College of Nurses of Ontario v. Tara Reid, 2024 ONCNO 125217

DISCIPLINE COMMITTEE OF THE COLLEGE OF NURSES OF ONTARIO

PANEL: Michael Hogard, RPN Chairperson Lynda Carpenter Public Member Morgan Krauter, NP Member Sherry Szucsko-Bedard, RN Member

BETWEEN:

COLLEGE OF NURSES OF ONTARIO (HAILEY BRUCKNER for College of Nurses of Ontario)

• and -

TARA REID Registration No. AB836684 (NO REPRESENTATION for Tara Reid)

(CHRISTOPHER WIRTH, Independent Legal Counsel)

Heard: July 26, 2024 via videoconference

DECISION AND REASONS

This matter was heard by a panel of the Discipline Committee (the "Panel") of the College of Nurses of Ontario (the "College") on July 26, 2024.

The Allegations

College Counsel advised the Panel that the College was seeking leave to withdraw the allegations set out in paragraphs #1(a), 2(a) and 3(a) in the Notice of Hearing dated June 13, 2024. The Panel granted this request. The remaining allegations against Tara Reid (the "Member") are as follows:

IT IS ALLEGED THAT:

1. You have committed an act of professional misconduct as provided by subsection 51(1)(c) of the Health Professions Procedural Code of the Nursing Act, 1991, S.O. 1991, c. 32, as amended and defined in subsection 1(1) of Ontario Regulation 799/93, in that, while registered as a Registered Practical Nurse and working for Alavida Lifestyles in Ottawa, Ontario (the "Facility"), you contravened a standard of practice of the profession or failed to meet the standards of practice of the profession as follows:

a. [Withdrawn];

b. In or around May or June 2020, you took a vanity owned by the Facility from Park Place Seniors' Suites and Retirement Residence for your own benefit and/or use and/or

2. You have committed an act of professional misconduct as provided by subsection 51(1)(c) of the Health Professions Procedural Code of the Nursing Act, 1991, S.O. 1991, c. 32, as amended and defined in subsection 1(8) of Ontario Regulation 799/93, while registered as a Registered Practical Nurse and working for Alavida Lifestyles in Ottawa, Ontario (the "Facility"), you misappropriated property from a client or workplace on the following occasions:

a. [Withdrawn];

b. In or around May or June 2020, you took a vanity owned by the Facility from Park Place Seniors' Suites and Retirement Residence for your own benefit and/or use and/or

3. 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 registered as a Registered Practical Nurse and working at the Facility, you engaged in conduct or performed an act, relevant to the practice of nursing, that, having regard to all the circumstances, would reasonably be regarded by members of the profession as disgraceful, dishonourable or unprofessional, as follows:

a. [Withdrawn];

b. In or around May or June 2020, you took a vanity owned by the Facility from Park Place Seniors' Suites and Retirement Residence for your own benefit and/or use.

Member's Plea

The Member admitted the allegations set out in paragraphs #1(b), 2(b) and 3(b) in the Notice of Hearing. The Panel received a written plea inquiry, which the Member signed. 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 advised the Panel that agreement had been reached on the facts and introduced an Agreed Statement of Facts, which reads, unedited and without exhibits, as follows:

THE MEMBER

1. Tara Reid (the "Member") registered with the College of Nurses of Ontario ("CNO") as a Registered Practical Nurse ("RPN") in the Temporary Class on June 25, 2012 until November 8, 2012. The Member registered in the General Class on November 8, 2012.

2. The Member worked full-time for Alavida Lifestyles in Ottawa, Ontario, from June 2014 to June 26, 2020. Alavida Lifestyles operates multiple retirement residences in the Ottawa area, including Park Place Retirement Home ("Park Place"). The Member started with Alavida Lifestyles as Director of Care in 2014. She was promoted to Corporate Nurse on June 18, 2018, and to General Manager of Park Place in September 2018.

3. On March 13, 2020, Alavida Lifestyles moved the Member out of the General Manager role and back to the Corporate Nurse role. The Corporate Nurse role operated out of the Alavida Lifestyles Head Office.

4. The Member resigned from Alavida Lifestyles on June 26, 2020.

INCIDENTS RELEVANT TO ALLEGATIONS OF PROFESSIONAL MISCONDUCT

5. In October 2018, the Member purchased a vanity for $250 through Kijiji for Alavida Lifestyles. The Member expensed the vanity and received reimbursement of $250 from Alavida Lifestyles.

6. The vanity was the property of Alavida Lifestyles and was used on the fourth floor memory care area of Park Place as an engagement station for patients.

7. In or around May or June 2020, after the Member had been moved out of her position as General Manager of Park Place, the Member contacted the Maintenance Manager at Park Place and advised that she was coming to pick up the vanity. The Member asked the Maintenance Manager for help bringing the vanity to the parking garage and putting the vanity in her van.

8. The Member was the Maintenance Manager's boss when she was General Manager at Park Place. The Maintenance Manager believed the Member had been promoted to Head Office. If the Maintenance Manager were to testify, he would say that he saw no reason to question the Member's request that he assist her to remove the vanity from Park Place. The Maintenance Manager complied with the Member's request.

9. The Maintenance Manager sent maintenance workers to pick up the vanity from the memory care floor at Park Place and bring it to the parking garage. When the Member arrived, he helped put the vanity in the Member's van. The Member left Park Place with the vanity.

10. The Member did not re-purchase the vanity, valued at approximately $250 dollars, from Alavida Lifestyles before she removed it from Park Place, nor did she have authorization to remove the vanity from Park Place for her own use. The Member did not return the vanity to Alavida Lifestyles or compensate Alavida Lifestyles after misappropriating it.

CNO STANDARDS

Code of Conduct

11. CNO's Code of Conduct is a standard of practice describing the accountabilities all Ontario nurses have to the public. The Code of Conduct consists of six principles, including:

• Nurses respect the dignity of patients and treat them as individuals;

• Nurses work together to promote patient well-being;

• Nurses maintain patients' trust by providing safe and competent care;

• Nurses work respectfully with colleagues to best meet patients' needs;

• Nurses act with integrity to maintain patients' trust and

• Nurses maintain public confidence in the nursing profession.

12. CNO's Code of Conduct further provides, in relation to the principle requiring nurses to maintain public confidence in the nursing profession, that:

• Nurses are accountable for their own actions and decisions, and

• Nurses respect the property of their patients and employers.

13. Attached as Exhibit "A" is a copy of CNO's Code of Conduct, which was in force at the time of the incidents.

Professional Standards

14. 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 and indicators that illustrate how the standard may be demonstrated pertaining to accountability, continuing competence, ethics, knowledge, knowledge application, leadership and relationships.

15. CNO's Professional Standards provides, in relation to the accountability standard statement, 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 ensuring their practice is consistent with CNO's standards of practice and guidelines as well as legislation.

16. CNO's Professional Standards further provides, in relation to the ethics standard statement, that ethical nursing includes acting with integrity, honesty and professionalism in all dealings with the patient and other health care team members.

17. 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.

18. Attached as Exhibit "B" is a copy of CNO's Professional Standards, which was in force at the time of the incidents and has since been retired.

Ethics

19. 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.

20. 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.

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

22. Attached as Exhibit "C" is a copy of CNO's Ethics Standard, which was in force at the time of the incidents and has since been retired.

23. The Member admits and acknowledges that she contravened CNO's Code of Conduct, Professional Standards and Ethics Standard when she took a vanity owned by Alavida Lifestyles from Park Place for her own benefit and use.

ADMISSIONS OF PROFESSIONAL MISCONDUCT

24. The Member admits that she committed the act of professional misconduct as alleged in paragraph 1(b) 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 23 above.

25. The Member admits that she committed the act of professional misconduct as alleged in paragraph 2(b) of the Notice of Hearing in that she misappropriated property from a workplace, as described in paragraphs 5 to 10 above.

26. The Member admits that she committed the act of professional misconduct as alleged in paragraphs 3 (b) of the Notice of Hearing, and in particular her conduct was dishonourable and unprofessional, as described in paragraphs 5 to 23 above.

OTHER

27. With the leave of the Panel of the Discipline Committee, CNO withdraws the remaining allegations in the Notice of Hearing, which are paragraphs 1(a), 2(a) and 3(a) of the Notice of Hearing.

Liability submissions

College Counsel made submissions on liability.

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 24 to 26 of the Agreed Statement of Facts and based on those facts and admissions, to make findings of professional misconduct concerning the allegations in the Notice of Hearing. College Counsel submitted that the Panel has taken the Member's written and verbal plea, which was voluntary and informed. 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 allegations #1(b) and 2(b) with the Panel. 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 and the Member's admissions that those standards were breached.

Regarding allegation #3(b), College Counsel submitted that the Member's actions were relevant to her professional duties as a nurse and constituted dishonourable and unprofessional conduct. Specifically, she was able to access the vanity she misappropriated through her role as a nurse at the Facility. Furthermore, she used her leadership position to involve staff in removing the vanity from the Facility.

The Member's conduct showed a serious and persistent disregard for her professional obligations to act with the honesty and integrity required of a nurse. The Member ought to have known that taking the vanity for her personal use was dishonest and lacked integrity.

The Member made no submissions on liability.

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(b), 2(b) and 3(b) of the Notice of Hearing. With respect to allegation #3(b), the Panel finds that the Member engaged in conduct that members would reasonably consider to be dishonourable and unprofessional.

Reasons for Decision

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

Allegation #1(b) in the Notice of Hearing is supported by paragraphs 5-24 in the Agreed Statement of Facts. The Member admitted to taking the vanity that belonged to the Facility. The Member had purchased the vanity in October 2018 for the Facility and received a reimbursement of $250.00 for this purchase. When the Member took the vanity from the Facility around May 2020 without permission, she failed to adhere to the College's Code of Conduct and Ethics Standard. The College's Code of Conduct emphasizes the importance of respecting the property of both patients and employers. The Ethics Standard further stipulates that nurses must act honestly and uphold ethical principles. The Member failed to meet the College's Code of Conduct and Ethics Standard by misappropriating the vanity. The Member breached the College's Professional Standards when she demonstrated a lack of integrity by taking the vanity from the Facility for her own personal use and gain.

Allegation #2(b) in the Notice of Hearing is supported by paragraphs 5-10 and 25 in the Agreed Statement of Facts. The Member admitted to misappropriating property from the Facility when she took the vanity without permission. The Facility had reimbursed her $250.00 for the original purchase, and the Member did not repay the Facility before removing it, which satisfies this head of professional misconduct.

With respect to allegation #3(b), the Panel finds that the Member's conduct in misappropriating the vanity from the Facility was relevant to the practice of nursing and was unprofessional, demonstrating a serious and persistent disregard for her professional obligations as set out in the Professional Standards and the Ethics Standard. The vanity belonged to her employer, the Facility, and was intended for resident use. The Member further showed disregard for her professional obligations by enlisting staff assistance to remove the vanity from the Facility and load it into her van for her personal use without permission.

The Panel also finds that the Member's conduct was dishonourable. It demonstrated an element of dishonesty and deceit by taking the Facility's vanity, without permission, for her own personal gain. The Facility had reimbursed her $250.00 for the original purchase, and the Member did not repay the Facility before removing it. The Member knew or ought to have known that her conduct was unacceptable and fell well below the standards of a professional.

Penalty

College Counsel and the Member advised that a Joint Submission on Order had been agreed upon and requested that the Panel make the following Order:

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

2. Directing the Executive Director to suspend the Member's certificate of registration for 1 month. This suspension shall take effect from the date this Order becomes final and shall continue to run without interruption as long as the Member remains in a practicing class.

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

a) The Member will attend 2 meetings with a Regulatory Expert (the "Expert") at the Member's own expense and within 6 months from the date that this Order becomes final. To comply, the Member is required to ensure that:

i. The Expert has expertise in nursing regulation and has been approved by CNO in advance of the meetings;

ii. At least 5 days before the first meeting, or within another timeframe approved by the Expert, the Member provides the Expert with a copy of:

1. the Panel's Order,

2. the Notice of Hearing,

3. the Agreed Statement of Facts,

4. this Joint Submission on Order, and

5. if available, a copy of the Panel's Decision and Reasons;

iii. Before the first meeting, the Member reviews the following CNO publications and completes the associated Practice Reflection Worksheets, online learning modules and decision tools (where applicable):

1. Code of Conduct;

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 Practice Reflection Worksheets;

v. The subject of the sessions with the Expert will include:

1. the acts or omissions for which the Member was found to have committed professional misconduct,

2. the potential consequences of the misconduct to the Member's patients, colleagues, profession and self,

3. strategies for preventing the misconduct from recurring,

4. the publications, questionnaires and modules set out above, and

5. the development of a learning plan in collaboration with the Expert;

vi. Within 30 days after the Member has completed the last session, the Member will confirm that the Expert forwards their report to CNO, in which the Expert will confirm:

1. the dates the Member attended the sessions,

2. that the Expert received the required documents from the Member,

3. that the Expert reviewed the required documents and subjects with the Member and

4. the Expert's assessment of the Member's insight into the Member's behaviour;

vii. If the Member does not comply with any one or more of the requirements above, the Expert may cancel any session scheduled, even if that results in the Member breaching a term, condition or limitation on the Member's certificate of registration;

b) For a period of 12 months from the date the Member returns to the practice of nursing, the Member will notify the Member's employers 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:

1. the Panel's Order,

2. the Notice of Hearing,

3. the Agreed Statement of Facts,

4. this Joint Submission on Order, and

5. a copy of the Panel's Decision and Reasons, once available;

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:

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

2. that they agree to notify CNO immediately upon receipt of any information that the Member has breached the standards of practice of the profession.

3. All documents delivered by the Member to CNO, the Expert or the employer(s) will be delivered by verifiable method, the proof of which the Member will retain.

College Submissions on Penalty

College Counsel made submissions that included the following.

The aggravating factors in this case were:

• The Member engaged in serious dishonesty at the expense of the Facility;

• The Member took advantage of the Facility's trust and her leadership role; and

• The Member ought to have known her conduct was wrong when she removed the vanity from the Facility.

The mitigating factors in this case were:

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

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

The proposed penalty provides for specific deterrence through:

• The oral reprimand. An oral reprimand allows the Member to gain insight into how the nursing profession and the public perceive her actions; and

• The 1 month suspension of the Member's certificate of registration.

The proposed penalty provides for general deterrence through:

• The 1 month suspension of the Member's certificate of registration. This will send a signal that this behaviour will not be accepted.

The proposed penalty provides for remediation and rehabilitation through the 2 meetings with a Regulatory Expert, as it will provide insight to the Member so she can return to an ethical practice, which is a standard that is expected of nurses.

Overall, the public is protected by the 12 months of employer notification, which will provide an additional level of oversight on the Member’s return to practice even if she changes employers. This further demonstrates to the public that the nursing profession is capable of self-governance.

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. Punchard (Discipline Committee, 2022): This case proceeded through an Agreed Statement of Facts and a Joint Submission on Order. The Member committed professional misconduct when she submitted false claims to a group benefits plan totalling $473.00. In this case, the Member not only misappropriated money but also falsified records and signed a falsified record in her professional capacity. The penalty included an oral reprimand, a 2-month suspension of the Member's certificate of registration, 2 meetings with a Regulatory Expert and 12 months of employer notification.

CNO v. Thomas (Discipline Committee, 2023): This case proceeded by way of an Agreed Statement of Facts and a Joint Submission on Order. The Member committed acts of professional misconduct when she submitted false claims to her employer's group benefits plan totalling $168.00. In this case, the Member misappropriated money and falsified records and signed a falsified record in her professional capacity. The penalty included an oral reprimand, a 2-month suspension of the Member's certificate of registration, 2 meetings with a Regulatory Expert and 12 months of employer notification.

Member's Submissions on Penalty

The Member made no submissions on penalty.

Penalty Decision

The Panel accepted the Joint Submission of Order and made the Order requested.

Reasons for Penalty Decision

There is a high threshold for departing from a Joint Submission on Order established by the Supreme Court of Canada in R. v. Anthony-Cook, 2016 SCC 43. Departing from a joint submission would require a finding that the proposed penalty would bring the administration of justice into disrepute or is otherwise contrary to the public interest.

The Panel concluded that the proposed penalty is not contrary to the public interest and does not bring the administration of justice into disrepute.

The Panel concluded that the proposed penalty is reasonable and in the public interest. It promotes public confidence in the ability of the College to regulate its members.

The Panel finds that the penalty satisfies the principles of specific and general deterrence, rehabilitation and remediation, and public protection. Specific deterrence is achieved through the oral reprimand and a 1-month suspension of the Member's certificate of registration. This sends a clear message to the Member that misappropriation of an employer's property will not be tolerated. General deterrence is achieved by the 1-month suspension of the Member's certificate of registration, which will deter the membership from participating in this type of conduct. Rehabilitation and remediation will be achieved through the 2 meetings with a Regulatory Expert and learning activities, including a review of the Code of Conduct. The public is protected through the 12 months of employer notification, which will allow employers to appropriately monitor the Member on her return to practice.

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

I, Michael Hogard, RPN, sign this decision and reasons for the decision as Chairperson of this Discipline Panel and on behalf of the members of the Discipline Panel.