College of Nurses of Ontario v. Elizabeth Lichacz, 2024 ONCNO 118259

DISCIPLINE COMMITTEE OF THE COLLEGE OF NURSES OF ONTARIO

PANEL: Mary MacNeil, RN Chairperson Aisha Jahangir, RN Member Sandra Larmour Public Member Ahamad Mohammed, RPN Member

BETWEEN:

COLLEGE OF NURSES OF ONTARIO GLYNNIS HAWE for College of Nurses of Ontario

• and -

ELIZABETH LICHACZ Registration No. 13561512 DANIELLE BISNAR for Elizabeth Lichacz CHRISTOPHER WIRTH Independent Legal Counsel

Heard: February 13, 2024

DECISION AND REASONS

This matter came on for hearing before a panel of the Discipline Committee (the “Panel”) of the College of Nurses of Ontario (the “College”) on February 13, 2024, via videoconference.

The Allegations

College Counsel advised the Panel that the College was requesting leave to withdraw the allegations set out in paragraphs #1(b), #3(a)(i), (ii), (iii), (iv), (b)(i), (ii), (iii), (c)(i), (ii), (iii), (iv), (v), (d)(i), (ii), (iii)(1), (2), (iv), (v), #4(b)(ii), #5(a)(ii), #6(a)(i), (ii), (iii), (iv), (b)(i), (ii), (iii), (c)(i), (ii), (iii), (iv), (v), (d)(i), (ii), (iii)(1), (2), (iv), (v) and (g)(vi) in the Notice of Hearing dated February 8, 2024. The Panel granted this request. The remaining allegations against Elizabeth Lichacz (the “Member”) are as follows:

IT IS ALLEGED THAT:

1. You have committed an act of professional misconduct as provided by subsection 51(1)(a) of the Health Professions Procedural Code of the Nursing Act, 1991, S.O. 1991, c. 32, as amended, in that, between 2016 - 2017, you were found guilty of an offence relevant to your suitability to practise, as follows:

a) on November 23, 2016, in the County Court At Law in McLellan County, Texas, you were found guilty of driving while intoxicated with a blood alcohol content of 0.15 or greater, contrary to section 49.04 of the Penal Code of Texas; and/or

b) [Withdrawn];

2. You have committed an act of professional misconduct as provided by subsection 51(1)(b) of the Health Professions Procedural Code of the Nursing Act, 1991, S.O. 1991, c. 32, as amended, in that, while registered with the College of Nurses of Ontario as a Registered Nurse, the governing body of a health profession in a jurisdiction other than Ontario found that you committed an act of professional misconduct that would, in the opinion of the panel, be an act of professional misconduct under the Health Professions Procedural Code of the Nursing Act, 1991, S.O. 1991, c. 32, or an act of professional misconduct as defined in the regulations, and in particular:

a) on or about February 13, 2018, the Texas Board of Nursing’s Eligibility and Disciplinary Committee found that you committed acts of professional misconduct in that:

i) on or about October 5, 2015, while employed as a Registered Nurse with Memorial Hermann Hospital in Houston, Texas, you attended work while you lacked the fitness to practice nursing with reasonable skill and safety;

ii) on or about January 18, 2017, you were found guilty of evading arrest or detention with a vehicle contrary to the Penal Code of Texas;

3. [Withdrawn];

4. You have committed an act of professional misconduct as provided by subsection 51(1)(c) of the Health Professions Procedural Code of the Nursing Act, 1991, S.O. 1991, c. 32, as amended, and defined in subsection 1(18) of Ontario Regulation 799/93, in that while registered with the College of Nurses of Ontario (“CNO”) as a Registered Nurse:

a) you contravened a term, condition or limitation on your certificate of registration, as provided by section 1.5(1)1.(ii) of Ontario Regulation 275/94 of the Nursing Act, 1991, in that you failed to report charges arising in any jurisdiction relating to any offence to CNO, as follows:

i) On February 22, 2015, in Montgomery County, Texas, you were charged with driving while intoxicated contrary to section 49.04 of the Penal Code of Texas;

ii) On October 19, 2015, in McLellan Country, Texas, you were charged with driving while intoxicated with a blood alcohol content of 0.15 or greater, contrary to section 49.04 of the Penal Code of Texas;

iii) On October 28, 2015, in McLellan Country, Texas, you were charged with evading arrest or detention with a vehicle, contrary to section 38.04 of the Penal Code of Texas; and/or

iv) On January 19, 2017, in Johnson Country, Texas, you were charged with the following offences:

1. assault causing bodily injury, contrary to section 22.01(A)(1) of the Penal Code of Texas;

2. assault causing bodily injury family violence, contrary to section 22.01(A)(1) of the Penal Code of Texas; and/or

3. resist arrest search or transport, contrary to section 38.03(A) of the Penal Code of Texas;

b) you contravened a term, condition or limitation on your certificate of registration, as provided by section 1.5(1)1.(i) of Ontario Regulation 275/94 of the Nursing Act, 1991, in that you failed to report a finding of guilt arising in any jurisdiction relating to any offence to CNO, as follows:

i) On November 23, 2016, in the County Court At Law, in McLellan County, Texas, you were found guilty of driving while intoxicated with a blood alcohol content of 0.15 or greater, contrary to section 49.04 of the Penal Code of Texas; and/or

ii) [Withdrawn];

c) you contravened a term, condition or limitation on your certificate of registration, as provided by section 1.5(1)1.(iii) of Ontario Regulation 275/94 of the Nursing Act, 1991, in that you failed to provide CNO with details of the finding of professional misconduct, incompetence or incapacity or any similar finding, made by the Texas Board of Nursing’s Eligibility and Disciplinary Committee on February 13, 2018; and/or

d) you contravened a term, condition or limitation on your certificate of registration, as provided by section 1.5(1)1.(iv) of Ontario Regulation 275/94 of the Nursing Act, 1991, in that you failed to provide CNO with details of a current investigation, inquiry or proceeding for professional misconduct, incompetence or incapacity or any similar investigation or proceeding in relation to your practice of nursing in Texas;

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(19) of Ontario Regulation 799/93, in that while registered with the College of Nurses of Ontario (“CNO”) as a Registered Nurse:

a) you contravened a provision of the Nursing Act, 1991, the Regulated Health Professions Act, 1991, or the regulations under either of those Acts, and in particular, s. 85.6.1 of the Health Professions Procedural Code, in that you failed to report a finding of guilt of an offence to CNO, as follows:

i) On November 23, 2016, in the County Court At Law, in McLellan County, Texas, you were found guilty of driving while intoxicated with a blood alcohol content of 0.15 or greater, contrary to section 49.04 of the Penal Code of Texas; and/or

ii) [Withdrawn]; and/or

6. 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, between 2015 and 2019, while registered with the College of Nurses of Ontario (“CNO”) as a Registered Nurse, 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 as follows:

a) [Withdrawn];

b) [Withdrawn];

c) [Withdrawn];

d) [Withdrawn];

e) you failed to provide CNO with details of a current investigation, inquiry or proceeding for professional misconduct, incompetence or incapacity or any similar investigation or proceeding in relation to your practice of nursing in Texas;

f) you failed to provide CNO with or details of a finding of professional misconduct, incompetence or incapacity or any similar finding made by the Texas Board of Nursing’s Eligibility and Disciplinary Committee on February 13, 2018; and/or

g) you failed to report charges and/or findings of guilt to CNO as follows:

i) On February 22, 2015, in Montgomery County, Texas, you were charged with driving while intoxicated contrary to section 49.04 of the Penal Code of Texas;

ii) On October 19, 2015, in McLellan Country, Texas, you were charged with driving while intoxicated with a blood alcohol content of 0.15 or greater, contrary to section 49.04 of the Penal Code of Texas;

iii) On October 28, 2015, in McLellan Country, Texas, you were charged with evading arrest or detention with a vehicle, contrary to section 38.04 of the Penal Code of Texas; and/or

iv) On January 19, 2017, in Johnson Country, Texas, you were charged with the following offences:

1. assault causing bodily injury, contrary to section 22.01(A)(1) of the Penal Code of Texas;

2. assault causing bodily injury family violence, contrary to section 22.01(A)(1) of the Penal Code of Texas; and/or

3. resist arrest search or transport, contrary to section 38.03(A) of the Penal Code of Texas;

v) On November 23, 2016, in the County Court At Law, in McLellan County, Texas, you were found guilty of driving while intoxicated with a blood alcohol content of 0.15 or greater, contrary to section 49.04 of the Penal Code of Texas; and/or

vi) [Withdrawn].

Member’s Plea

The Member admitted the allegations set out in paragraphs #1(a), #2(a)(i), (ii), #4(a)(i), (ii), (iii), (iv)(1), (2), (3), (b)(i), (c), (d), #5(a)(i), #6(e), (f), (g)(i), (ii), (iii), (iv)(1), (2), (3) and (v) 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 admissions were 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 without exhibits, as follows:

THE MEMBER

1. Elizabeth Lichacz (the “Member”) registered with the College of Nurses of Ontario (“CNO”) as a Registered Nurse (“RN”) on August 23, 2013.

2. On December 20, 2023, the Member resigned her certificate of registration with CNO.

3. From 2014 to 2017, the Member was employed at Memorial Hermann Hospital in Houston, Texas. The Member was employed at Humber River Hospital (the “Hospital”) from June 5, 2017 to March 31, 2019.

PRIOR HISTORY

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

INCIDENTS RELEVANT TO ALLEGATIONS OF PROFESSIONAL MISCONDUCT

Reporting Obligations

5. At the time of the incidents below, the Member was obligated to self-report criminal charges and findings of guilt to CNO, as follows:

a. the Member was under an obligation to report any finding of guilt to the Executive Director of CNO, both as a condition of her certificate of registration, in accordance with section 1.5(1)(i) of Ontario Regulation 275/94, made under the Nursing Act, 1991, as well as being required by statute, under section 85.6.1(1) of the Health Professions Procedural Code; and

b. the Member was under an obligation to report any charge arising in any jurisdiction relating to any offence to the Executive Director of CNO, as a condition of her certificate of registration, in accordance with section 1.5(1)(ii) of Ontario Regulation 275/94, made under the Nursing Act, 1991.

6. At the time of the incidents below, Ontario Regulation 275/94, made under the Nursing Act, 1991 required the Member to report, as a condition of her certificate of registration:

a. any current investigation, inquiry or proceeding for professional misconduct, incompetence or incapacity or any similar investigation or proceeding in relation to the practice of nursing or another profession in any jurisdiction; and

b. any finding of professional misconduct, incompetence or incapacity or any similar finding, in relation to the practice of nursing or another profession in any jurisdiction.

Texas Board of Nursing Eligibility and Disciplinary Committee Proceedings

7. On November 9, 2017, the Texas Board of Nursing’s Eligibility and Disciplinary Committee (the “Texas Disciplinary Committee”) issued charges against the Member in connection with her nursing practice in the State of Texas. Specifically, the Member was charged with:

a. attending work as an RN at Memorial Hermann Hospital in Houston, Texas on October 5, 2015 when she lacked fitness to practice due to intoxication; and

b. pleading guilty to evading arrest or detention with a vehicle under the Penal Code of Texas on January 18, 2017.

8. On February 13, 2018, the Texas Disciplinary Committee issued an order revoking the Member’s registration to practice nursing in the State of Texas in connection with the charges (the “Order”). The Member did not attend the hearing and the Order was issued in her absence.

9. The Member admits that she did not report the charges or the Order to CNO.

Texas Criminal Charges

10. On February 22, 2015, the Member was charged with driving while intoxicated, contrary to section 49.04 of the Penal Code of Texas.

11. On October 19, 2015, the Member was charged with driving while intoxicated with a blood alcohol content of 0.15 or greater, contrary to section 49.04 of the Penal Code of Texas.

12. On or around October 28, 2015, the Member was charged with Evading Arrest or Detention with a Vehicle, contrary to section 38.04 of the Penal Code of Texas. On January 18, 2017, the Member was sentenced in relation to this charge. The sentence included an order deferring adjudication of the Member’s guilt pending completion of probation. On January 21, 2022, the Member’s sentence was discharged without a finding of guilt.

13. On January 19, 2017, the Member was charged with:

a. assault causing bodily injury, contrary to section 22.01(A)(1) of the Penal Code of Texas;

b. assault causing bodily injury family violence, contrary to section 22.01(A)(1) of the Penal Code of Texas; and

c. resist arrest search or transport, contrary to section 38.03(A) of the Penal Code of Texas.

14. The Member admits that she did not report these charges to CNO.

Texas Criminal Convictions

15. On November 23, 2016, the Member was found guilty of driving while intoxicated with a blood alcohol content of .15 or greater, contrary to section 49.04 of the Penal Code of Texas. The Member was sentenced to 365 days in jail, a $4,000 fine, and 24 months’ probation.

16. If the Member were to testify, she would state that she was suffering with an active alcohol addiction at the relevant time, which affected her behaviour and judgment. She would also state that during the relevant period, she did not effectively seek treatment and supports for her substance dependence due to extreme feelings of shame and stigmatization about being a health care provider with an addiction. The Member states that she has now been in recovery for more than three years and has completed a number of treatment programs for her substance abuse disorder.

CNO STANDARDS

Professional Standards

17. 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.

18. 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 standard 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.

19. Attached as Exhibit “A” is a copy of CNO’s Professional Standards which was in force at the time of the incidents and has since been retired.

ADMISSIONS OF PROFESSIONAL MISCONDUCT

20. The Member admits that she committed the acts of professional misconduct as alleged in paragraphs 1(a); 2(a)(i) and (ii); 4(a)(i) to (iv); 4(b)(i); 4(c); 4(d); 5(a)(i) of the Notice of Hearing, as described in paragraphs 5 to 16 above.

21. The Member admits that she committed the acts of professional misconduct as alleged in paragraphs 6(e) and (f); 6(g)(i) to (v) the Notice of Hearing, and in particular her conduct was dishonourable and unprofessional, as described in paragraphs 5 to 16 above.

OTHER

22. With the leave of the Panel of the Discipline Committee, CNO withdraws the remaining allegations in the Notice of Hearing, which are as follows:

a. 1(b);

b. 3(a) (i) to (iv); 3(b)(i) to (iii); 3(c)(i) to (v); 3(d)(i) to (v);

c. 4(b)(ii);

d. 5(a)(ii);

e. 6(a)(i) to (iv);6 (b)(i) to (iii); 6(c)(i) to (v); 6(d)(i) to (v); and 6(g)(vi).

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 that were not withdrawn and as set out in paragraphs 20-21 of the Agreed Statement of Facts and, on the basis of those facts and admissions, make findings of professional misconduct with respect to those 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 the allegations that remain in the Notice of Hearing. College Counsel submitted that while the allegation of a breach of the College standards was withdrawn, statements from the Professional Standards are included in the Agreed Statement of Facts, paragraphs 17-19, to provide context for allegation #6 that relates to disgraceful, dishonourable and unprofessional conduct.

With respect to allegation #1(a) that the Member’s conduct was relevant to her suitability to practice, College Counsel referred to the CNO v. Toth (Discipline Committee, 2019) case in which the member was found guilty of disorderly conduct, resisting an officer, careless driving and failing to report charges relating to driving under the influence. College Counsel read from the Toth case submitting that “while the member’s criminal conduct is not related to her nursing professional practice, her conduct contradicts the values of the nursing profession” and that “when working as a nurse, one holds a certain level of respect and trust of the public. A nurse must always conduct herself in an appropriate manner that, to the public eye, is reflective of the profession.” College Counsel submitted that the panel in the Toth case accepted the submission that the member’s conduct was relevant to her suitability to practice and asked the Panel to make a similar finding.

With regard to allegations #6(e), (f), (g)(i), (ii), (iii), (iv)(1), (2), (3) and (v) involving disgraceful, dishonourable and unprofessional conduct, College Counsel asked the Panel to make a finding that the Member's conduct was dishonourable and unprofessional, not disgraceful. College Counsel submitted that the member’s conduct in the Toth case, was considered disgraceful as well as dishonourable and unprofessional because the member had charges and finding of guilt whereby, she had been reminded to self-report the charges and findings, acknowledged her responsibility to do so and then disregarded this obligation during repeat offenses. College Counsel submitted that those conditions do not exist in the case before this Panel therefore, the Panel is not being asked to make a finding of disgraceful conduct. However, College Counsel submitted that it is a basic competency and expectation of nurses to report charges and findings of guilt. When the Member renewed her license and disregarded these obligations to report, she acted in an unprofessional manner. College Counsel submitted that her conduct was also dishonourable as the Member knew or ought to have known this was required but instead, she ignored this obligation.

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

The Member’s Counsel asked the Panel to accept the statements in the Agreed Statement of Facts that had been negotiated between the parties. The Member’s Counsel submitted that the criminal charge outlined in the Agreed Statement of Facts, paragraphs 10-14 and the conviction mentioned in paragraph 15 all occurred during a period from several years ago and was related to a period of active substance abuse. The Member now has access to effective treatment and has been able to recover and remain in recovery for more than 3 years since the occurrence of these events. The Member’s Counsel urged the Panel to consider that there was an active disability that was relevant to the Member’s conduct.

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), #2(a)(i), (ii), #4(a)(i), (ii), (iii), (iv)(1), (2), (3), (b)(i), (c), (d), #5(a)(i), #6(e), (f), (g)(i), (ii), (iii), (iv)(1), (2), (3) and (v) of the Notice of Hearing. As to allegations #6(e), (f), (g)(i), (ii), (iii), (iv)(1), (2), (3) and (v), the Panel finds that the Member engaged in conduct that would reasonably be regarded by members of the profession to be dishonourable and unprofessional.

Reasons for Decision

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

The facts of the case as outlined in the Agreed Statement of Facts include:

• The Member was registered with the College since August 23, 2013;

• The Member worked as a nurse in Houston, Texas from 2014 to 2017;

• On February 22, 2015, and October 19, 2015, the Member was charged with driving while intoxicated. On November 23, 2016, the Member was found guilty of driving while intoxicated. Neither the charges nor the finding of guilt were reported to the College;

• On October 28, 2015, the Member was charged with evading arrest. The charge was not reported to the College;

• On January 19, 2017, the Member was charged with assault causing bodily injury and resisting arrest. The charge was not reported to the College;

• On November 9, 2017, the Texas Board of Nursing’s Eligibility and Disciplinary Committee issued charges against the Member in that: 1) she attended work while lacking a fitness to practice due to intoxication; and 2) she had pled guilty to evading arrest. On February 13, 2018, the same committee issued an order to revoke the Member’s registration to practice in the State of Texas in connection with the charges. Neither the charges nor the Order from the Texas Board of Nursing’s Eligibility and Disciplinary Committee were reported to the College; and

• At the time of the incidents in Texas, the Member was obligated to self-report criminal charges and findings of guilt to the College (Agreed Statement of Facts, paragraph 5). The Member was also obligated to report any investigation or finding of professional misconduct in relation to the practice of nursing in any jurisdiction (Agreed Statement of Facts, paragraph 6).

Allegation #1(a) in the Notice of Hearing is supported by paragraphs 5-16 in the Agreed Statement of Facts. The Panel found that the guilty finding on November 23, 2016, of driving while intoxicated was relevant to the Member’s suitability to practice nursing. Nurses have a duty to act with integrity and in a way that would not compromise the public’s trust in the profession. Driving while intoxicated and consequently putting lives in danger does not inspire public trust in the profession nor does it show that the Member was acting with integrity. Therefore, driving while intoxicated and a finding of guilt related to this was relevant to the Member’s suitability to practice and meets the threshold of professional misconduct as defined in the Health Professions Procedural Code.

Allegations #2(a)(i), (ii), #4(a)(i), (ii), (iii), (iv)(1), (2), (3), (b)(i), (c), (d) and #5(a)(i) in the Notice of Hearing are supported by paragraphs 5-16 in the Agreed Statement of Facts. The Panel found that the Agreed Statement of Facts supported the allegations of failing to report investigations and findings of professional misconduct, as well as charges and/or findings of guilt related to driving while intoxicated, evading arrest, assault causing bodily harm and resisting arrest. Nurses acknowledge this duty to report with the annual College registration process and as a nurse registered with the College since 2013, the Member would have been aware of her duty to report. Failing to report was an act of professional misconduct.

Allegations #6(e), (f), (g)(i), (ii), (iii), (iv)(1), (2), (3) and (v) in the Notice of Hearing are supported by paragraphs 5-16 in the Agreed Statement of Facts. The Member’s conduct was relevant to her professional nursing practice as her conduct undermined the public trust for nurses to act with integrity, support public safety and uphold the values of the profession. The Panel finds that the Member’s criminal charge of driving while intoxicated, as well as her failure to report the investigation and findings of the Texas Board of Nursing’s Eligibility and Disciplinary Committee along with the various criminal charges and/or findings of guilt was unprofessional as it demonstrated a serious and persistent disregard for her professional obligations. The Member was obligated to act with integrity and in a way that would not compromise the trust of the public. Disregarding this, she drove while intoxicated. She also disregarded her obligation to report. The Panel acknowledged that at the time of the incidents, the Member was suffering from an active alcohol addiction. Her addiction affected her behavior and judgement. However, the Member’s professional obligations make her accountable for her actions regardless of her disability and her actions were unprofessional.

The Panel also finds that the Member’s conduct was dishonourable. Not reporting to the College demonstrated an element of dishonesty and deceit. The Member knew or ought to have known there was an obligation to report, and she failed to do so. The Member also 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 three months of the date that this Order becomes final.

Penalty Submissions

Submissions on penalty were made by College Counsel.

College Counsel submitted that the Joint Submission on Order also provides in Appendix “A” an undertaking and agreement by the Member for the Member’s permanent resignation as a member of the College effective from the date the Order made by the Panel becomes final (the “Undertaking”). Pursuant to this Undertaking, the Member undertakes, acknowledges and agrees to:

a) Permanently resign as a member of the College, effective from the date that the Order made by the Discipline Committee in accordance with the Joint Submission on Order becomes final;

b) Not apply for membership with the College as a Registered Nurse or Registered Practical Nurse at any time in the future;

c) Agree that the public portion of the College’s Register will indefinitely reflect that the Member entered into an Undertaking with the Executive Director to permanently resign as a member of the College as part of an agreed resolution of allegations of professional misconduct;

d) No longer have a right to the issuance or reinstatement of her Certificate of Registration from the College;

e) No longer have a right to use the title “Nurse”, “Registered Nurse”, “Registered Practical Nurse”, “RN”, “RPN” or a variation, an abbreviation or an equivalent in another language;

f) No longer have a right to hold herself out as a Nurse, Registered Nurse, Registered Practical Nurse or as a person who is qualified to practise in Ontario as a Nurse, Registered Nurse or Registered Practical Nurse;

g) No longer have a right to engage in the practice of nursing in any capacity; and

h) Agree that the College is authorized to and may, in its sole discretion, provide a copy of the Undertaking and/or its terms to a governing body that regulates nursing in Canada or elsewhere in response to an inquiry or otherwise.

In light of the Undertaking, College Counsel and the Member submitted a Joint Submission on Order requiring the Member to appear before the Panel for an oral reprimand within 3 months of the date that the Order becomes final.

The aggravating factors in this case were:

• The Member had multiple repeated instances of serious acts, including criminal charges and findings of guilt; and

• The Member had multiple breaches related to her obligation to report charges and findings of guilt.

The mitigating factors in this case were:

• The Member had no prior discipline history with the College;

• The Member took responsibility for her conduct and cooperated with the College throughout the process by entering into an Agreed Statement of Facts and a Joint Submission on Order with the College; and

• The Member suffers from a substance abuse disorder that was relevant and contributed to the incidents.

College Counsel submitted that the objectives of specific and general deterrence are met through the Member’s permanent resignation. The penalty of an oral reprimand and her commitment to not apply for membership with the College in the future is sufficient.

General deterrence is achieved through the oral reprimand and the fact that the findings will also be posted publicly on the College website. College Counsel submitted that the penalty should discourage other members of the profession sending a clear message that there are serious consequences for a failure to honour professional obligations.

College Counsel submitted that rehabilitation and remediation are not necessary as the Member is resigning, but she has shown responsibility for her conduct by cooperating with the College.

Overall, the public is protected by the resignation of the Member’s certificate of registration, her commitment to not reapply and the ability of the College to communicate this to any governing body that regulates nursing in Canada. The Member’s resignation is not a simple resignation, but has terms applied. College Counsel submitted this is the ultimate form of public protection and should inspire confidence that the College can protect the profession and the public.

College Counsel submitted the following cases to the Panel to demonstrate that the proposed penalty fell within a range of penalties that have been ordered by the Discipline Committee for similar conduct:

CNO v. Toth (Discipline Committee, 2019): In this case, the member was found guilty of disorderly conduct, resisting an officer, careless driving and failing to report charges relating to driving under the influence. The penalty included an oral reprimand, a 5-month suspension of the member’s certificate of registration, terms conditions and limitations including a minimum of 2 meetings with a Nursing Expert, review of the College’s publications and 18 months of employer notification. College Counsel submitted that this case is an example of the type of penalty that could be ordered by a panel in the absence of an undertaking to permanently resign.

CNO v. Demme (Discipline Committee, 2020): This case proceeded by way of an Agreed Statement of Facts and a Joint Submission on Order. The member misappropriated narcotics and falsified and inappropriately accessed patient health records. The penalty included an oral reprimand, and an Undertaking signed by the member to permanently resign as a member of the College.

College Counsel submitted that, in light of the Undertaking to permanently resign, the penalty is reasonable and appropriate. The penalty also appropriately reflects the aggravating and mitigating circumstances of the case and meets the goals of penalty including protection of the public.

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

The Member’s Counsel submitted that the Panel should accept the Joint Submission on Order.

The Member’s Counsel submitted that the mitigating factors were:

• The Member cooperated and entered into an Agreed Statement of Facts and a Joint Submission on Order with the College;

• The Member demonstrated accountability and saved the expense of a contested hearing;

• The Member has no prior acts of professional misconduct;

• The Member’s substance abuse disorder is a disability which is relevant and contributed to her failure to report;

• The Member has sought treatment and is 3 years clean; and

• The Member’s permanent resignation while in excess of what could otherwise be appropriate, takes into account the Member’s own decision to leave nursing.

Penalty Decision

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

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

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. In the normal course, 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.

In this case, because the Member has undertaken to permanently resign, the oral reprimand is a sufficient penalty, and no other specific deterrence is required.

Furthermore, because of the Member’s resignation, it is not necessary to consider remediation and rehabilitation in determining the appropriate penalty.

General deterrence is also addressed as the Panel concluded that had the Member’s situation been different and no Undertaking given, the Panel would have ordered a suspension, and terms, conditions and limitations on the Member’s certificate of registration which would have been in line with previous penalties.

Finally, the penalty of a reprimand is appropriate because the public is already protected through the permanent resignation and the Undertaking to never apply for registration as a nurse in Ontario again in the future.

The penalty is also in line with what has been ordered in previous cases in similar circumstances as demonstrated by the cases submitted and referred to by College Counsel.

I, Mary MacNeil, 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.