DISCIPLINE COMMITTEE
OF THE COLLEGE OF NURSES OF ONTARIO
PANEL: Ingrid Wiltshire-Stoby, NP Chairperson
Sandra Larmour Public Member
Mary MacNeil, RN Member
Donna May, RPN Member
BETWEEN:
COLLEGE OF NURSES OF ONTARIO) DENISE COONEY for
) College of Nurses of Ontario
- and -)
MARYBETH TABAQUIN TING) PHILIP ABBINK for
Registration No. 07299309 ) Marybeth Tabaquin Ting
) PATRICIA HARPER
) Independent Legal Counsel
) Heard: April 25, 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 25, 2023, via videoconference.
The Allegations
The allegations against Marybeth Tabaquin Ting (the “Member”) as stated in the Notice of Hearing dated February 7, 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 Mount Sinai 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 2017, you submitted and/or accepted payment for false claims under the Facility’s employee group benefit plan.
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 Mount Sinai Hospital in Toronto, Ontario (the “Facility”), you misappropriated property from a client or workplace, and in particular, in or around 2015 to 2017, 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 Mount Sinai Hospital in Toronto, Ontario (the “Facility”), you falsified a record relating to your practice, and in particular, in or around 2015 to 2017, 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 Mount Sinai 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 2017, you submitted and/or accepted payment for false claims under the Facility’s employee group benefit plan.
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 Mount Sinai 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 2017, you submitted and/or accepted payment for false claims under the Facility’s employee group 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 as amended reads, unedited, as follows:
MEMBER
Marybeth Tabaquin Ting (the “Member”) registered with the College of Nurses of Ontario (“CNO”) as a Registered Nurse (“RN”) on January 16, 2007.
At the time of the incident, the Member was employed at Mount Sinai Hospital in Toronto, Ontario (the “Facility”). Her employment with the Facility was terminated on October 27, 2018, following the Facility’s investigation into the incident 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”). Manulife Financial (“Manulife”) 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 would complete a medical expense claim form provided by Manulife. 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 the claim.
INCIDENTS RELEVANT TO ALLEGATIONS OF PROFESSIONAL MISCONDUCT
Between 2015 and 2017, the Member submitted claims to the Benefit Plan for various products and services, including compression stockings and orthopedic shoes. Instead of the products claimed, she received products which were not covered by the Benefit Plan.
Following a routine audit, the Facility identified the Member as having submitted $6,615 in improper claims.
On October 26, 2017, the Member’s employment was terminated in relation to her submission of improper claims.
The Member paid $6,615 in restitution of the improper claims.
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 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 8 and 10 to 16 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 8 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 8 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 8 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 8 and 10 to 16 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 17-21 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, which, as confirmed by the verbal and written plea inquiry, was voluntary, informed, and made on the advice of experienced Counsel. 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 of the allegations in the Notice of Hearing.
With regard to allegation #1, College Counsel submitted that the Panel was provided evidence of the relevant College standards, namely the Professional Standards and the Ethics Standard that the Member breached. The Member also admitted to breaching the standards. This evidence provides a basis on which to make a finding for allegation #1.
With regard to allegation #5, paragraph 21 in the Agreed Statement of Facts indicates that the Member agreed that her conduct was relevant to the practice of nursing and would be characterized as dishonourable and unprofessional. College Counsel submitted that the conduct at issue is that the Member submitted improper insurance claims to Mount Sinai Hospital’s (the “Facility”) employee group benefit plan (the “Benefit Plan”). The claims were submitted between 2015 and 2017 and totalled $6,615.00. The Member’s conduct is relevant to the practice of nursing as she was only able to access the Benefit Plan by virtue of her employment at the Facility. Additionally, the false insurance claims were submitted to the Facility’s Benefit Plan.
College Counsel submitted that the Agreed Statement of Facts contains a summary of the relevant professional obligations required by nurses to act with honesty and integrity. A nurse submitting false insurance claims and false documentation to their employer constitutes a persistent disregard to act with honesty and integrity and forms the basis of a finding of unprofessional conduct. The Member’s conduct also involved dishonesty and deceit for the Member’s personal gain over a three-year period, which was long enough for the Member to stop and take accountability. Instead, the Member failed to act with the integrity the public expects of nurses and thereby brought shame to the nursing profession. In this way, the Member’s conduct was also dishonourable.
Submissions on liability were made by the Member’s Counsel.
The Member’s Counsel submitted that the Member’s plea and the details in the Agreed Statement of Facts, particularly those contained in paragraphs 5-8, provide sufficient facts to make findings of misconduct. The Member acknowledges submitting $6,615.00 in false insurance claims. Her admissions are detailed in paragraphs 18-21 of the Agreed Statement of Facts. With regard to allegation #5 in the Notice of Hearing, the Member only admitted that her conduct was unprofessional and dishonourable. Disgraceful conduct is conduct that is more serious and the Member has not admitted to her conduct being disgraceful. The Panel has also been provided with the relevant College standards in paragraphs 10-16 of the Agreed Statement of Facts. The Member’s Counsel submitted that the facts of the case provide grounds to make findings for all the allegations.
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 5-8 and 10-17 in the Agreed Statement of Facts. The Member admitted to submitting false claims through the Facility’s Benefit Plan between 2015 and 2017 for compression stockings and orthopedic shoes. Instead of the products claimed, the Member received products which were not covered by the Benefit Plan. Following a routine audit, the Facility identified the Member as having submitted $6,615.00 in improper claims. 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, have integrity and conduct themselves in a way that ensures respect for the nursing profession. The Ethics Standard also requires nurses to be truthful and act without intending to deceive. The Member failed to meet these standards over multiple years when she submitted false claims under the Facility’s Benefit Plan.
Allegation #2 in the Notice of Hearing is supported by paragraphs 5-8 and 18 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 and received product not covered by the benefit plan. The Member’s conduct constitutes a misappropriation of property.
Allegation #3 in the Notice of Hearing is supported by paragraphs 5-8 and 19 in the Agreed Statement of Facts. The Member admitted to falsifying a record relating to her practice 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 so her actions were related to her practice as a nurse. When the Member submitted the medical expense claim form to the Facility’s Benefit Plan, she had to sign and certify that all goods or services were received as claimed and that “the information provided for this claim is true and complete”. The Member admitted to signing this form and submitting false claims. Accordingly, the facts support the allegation that the Member falsified a record relating to her practice and did so in the context of her employment as an RN at the Facility.
Allegation #4 in the Notice of Hearing is supported by paragraphs 5-8 and 20 in the Agreed Statement of Facts. The Member admitted 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 the Member signed the medical expense claim form that required her to certify that “the information provided for this claim is true and complete”, she knew or ought to have known that she was signing a document that contained a false or misleading statement and that it was a false claim under the Facility’s Benefit Plan. As noted above, the Member had access to the Facility’s Benefit Plan by virtue of her employment as a nursing professional. When she signed and submitted the claim forms on her behalf, she did so in her capacity as an RN employee of the Facility. Accordingly, the facts support the allegation that the Member signed or issued, 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 5-8, 10-16 and 21 in the Agreed Statement of Facts. The Panel finds that the Member’s conduct in submitting false 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 Member ignored these standards over multiple years when she submitted false benefit claims and received products that were not covered by the Benefit Plan.
The Panel also finds that the Member’s conduct was dishonourable as it demonstrated an element of dishonesty and deceit and 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:
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, 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 this case were:
The Member admitted to submitting false claims totalling $6,615.00 to the Facility’s Benefit Plan between 2015 and 2017;
The Member’s conduct showed a serious and persistent level of dishonesty and deceit for her own personal gain and at the expense of the Facility’s Benefit Plan;
The Member took advantage of the trust placed in her by the Facility and the Benefit Plan administrator; and
The Member abused her access to the Facility’s Benefit Plan, which is a benefit to which not all nurses have access.
The mitigating factors in this case were:
The Member has taken responsibility by admitting to the allegations and entering into an Agreed Statement of Facts and a Joint Submission on Order with the College;
The Member has no discipline history with the College; and
The Member has made restitution with respect to the full amount of the false claims.
College Counsel submitted that the proposed penalty meets the goals of penalty to protect the public, maintain high professional standards within the profession and enhance public confidence in the College’s ability to regulate nurses.
The proposed penalty provides for general deterrence through the 3-month suspension of the Member’s certificate of registration, indicating to other members of the profession that this conduct is treated as serious and is unacceptable. General deterrence is particularly significant in this case as the Agreed Statement of Facts indicates at least 82 benefit fraud cases have been referred to the Discipline Committee. The widespread nature of this misconduct requires a clear message that dishonest conduct in this form is unacceptable.
The proposed penalty provides for specific deterrence through the oral reprimand and the 3-month suspension on the Member’s certificate of registration. The oral reprimand will help the Member gain an understanding of how her actions are perceived by the public and by members of the profession. The suspension sends a strong signal to the Member that this conduct is unacceptable and will help ensure she will not repeat it.
The proposed penalty provides for remediation and rehabilitation through the 2 meetings with a Regulatory Expert and review of the College’s publications. These steps will prepare the Member to return to an ethical practice which is expected of all nurses.
Overall, the public is protected through the 12 months of employer notification, which will help ensure 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. Fejedelem (Discipline Committee, 2022): In this case, the member misappropriated approximately $5,892.50 related to false claims that were submitted to her employee benefit plan. The member made full restitution to the facility and served a five-day, unpaid suspension. The penalty included an oral reprimand, a 3-month suspension of the member’s certificate of registration, and terms, conditions and limitations similar to that proposed in the case before this Panel i.e., 2 meetings with a Regulatory Expert, review of the College’s publications and 12 months of employer notification.
CNO v. Santiago (Discipline Committee, 2022): In this case, the member misappropriated $5,530.00 related to false claims that were submitted to her employee benefit plan. The member received a five-day unpaid suspension from the facility and entered into a payment agreement with the facility to pay back the $5,530.00. The penalty included an oral reprimand, a 3-month suspension of the member’s certificate of registration, and terms, conditions and limitations identical to that proposed in the case before this Panel i.e., 2 meetings with a Regulatory Expert, review of the College’s publications and 12 months of employer notification.
CNO v. Pasion-Santos (Discipline Committee, 2022): In this case, the member misappropriated $4,900.00 related to false claims that were submitted to her employee benefit plan. The member made full restitution to the facility. The penalty included an oral reprimand, a 3-month suspension of the member’s certificate of registration, and terms, conditions and limitations identical to that proposed in the case before this Panel i.e., 2 meetings with a Regulatory Expert, review of the College’s publications and 12 months of employer notification.
College Counsel submitted that the Panel can be confident that the Joint Submission on Order is within the range of penalties ordered in other cases of similar conduct.
Submissions were made by the Member’s Counsel.
The Member’s Counsel submitted that he agreed with College Counsel’s summary of the general principles concerning penalty and how they apply in this case. The three cases submitted by College Counsel are similar to the case before this Panel and contain similar allegations, findings and penalties ordered. The members in the 3 cases submitted by College Counsel also all paid restitution. The Member’s Counsel submitted that the Panel should be assured that what is being proposed is reasonable. By admitting her misconduct and accepting responsibility, it makes it more likely that the Member will make amends and shows a positive sign toward rehabilitation. The Member’s admission and cooperation with the College has also allowed the administration of justice to be more efficient by avoiding costs associated with a contested hearing. The Member also has no discipline history with the College and has made restitution. The Member’s Counsel submitted that the penalty is appropriate based on the principles of sentencing and is also within the range of previous cases.
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, 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. Specifically, the oral reprimand and the 3-month suspension of the Member’s certificate of registration provides for specific deterrence. The 3-month suspension of the Member’s certificate of registration 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, Ingrid Wiltshire-Stoby, NP, sign this decision and reasons for the decision as Chairperson of this Discipline panel and on behalf of the members of the Discipline panel.