College of Nurses of Ontario v. Petr Romanchik, 2024 CanLII 131475

DISCIPLINE COMMITTEE OF THE COLLEGE OF NURSES OF ONTARIO

PANEL: Mary MacNeil, RN Chairperson Lynda Carpenter Public Member Sylvia Douglas Public Member Sarah Louwagie, RPN Member Kimberly Wagg, RPN Member

BETWEEN:

COLLEGE OF NURSES OF ONTARIO JESSICA ROHER for College of Nurses of Ontario

• and -

PETR ROMANCHIK Registration No. AG298390 NO REPRESENTATION for Petr Romanchik

CHRISTOPHER WIRTH Independent Legal Counsel

Heard: September 13, 2024, via videoconference

DECISION AND REASONS

Publication Ban

By Order of the Discipline Panel dated September 13, 2024, pursuant to subsection s.45(3) of the Health Professions Procedural Code of the Nursing Act, 1991, no one shall publish or broadcast the names of the patients, or any information that could disclose their identities, referred to orally or in any documents presented at the Discipline hearing of Petr Romanchik.

This matter was heard by a panel of the Discipline Committee (the “Panel”) of the College of Nurses of Ontario (the “College”) on September 13, 2024.

The Allegations

The allegations against Petr Romanchik (the “Member”) as stated in the Notice of Hearing dated August 7, 2024 are as follows:

IT IS ALLEGED THAT:

1. You have committed an act of professional misconduct as provided by subsection 51(1)(b.1) of the Health Professions Procedural Code of the Nursing Act, 1991, S.O. 1991, c. 32, as amended, in that while practicing as a Registered Practical Nurse at St. Joseph’s Health Care London in London, Ontario, you sexually abused a patient, in that in or about February 2022:

(a) you masturbated in the presence of Patient A by videochat;

(b) you encouraged Patient A to masturbate in your presence by videochat;

(c) you made remarks of a sexual nature towards Patient A;

(d) you requested and/or received personal and/or sexual pictures of Patient A;

(e) you requested and/or received a pair of Patient A’s used underwear; and/or

(f) you engaged in touching of a sexual nature with respect to Patient A, including but not limited to touching Patient A’s pubic and/or genitals and/or buttocks region for no clinical purpose.

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(1) of Ontario Regulation 799/93, in that while practicing as a Registered Practical Nurse at St. Joseph’s Health Care London in London, Ontario, you contravened a standard of practice of the profession or failed to meet the standards of practice of the profession in that in or about February 2022:

(a) you masturbated in the presence of Patient A by videochat;

(b) you encouraged Patient A to masturbate in your presence by videochat;

(c) you made remarks of a sexual nature towards Patient A;

(d) you requested and/or received personal and/or sexual pictures of Patient A;

(e) you requested and/or received a pair of Patient A’s used underwear;

(f) you engaged in touching of a sexual nature with respect to Patient A, including but not limited to touching Patient A’s pubic and/or genitals and/or buttocks region for no clinical purpose; and/or

(g) you accessed personal health information for Patient A without consent, authorization and/or professional purpose.

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 practicing as a Registered Practical Nurse at St. Joseph’s Health Care London in London, Ontario, you engaged in conduct that would reasonably be regarded by members of the profession as disgraceful, dishonourable or unprofessional with respect to the following incidents:

(a) you masturbated in the presence of Patient A by videochat;

(b) you encouraged Patient A to masturbate in your presence by videochat;

(c) you made remarks of a sexual nature towards Patient A;

(d) you requested and/or received personal and/or sexual pictures of Patient A;

(e) you requested and/or received a pair of Patient A’s used underwear;

(f) you engaged in touching of a sexual nature with respect to Patient A, including but not limited to touching Patient A’s pubic and/or genitals and/or buttocks region for no clinical purpose; and/or

(g) you accessed personal health information for Patient A without consent, authorization and/or professional purpose.

Member’s Plea

The Member admitted the allegations set out in paragraphs 1(a), (b), (c), (d), (e), (f), 2(a), (b), (c), (d), (e), (f), (g) and 3(a), (b), (c), (d), (e), (f) and (g) 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 advised the Panel that agreement had been reached on the facts and introduced an Agreed Statement of Facts, which as amended reads, unedited and without exhibits mentioned therein, as follows:

THE MEMBER

1. Petr Romanchik (the “Member”) registered with the College of Nurses (“CNO”) as a Registered Practical Nurse (“RPN”) on September 22, 2017. The Member resigned his certificate of registration with CNO on August 10, 2023.

THE FACILITY

2. At the time of the incidents, the Member was employed at St. Joseph’s Health Care London – Parkwood Institute located in London, Ontario (the “Facility”).

3. The Member began working at the Facility as a housekeeper on February 14, 2006. On or around November 3, 2017, the Member started working at the Facility as an RPN.

4. The Member’s employment was terminated on February 28, 2022, in relation to the incidents set out below.

5. At the time of the incidents, the Member was working in the Facility’s Mental Health H3 unit (the “Unit”). The Unit is a 24-bed inpatient mental health unit. Patients can be involuntarily or voluntarily admitted to the Unit.

INCIDENTS RELEVANT TO ALLEGATIONS OF PROFESSIONAL MISCONDUCT

Patient A

6. Patient A (the “Patient”) was a [ ] female patient who was admitted to the Facility [ ], on an involuntary basis under a Form 1 because she had threatened or was threatening to cause herself harm and had a plan [ ].

7. The Patient had diagnoses of major depressive disorder, persistent depressive disorder, anorexia nervosa, binge purge subtype by history, obsessive compulsive disorder by history, generalized anxiety disorder by history, alcohol use disorder in sustained remission, and borderline personality disorder.

8. In December 2021, the Patient was transferred to the Unit, where she stayed on an involuntary basis until she was discharged from the Unit [ ].

9. On December 27, 2021 and January 24, 2022, the Member was assigned to the Patient, provided care to the Patient and documented in her medical record.

Relationship with the Patient

10. Starting in or around late December 2021, the Member began flirting with the Patient. On various occasions between December 2021 and February 2022, the Member complimented the Patient’s hair, implied that he had a dream about her, and told the Patient that she was blushing. The Member also winked at the Patient and touched her shoulder without a clinical purpose.

11. On or around February 11, 2022, the Patient added the Member on Snapchat at the Member’s request. The Member’s Snapchat username was “funfriends22”.

12. Snapchat is a social media platform on which users can exchange messages, photographs, and videos. Messages, photographs and videos that users exchange on Snapchat disappear shortly after they are viewed. A recipient can save messages, photographs and videos; however, Snapchat notifies the sender if the recipient saves a message, photograph or video.

13. Between on or around February 11 and 18, 2022, the Patient and the Member exchanged messages over Snapchat. These messages included text messages, photographs, and videos.

14. The Member sent the Patient messages over Snapchat during this time that were of a personal and/or sexual nature, including but not limited to the following messages:

• “First time I saw you, thought Fuck she’s hot, is she act or new nurse”;

• “I wanna fuck bad [/] Like really bad”;

• “Wanna eat your pussy out [/] To begin [/] Why not [/] Rest comes later [/] ”;

• When the Patient was holding out her t-shirt to show another patient what was written on her shirt, the Member messaged the Patient, “Do that again [/] But higher [/] I want what’s under that”; and

• The Member messaged the Patient that he wanted to touch her and said that she was “welcome” to touch him.

15. On more than one occasion between February 11 and 18, 2022, the Member and the Patient exchanged personal and/or sexual photographs and videos, including but not limited to:

• The Patient sent the Member a photograph in which the Patient was half naked in the shower;

• The Member asked the Patient to send a photograph of herself with makeup on, which she did. In response, the Member told the Patient that she “looked really nice”;

• The Member sent the Patient a photograph of himself in his boxers;

• The Member sent the Patient a video of himself making a gesture with his mouth and tongue that implied that he wanted to perform oral sex on the Patient;

• The Member sent the Patient videos of himself masturbating; and

• The Member sent the Patient at least one video and/or photograph of his penis and ejaculate.

16. On or around February 13, 2022, the Member participated in a live video call with the Patient over Snapchat in which the Member told the Patient to remove her top, which she did. During this live video call, the Member masturbated, showed the Patient his penis and ejaculate, and encouraged the Patient to masturbate, which she did.

17. On or around February 14, 2022, the Member messaged the Patient over Snapchat and asked the Patient to give him a pair of her used underwear so that he could “get off to it” or words to that effect. The Patient met the Member in the laundry room on the Unit and gave him a pair of her used underwear.

18. The Member brought the Patient’s underwear home. On or around February 16, 2022, the Member sent a picture of the Patient’s underwear to the Patient by Snapchat with a message that said he could not wait to “eat the pussy that they belonged to” or words to that effect. The Member returned the underwear to the Patient on or around February 17, 2022.

19. On or around February 16 or 17, 2022, the Member sent a message to the Patient on Snapchat that said, “maybe one day I’ll make you really wet and maybe you’d share another pair”, referring to the Patient providing him with another pair of her underwear.

20. Finally, on one occasion between February 13, 2022 and February 17, 2022, the Member met the Patient in the laundry room and touched the Patient’s vaginal area and buttocks over her underwear for no clinical purpose.

Accessing the Patient’s personal health information

21. On February 13, 2022, the Member accessed the Patient’s medical chart. At the time, the Member was not in the Patient’s circle of care, he did not have clinical or professional purpose for accessing her chart, and the Patient did not consent to the Member accessing her chart.

22. The Member spent 46 minutes and 45 seconds viewing the Patient’s chart, during which time he viewed the Patient’s Medication Administration Record, clinical documentation list and clinical documentation.

HEALTH PROFESSIONS PROCEDURAL CODE

23. The Health Professions Procedural Code, Schedule 2 to the Regulated Health Professions Act, 1991, SO 1991, c 18 (“Code”), defines sexual abuse of a patient by a member in s. 1(3) as:

(a) sexual intercourse or other forms of physical sexual relations between the member and the patient,

(b) touching, of a sexual nature, of the patient by the member, or

(c) behavior or remarks of a sexual nature by the member towards the patient.

24. Subsection 1(6) of the Code provides that a “patient”, without restricting the ordinary meaning of the term, includes:

(a) an individual who was a member’s patient within one year or such longer period of time as may be prescribed from the date on which the individual ceased to be the member’s patient, and

(b) an individual who is determined to be a patient in accordance with the criteria in any regulations made under clause 43(1)(o) of the Regulated Health Professions Act, 1991.

25. The regulation Patient Criteria Under Subsection 1(6) of the Health Professions Procedural Code, O Reg 260/18, which is made under clause 43(1)(o), sets out the criteria for determining whether an individual is a patient for the purposes of subsection 1(6) of the Code. Section 1 of this regulation provides that an individual is a patient of a member if there is direct interaction between the member and the individual and any of the following conditions are satisfied:

• The member has, in respect of a health care service provided by the member to the individual, charged or received payment from the individual or a third party on behalf of the individual;

• The member has contributed to a health record or file for the individual;

• The individual has consented to the health care service recommended by the member; or

• The member prescribed a drug for which a prescription is needed to the individual.

CNO STANDARDS

Code of Conduct

26. 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.

27. Regarding the principle requiring nurses to act with integrity to maintain patients’ trust, the Code of Conduct provides that:

• Nurses protect the privacy and confidentiality of patients’ personal health information;

• Nurses maintain professional boundaries with patients; and

• Nurses do not engage in any sexual relationship with patients while caring for them. This law stays in effect for one year after the end of the nurse-patient relationship.

28. The Code of Conduct provides the following definition of “boundaries” in a nurse-patient relationship:

Boundaries: The points when a relationship changes from professional and therapeutic to unprofessional and personal. Therapeutic nurse-patient relationships put patients’ needs first. Crossing a boundary means a nurse is misusing their power and trust in the relationship to meet personal needs or behaving in an unprofessional manner with the patient. Crossing a boundary can be intentional or unintentional.

29. The Code of Conduct provides the following definition of “personal health information”:

Personal health information: Any identifying information about patients’ physical or mental health, including information about the health history of their family.

30. Attached as Exhibit “A” is a copy of CNO’s Code of Conduct that was in force at the time of the incidents.

Professional Standards

31. CNO’s Professional Standards, in force at the time of the incidents, 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.

32. 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 meet 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. A nurse demonstrates this standard by ensuring their practice is consistent with CNO’s standards of practice and guidelines as well as legislation.

33. CNO’s Professional Standards further provides, in relation to the ethics standard, that ethical nursing includes acting with integrity, honesty and professionalism in all dealings with the patient and other health care team members. A nurse demonstrates having met this standard by identifying ethical issues and communicating them to the healthcare team.

34. CNO’s Professional Standards provides, in relation to the relationship standard and the therapeutic nurse-patient relationship, that the patient’s needs are the focus of the relationship. A nurse demonstrates this standard by:

• Maintaining boundaries between professional therapeutic relationships and non-professional personal relationships;

• Ensuring [patients’] needs remain the focus of nurse-[patient] relationships; and

• Ensuring his or her personal needs are met outside of the therapeutic nurse-[patient] relationships.

35. In addition, CNO’s Professional Standards further provides, in relation to the leadership standard, that a nurse demonstrates leadership role-modelling professional values, beliefs and attributes.

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

Therapeutic Nurse-Client Relationship

37. CNO’s Therapeutic Nurse-Client Relationship Standard (“TNCR Standard”), contains four standard statements which describe nurses’ accountabilities with respect to therapeutic communication, patient-centred care, maintaining boundaries and protecting the patient from abuse. The TNCR Standard provides that the nurse-patient relationship is built on trust, respect, empathy and professional intimacy and requires the appropriate use of power inherent in the care provider’s role.

38. CNO’s TNCR Standard defines a boundary in the nurse-patient relationship as “the point at which the relationship changes from professional and therapeutic to unprofessional and personal.” CNO’s TNCR Standard places the responsibility for establishing and maintaining the limits and boundaries in the therapeutic nurse-patient relationship on the nurse. CNO’s TNCR Standard provides that:

Crossing a boundary means that the care provider is misusing the power in the relationship to meet his/her personal needs, rather than the needs of the [patient], or behaving in an unprofessional manner with the [patient].

39. CNO’s TNCR Standard provides, in relation to maintaining boundaries, that a nurse meets this standard by:

• Setting and maintaining the appropriate boundaries within the relationship, and helping [patients] understand when their requests are beyond the limits of the therapeutic relationship;

• Abstaining from disclosing personal information, unless it meets an articulated therapeutic need of the [patient];

• Continually clarifying her/his role in the therapeutic relationship, especially in situations in which the [patient] may become unclear about the boundaries and limits of the relationship;

• Consulting with colleagues and/or the manager in any situation in which it is unclear whether a behavior may cross a boundary of the therapeutic relationship, especially circumstances that include self-disclosure or giving a gift to or accepting a gift from a [patient]; and

• Ensuring that the nurse-[patient] relationship and nursing strategies are developed for the purpose of promoting the health and well-being of the [patient] and not to meet the needs of the nurse, especially when considering self-disclosure, giving a gift to or accepting a gift from a [patient].

40. CNO’s TNCR Standard defines abuse as:

[T]he misuse of the power imbalance intrinsic in the nurse-[patient] relationship. It can also mean the nurse betraying the [patient]’s trust, or violating the respect or professional intimacy inherent in the relationship, when the nurse knew, or ought to have known the action could cause, or could be reasonably expected to cause physical, emotional or spiritual harm to the [patient].

41. CNO’s TNCR Standard provides that abuse may be verbal, emotional, physical, sexual, financial, or take the form of neglect. The TNCR Standard further provides that sexual abuse includes, but is not limited to, consensual and non-consensual:

• Sexually demeaning, seductive, suggestive, exploitative, derogatory or humiliating behavior, comments or language toward a [patient];

• Touching of a sexual nature or touching that may be perceived by the [patient] or others to be sexual;

• Sexual intercourse or other forms of sexual contact with a [patient]; and

• Non-physical sexual activity such as viewing pornographic websites with a [patient].

42. CNO’s TNCR Standard requires nurses to protect the patient from harm by ensuring that abuse is prevented or stopped and reported. With respect to protecting the patient from abuse, a nurse demonstrates having met the TNCR Standard by:

• Not entering a friendship, or a romantic, sexual or other personal relationship with a [patient] when a therapeutic relationship exists; and

• Not engaging in behaviors with a [patient] or making remarks that may reasonably be perceived by other nurses and/or others to be romantic, sexually suggestive, exploitive and/or sexually abusive (for example, spending extra time together outside of the [patient’s] care plan).

43. Attached as Exhibit “C” is a copy of CNO’s TNCR Standard that was in force at the time of the incidents.

Confidentiality and Privacy: Personal Health Information

44. CNO’s Confidentiality and Privacy - Personal Health Information Standard (“Privacy Standard”) largely incorporates the Personal Health Information Protection Act, 2004. The Privacy Standard provides that nurses have ethical and legal responsibilities to maintain the confidentiality and privacy of patient health information obtained while providing care. It requires that personal health information be kept confidential and secure. Nurses comply with the Privacy Standard by:

• Collecting only information that is needed to provide care;

• Accessing information for her/his [patients] only and not accessing information for which there is no professional purpose; and

• Safeguarding the security of computerized, printed or electronically displayed or stored information against theft, loss, unauthorized access or use, disclosure, copying, modification, or disposal.

45. Attached as Exhibit “D” is a copy of CNO’s Privacy Standard which was in force at the time of the incidents.

Contravention of CNO Standards

46. The Member admits and acknowledges that he contravened CNO’s Code of Conduct, Professional Standards, and TNCR Standard when he:

• masturbated in the presence of the Patient by videochat;

• encouraged the Patient to masturbate in his presence by videochat;

• made remarks of a sexual nature towards the Patient;

• requested and received personal and sexual pictures of the Patient;

• requested and received a pair of the Patient’s used underwear; and

• engaged in touching of a sexual nature with respect to the Patient including but not limited to touching her pubic and genitals and buttocks regions for no clinical purpose.

47. The Member further admits and acknowledges that he contravened CNO’s Code of Conduct, Professional Standards, and Privacy Standard when he accessed the personal health information of the Patient without consent, authorization or professional purpose.

ADMISSIONS OF PROFESSIONAL MISCONDUCT

48. The Member admits that he committed the acts of professional misconduct as alleged in paragraphs 1(a)-1(f) of the Notice of Hearing in that he sexually abused the Patient, as described in paragraphs 6 to 20 and 23-25 above.

49. The Member admits that he committed the acts of professional misconduct as alleged in paragraphs 2(a)-2(g) of the Notice of Hearing in that he contravened a standard of practice of the profession or failed to meet the standards of practice of the profession, as described in paragraphs 6 to 47 above.

50. The Member admits that he committed the acts of professional misconduct as alleged in paragraphs 3(a)-3(g) of the Notice of Hearing, and in particular his conduct was disgraceful, dishonourable and unprofessional, as described in paragraphs 6 to 47 above.

Decision

The College bears the onus of proving the allegations in accordance with the standard of proof, that being the balance of probabilities based upon clear, cogent and convincing evidence.

Having considered the evidence and the onus and standard of proof, the Panel finds that the Member committed acts of professional misconduct as alleged in paragraphs 1(a), (b), (c), (d), (e), (f), 2(a), (b), (c), (d), (e), (f), (g) and 3(a), (b), (c), (d), (e), (f), and (g) of the Notice of Hearing. As to allegations #3(a), (b), (c), (d), (e), (f) and (g), the Panel finds that the Member engaged in conduct that would reasonably be regarded by members of the profession to be disgraceful, 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.

Allegations #1(a), (b), (c), (d), (e) and (f) in the Notice of Hearing are supported by paragraphs 6 - 20, 23 -25 and 48 in the Agreed Statement of Facts. The Member admitted that in February 2022 while employed at St. Joseph’s Health Care London – Parkwood Institute (the “Facility”) he sexually abused Patient A. The Panel found that the Member’s conduct as set out in paragraphs 6 - 20 of the Agreed Statement of Facts constituted sexual abuse when he:

1. masturbated in the presence of Patient A by videochat;

2. encouraged Patient A to masturbate in his presence by videochat;

3. made remarks of a sexual nature towards Patient A;

4. requested and/or received personal and/or sexual pictures of Patient A;

5. requested and/or received a pair of Patient A’s used underwear; and

6. engaged in touching of a sexual nature with respect to the Patient including but not limited to touching her pubic and genitals and buttocks regions for no clinical purpose.

This conduct constitutes sexual abuse as defined in the Health Professions Procedural Code and reproduced in the Agreed Statement of Facts at paragraphs 23 - 25, as well as the Member’s admission at paragraphs 48 of the Agreed Statement of Facts.

Allegations #2(a), (b), (c), (d), (e), (f) and (g) in the Notice of Hearing are supported by paragraphs 6 - 47 and 49 in the Agreed Statement of Facts. The Member admitted that he contravened a standard of practice of the profession or failed to meet the standards of practice of the profession. The Panel found that the Member contravened the standards of practice as set out in the Agreed Statement of Facts and specific to the Health Professions Procedural Code when he touched Patient A in a sexual manner as set out at paragraph 23 of the Agreed Statement of Facts and where Patient A met the definition of a patient as set out at paragraph 24 of the Agreed Statement of Facts.

The Member contravened the Code of Conduct – Exhibit “A”, as set out at paragraphs 26 - 29 of the Agreed Statement of Facts when he contravened the six principles of the Code of Conduct specific to paragraph 26 and failed to protect the privacy of Patient A and to respect the therapeutic versus personal boundaries with Patient A.

The Member contravened the Professional Standards - Exhibit “B”, as set out at paragraphs 31 - 35 of the Agreed Statement of Facts when he contravened the seven broad standard statements as set out at paragraph 31 and failed to maintain integrity and professionalism and meet the needs of Patient A who was in a vulnerable position.

The Member contravened the Therapeutic Nurse-Client Relationship Standard (“TNCR Standard”) – Exhibit “C”, as set out at paragraphs 37 - 42 of the Agreed Statement of Facts when he contravened the four standard statements as set out at paragraph 37 in that his conduct reflected a misuse of power in the relationship with Patient A to meet his personal needs rather than the needs of his patient.

The Member contravened the Confidentiality and Privacy - Personal Health Information Standard (“Privacy Standard”) - Exhibit “D”, as set out at paragraph 44 of the Agreed Statement Facts when he failed to protect the privacy of Patient A by accessing Patient A’s personal health information without consent and for no therapeutic reason.

Allegations #3(a), (b), (c), (d), (e), (f) and (g) in the Notice of Hearing are supported by paragraphs 6 - 47 and 50 in the Agreed Statement of Facts. The Panel finds that the Member’s conduct was relevant to the practice of nursing as he misused his position of power to repeatedly take advantage of a vulnerable patient by way of a sexual relationship and was unprofessional as it demonstrated a serious and persistent disregard for his professional obligations in contravening the Health Professions Procedural Code, the Code of Conduct, the Professional Standards, the TNCR Standard and the Privacy Standard.

The Panel also finds that the Member’s conduct was dishonourable. It demonstrated an element of moral failing when he sexually abused Patient A and accessed Patient A’s personal health information without consent, authorization or professional purpose. The Member knew or ought to have known that his conduct was unacceptable and fell well below the standards of a professional.

Finally, the Panel finds that the Member’s conduct was disgraceful as it shames the Member and by extension the profession. The Member’s conduct of misusing his position of power to repeatedly take advantage of a vulnerable patient by way of a sexual relationship casts serious doubt on the Member’s moral fitness and inherent ability to discharge the higher obligations the public expects of the profession. The Member knew or ought to have known that the public and the membership at large would consider this conduct as egregious in nature.

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. Requiring the Member to reimburse CNO for funding provided for Patient A under the program required by s. 85.7 of the Health Professions Procedural Code, up to the amount of $5,000, if Patient A accesses the fund.

3. Directing the Executive Director to immediately revoke the Member’s certificate of registration.

College Submissions on Penalty

College Counsel made submissions which included the following:

The aggravating factors in this case were:

• The Member engaged and pursued Patient A for the purpose of sexual encounters on multiple occasions;

• The Member exploited his position of power over a vulnerable patient within his circle of care for his own gratification;

• The Member sent text messages of no therapeutic value and of a sexual nature by way of Snapchat, a site that deletes communications automatically within 24 hours;

• The Member breached the boundaries of the nurse-patient relationship;

• The Member breached Patient A’s privacy by looking through her chart for no therapeutic reason and without consent; and

• The Member’s conduct was a significant breach of the standards and conduct that would be considered disgraceful, dishonourable and unprofessional.

The mitigating factors in this case were:

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

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

• The Member resigned his certificate of registration voluntarily.

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. Rodgers (Discipline Committee, 2018): This hearing proceeded by way of an Agreed Statement of Facts and a Joint Submission on Order. This case was very similar to the case before this Panel in that the allegations involved a breach of standards specific to the boundaries of the therapeutic nurse-client relationship and sexual abuse. The member exchanged messages, shared photos and videos with the patient, engaged in masturbation and encouraged masturbation online and in person with the patient. The penalty included an oral reprimand, reimbursement for therapy for the patient and mandatory revocation of the member’s certificate of registration, which is the same penalty proposed in the case before this Panel.

CNO v. Pezzano (Discipline Committee, 2020): This hearing proceeded by way of an Agreed Statement of Facts and a Joint Submission on Order. The allegations in this case involved a breach of standards specific to the boundaries of the therapeutic nurse-client relationship and sexual abuse. The member engaged in behaviour and remarks of a sexual nature that included touching and a romantic relationship. The penalty included an oral reprimand, reimbursement for therapy for the patient and mandatory revocation of the member’s certificate of registration, which is the same penalty proposed in the case before this Panel.

CNO v. Kozlov (Discipline Committee, 2012): This was a contested hearing as the member denied the allegations. The member engaged in behaviour of a sexual nature that included the removal of the patient’s brief such that it exposed the patient’s buttocks while the member engaged in self-masturbation. The penalty included an oral reprimand and mandatory revocation of the member’s certificate of registration.

CNO v. Laroa (Discipline Committee, 2023): This hearing proceeded by way of an Agreed Statement of Facts and a Joint Submission on Order. This case involved a breach of standards specific to the boundaries of the therapeutic nurse-client relationship and sexual abuse. The member engaged in behaviour of a sexual nature that included texting and sexual intercourse with a patient, as well as sexual harassment of a colleague. The penalty included an oral reprimand and mandatory revocation of the member’s certificate of registration.

Member’s Submissions on Penalty

The Member made no submissions.

Penalty Decision

The Panel accepted the Joint Submission on 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.

Having concluded that the Member sexually abused Patient A and that the sexual abuse consisted of or included one or more of the sexual conduct listed in Section 51(5)(3) of the Health Professions Procedural Code (the “Code”), the Panel is required by Section 51(5) to reprimand the Member and revoke his certificate of registration. These are minimum mandatory penalty terms, which the Panel orders, and do not preclude the Panel from making other orders under Section 51(2) including requiring the Member to reimburse the College for funding provided for Patient A under the program required under section 85.7 of the Code.

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 nurses.

The Panel finds that the proposed penalty satisfies the penalty goals of specific and general deterrence by providing reassurance to all members and to the public that this type of conduct will not be tolerated. It is designed to promote public confidence in the ability of the College to regulate nurses and to protect the public.

The proposed penalty provides for specific deterrence to the Member through revocation of the Member’s certificate of registration.

Overall, the public is protected as the Member will no longer be able to practice nursing.

The Panel acknowledges that the Member has co-operated with the College and, by agreeing to the facts and a proposed penalty, has accepted responsibility, which is a mitigating factor.

The penalty is in line with the range of what has been ordered in previous similar cases 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.