted to misappropriating property from the Facility when she submitted false claims through the Facility’s Benefit Plan. Submitting false benefit claims constitutes misappropriation of benefits from the Facility’s Benefit Plan and is thus misappropriation of property from the Facility.
Allegations #3, #4(a) and (b) in the Notice of Hearing are supported by paragraphs 5-9 and 21-22 in the Agreed Statement of Facts. The Member admitted to falsifying a record relating to her practice and to signing or issuing, in her professional capacity, a document that she knew or ought to have known contained a false or misleading statement when she submitted false claims to the Facility‘s Benefit Plan. The Member, as a Registered Nurse (“RN”) employee of the Facility, had access to the Benefit Plan by virtue of her employment as a nursing professional and her actions were related to her practice as a nurse. When she signed and submitted claim forms certifying that “the information provided for this claim is true and complete” she did so in her capacity as an RN employee of the Facility. The Member attested to a false statement when she submitted the false claims. Additionally, the Member submitted prescriptions for orthopaedic footwear and compression stockings to support the false claims to the Benefit Plan which were endorsed by the unauthorized use of a physician's stamp. Accordingly, the facts support that the Member falsified a record relating to her practice and signed or issued, in her professional capacity, a document that she knew or ought to have known contained a false or misleading statement.
Allegations #5(a) and (b) in the Notice of Hearing are supported by paragraphs 5-9, 12-18 and 23 in the Agreed Statement of Facts. The Panel finds that the Member’s conduct in submitting false benefit claims was clearly relevant to the practice of nursing and was unprofessional as it demonstrated a serious and persistent disregard for her professional obligations as set out in the Professional Standards and the Ethics Standard.
The Panel also finds that the Member’s conduct was dishonourable. It demonstrated an element of dishonesty and deceit through submitting false benefit claims to the Facility’s Benefit Plan. The Panel found that the conduct of authoring prescriptions endorsed through the unauthorized use of a colleague’s physician stamp particularly deceitful. 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 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 4 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, 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 employer(s) of the decision. To comply, the Member is required to:
i. Inform any employer of the decision prior to commencing or prior to resuming employment in any nursing position;
ii. 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;
iii. 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;
iv. 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.
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.
The aggravating factors in the case were:
The Member’s conduct was dishonest;
The Member submitted false claims over a lengthy period of time between November 2015 and May 2016 totalling $2,280.00;
The Member submitted prescriptions which were endorsed by a physician’s stamp which the Member was not authorized to use;
The Member’s misconduct was at the expense of the Benefit Plan;
The Member took advantage of the privilege of having the Benefit Plan; and
The Member took advantage of the trust placed in her by the Facility and the Benefit Plan.
The mitigating factors in the case were:
The Member has taken responsibility by entering into an Agreed Statement of Facts and a Joint Submission on Order with the College;
The Member admitted the allegations and entered into a resolution;
The Member saved the College the time and expense required to prosecute the case in a contested manner;
The Member has paid restitution; and
The Member has no previous discipline history with the College.
General deterrence is achieved through the 4-month suspension of the Member’s certificate of registration, which will demonstrate to the membership that there are serious consequences for this type of behaviour.
Specific deterrence is achieved through the oral reprimand, which will assist the Member with gaining greater insight into her conduct and how it is perceived by both the public and members of the profession and the 4-month suspension of the Member’s certificate of registration, which sends a signal to the Member that her misconduct was unacceptable.
Remediation and rehabilitation are achieved through the 2 meetings with a Regulatory Expert and the review of the College’s publications, which will assist the Member with returning to ethical nursing practice.
Overall, the public is protected through the 12 months of employer notification as this will allow for a heightened level of employer oversight on the Member’s return to nursing 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. Soosaipillai (Discipline Committee, 2022): This case proceeded by way of an Agreed Statement of Facts and a Joint Submission on Order. In this case, the member committed acts of professional misconduct when she was involved in similar benefit plan misuse in the amount of $2,150.00. The member received a five-day unpaid suspension from the facility and entered into a payment agreement with the facility to pay back the $2,150.00. The penalty included an oral reprimand, a 3-month suspension of the member’s certificate of registration, 2 meetings with a Regulatory Expert and 12 months of employer notification. This case differs from the case before this Panel in that there was no unauthorized use of a physician’s stamp.
CNO v. Rosales (Discipline Committee, 2023): This case proceeded by way of an Agreed Statement of Facts and a Joint Submission on Order. In this case, the member committed acts of professional misconduct when she was involved in similar benefit plan misuse in the amount of $4,350.00. The member supported the false benefit claims through the unauthorized use of a physician’s stamp. The member did not make restitution. The penalty was an oral reprimand as the member had voluntarily signed an undertaking to permanently resign as a member of the College.
CNO v. Directo (Discipline Committee, 2023): This case proceeded by way of an Agreed Statement of Facts and a Joint Submission on Order. In this case, the member committed acts of professional misconduct when she was involved in similar benefit plan misuse in the amount of $2,090.00. The member supported the false benefit claims through the unauthorized use of a physician’s stamp. The member made restitution. The penalty included an oral reprimand, a 4-month suspension of the member's certificate of registration, 2 meetings with a Regulatory Expert and 12 months of employer notification.
The Member was given an opportunity by the Panel to make submissions on penalty. The Member declined to make any submissions.
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 4 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, 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 employer(s) of the decision. To comply, the Member is required to:
i. Inform any employer of the decision prior to commencing or prior to resuming employment in any nursing position;
ii. 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;
iii. 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;
iv. 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.
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.
The penalty provides for specific deterrence through the oral reprimand and the 4-month suspension of the Member’s certificate of registration, which will allow the Member an opportunity to hear how her misconduct is perceived by both the public and fellow members and will demonstrate to the Member that her conduct is unacceptable.
The proposed penalty provides for general deterrence through the 4-month suspension of the Member’s certificate of registration, which will signal to the membership that there are serious consequences for engaging in similar misconduct.
The proposed penalty provides for remediation and rehabilitation through the 2 meetings with a Regulatory Expert and the review of the College’s publications, which will assist the Member with gaining a greater level of insight into her misconduct and assist with transitioning the Member to ethical nursing practice on her return to nursing.
Overall, the public is protected through the 12 months of employer notification, which will provide a heightened level of employer oversight on the Member’s return to nursing practice.
The penalty is also in line with what has been ordered in previous cases in similar circumstances.
I, Jane Mathews, 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.