College of Nurses of Ontario v. Abello, 2025 ONCNO 152779

DISCIPLINE COMMITTEE OF THE COLLEGE OF NURSES OF ONTARIO

PANEL: Grace Fox, NP Chairperson

Randall Burke Public Member

Tanya Dion, RN Member

Sam Jennings, RPN Member

Lalitha Poonasamy Public Member

BETWEEN:

COLLEGE OF NURSES OF ONTARIO ) ALYSHA SHORE for

) College of Nurses of Ontario

• and - )

RAMILYN ABELLO ) NO REPRESENTATION for

Registration No. AE100070 ) Ramilyn Abello

) ELYSE SUNSHINE

) Independent Legal Counsel

) Heard: December 19, 2025,

) via videoconference

DECISION AND REASONS

This matter was heard by a panel of the Discipline Committee (the “Panel”) of the College of Nurses of Ontario (the “College”) on December 19, 2025.

The Allegations

The allegations against Ramilyn Abello (the “Member”) as stated in the Notice of Hearing dated October 6, 2025 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 paragraph 1(24) of Ontario Regulation 799/93 in that, while registered as a Registered Practical Nurse, you failed to abide by a written undertaking given by yourself to the College of Nurses of Ontario (“CNO”) or failed to carry out an agreement entered into with CNO in that:

a. between on or about November 22, 2021 to on or about April 8, 2024, you failed to abide by the requirements of the Undertaking and Acknowledgement to CNO dated March 11, 2020 (the “Undertaking”) within the timeframes set out in the Undertaking and/or by the extended deadlines provided by CNO, including that:

i. you failed to review the following CNO publications and complete the associated Reflective Questionnaires, online learning modules, decisions tools and online participations forms (where applicable):

• Professional Standards;

• Medication;

• Documentation;

• Confidentiality and Privacy; and/or

• Decisions about Procedure and Authority; and/or

ii. you failed to successfully complete education (i.e. courses) and/or failed to advise CNO of the successful completion of courses, in the following areas:

• Medication administration;

• Documentation; and/or

• Health Assessment;

2. You have committed an act or acts 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 paragraph 1(37) of Ontario Regulation 799/93, in that, while registered as a Registered Practical Nurse, you engaged in conduct, 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. between on or about November 22, 2021 to on or about April 8, 2024, you failed to abide by the requirements of the Undertaking and Acknowledgement to CNO dated March 11, 2020 (the “Undertaking”), within the timeframes set out in the Undertaking and/or by the extended deadlines provided by CNO, including that:

i. you failed to review the following CNO publications and complete the associated Reflective Questionnaires, online learning modules, decisions tools and online participations forms (where applicable):

• Professional Standards;

• Medication;

• Documentation;

• Confidentiality and Privacy; and/or

• Decisions about Procedure and Authority; and/or

ii. you failed to successfully complete education (i.e. courses) and/or failed to advise CNO of the successful completion of courses, in the following areas:

• Medication administration;

• Documentation; and/or

• Health Assessment.

Member’s Plea

The Member admitted the allegations set out in paragraphs 1 and 2 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 Member advised the Panel that agreement had been reached on the facts and introduced an Agreed Statement of Facts, which reads, unedited and without exhibits mentioned therein, as follows:

THE MEMBER

1. Ramilyn Abello (the “Member”) registered with the College of Nurses of Ontario (“CNO”) as a Registered Practical Nurse (“RPN”) on March 31, 2015.

2. The Member has reported current nursing employment with Forest Hill, in Kanata, Ontario, The Ottawa Hospital – Civic Campus, in Ottawa, Ontario and Focus Eye Centre - Ottawa, in Ottawa, Ontario.

PRIOR HISTORY

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

BACKGROUND

4. On January 29, 2020, a panel of the Inquiries, Complaints and Reports Committee (“ICRC”) reviewed information received about the Member’s nursing practice.

5. On March 11, 2020, the Member signed an Undertaking and Agreement (“Undertaking”) with CNO to complete specified education within 18 months from the date of the ICRC Decision. On May 20, 2020, the ICRC reviewed the matter and accepted the Member’s signed Undertaking and took no further action regarding the investigation into the Member’s nursing practice or conduct.

6. The Member’s signed Undertaking included the following but not limited to:

Review and Reflection of CNO Practice Standards

1. I agree to review the following CNO publications and complete the associated Reflective Questionnaires, online learning modules, decision tools and online participation forms (where applicable):

• Professional Standards;

• Medication;

• Documentation;

• Confidentiality and Privacy; and,

• Decisions about Procedure and Authority.

Additional Education

2. I agree to successfully complete education (i.e. courses) in the following areas:

• Medication Administration

• Documentation

• Health Assessment

within 18 months from the date of the ICRC Decision.

3. I understand and agree that all education must be pre-approved by the Director.

4. I understand and agree that in order for the education to be considered successfully completed, I must achieve a minimum passing grade of 65%, or the course(s) are otherwise completed to the satisfaction of the Director.

5. I acknowledge and agree that I am responsible for the costs of any education identified in paragraphs [2-4].

Length of Undertaking and Posting on the Public Register

6. This Undertaking will remain in force until the Director has confirmed to me, in writing, receipt and approval of the following:

a) the documents required by paragraph [1]; and

b) proof of enrolment and successful completion of education as described in paragraphs [2-5] above.

11. I agree and acknowledge that I am responsible for ensuring that I am in compliance with this Undertaking and any failure to comply with this Undertaking will constitute a breach of this Undertaking by me.

12. I understand and acknowledge that any breach of this Undertaking by me may amount to an act of professional misconduct.

INCIDENTS RELEVANT TO ALLEGATIONS OF PROFESSIONAL MISCONDUCT

Failure to comply with an Undertaking

2020

7. On June 1, 2020, the Member was advised in writing that the ICRC accepted her signed Undertaking and would take no further action regarding the investigation into her practice or conduct.

8. On June 2, 2020, CNO's Monitoring Administrator (“Monitoring”) sent a letter to the Member via eMsg advising the Member that CNO would be monitoring the Undertaking accepted by the ICRC on May 20, 2020. The Member was advised to complete reflective documents and to provide the Director with proof of successful completion of courses with a minimum passing grade of 65% by November 20, 2021. The letter explained that failing to comply with any part of the Undertaking may amount to an act of professional misconduct and the Executive Director may initiate an investigation.

9. On June 25, 2020, Monitoring followed up with the Member via email to confirm whether the Member had accessed the documents sent to her on June 2, 2020.

10. The Member did not respond to CNO’s Monitoring team.

2021

11. On November 22, 2021, Monitoring sent the Member a letter via OneDrive and regular mail advising that she had not completed terms of her Undertaking by the due date. The Member was invited to a request an extension of the due date to complete the terms of the Undertaking by December 13, 2021.

12. On December 12, 2021, the Member emailed Monitoring advising that she had previously faxed her reflection documents in June. The Member indicated struggling with COVID-19 and requested a telephone call with Monitoring to provide an explanation.

13. On December 16, 2021, Monitoring replied to the Member via email. Monitoring indicated an attempt to contact the Member by telephone was made but the automated voice recording indicated that the call could not be completed as dialed. The Member was advised to ensure her contact information is up to date by accessing Maintain Your Membership. Monitoring requested the Member’s availability and their telephone number.

2022

14. On January 4, 2022, the Member replied to Monitoring via email, providing a telephone number. The Member indicated she will contact or email at another time due to being sick.

15. On January 6, 2022, Monitoring emailed the Member reminding the Member to request an extension to complete the terms of her Undertaking.

16. On January 26, 2022, the Member had a telephone discussion with Monitoring. The Member indicated being unwell with COVID-19 and that she had faced many challenges throughout the pandemic. The Member admitted that she had forgotten about her obligations to complete the requirements set out in her Undertaking and was financially unstable to afford courses. The Member was advised that any forms or learning plans the Member submitted to CNO in the past were separate from the Undertaking and she must comply with the terms of the Undertaking.

17. On the same day, Monitoring emailed the Member that the deadline to submit an extension request and proposed courses was extended to February 16, 2022. Monitoring clarified that the onus was on the Member to seek out courses for approval in accordance with the Undertaking.

18. The Member did not submit an extension request or information regarding proposed courses by February 16, 2022.

19. On February 17, 2022, and on February 22, 2022, Monitoring followed up with the Member via email. On February 26, 2022, the Member replied to Monitoring indicating she was having a hard time finding the right course and had assumed Monitoring would recommend or provide an example of a course.

20. On February 28, 2022, Monitoring replied, indicating the onus was on the Member to seek out courses for approval. The Member was granted until March 4, 2022, to submit her request for an extension and proposed courses.

21. On March 4, 2022, the Member emailed a letter to Monitoring requesting an extension. The Member explained that she struggled during the pandemic, and she was responsible for financially supporting her family residing outside of the country. The Member indicated she had become unwell, including issues related to her mental health. The Member requested extra time to focus and become financially stable.

22. Also on March 4, 2022, the Member emailed Monitoring indicating having difficulty finding courses and whether it was possible to complete learning modules provided by the clinical educator at her workplace.

23. On March 9, 2022, Monitoring emailed the Member requesting details of her learning courses for consideration by March 11, 2022. The Member replied to this email on the same day, indicating that she would submit “it as soon as possible". The Member did not provide any further reply by the deadline of March 11, 2022.

24. On March 16, 2022, Monitoring sent the Member a letter via email, advising that she had not completed any of the terms of her Undertaking. The Member was warned again that failure to complete any terms of the Undertaking could result in allegations of professional misconduct being referred to the Discipline Committee. The Member was granted until March 18, 2022, to submit proposed courses to the Monitoring team.

25. On March 21, 2022, the Member emailed Monitoring samples of documents from the Member's employer's learning modules, which the Member proposed as the educational course work of the Undertaking. On the same day Monitoring replied to the Member via email confirming receipt of the documentation the Member had sent and asked the Member to propose a new date when the Member would complete the courses. Monitoring asked the Member to provide an extension request by March 25, 2022. The Member did not provide a reply to this email.

26. Between March 25 and March 30, 2022, Monitoring left the Member voicemail messages requesting a proposed due date to complete her Undertaking. The Member was asked to contact Monitoring.

27. On March 30, 2022, the Member responded to Monitoring by telephone. Monitoring discussed, again, the process to request an extension and course approval. The Member requested a one-year extension from March 30, 2022, to complete the terms of the Undertaking because she required extra time due to working two jobs.

28. On March 31, 2022, CNO sent the Member a letter via OneDrive and regular mail denying the Member’s request to approve courses with her employer as the learning modules were not courses provided by an educational institution and CNO denied the Member’s request to complete the courses by March 30, 2023. However, the Member was granted an extension to December 31, 2022, to complete the courses required by the Undertaking. The Member was required to provide proof of enrolment in at least one of CNO’s pre-approved online courses by April 22, 2022, specifically:

• PHAR 1012 Pharmacology for Nurses at George Brown

• NRSG141 Health Assessment Theory Review for Nurses at Fleming College

• NURS 0162 Documentation in Nursing at MacEwan University

29. CNO’s March 31, 2022 letter included another reminder for the Member to provide completed Reflective Questionnaires, online learning modules, decision tools and online participation forms as required by her Undertaking.

30. On April 14, 2022, and April 26, 2022, Monitoring followed up with the Member via email requesting confirmation of enrolment in at least one of the three pre-approved online courses. On May 1, 2022, the Member responded, confirming enrolment in the Pharmacology course.

2023

31. On January 3, 2023, Monitoring sent a letter to the Member via email concerning the Member’s non-compliance with terms of her Undertaking and outstanding documentation. Monitoring provided a deadline of January 17, 2023, to respond in writing and to send the outstanding documents. The Member was warned again that failure to complete any terms of the Undertaking could result in allegations of professional misconduct being referred to the Discipline Committee.

32. The Member responded on January 3, 2023, indicating she would contact the schools for her grades, and she was working on the Documentation course. Monitoring replied to the Member on the same day, reminding her to complete the reflective component and to send transcripts for the courses.

33. On March 8, 2023, Monitoring followed up with the Member via email to request an official transcript for her courses and the reflective documents. The Member was granted until March 15, 2023 to comply.

34. On March 30, 2023, Monitoring left a voicemail message for the Member. The message reminded the Member that documents had not been received to complete her Undertaking. The voicemail message reminded the Member of the deadline of March 15, 2023.

35. On April 4, 2023, the Member informed Monitoring via email that she was still taking the Documentation course because she had a hard time enrolling in the course and she needed more time. On the same day Monitoring replied, reminding the Member she had not provided an official transcript for courses completed or reflective components in relation to reviewing the standards. The Member was provided with a final deadline of April 14, 2023 to submit the requested documents.

36. On April 14, 2023, the Member sent Monitoring an email with the subject line "Grades". The body of the email contained the words "Health assessment theory" and included a printout with the word "Grades". On the same day, the Member sent Monitoring another email requesting the reflective questionnaire because she had lost her hard copy. On the same day Monitoring replied to the Member via email reminding her of the official transcripts and the reflective components being due that day. The Member responded to Monitoring via email indicating she had contacted Fleming College and George Brown College.

37. On July 20, 2023, Monitoring emailed the Member to notify her CNO had still not received her transcripts from Fleming College and George Brown College. The Member was advised to send a copy of the transcripts as soon as possible.

38. The Member emailed Monitoring on August 28, 2023, indicating she had emailed George Brown College and Fleming College concerning her grades but had not heard back. On the same day, Monitoring replied and asked the Member if she could take a picture of what she had received including her grades for all the completed courses and submit them with the reflective documents.

39. On November 28, 2023, Monitoring notified the Member via email that CNO was not in receipt of her reflective documents and a copy of the transcript from George Brown College. The Member was advised if she did not have the official transcript, to take a picture of what she had received and submit this including her grades by a final deadline of December 5, 2023, after which time her file would be processed as incomplete.

40. The Member responded on December 12, 2023, indicating that she was recovering from COVID-19, and to provide her with “reconsideration” to finish everything. On the same day Monitoring replied advising the Member via email to take a picture of their transcript and return it to Monitoring by email. The Member was also advised to complete the reflective component of the Undertaking as soon as possible. The Member was warned to provide the documents by December 19, 2023, or her file would be processed as incomplete.

2024

41. On January 19, 2024, Monitoring followed up with the Member via email reminding the Member to take a picture of the transcript and submit this along with her reflective documents.

42. On January 31, 2024, Monitoring sent a letter to the Member via email indicating CNO had not received the reflective documents, as well as proof of completion of the three courses in accordance with her Undertaking. The letter also advised the Member that her file had been transferred to determine if the Executive Director should launch an investigation, and that this could result in allegations of professional misconduct being referred to the Discipline Committee. On the same day, the Member responded, asking whether she could resend her documents and explained she had been sick over the last weeks.

43. On April 8, 2024, CNO sent the Member a letter via Sharepoint concerning the appointment of a CNO investigator (“Investigator”) in relation to the Member’s failure to complete the terms of her Remedial Undertaking. The letter notified the Member that the ICRC had approved an investigation into her practice. The letter invited the Member to submit a written response to CNO’s investigation by May 8, 2024.

44. On April 17, 2024, and April 26, 2024, the Investigator followed up with the Member reminding her of the deadline to provide a response to CNO’s investigation.

45. On May 6, 2024, the Member responded to CNO and requested a copy of the documents sent to her on April 8, 2024, and which the Investigator re-sent. The Member sent another email on the same day indicating she had one more course to complete. On the same day the Investigator replied advising the Member of CNO’s investigation into her practice for failure to complete the terms of the Undertaking. The Investigator reminded the Member of the May 8, 2024 deadline to submit a response including confirmation of any of the required activities set out in her Undertaking.

46. On May 7, 2024, the Member replied to the Investigator via email requesting an extension to complete the terms of the Undertaking. On May 8, 2024, the Investigator replied to the Member via email granting a short extension to May 24, 2024 to submit a response to the investigation. The Investigator advised the Member this was not an extension to complete the terms of the Undertaking.

47. On May 24, 2024, the Member emailed the Investigator stating she was still waiting for her transcript. On May 28, 2024, the Investigator replied to the Member providing her with a final extension of June 3, 2024, to submit a response and include any supporting documentation. The Member was further advised that her matter will go before the ICRC with or without her response.

48. On May 28, 2024, the Member emailed the Investigator asking if the investigation was about the terms of the Undertaking. On the same day the Investigator replied advising the Member, she was being investigated for non-compliance with an ICRC Undertaking. The Investigator advised the opportunity to complete the terms of her Undertaking had passed.

49. On June 3, 2024, the Member submitted a response to the Investigator via email. The Member explained the impact of the COVID-19 pandemic, stress at work, being unwell, and difficulties related to her personal and family life. The Member advised she finished two courses and was still working on the last course. The Member included, with her response, an official transcript from George Brown College for Pharmacology for Nurses (Spring 2022), an unofficial transcript from Fleming College for Health Assess Theory (Spring 2022), and an Online Participation Form and Reflective Questionnaires for Documentation, Consent, Confidentiality and Privacy all dated June 3, 2024.

2025

50. On December 17, 2025, the Member provided CNO with an official transcript from Fleming College for Health Assess Theory (Spring 2022), thus satisfying that element of the Undertaking.

51. To date the Member has not submitted proof of completion for the following items of the Undertaking:

Term 1

Review and Reflection of CNO Practice Standards

o Medication

o Decisions about Procedure and Authority

o Professional Standards

Term 2

Additional Education

o Documentation

52. If the Member were to testify, she would explain that the COVID-19 pandemic and difficulties related to her personal and family life affected her ability to complete all the terms of the Undertaking. The Member, however, admits she failed to abide by all the requirements of the Undertaking to CNO dated March 11, 2020, despite reminders from CNO and additional time granted to complete the terms of the Undertaking.

CNO STANDARDS

Code of Conduct

53. CNO’s Code of Conduct, in effect from 2019 to June 2023, 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.

• Nurses maintain public confidence in the nursing profession.

54. With respect to the principle requiring that nurses maintain public confidence in the nursing profession, CNO’s Code of Conduct provides that nurses are accountable for their own actions and decisions.

55. Attached as Exhibit “A” is a copy of CNO’s Code of Conduct which was in force from 2019 to June 2023 at the time of the incidents.

56. On June 5, 2023, CNO’s revised Code of Conduct came into effect. CNO’s revised Code of Conduct consists of six principles including:

• Nurses respect clients’ dignity.

• Nurses provide inclusive and culturally safe care by practicing cultural humility.

• Nurses provide safe and competent care.

• Nurses work respectfully with the health care team.

• Nurses act with integrity in clients’ best interests.

• Nurses maintain public confidence in the nursing profession.

57. With respect to the principle requiring that nurses maintain public confidence in the nursing profession, CNO’s Code of Conduct provides that nurses understand and practice in compliance with relevant laws and standards of practice and do not breach them; nurses are accountable for their own decisions, actions, omissions and related outcomes; nurses self-reflect, identify learning needs in their practice and engage in continuous learning to improve their competence and nurses cooperate with CNO, including cooperation in investigations and offering complete and accurate information.

58. Attached as Exhibits “B” and “C” are copies of CNO’s Code of Conduct in force at the time of the incidents.

ADMISSIONS OF PROFESSIONAL MISCONDUCT

59. The Member admits that she committed the acts of professional misconduct as alleged in paragraph 1 (a)(i)(ii) of the Notice of Hearing, in that she contravened a standard of practice of the profession or failed to meet the standards of practice of the profession as described in paragraphs 7-58 above.

60. The Member admits that she committed the acts of professional misconduct as alleged in paragraph 2 (a)(i)(ii) of the Notice of Hearing, and in particular her conduct was dishonourable and unprofessional, as described in paragraphs 7-58 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 and 2 of the Notice of Hearing. With respect to allegation #2, the Panel found that the Member’s conduct would reasonably be regarded by members of the profession as dishonourable and unprofessional.

Reasons for Decision

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

Allegation #1 in the Notice of Hearing, that the Member failed to abide by the Undertaking, is supported by paragraphs 1 - 59 in the Agreed Statement of Facts. The Member admitted that following the College’s receipt of information about the Member’s practice, she voluntarily entered into the Undertaking with the College to complete various educational and reflective activities to support her safe nursing practice. The Member was notified on June 1, 2020 that the Undertaking had been accepted by a panel of the ICRC and they were therefore taking no further action. Between June 2020 and January 2024, the Member did not comply with the terms of the Undertaking as she was required to do. She was granted several extensions to meet the terms of the Undertaking and was provided with support in identifying courses which would satisfy the terms of the Undertaking. At the time of this hearing, which took place over five years after the Member signed the Undertaking, the Member has still failed to comply with the Undertaking in full.

The College’s Code of Conduct provides that nurses are expected to:

• Practice in compliance with relevant laws and standards of practice and do not breach them;

• Be accountable for their own decisions, actions, omissions and related outcomes;

• Self-reflect, identify learning needs in their practice and engage in continuous learning to improve their competence; and

• Cooperate with the College, including in investigations and by offering complete and accurate information.

An undertaking is a formal, legally binding promise made to do something or not do something. The Member entered into the Undertaking. The Member did not complete the requirements of the Undertaking. By breaching her Undertaking the Member failed to cooperate with the College, failed to self-reflect and engage in continuous learning, failed to maintain accountability for her actions, and practiced in contravention of the standards of the profession. The Code sets out that it is an act of misconduct to fail to abide by an undertaking give to the College or fail to carry out an agreement with the College. The evidence is clear that the Member entered into an Undertaking with the College and did not abide by it and therefore engaged in misconduct.

With respect to allegation #2, that the conduct would reasonably be regarded by members as disgraceful, dishonourable or unprofessional, the Panel finds that the Member’s conduct in failing to comply with the terms of her Undertaking was relevant to the practice of nursing, because compliance with commitments to one’s regulator is integral to membership in a self-regulating profession. As such, the Panel finds the Member’s conduct to be relevant to the profession of nursing and that it was unprofessional as it demonstrated a serious and persistent disregard for her professional obligations.

The Panel also finds that the Member’s conduct was dishonourable. It demonstrated an element of dishonesty, because the Member knew or ought to have known that her ongoing failure to abide by the terms of her Undertaking with the College was unacceptable and fell well below the standards of a professional. On several occasions, the Member requested and was granted extensions to complete her work, and she repeatedly failed to meet these deadlines. Even at the time of the hearing before this Panel, the Member had not completed all the objectives in the Undertaking.

The Panel’s view is the Member’s conduct, especially given the extensions and assistance provided to her by the College, was disrespectful to the profession. The Member repeatedly, and over an extended period of time, ignored the consequences put before her by the College’s Monitoring department. The Panel is concerned that the Member mistook the extensions granted to her by College as permission to continue to avoid her responsibilities to the profession, which was unacceptable. The Panel would remind the Member and other members of the profession, that entering into a formal agreement (such as an Undertaking with one’s regulator) is very serious and a failure to comply will warrant sanctions.

Penalty

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

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

2. Directing the Registrar 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 Registrar to impose the following terms, conditions and limitations on the Member’s certificate of registration:

a) The Member will complete the terms of the Undertaking and Agreement, being the completion of:

Term 1

Completion of Reflective Questionnaires, online learning modules, decision tools, and online participation forms (where applicable)

o Medication

o Decisions about Procedure and Authority

o Professional Standards

Term 2

Additional Education

o Documentation

within six months from the date that this Order becomes final;

b) 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 that 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 Practice Reflection Worksheets, online learning modules and decision tools (where applicable):

1. Code of Conduct;

iv. At least 5 days before the first meeting, or within another timeframe approved by the Expert, the Member provides the Expert with a copy of the completed Practice Reflection Worksheets;

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

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

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

3. strategies for preventing the misconduct from recurring,

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

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

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

1. the dates the Member attended the sessions,

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

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

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

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

4. 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.

Submissions on Penalty

College Counsel submitted that joint submission was appropriate as it reflected the goals of penalties, considered the specific factors of this case, and was consistent with prior decisions.

College Counsel outlined that the penalty would protect the public by requiring the Member to complete the Undertaking and through all the other elements. The oral reprimand would help the Member to understand her conduct. She would be further remediated thorough the completion of the Undertaking and the meetings with the Regulatory Expert. The suspension would serve a deterrent factor on the Member and other members of the profession.

College Counsel submitted that the Panel could consider as an aggravating factor the fact that the Member disregarded her professional obligations. It is clear that the Member entered into the Undertaking, was aware of the terms and signed it. Despite extensions and warnings of the consequences for failing to complete the Undertaking, the Member failed to comply. This brings about concerns for the Member’s governability.

The mitigating factors include that the Member has no prior disciplinary history with the College, despite the matter before a panel of the ICRC giving rise to the Undertaking. College Counsel noted that the Member has also experienced a lot of personal issues, related to both her health and family responsibilities, which impacted her ability to comply with the Undertaking. The Member has also taken steps to complete elements of the Undertaking. Another important mitigating factor is that the Member has taken responsibility for her actions by entering into an Agreed Statement of Facts and a Joint Submission on Order with the College.

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 Moran (Discipline Committee, 2021), CNO v Watson (Discipline Committee, 2023), CNO v. MacNeil (Discipline Committee, 2025)

The Member did not make any submissions on penalty.

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 joint submission is not contrary to the public interest and does not bring the administration of justice into disrepute.

The Panel concluded that the 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 penalty satisfies the penalty goals of specific and general deterrence, rehabilitation and remediation, and public protection. The penalty provides for specific and general deterrence through the three-month suspension, which signals to both the Member and the membership that this conduct is unacceptable and there are consequences for failing to comply with the terms of an undertaking to the College.

The penalty provides for both specific deterrence and remediation through the oral reprimand which will give the Member insight into her conduct and help her understand how her conduct has affected the profession and the public.

The penalty also provides for remediation and rehabilitation through the requirement that the Member complete the terms of the Undertaking, as well as through the meetings with a Regulatory Expert which will help her further understand her conduct in the context of the legislation and standards of the profession. This will assist the Member to identify how she will prevent similar misconduct in the future.

Overall, the public is protected because the Member is being held accountable for her conduct by ensuring that she complies with the terms of her Undertaking, and through the rehabilitative and remedial components of the order. These aspects will both improve the Member’s practice, which protects the public, and will assist her to gain and reinforce insight into her conduct which should prevent this type of issue from arising in the future.

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, Grace Fox, NP, sign this decision and reasons for the decision as Chairperson of this Discipline Panel and on behalf of the members of the Discipline Panel.