College of Nurses of Ontario v. Harneet Singh, 2024 ONCNO 142095

DISCIPLINE COMMITTEE OF THE COLLEGE OF NURSES OF ONTARIO

PANEL: Sherry Szucsko-Bedard, RN Chairperson Nazlin Hirji, RN Member Lisa Donnelly, RN Member Sylvia Douglas Public Member

BETWEEN:

COLLEGE OF NURSES OF ONTARIO ) SARAH CORMAN for ) College of Nurses of Ontario

• and - )

HARNEET SINGH ) REBECCA YOUNG for REGISTRATION NO. 19205361 ) Harneet Singh ) KIMBERLEY ISHMAEL ) Independent Legal Counsel ) Heard: November 18, 2024, ) via videoconference

DECISION AND REASONS

Publication Ban

By Order of the Discipline Panel dated November 18, 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 and/ or young persons, or any information that could disclose the identities of the patients and/ or young persons referred to orally or in any documents presented at the Discipline hearing of Harneet Singh.

This matter was heard by a panel of the Discipline Committee (the “Panel”) of the College of Nurses of Ontario (the “College”) on November 18, 2024.

The Allegations

The allegations against Harneet Singh (the “Member”) as stated in the Notice of Hearing dated October 17, 2024 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 between in or around June 2020 and October 2020, during your employment as a Registered Nurse at Roy McMurtry Youth Centre, Ministry of Children, Community and Social Services in Brampton, Ontario (the “Facility”), you contravened a standard of practice of the profession or failed to meet the standard of practice of the profession in that:

(a) You failed to appropriately establish and/or maintain the boundaries of the therapeutic nurse-client relationship with Patient A by carrying on a personal relationship with Patient A while Patient A was in custody at the Facility;

(b) You brought various contraband items to Patient A, including:

i. a cellular telephone;

ii. a charging cable;

iii. cannabis e-cigarettes; and/or

iv. edible marijuana gummies;

(c) You communicated with Patient A for no clinical purpose using a personal electronic device, including using the following methods and/or platforms:

i. text messages;

ii. telephone calls;

iii. emails;

iv. FaceTime; and/or

v. Snapchat;

(d) You sent personal photos of yourself to Patient A for them to view on their contraband cellular telephone while they were in custody at the Facility; and/or

(e) You failed to report that Patient A had obtained a contraband item or contraband items through unauthorized channels while in custody at the Facility when they disclosed that information to you.

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(37) of Ontario Regulation 799/93, in that, between on or about June 2020 and October 2020, during your employment as a Registered Nurse at the Facility, you performed an act or acts relevant to the practice of nursing that, having regard to all the circumstances, would reasonably be regarded by members as disgraceful, dishonourable or unprofessional, in that:

(a) You failed to appropriately establish and/or maintain the boundaries of the therapeutic nurse-client relationship with Patient A by carrying on a personal relationship with Patient A while Patient A was in custody at the Facility;

(b) You brought various contraband items to Patient A, including:

i. a cellular telephone;

ii. a charging cable;

iii. cannabis e-cigarettes; and/or

iv. edible marijuana gummies;

(c) You communicated with Patient A for no clinical purpose using a personal electronic device, including using the following methods and/or platforms:

i. text messages;

ii. telephone calls;

iii. emails;

iv. FaceTime; and/or

v. Snapchat;

(d) You sent personal photos of yourself to Patient A for them to view on their contraband cellular telephone while they were in custody at the Facility; and/or

(e) You failed to report that Patient A had obtained a contraband item or contraband items through unauthorized channels while in custody at the Facility when they disclosed that information to you.

Member’s Plea

The Member admitted the allegations set out in paragraphs #1(a), (b)(i), (ii), (iii), (iv), (c)(i), (ii), (iii), (iv), (v), (d), (e) and #2(a), (b)(i), (ii), (iii), (iv), (c)(i), (ii), (iii), (iv), (v), (d) and (e) 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 as amended reads, unedited, as follows:

THE MEMBER

1. Harneet Singh (the “Member”) registered with the College of Nurses of Ontario (“CNO”) as a Registered Nurse (“RN”) on September 9, 2019.

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

THE FACILITY

3. The Member was employed at the Roy McMurtry Youth Centre in Brampton, Ontario (the “Facility”) from February 18, 2020 until her resignation on November 9, 2020.

4. The Facility is located in Brampton, Ontario. It is an Ontario Ministry of Children, Community and Social Services (the “Ministry”) facility that houses youth on remand and youth who have been ordered to serve a custodial sentence for committing a crime. The residents are all male, typically between the ages of 12 and 17 years old.

5. The Member worked as a casual RN in the health unit of the Facility. Her role included providing healthcare education to residents, dispensing medication, triaging, conducting intake assessments, assessing injuries, and assessing residents in crisis.

6. When the Member was hired by the Facility, she received training related to Facility policies, security protocols, personal items, managing Facility keys, and securing areas when leaving. As part of this training, she was provided with information on what items could be brought into the Facility and its secure areas.

7. The Facility’s Code of Conduct explicitly prohibits Facility staff from engaging in any personal relationship with a resident or ex-resident, or their friends and relatives, without receiving prior approval. It also prohibits staff from providing personal information to a resident, ex-resident or their friends and relatives. The Facility’s Contraband policy states that young persons in custody/detention are not permitted to have items identified as contraband, including non-prescribed drugs and cell phones or other electronic devices. It also states that staff shall not bring these items into the secure area of the Facility.

THE PATIENT

8. The Patient was a young person in custody at the Facility for whom the Member provided care.

INCIDENTS RELEVANT TO ALLEGATIONS OF PROFESSIONAL MISCONDUCT

Failing to report the Patient’s contraband cell phone

9. During her first few months at the Facility, the Patient and the Member would interact in the normal course of the Member’s duties. The Patient began confiding personal information to the Member and, in June 2020, the Patient told the Member that he had a contraband cell phone at the Facility.

10. To keep the Facility secure, residents are not permitted to have cell phones or other restricted personal items. Cell phones pose a high risk to the safety and privacy of youth in the Facility, as a cell phone could be used to disclose personal information about other residents or could be used to arrange for items to be dropped into the Facility through one of its open-air areas.

11. The Member did not report her knowledge of the Patient’s cell phone to anyone at the Facility. The Member knew that she was professionally obligated to report the Patient’s possession of the cell phone, but she did not do so.

12. If the Member were to testify, she would state that she did not report the Patient’s possession of the cell phone out of concern for her safety. According to the Member, after the Patient told the Member he had the phone he said that she was the only person at the Facility who knew about it and that if she told anyone he could get her “jumped”.

Failing to maintain the boundaries of the therapeutic nurse-client relationship with the Patient

13. From in or around June to October 2020, the Member carried on a personal relationship with the Patient.

14. In or around June 2020, shortly after the Patient told the Member about his contraband cell phone, the Patient asked for a way to contact the Member directly. The Member provided the Patient with a Snapchat account where the Patient could message her.

15. Over the next several months, the Member frequently communicated with the Patient by Snapchat, text message, phone calls, email and FaceTime video call. These communications had no clinical or therapeutic purpose. As described below, the Patient would sometimes use these communications to request the Member do certain favours for him.

16. In or around July 2020, the Member acquired a second cell phone as a means to communicate with the Patient and his family and friends in the community. The Member would participate in three-way calls with the Patient and his friends and family.

17. The Member occasionally sent personal photographs of herself to the Patient, including on July 18 and 21, 2020. Many of the photographs were sent via Snapchat, which would automatically delete the photographs the Member sent to the Patient. The Patient would also occasionally send photos he had taken of himself to the Member.

18. The Member also provided her personal email address and password so the Patient could log into the Member’s Crave TV television streaming account. At the Patient’s request, she also provided this log-in information by text message to the Patient’s brother in the community.

Bringing contraband items to the Patient

19. From in or around June to October 2020, at the Patient’s request, the Member made arrangements to bring several contraband items to the Patient while he was in custody at the Facility.

20. In or around July 2020, the Member brought a cannabis e-cigarette and four edible marijuana gummies to the Patient, which she had picked up from the Patient’s friend. The Member provided the contraband to the Patient while she was providing health education to him, by hiding it in papers which the Patient then mixed in with his schoolwork.

21. Around the same time, the Patient told the Member that his existing cell phone was not working properly and that he had arranged for another friend in the community to provide him with a new phone. At the Patient’s request, the Member picked up the new phone and a charging cable from the Patient’s friend and brought them to the Patient in the Facility.

22. In or around August 2020, the Member brought the Patient a second cannabis e-cigarette and two marijuana gummies which she obtained from a third friend of the Patient. The Member provided the e-cigarette to the Patient by hiding it in paper towel wrapped around an ice pack given to the Patient for his injured hand.

23. In or around October 2020, the Member met with the Patient’s girlfriend in the community. The Member picked up the Patient’s girlfriend from her home and drove her to Walmart to pick up print photographs of the Patient’s girlfriend, which the Member had agreed to provide to the Patient. The Member did not provide the photographs to the Patient.

24. If the Member were to testify, she would state that she was uncomfortable with her relationship with the Patient and his frequent requests for her to bring him contraband items. She would also state, however, that she was too scared to deny the Patient’s requests.

25. At no point did the Member report, document or seek assistance in respect to the Patient’s requests. At no point did the Member report the Patient’s possession of restricted personal items and contraband items.

26. The Member’s conduct was discovered during an investigation initiated by the Ministry. The Member was interviewed in the context of the Ministry investigation and subsequently cooperated with the Ministry and CNO investigations.

27. The Member admits that she entered into an inappropriate personal relationship with the Patient and breached the boundaries of the therapeutic nurse-client relationship. She further admits that her actions of bringing contraband items and restricted personal items into the Facility and failing to report her knowledge of such items in the Facility breached the Facility’s Code of Conduct and security policies and protocols and CNO standards of practice.

CNO STANDARDS

Code of Conduct

28. 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.

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

• Nurses declare any conflict of interest that could affect their judgment; and

• Nurses maintain professional boundaries with patients.

30. CNO’s Code of Conduct defines boundaries as:

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.

Therapeutic Nurse-Client Relationship

31. CNO’s Therapeutic Nurse-Client Relationship standard (the “TNCR Standard”) places the responsibility for establishing and maintaining the limits and boundaries in the therapeutic nurse-client relationship on the nurse.

32. The TNCR Standard states 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 client, or behaving in an unprofessional manner with the client.”

33. The TNCR Standard further clarifies that a nurse may cross a boundary in a number of different ways, including:

• Failing to ensure that the nurse-client relationship promotes the well-being of the client and not the needs of the nurse;

• Engaging in behaviour that suggests a special relationship between the nurse and the client; and

• Entering into a personal relationship with a client.

Professional Standards

34. 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.

35. CNO’s Professional Standards provides, in relation to the accountability standard, that nurses are accountable to the public and responsible for ensuring their practice and conduct meets the legislative requirements and the standards of the profession. Nurses are responsible for their actions and the consequences of those actions as well as for conducting themselves in ways that promote respect for the profession. Nurses demonstrate this standard by actions such as ensuring their practice is consistent with CNO’s standards of practice and guidelines as well as legislation.

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

37. CNO’s Professional Standards also provides, in relation to the relationship standard and the therapeutic nurse-client relationship, that a nurse demonstrates this standard by:

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

• Ensuring clients’ needs remain the focus of the nurse-client relationship;

• Ensuring the member’s personal needs are met outside of the therapeutic nurse-client relationship; and

• Recognizing the potential for client abuse.

ADMISSIONS OF PROFESSIONAL MISCONDUCT

38. The Member admits that she committed the acts of professional misconduct as alleged in paragraph 1 of the Notice of Hearing, in that she contravened a standard of practice of the profession or failed to meet the standard of practice of the profession, as described in paragraphs 9 to 24 above.

39. The Member admits that she committed the acts of professional misconduct as alleged in paragraph 2 of the Notice of Hearing, and in particular that her conduct was dishonourable and unprofessional, as described in paragraphs 9 to 24 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)(i), (ii), (iii), (iv), (c)(i), (ii), (iii), (iv), (v), (d), (e) and #2(a), (b)(i), (ii), (iii), (iv), (c)(i), (ii), (iii), (iv), (v), (d) and (e) of the Notice of Hearing. As to allegations #2(a), (b)(i), (ii), (iii), (iv), (c)(i), (ii), (iii), (iv), (v), (d) and (e), 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 this evidence supports findings of professional misconduct as alleged in the Notice of Hearing.

Allegations #1(a), (b)(i), (ii), (iii), (iv), (c)(i), (ii), (iii), (iv), (v), (d) and (e) in the Notice of Hearing are supported by paragraphs 9 - 27 and 38 in the Agreed Statement of Facts. The Panel found and the Member admitted that while employed as a Registered Nurse (“RN”) at the Roy McMurtry Youth Centre in Brampton, Ontario (the “Facility”), she committed professional misconduct when she: received training on the Facility’s policies and procedures, and subsequently breached those policies and procedures by failing to report a contraband cell phone when she became aware of it, by engaging in communications that were personal in nature which involved the Patient using the contraband cell phone, and by hiding and bringing other contraband items (e-cigarettes and cannabis) to the Patient. The Therapeutic Nurse-Client Relationship Standard (“TNCR Standard”) provides that a nurse should not enter a personal relationship with a patient. The Member contravened this standard, as she admitted to engaging in personal interactions with the Patient’s friends and family, and by failing to document or report any of this conduct. Through this conduct, the Member breached the College’s Code of Conduct, the TNCR Standard, and the Professional Standards.

Allegations #2(a), (b)(i), (ii), (iii), (iv), (c)(i), (ii), (iii), (iv), (v), (d) and 2(e) in the Notice of Hearing are supported by paragraphs 9 - 24 and 39 in the Agreed Statement of Facts. The Panel finds that the Member’s conduct in providing contraband items to the Patient, not reporting the Patient who had contraband items, and engaging in personal communications with the Patient and the Patient’s family and friends, was clearly relevant to the practice of nursing and was unprofessional as it demonstrated a serious and persistent disregard for her professional obligations in contravening the Code of Conduct, the TNCR Standard and the Professional Standards.

The Panel also finds that the Member’s conduct was dishonourable. It demonstrated an element of dishonesty and deceit through the seriousness and persistence of the Member’s actions, the fact that the Member knew she was breaching both the Facility’s and the College’s Code of Conduct, the Facility’s safety policies, and the College’s Professional Standards, which resulted in putting the other patients, the staff, and the Member’s colleagues at risk. 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’s Counsel 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 4 months. This suspension shall take effect from the date that this Order becomes final and shall continue to run without interruption as long as the Member remains in a practicing class.

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 a minimum of 2 meetings with a Regulatory Expert (the “Expert”) at the Member’s own expense and within 6 months from the date of this Order. If the Expert determines that a greater number of sessions are required, the Expert will advise CNO regarding the total number of sessions that are required and the length of time required to complete the additional sessions, but in any event, all sessions shall be completed within 12 months from the date of this Order. 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, and

2. Therapeutic Nurse-Client Relationship;

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 on penalty which included the following.

The aggravating factors in this case included that the Member put youth residents, staff, and colleagues at risk by not reporting a contraband item in the Patient’s possession (a cell phone), as well as by secretly bringing in contraband items (e-cigarettes and cannabis) for the Patient. Her actions were serious and repeated over time. The clinical setting was a youth detention centre where she knew and was required to follow the Facility’s policies and procedures, professional requirements and safety protocols, but she did not. Finally, the Member attempted to hide her actions, which was dishonest and discredits the nursing profession.

The mitigating factors included that the Member had no prior disciplinary history with the College. She was an inexperienced nurse at the time of the misconduct. The Member accepted responsibility, admitted to her actions by entering into an Agreed Statement of Facts and a Joint Submission on Order with the College, co-operated with the College, and expressed remorse. Finally, the Member is committed to the profession and her conduct since this situation has contributed to the profession.

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. Blaney (Discipline Committee, 2016): This case proceeded by way of an Agreed Statement of Facts and a Joint Submission on Order. The member had a personal relationship with an adult client in a correctional facility. This case involved a cell phone, three-way calls, letters, and a romantic element to the communications. The situation created a serious safety risk and involved manipulative behaviour. The penalty included a four-month suspension of the member’s certificate of registration, an oral reprimand, two meetings with a Nursing Expert and 12 months of employer notification.

CNO v. Premji (Discipline Committee, 2017): This case proceeded by way of an Agreed Statement of Facts and a Joint Submission on Order. The misconduct at issue occurred in a hospital pediatric emergency room setting and involved a 16-year-old youth. In this case, the member showed the patient a cell phone and allowed the patient to watch an “R-rated” movie on his iPad. The member exchanged phone numbers with the patient prior to his discharge, and asked the patient for the contact information of his cannabis dealer. The penalty included a three-month suspension of the member’s certificate of registration, an oral reprimand, two meetings with a Nursing Expert and 12 months of employer notification.

CNO v. O’Connell (Discipline Committee, 2019): This case involved a patient living in supportive housing, and proceeded by way of an Agreed Statement of Facts and a Joint Submission on Order. The member was an outreach nurse who engaged in a personal relationship with the patient, including a high volume of texts and phone calls, during which personal information was disclosed, and engaged in a personal outing with the patient that was not documented. In this case, the member did seek consultation but failed to disengage with the client. When communication ceased with the client, it was distressing for him. This case involved documentation breaches, but not contraband items. The penalty included a five-month suspension of the member’s certificate of registration, an oral reprimand, two meetings with a Regulatory Expert and 12 months of employer notification.

Member’s Submissions on Penalty

The Member’s Counsel indicated that she agreed with the College’s submissions. The Member’s Counsel submitted the following mitigating factors:

• The Member was young and practicing in a unique practice setting;

• The Member was uncomfortable with the situation but did not disclose it for fear of retribution because the Patient had indicated he could have her “jumped” and so she was afraid for her safety;

• The Member was relieved when everything came out and she was truthful and cooperative. The Member entered into an Agreed Statement of Facts and a Joint Submission on Order with the College, which saved resources and witnesses having to testify; and

• The Member has been working at a hospital for four years on a secure mental health unit where security is paramount, where she has the support of her employer and colleagues, has demonstrated an ability to adhere to facility standards and guidelines and has had no reports or complaints.

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.

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, rehabilitation and remediation, and public protection.

The proposed penalty provides for general deterrence through the four-month suspension of the Member’s certificate of registration, which demonstrates to all members the seriousness of the breaches and the consequences that follow such breaches.

The proposed penalty provides for specific deterrence through the oral reprimand during which the Member was cautioned by the Panel about her obligations to the profession and the public and by the four-month suspension of the Member’s certificate of registration. This penalty will provide the Member with an opportunity to reflect on her behavior and gain a better understanding of how her actions are perceived by the public and her peers so that this misconduct is not repeated.

The proposed penalty provides for remediation and rehabilitation through a minimum of two meetings with a Regulatory Expert, where the Member will reflect on her conduct and develop a learning plan, which will support her learning and safe return to nursing practice.

Overall, the public is protected through the 12 months of employer notification, which serves to protect the public through close monitoring of her practice and because the goals of penalty are met, the Member will return to ethical and safe practice.

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.

I, Sherry Szucsko-Bedard, 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.