College of Nurses of Ontario v. Katelynn Pys, 2024 ONCNO 98986

DISCIPLINE COMMITTEE OF THE COLLEGE OF NURSES OF ONTARIO

PANEL: Tyler Hands, RN Chairperson

Carly Gilchrist, RPN Member

Sandra Larmour Public Member

Shannon Mantha, RN Member

BETWEEN:

COLLEGE OF NURSES OF ONTARIO ) ALYSHA SHORE for

) College of Nurses of Ontario

• and - )

KATELYNN PYS ) CARINA LENTSCH for

Registration No. AD070104 ) Katelynn Pys

) CHRISTOPHER WIRTH

) Independent Legal Counsel

) Heard: June 3, 2024, via videoconference

DECISION AND REASONS

Publication Ban

By Order of the Discipline Panel dated June 3, 2024, pursuant to s.45(3) of the Health Professions Procedural Code of the Nursing Act, 1991, no one shall publish or broadcast the name(s) of the patient(s), or any information that could disclose the identity(ies) of the patient(s), referred to orally or in any documents presented at the Discipline hearing of Katelynn Pys.

This matter was heard by a panel of the Discipline Committee (the “Panel”) of the College of Nurses of Ontario (the “College”) on June 3, 2024.

The Allegations

The allegations against Katelynn Pys (the “Member”) as stated in the Notice of Hearing dated April 9, 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 while you were employed as a Registered Practical Nurse at Cambridge Memorial Hospital in Cambridge, Ontario, you contravened a standard of practice of the profession or failed to meet the standards of practice of the profession when you:

(a) accessed personal health information in electronic medical records for approximately 166 patients, without consent, authorization or clinical purpose, between June 1, 2020 and August 10, 2021; and/or

(b) accessed the personal health information in [the Patient]’s electronic medical record without consent, authorization or clinical purpose on July 16, 2021; 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(37) of Ontario Regulation 799/93, in that while employed as a Registered Practical Nurse at Cambridge Memorial Hospital in Cambridge, Ontario, you engaged in conduct relevant to the practice of nursing that would reasonably be regarded by members of the profession as disgraceful, dishonourable or unprofessional, when you:

(a) accessed personal health information in electronic medical records for approximately 166 patients, without consent, authorization or clinical purpose, between June 1, 2020 and August 10, 2021; and/or

(b) accessed the personal health information in [the Patient]’s electronic medical record without consent, authorization or clinical purpose on July 16, 2021.

Member’s Plea

The Member admitted the allegations set out in paragraphs 1(a), 1(b), 2(a) and 2(b) in the Notice of Hearing. The Panel received a written plea inquiry which was signed by the Member. The Panel also conducted an oral plea inquiry and was satisfied that the Member’s admissions were voluntary, informed and unequivocal.

Agreed Statement of Facts

College Counsel and the Member’s Counsel advised the Panel that agreement had been reached on the facts and introduced an Agreed Statement of Facts, which reads, unedited and without exhibits mentioned therein, as follows:

THE MEMBER

1. Katelynn Pys (the “Member”) registered with the College of Nurses of Ontario (“CNO”) as a Registered Practical Nurse (“RPN”) on August 28, 2014.

2. The Member has no prior CNO disciplinary history.

THE FACILITY

3. The Member was employed as a full-time nurse at Cambridge Memorial Hospital located in Cambridge, Ontario (the “Facility”) from June 11, 2018 until her termination on August 16, 2021.

4. The Member worked on a medicine unit (the “Unit”).

INCIDENTS RELEVANT TO ALLEGATIONS OF PROFESSIONAL MISCONDUCT

Confidentiality Agreement and Privacy Training

5. The Member signed a confidentiality agreement with the Facility on May 17, 2018. She completed a privacy and confidentiality course offered by the Facility on June 4, 2018, September 4, 2019 and August 11, 2020.

The Facility’s Electronic Medical Record (EMR) Database

6. The Facility uses electronic medical records (“EMRs”) for all patients.

7. The Facility’s system tracks who accesses EMRs and what parts of an individual EMR are accessed.

Unauthorized Access to [the Patient]’s Medical Record

8. [The Patient] is an employee of the Facility. She was admitted to the Facility’s Emergency Department (“ED”) on or around July 16, 2021.

9. After receiving a report that a member of staff on the Unit reviewed [the Patient]’s records without clinical purpose or consent/authorization, the Facility conducted an audit of accesses made to [the Patient]’s EMR.

10. The audit revealed that the Member accessed [the Patient]’s EMR on July 16, 2021 between 0403 and 0411 hours. In particular, the Member accessed [the Patient]’s patient care inquiry, patient care notes, medical records, patient alerts, medication orders, and assessment forms.

Further Audit Results of Unauthorized Access to Patient Records Without Consent

11. The Facility ran a further audit of the Member’s patient records accesses from June 1, 2020 to August 10, 2021.

12. This audit identified that the Member accessed approximately 166 EMRs, without the patients’ consent, proper authorization, or clinical purpose.

13. Following the further audit, the Facility met with the Member to discuss the results. At the time, the Member could not recall any of the specific examples put to her. She admitted that sometimes she looked up patients she provided care to previously. On other occasions, she looked at patients on different units to determine the number of open beds.

14. The Facility terminated the Member’s employment.

15. If the Member were to testify, she would explain that she was a relatively new nurse to the Unit and took cues from more senior and experienced nurses. Those nurses told the Member to check the ED and ICU status boards to determine if new patients would be transferred to the Unit.

16. The Member advises that she did not realize at the time that doing so was a breach of privacy and contrary to the standards of practice.

17. The Member cooperated with CNO throughout its investigation. She admits and acknowledges that she had no clinical reason to access these EMRs, including that of [the Patient], and did not have consent or authorization to do so. As a result, the Member admits that she breached these patients’ privacy by inappropriately accessing their EMRs.

18. The Member has demonstrated insight and remorse and has voluntarily taken proactive steps to remediate. Following her termination from the Facility, the Member reviewed relevant resources, including those from CNO, and worked with a professional coach to reflect on the incidents, nurses’ privacy obligations, as well as the professional and ethical implications of privacy breaches. If the Member were to testify, she would state that she sincerely apologizes to the affected patients, the Facility, and the nursing profession for her conduct, which she deeply regrets.

CNO STANDARDS

Code of Conduct

19. 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:

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

b. Nurses work together to promote patient well-being;

c. Nurses maintain patients’ trust by providing safe and competent care;

d. Nurses work respectfully with colleagues to best meet patients’ needs;

e. Nurses act with integrity to maintain patients’ trust; and

f. Nurses maintain public confidence in the nursing profession.

20. CNO’s Code of Conduct provides, in relation to the principle requiring nurses to maintain patients’ trust by providing safe and competent care, that nurses are accountable to, and practice under, relevant laws and CNO’s standards of practice.

21. CNO’s Code of Conduct provides, in relation to the principle requiring nurses to act with integrity to maintain patients’ trust, that nurses protect the privacy and confidentiality of patients’ personal health information.

22. CNO’s Code of Conduct also 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.

23. 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

24. 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.

25. CNO’s Professional Standards further provides, in relation to the Ethics Standard, that ethical nursing care means promoting the values of patient well-being, respecting patient choice, assuring privacy and confidentiality, respecting the sanctity and quality of life, maintaining commitments, respecting truthfulness and ensuring fairness in the use of resources.

26. In addition, 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. Nurses demonstrate their leadership by providing, facilitating and promoting the best possible care/service to the public and by role-modelling professional values, beliefs and attributes.

27. 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.

Confidentiality and Privacy: Personal Health Information

28. 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:

a. Seeking information about issues of privacy and confidentiality of personal health information;

b. Maintaining confidentiality of [patients’] personal health information with members of the healthcare team, who are also required to maintain confidentiality, including information that is documented or stored electronically;

c. Collecting only information that is needed to provide care;

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

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

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

30. The Member admits and acknowledges that she contravened CNO’s Code of Conduct, Professional Standards and Privacy Standard when she accessed the EMRs for approximately 166 patients without consent, authorization or clinical purpose between June 1, 2020 and August 10, 2021, including the EMR of [the Patient].

ADMISSIONS OF PROFESSIONAL MISCONDUCT

31. The Member admits that she committed the acts of professional misconduct as alleged in paragraph 1 of the Notice of Hearing and 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 8 to 30 above.

32. The Member admits that she engaged in conduct or performed an act relevant to the practice of nursing that, having regard to all the circumstances, would reasonably be regarded by members as dishonourable and unprofessional, as alleged in paragraph 2 in the Notice of Hearing and as described in paragraphs 8 to 30 above.

College Counsel’s Submissions on Liability

College Counsel asked the Panel to accept the Agreed Statement of Facts, as well as the Member’s admissions and make findings of professional misconduct with respect to allegations #1(a), #1(b), #2(a) and #2(b) in the Notice of Hearing.

With respect to allegations #1(a) and #1(b), the Panel has the evidence of the standards with relevant excerpts that were put directly in the Agreed Statements of Facts. The Panel also has the Member’s admissions that her conduct in accessing these patients records without consent, authorization or clinical purpose was a breach of the standards of the profession in particular the Code of Conduct, the Professional Standards and the Confidentiality and Privacy - Personal Health Information Standard.

College Counsel submitted that with respect to allegations #2(a) and #2(b), the Panel must be satisfied that the conduct at issue was relevant to the act of nursing. College Counsel submitted that it was clearly relevant in that the Member accessed patient records as a result of her position as a Registered Practical Nurse (“RPN”) at Cambridge Memorial Hospital (the “Facility”) and associated access to the Facility’s electronic medical records. College Counsel submitted that secondly, members of the profession would find the conduct to be disgraceful, dishonourable or unprofessional. College Counsel submitted that the Panel does not need expert evidence to make the finding. College Counsel reminded the Panel that this provision is a disjunctive term meaning that the Panel only has to find one or two or all three in order to make a finding under these allegations. College Counsel submitted that it is the College’s position, as well as admitted by the Member that her conduct was dishonorable and unprofessional. College Counsel submitted that the Member’s conduct was unprofessional as it displayed a serious and persistent disregard for the Member’s professional obligations. College Counsel submitted that the Member’s conduct was dishonourable as the Member knew or ought to have known that her conduct fell below the standards of the profession. College Counsel submitted that the Member’s conduct was deliberate, intentional and included an element of moral failing.

College Counsel provided the Panel with the following two prior decisions from this Discipline Committee which demonstrates prior findings with similar allegations:

CNO v. Fazzari (Discipline Committee, 2022): This case proceeded by way of an Agreed Statement of Facts. The allegations in the Notice of Hearing were similar to the case before this Panel. The member accessed 57 patient records without authorization and some of these records belonged to people that the member knew. Evidence was also presented that the member used information in the health record for her own purposes. The panel found the member’s conduct to be unprofessional as it breached the College’s Professional Standards and the Confidentiality and Privacy – Personal Health Information Standard. The panel also found that the member’s conduct was dishonourable as it demonstrated an element of dishonesty and deceit through the repeated unauthorized access to private records over an extended period of time.

CNO v. Trudel (Discipline Committee, 2018): This case proceeded by way of an Agreed Statement of Facts. The allegations in the Notice of Hearing were similar to the case before this Panel. The member accessed 63 patient records without authorization and some of these records belonged to people that the member knew. Evidence was also presented that the member used information in the health record for her own purposes. The panel found the member’s conduct to be unprofessional as it breached the College’s Confidentiality and Privacy – Personal Health Information Standard. The panel also found that the member’s conduct was dishonourable as it demonstrated an element of dishonesty and deceit through the repeated unauthorized access to private records over an extended period of time.

The Member’s Counsel’s Submissions on Liability

The Member’s Counsel submitted that the Panel has admissions within the Agreed Statement of Facts and that the Member agrees with the findings before the Panel. The Member’s Counsel submitted one point of clarification. With respect to allegations #2(a) and #2(b), College Counsel outlined the test to the Panel relating to the disgraceful, dishonourable and unprofessional finding and that the Member has made admissions that her conduct was dishonourable and unprofessional. The Member’s Counsel submitted that with respect to the dishonourable conduct, there is the qualification that the Member knew or ought to have known that her conduct was not acceptable. The Member’s Counsel submitted that the Agreed Statement of Facts does address the circumstances within this case and there is no evidence that the Member knew that her conduct was dishonourable. The Member’s Counsel submitted that the Member, as noted in the Agreed Statement of Facts, ought to have known her conduct was dishonourable. The Member’s Counsel referred to the training the Member completed and that all nurses are expected to know the Professional Standards including the Confidentiality and Privacy - Personal Health Information Standard from the College.

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), #1(b), #2(a) and #2(b) of the Notice of Hearing. As to allegations #2(a) and #2(b), 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) and #1(b) in the Notice of Hearing are supported by paragraphs 8-30 and 31 in the Agreed Statement of Facts. The Member was employed as a full-time RPN at the Facility from June 11, 2018 to August 16, 2021. The Member signed a confidentiality agreement with the Facility on May 17, 2018. The Member completed annual privacy and confidentiality courses offered by the Facility in 2018, 2019 and 2020.

[The Patient] is an employee of the Facility and was admitted to the Facility's Emergency Department on or around July 16, 2021. The Member received a report that a member of staff on the Unit reviewed [the Patient]’s records without clinical purpose or consent/authorization. The Facility conducted an audit of accesses made to [the Patient]’s electronic medical record (“EMR”). The audit revealed that the Member accessed [the Patient]’s EMR on July 16, 2021 between 0403 and 0411 hours. A further audit was completed and identified that the Member accessed approximately 166 EMRs, without the patients’ consent, proper authorization, or clinical purpose.

The Code of Conduct is a standard of practice describing the accountabilities all Ontario nurses have to the public. It provides the requirement that nurses maintain patients’ trust by providing safe and competent care, that nurses are accountable to, and practice under, relevant laws and the College’s standards of practice. Nurses must act with integrity to maintain patients’ trust, and nurses protect the privacy and confidentiality of patients’ personal health information. In order to maintain public confidence in the nursing profession, nurses are accountable for their own actions and decisions.

The Professional Standards provides an overall framework for the practice of nursing and a link with other standards, guidelines and competencies. The Professional Standards further provides, that ethical nursing care means promoting the values of patient well-being, respecting patient choice, assuring privacy and confidentiality, respecting the sanctity and quality of life, maintaining commitments, respecting truthfulness and ensuring fairness in the use of resources. In addition, the College’s Professional Standards provides that nurses must demonstrate respect, trust and integrity. Nurses demonstrate their leadership by providing, facilitating and promoting the best possible care/service to the public.

The Confidentiality and Privacy - Personal Health Information 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 must comply with this standard by maintaining confidentiality of patients’ personal health information with members of the healthcare team, accessing information for patients only and not accessing information for which there is no professional purpose. Consequently, the Member’s conduct breached the Code of Conduct, the Professional Standards and the Confidentiality and Privacy - Personal Health Information Standard.

Allegations #2(a) and #2(b) in the Notice of Hearing are supported by paragraphs 8-30 and 32 in the Agreed Statement of Facts. The Panel finds that the Member’s conduct in accessing [the Patient]’s chart, as well as accessing 166 EMRs without patient consent, proper authorization or clinical purpose was clearly relevant to the practice of nursing. It was unprofessional as it demonstrated a serious and persistent disregard for her professional obligations in breaching the College’s Code of Conduct, the Professional Standards and the Confidentiality and Privacy - Personal Health Information Standard.

The Panel also finds that the Member’s conduct was dishonourable. It demonstrated an element of dishonesty through the repeated unauthorized access of health records. The Member completed yearly privacy and confidentiality courses as part of her employment at the Facility. The Member is also expected to know and follow the standards expected of the nursing profession. The Member knew or ought to have known that her conduct was unacceptable and fell below the standards of a professional.

Penalty

College Counsel and the Member’s Counsel advised 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 3 months. This suspension shall take effect from the date that this Order becomes final and shall continue to run without interruption as long as the Member remains in a practicing class.

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 this Order becomes final. 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 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 Reflective Questionnaires, online learning modules and decision tools (where applicable):

1. Code of Conduct, and

2. Confidentiality and Privacy – Personal Health Information;

iv. Before the first meeting, the Member reviews Circle of Care: Sharing Personal Health Information for Health-Care Purposes, as released by the Information and Privacy Commissioner of Ontario;

v. At least 5 days before the first meeting, or within another timeframe approved by the Expert, the Member provides the Expert with a copy of the completed Reflective Questionnaires;

vi. 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;

vii. 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;

viii. 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 Counsel’s Submissions on Penalty

College Counsel made submissions which included the following.

College Counsel reviewed the principles with the Panel on penalty. First, the penalty is intended to protect the public and enhance the public’s confidence in the College’s ability to self-regulate, it is not intended to punish the Member. College Counsel submitted that public protection is achieved through specific deterrence with respect to the Member, general deterrence for the profession at large and when appropriate remediation and rehabilitation of the Member. College Counsel submitted that in meeting those three objectives the Panel should consider a balance between the aggravating and mitigating circumstances in this case.

The aggravating factors in this case were:

• There is a significant pattern of misconduct in that the Member accessed 166 patient records without clinical purpose in a one-year period. This conduct is serious and demonstrates a breach of trust of those patients; and

• The Member’s conduct was repeated, which shows a disregard for her professional obligations.

The mitigating factors in this case were:

• The Member has no prior disciplinary history with the College;

• The Member has taken full responsibility and accountability for her conduct by entering into an Agreed Statement of Facts and a Joint Submission on Order with the College;

• The Member has expressed sincere and genuine remorse; and

• There is no evidence before the Panel that the Member disclosed any of the information contained in the charts to third parties.

Public protection is achieved through the 12 months of employer notification.

General deterrence to the membership is achieved through the 3-month suspension of the Member’s certificate of registration, which will demonstrate to the nursing profession that this type of conduct will not be tolerated, and significant penalties are imposed.

Specific deterrence to the Member is met through the oral reprimand and the 3-month suspension of the Member’s certificate of registration.

Remediation and Rehabilitation is achieved through a minimum of 2 meetings with a Regulatory Expert and review of the College’s Code of Conduct and Confidentiality and Privacy – Personal Health Information Standard.

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. Fazzari (Discipline Committee, 2022): This case proceeded by way of an Agreed Statement of Facts and a Joint Submission on Order. The allegations in the Notice of Hearing were similar to the case before this Panel. The member accessed 57 patient records without authorization and some of these records belonged to people that the member knew. Evidence was also presented that the member used information in the health records for her own purposes. The penalty included an oral reprimand, a 3-month suspension of the member’s certificate of registration, 2 meetings with a Regulatory Expert, 18 months of employer notification and 3 random spot audits of the member’s accesses to electronic health records.

CNO v. Trudel (Discipline Committee, 2018): This case proceeded by way of an Agreed Statement of Facts and a Joint Submission on Order. The allegations in the Notice of Hearing were similar to the case before this Panel. The member accessed 63 patient records without authorization and some of these records belonged to people that the member knew. Evidence was also presented to the panel that the member used information in the health records for her own purposes. The penalty included an oral reprimand, a 4-month suspension of the member’s certificate of registration, 2 meetings with a Nursing Expert and 12 months of employer notification.

College Counsel submitted that the Panel is generally expected to accept the Joint Submission on Order unless doing so would be contrary to public interest or bring the administration of justice into disrepute. College Counsel submitted that this case is not considered one of those rare cases. The penalty agreement has been arranged between experienced counsel, the agreement has been negotiated and the proposed penalty is reasonable and meets the goals and objectives of penalties and the penalty falls within prior decisions of this Discipline Committee.

The Member’s Counsel’s Submissions on Penalty

The Member’s Counsel made submissions which included the following.

The Member’s Counsel submitted that the Panel has the Joint Submission on Order which was agreed on by the Member and the College. The Member’s Counsel submitted that the guiding principle is that the Joint Submission on Order should not be interfered with lightly. The Member’s Counsel submitted that the Joint Submission on Order in this case is not one that the Panel should interfere with and that it is in line with previous decisions. The Member’s Counsel highlighted some of the mitigating factors of this case. These included:

• The Member has cooperated with the College;

• The Member has admitted to the allegations since the investigation stage;

• The Member has taken and accepted responsibility;

• The Member has taken steps to proactively remediate her misconduct; and

• The Member has demonstrated insight and remorse and has expressed an apology to the patients, the profession and the Facility.

Penalty Decision

The Panel accepted the Joint Submission on Order and made the order as 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 Panel agrees with Counsel that the Joint Submission on Order demonstrates public protection through the 12 months of employer notification. General deterrence to the membership is achieved through the 3-month suspension of the Member’s certificate of registration, which will demonstrate to the profession that this type of conduct is not tolerated, and significant penalties are imposed. Specific deterrence to the Member is achieved through the oral reprimand and the 3-month suspension of the Member’s certificate of registration. Remediation and Rehabilitation is achieved through a minimum of 2 meetings with a Regulatory Expert and review of the College’s Code of Conduct and the Confidentiality and Privacy – Personal Health Information Standard.

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 Panel recognizes that although the Member was advised by other staff to access patient charts without consent, authorization or clinical purpose, it is imperative for a nurse to maintain the high expectations of the profession and ensure that they are meeting the College standards. This ensures privacy and confidentiality are maintained for every patient.

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

I, Tyler Hands, 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.