DISCIPLINE COMMITTEE OF THE COLLEGE OF NURSES OF ONTARIO

PANEL: Michael Hogard, RPN Chairperson Tina Colarossi, NP Member Randall Burke Public Member

BETWEEN:

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

• and - )

KRISTAL NICOLE PITTER ) ALEXANDER BOISSONNEAU-LEHNER for Registration NO. 9622374 ) Kristal Nicole Pitter

) KIMBERLEY ISHMAEL ) Independent Legal Counsel

) Heard: May 6, 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 May 6, 2025.

The parties consented to proceeding with the hearing with one public member and two professional members, which constitutes a quorum pursuant to section 38(5) of the Health Professions Procedural Code.

The Allegations

The allegations against Kristal Nicole Pitter (the “Member”) as stated in the Notice of Hearing dated April 25, 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 subsection 1(1) of Ontario Regulation 799/93, in that while registered as a Registered Nurse, you contravened a standard of practice of the profession or failed to meet the standards of practice of the profession in that on or after December 23, 2020, you held yourself out as a Registered Nurse in the Extended Class, and/or used the restricted title “Nurse Practitioner” when you were not registered as such;

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 subsection 1(16) of Ontario Regulation 799/93, in that while registered with CNO as a Registered Nurse, you inappropriately used a term, title or designation in respect of your practice in that, on or after December 23, 2020, you held yourself out as a Registered Nurse in the Extended Class, and/or used the restricted title “Nurse Practitioner” when you were not registered as such; and/or

3. You have committed an act of professional misconduct as provided by subsection 51(1)(c) of the Health Professions Procedural Code of the Nursing Act, 1991, S.O. 1991, c. 32, as amended, and defined in subsection 1(37) of Ontario Regulation 799/93, in that while registered as a Registered Nurse, 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, in that on or after December 23, 2020, you held yourself out as a Registered Nurse in the Extended Class, and/or used the restricted title “Nurse Practitioner” when you were not registered as such.

4. You have committed an act of professional misconduct as provided by subsection 51(1)(c) of the Health Professions Procedural Code of the Nursing Act, 1991, S.O. 1991, c. 32, as amended, and defined in subsection 1(37) of Ontario Regulation 799/93, in that while registered as a Registered Nurse, you engaged in conduct or performed an act, relevant to the practice of nursing that, having regard to all the circumstances, would reasonably be regarded by members of the profession as disgraceful, dishonourable or unprofessional, and, in particular, you failed to comply with an Inquiries, Complaints, and Reports Committee decision, dated October 6, 2021, that ordered you to complete a Specified Continuing Education or Remediation Program and receive a caution.

Member’s Plea

The Member admitted the allegations set out in paragraphs #1, #2, #3 and #4 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. Kristal Nicole Pitter (the “Member”) first registered with CNO as a Registered Nurse (“RN”) on July 15, 1996. From November 14, 2007 to December 23, 2020, the Member was authorized to practice in the Extended Class as a Nurse Practitioner (“NP”). From December 23, 2020 onwards, the Member was registered with CNO as an RN in the General Class.

2. She was administratively suspended on February 15, 2024 for non-payment of fees. She resigned her certificate on March 17, 2024, and is no longer entitled to practise nursing in Ontario.

PRIOR HISTORY

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

INCIDENTS RELEVANT TO ALLEGATIONS OF PROFESSIONAL MISCONDUCT

Failure to comply with an order of the Inquiries, Complaints and Reports Committee (the “ICRC”)

4. The Member has refused to comply with an October 6, 2021 order from the ICRC requiring her to complete a remediation program and attend to be cautioned. To date, she has not met the requirements of this order.

The ICRC orders a SCERP and caution

5. In 2020, the Member was working as a nurse in the Ministry of Health and Long-Term Care’s inspection branch. In July 2020, CNO received a letter of report from the Ministry concerning the Member’s activity on her social media accounts relating to COVID-19. It alleged that, in June and July 2020, the Member had made public posts on social media in which she identified herself as a “Nurse Practitioner” and commented about the COVID-19 pandemic. She allegedly had discouraged public health measures such as masking, saying they did not work or could cause harm. She allegedly promoted non-scientific theories about the COVID-19 pandemic, including that COVID-19 vaccines would track and manipulate individuals’ thoughts and movements, and that mask mandates were “negligent and dangerous”.

6. The ICRC considered CNO’s investigation into the Ministry’s report, including the Member’s social media posts, and the Member’s response that there was truth to her statements. The ICRC expressed concern that four of the Member’s social media posts about COVID-19 were plainly false, inaccurate, or misleading, and that she had used her title as a nurse to lend legitimacy to those false statements.

7. On October 6, 2021, the ICRC ordered the Member to complete a remediation program (“SCERP”) and appear to be cautioned (the “Order”). The SCERP required the Member to:

a. Register for the CPEP Probe: Ethics & Boundaries Program (“PROBE”) and provide proof of registration to CNO’s Monitoring Team within three months of the ICRC’s decision;

b. Complete all aspects of the PROBE program with a grade of “unconditional pass” within six months of the ICRC’s decision and provide proof of same to CNO’s Monitoring team;

c. Meet once with an approved regulatory expert to discuss the incidents investigated, the applicable nursing standards, and the Member’s insights and learning gained from practice reflection within three months of completing the PROBE program. The Member was also required to complete additional remedial training before the meeting with the regulatory expert (reviewing practice standards and completing reflective questionnaires, completing online learning modules and reviewing CNO’s Social Media: Reflect Before You Post webcast); and

d. Pay the costs required to complete the terms of the SCERP.

8. CNO provided a copy of the ICRC’s Order to the Member on November 18, 2021. On November 19, 2021, CNO provided her with detailed instructions on fulfilling the Order. CNO reminded the Member that she had nine months to complete the remediation program and attend for a caution, and that failure to comply with the Order could result in a referral to discipline.

The Divisional Court dismisses the Member’s application for judicial review

9. On January 26, 2022, CNO received notice that the Member intended to bring an application for judicial review of the ICRC’s Order. The Member filed her application in Divisional Court thereafter.

10. On February 4, 2022, the Divisional Court issued an order on consent staying the ICRC’s decision until the Member’s application for judicial review had been decided.

11. The Member’s application for judicial review was unsuccessful. It was heard on September 13, 2022. On September 30, 2022, the Divisional Court upheld the ICRC’s decision, dismissed the Member’s application for judicial review, and ordered the Member to pay $17,500 in costs to CNO.

12. On October 4, 2022, CNO wrote to the Member and her counsel advising them that the Order was again in effect. CNO provided the Member with updated instructions for completing the SCERP. The letter stated that the Member had to register in the PROBE course by January 3, 2023, complete it by April 3, 2023, and meet with the regulatory expert by July 3, 2023.

13. On October 17, 2022, the Member’s counsel gave CNO notice of the Member’s motion seeking leave to appeal the Divisional Court’s decision to the Court of Appeal, which was later filed with the Court on November 8, 2022. However, the Member did not perfect her motion for leave, and on January 16, 2023, the Court notified the Member that her motion would be dismissed for delay if she did not perfect her appeal by January 31, 2023. The Member has since abandoned her motion for leave, and her motion was formally dismissed by the Court of Appeal on July 31, 2024.

The Member fails to complete the SCERP and caution

14. The Member did not comply with the Order after her judicial review was unsuccessful and the stay ended.

15. The Member did not provide CNO with confirmation that she had registered in the PROBE program by January 3, 2023, as required.

16. From January to June, 2023, CNO’s Monitoring team contacted the Member and her counsel to remind her of the requirement that she complete the SCERP and to provide her with additional opportunities to comply:

a. On January 18, 2023, CNO advised the Member that she had not complied with the Order and requested confirmation of her registration in the PROBE program by January 25, 2023.

b. On February 6, 2023, CNO still had not received a response from the Member and sent her another letter requesting a response by February 17, 2023.

c. On February 7, 2023, the Member’s counsel emailed CNO’s Monitoring team indicating that he would respond to their correspondence in due course.

d. On March 23, 2023, CNO’s Monitoring Administrator replied to counsel’s email. She asked when she would receive a response and reminded him that the Member’s deadline to complete the PROBE program was April 3, 2023.

e. Having not received a response from the Member or her counsel, on April 12, 2023, CNO sent the Member’s counsel a letter requesting a response by April 26, 2023.

f. CNO’s Monitoring Administrator attempted to call the Member’s counsel on April 28, 2023 and May 1, 2023, but could not reach him.

g. On May 1, 2023, the Member’s counsel emailed CNO’s Monitoring team and advised that the Member would be requesting an extension of the deadline to complete the PROBE program and that she was recovering from surgery.

h. On May 15, 2023, CNO’s Monitoring Administrator wrote to the Member’s counsel advising him of the information the Member would be required to provide to formally request an extension. She asked that he provide the necessary information by June 5, 2023.

i. On June 12, 2023, CNO’s Monitoring Administrator followed up by telephone and left a voicemail requesting an update in response to her May 15, 2023 letter.

17. By July 26, 2023, when the Member still had not complied with the Order or formally requested an extension to do so after the above exchanges, CNO commenced an investigation into the Member’s failure to comply with the ICRC’s Order. The Member was notified of the investigation on the same day.

18. On August 17, 2023, CNO’s Investigator interviewed the Member’s counsel. The Member’s counsel advised that the Member had not complied with the Order due to her moral views, a medical condition preventing her from working and using her hand, and her lack of financial resources. However, the “ultimate reason” for the Member’s non-compliance with the Order was that she could not morally accept the Order. In the Member’s view, complying with the Order would constitute a “partial admission”; the Member had no intention of complying with the Order “from a moral standpoint”.

19. To date, the Member has not complied with the Order, and advises that she has no intention to do so. She has not completed the SCERP or received the oral caution.

Inappropriate use of a term, title or designation

20. Under the Nursing Act, 1991, S.O. 1991, c. 32, s. 11(1), the title “nurse practitioner” is a restricted title.

21. O. Reg. 275/94 (General Regulation to the Nursing Act, 1991) s. 4.2(7) provides that:

(7) No member shall use the title “Nurse Practitioner” or any variation or abbreviation thereof, or the designation “Registered Nurse Extended Class” or any variation or abbreviation thereof, unless the member holds an extended class certificate of registration.

22. After December 23, 2020, the Member did not hold an extended class certificate of registration and was therefore not entitled to use the protected title of “Nurse Practitioner”. The Member nevertheless publicly held herself out as a “Nurse Practitioner” as follows:

a. On or about April 14, 2021, the Member introduced herself as a “Nurse Practitioner” at a public speech in front of the CNO building at 101 Davenport Rd, Toronto, Ontario;

b. On or about May 17, 2021, the Member introduced herself as a “Nurse Practitioner” at a public speech in London, Ontario, which was recorded and posted on Facebook where it was publicly available;

c. On or about June 4, 2021, the Member introduced herself as a “Nurse Practitioner in Ontario” in a video interview with Michael Thiessen which was posted on YouTube where it was publicly available for viewing;

d. Until at least September 21, 2021, the Member described herself as a “Nurse Practitioner” on her biography on the “Canadian Frontline Nurses” website. The Member was a board member of Canadian Frontline Nurses at the time this description was posted on its website;

e. Until at least September 21, 2021, the Member identified herself as a “Nurse Practitioner (Active)” in signing a statement by “Professionals Against Lockdowns” on the “Liberty Coalition Canada” website; and

f. Until at least December 9, 2021, the Member described herself as a “Nurse Practitioner” on her personal Facebook profile page, which was publicly accessible.

CNO STANDARDS OF PRACTICE

Code of Conduct

23. 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. Under the principle that nurses maintain patients’ trust by providing safe and competent care, the Code of Conduct provides that nurses identify themselves, their first name, last name, title and their role, and that nurses are accountable to, and practice under, relevant laws and CNO’s standards of practice.

24. 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

25. CNO’s Professional Standards, was in effect at the time of these incidents. The 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.

26. 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. It further provides that nurses are responsible for identifying themselves and explaining their roles.

27. CNO’s Professional Standards provides, in relation to the knowledge standard, sets out an expectation that nurses are informed and objective about the various nursing roles and their relationship to one another.

28. Attached as Exhibit “B” is a copy of CNO’s Professional Standards which was in force at the time of the incidents.

ADMISSIONS OF PROFESSIONAL MISCONDUCT

29. The Member admits that she committed the act of professional misconduct as alleged in paragraphs 1, 2 and 3 of the Notice of Hearing, in that she inappropriately used the restricted title “Nurse Practitioner” when she was not registered as such, and that in doing so: she breached the standards of practice of the profession; she inappropriately used a term, title or designation in respect of her practice; and 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 of the profession as dishonourable and unprofessional, as described in paragraphs 20 to 28, above.

30. The Member admits that she committed the act of professional misconduct as alleged in paragraph 4 of the Notice of Hearing, in that she failed to complete the SCERP and receive an oral caution pursuant to the decision and order of the ICRC dated October 6, 2021, and that in doing so, 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 of the profession as dishonourable and unprofessional, as described in paragraphs 4 to 19, 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, #2, #3 and #4 in the Notice of Hearing. As to allegations #3 and #4, 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.

Allegation #1 in the Notice of Hearing is supported by paragraphs 1, 2 and 20 to 29 in the Agreed Statement of Facts. The Member admitted that she committed an act of professional misconduct by holding herself out as a Registered Nurse in the Extended Class, and using the restricted title “Nurse Practitioner”, when she did not hold an extended class certificate of registration and was therefore not entitled to use the protected title of “Nurse Practitioner”. The Member contravened the College’s Code of Conduct, which provides that nurses identify themselves by their first name, last name, title and their role, and that nurses are accountable to, and practice under, relevant laws and the College’s standards of practice. The Member contravened the College’s Professional Standards in relation to the accountability standard, that nurses are accountable to the public and responsible for ensuring that their practice and conduct meets the legislative requirements and the standards of the profession. It further provides that nurses are responsible for identifying themselves and explaining their roles. On or about May 17, 2021, the Member introduced herself as a “Nurse Practitioner” at a public speech in London, Ontario, which was recorded and posted on Facebook where it was publicly available. The Member contravened this standard of practice of the profession when she publicly held herself out as a “Nurse Practitioner” after December 23, 2020 on many occasions.

Allegation #2 in the Notice of Hearing is supported by paragraphs 1, 2 and 20 to 29 in the Agreed Statement of Facts. The Member admitted that she committed an act of professional misconduct by holding herself out as a Registered Nurse in the Extended Class and used the restricted title “Nurse Practitioner” when she was not registered as such on the following occasions:

• On or about April 14, 2021, the Member introduced herself as a “Nurse Practitioner” at a public speech in front of the College’s building at 101 Davenport Road, Toronto, Ontario;

• On or about May 17, 2021, the Member introduced herself as a “Nurse Practitioner” at a public speech in London, Ontario, which was recorded and posted on Facebook where it was publicly available;

• On or about June 4, 2021, the Member introduced herself as a “Nurse Practitioner in Ontario” in a video interview with Michael Thiessen which was posted on YouTube where it was publicly available for viewing;

• Until at least September 21, 2021, the Member described herself as a “Nurse Practitioner” on her biography on the “Canadian Frontline Nurses” website. The Member was a board member of Canadian Frontline Nurses at the time this description was posted on its website until at least September 21, 2021;

• The Member identified herself as a “Nurse Practitioner (Active)” in signing a statement by “Professionals Against Lockdowns” on the “Liberty Coalition Canada” website; and

• Until at least December 9, 2021, the Member described herself as a “Nurse Practitioner” on her personal Facebook profile page, which was publicly accessible.

Allegation #3 in the Notice of Hearing is supported by paragraphs 1, 2 and 20 to 29 in the Agreed Statement of Facts. The Panel finds that the Member’s conduct in publicly holding herself out as a Registered Nurse in the Extended Class, and/or using the restricted title “Nurse Practitioner” when she was not registered as such, through various public posts on social media in which she commented about the COVID-19 pandemic, was relevant to the practice of nursing. It was unprofessional as it demonstrated a serious and persistent disregard for her professional obligations in contravening the College’s Code of Conduct and the Professional Standards.

The Panel also finds that the Member’s conduct was dishonourable. The Member’s conduct in promoting non-scientific theories about the COVID-19 pandemic, including that COVID-19 vaccines would track and manipulate individuals’ thoughts and movements, and that mask mandates were “negligent and dangerous”, and by discouraging public health measures such as masking, while improperly using the restricted title of “Nurse Practitioner” demonstrated an element of dishonesty, deceit and moral failing. The Member knew or ought to have known that her conduct was unacceptable and fell well below the standards of a professional.

Allegation #4 in the Notice of Hearing is supported by paragraphs 4 to 19 and 30 in the Agreed Statement of Facts. The Member’s conduct in failing to comply with an Inquiries, Complaints, and Reports Committee (“ICRC”) order dated October 6, 2021, which required the Member to complete a Specified Continuing Education or Remediation Program (“SCERP”) and to appear before the ICRC to be cautioned, even after the Member’s application for judicial review was dismissed, was relevant to the practise of nursing. It was unprofessional as it demonstrated a serious and persistent disregard for her professional obligations in contravening the College’s Code of Conduct and the Professional Standards, which persists to date as the Member has continued to refuse to comply with the order.

The Panel also finds that the Member’s conduct was dishonourable. It demonstrated an element of moral failing. The Member failed to complete the SCERP and to appear to be cautioned. To date, she has refused to comply with this order. 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.

College Submissions on Penalty

College Counsel submitted that the Joint Submission on Order also provides in Appendix “A” an undertaking and agreement by the Member for the Member’s permanent resignation as a member of the College effective April 30, 2025 (the “Undertaking”). Pursuant to this Undertaking, the Member undertakes, acknowledges and agrees to:

a) Permanently resign as a member of the College, effective from the date that the Member executes the Undertaking and Agreement;

b) Not apply for membership with the College as a Registered Nurse or Registered Practical Nurse at any time in the future;

c) Agree that the public portion of the College’s Register will indefinitely reflect that the Member entered into an Undertaking with the Executive Director to permanently resign as a member of the College as part of an agreed resolution of allegations of professional misconduct;

d) No longer have a right to the issuance or reinstatement of a Certificate of Registration from the College;

e) No longer have a right to use the title “Nurse”, “Registered Nurse”, “Registered Practical Nurse”, “Nurse Practitioner”, “RN”, “RPN”, “NP” or a variation, an abbreviation or an equivalent in another language;

f) No longer have a right to hold herself out as a Nurse, Registered Nurse, Registered Practical Nurse or Nurse Practitioner as a person who is qualified to practise in Ontario as a Nurse, Registered Nurse, Registered Practical Nurse or Nurse Practitioner;

g) No longer have a right to engage in the practice of nursing in any capacity; and

h) Agree that the College is authorized to and may, in its sole discretion, provide a copy of the Undertaking and/or its terms to a governing body that regulates nursing in Canada or elsewhere in response to an inquiry or otherwise.

College Counsel made additional submissions on the aggravating and mitigating factors in this case.

The aggravating factors in this case were the seriousness of the misconduct. On August 17, 2023, the College’s investigator interviewed the Member’s Counsel. The Member’s Counsel advised that the Member had not complied with the Order. The Member had no intention of complying with the Order “from a moral standpoint”. To date, the Member has not complied with the Order and advises that she has no intention to do so. She has not completed the SCERP or received the oral caution. After December 23, 2020, the Member did not hold an extended class certificate of registration and was therefore not entitled to use the protected title of “Nurse Practitioner”. The Member nevertheless publicly held herself out as a “Nurse Practitioner”.

The College submitted that the mitigating factors in this case were that the Member does not have any prior disciplinary history with the College. Also, the Member co-operated with the College by entering into an Agreed Statement of Facts and a Joint Submission on Order with the College, sparing the College the expense and inconvenience of a contested hearing.

The College submitted that the proposed order satisfies the overall goals of penalty as follows.

Specific deterrence is not essential in this case because the Member has already undertaken to permanently resign from the practice of nursing. In such circumstances, the penalty of an oral reprimand is sufficient.

General deterrence is achieved through the oral reprimand and the fact that the findings will be publicly posted indefinitely and sends a clear message to other members of the profession that this type of conduct will not be tolerated.

Remediation and rehabilitation are not relevant in this case given the Member’s permanent resignation. There is no public interest served in including remedial terms in the penalty.

Overall, the public is protected by the resignation of the Member’s certificate of registration and the ability of the College to communicate this to any governing body that regulates nursing in Canada or elsewhere. Accordingly, the Panel does not need to impose further conditions to achieve protection of the public.

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. Blasco (Discipline Committee, 2024): The allegations in this case included that the member failed to appear before a panel of the ICRC to be cautioned. The member was not present nor represented, and the hearing proceeded on the basis that the member denied the allegations. The panel was satisfied that the member was aware of the ICRC’s order requiring her to complete a SCERP and appear before the ICRC to be cautioned and that she failed to do so. The penalty included an oral reprimand, a four-month suspension of the member’s certificate of registration, commencing when the member completes the SCERP and appears before a panel of the ICRC to be cautioned, as well as a minimum of two meetings with a Regulatory Expert. The similarities to the case before this Panel were that both members failed to comply with ICRC and both members were given multiple opportunities to comply. The penalty ordered in both cases includes an oral reprimand. In the Blasco case, the penalty included a suspension until the member complied with the ICRC. In the case before this Panel, as the Member signed an undertaking permanently resigning her certificate of registration, a suspension was not necessary.

CNO v. Watson (Discipline Committee, 2023): This case proceeded on a contested basis, and the allegations included that the member failed to complete a SCERP ordered by the ICRC. The penalty included an oral reprimand, and a four-month suspension of the member’s certificate of registration or a suspension until such a time as the member completed the SCERP and appeared before the ICRC to be cautioned, as well as a minimum of two meetings with a Regulatory Expert. In the Watson case and the case before this Panel, both members failed to comply with an ICRC order and both members were given multiple opportunities to comply. Both cases include an oral reprimand. In the Watson case, the penalty included a suspension until the member complied with the ICRC order. In the case before this Panel, as the Member signed an undertaking permanently resigning her certificate of registration, a suspension was not necessary. There were also similar mitigating factors in both cases.

CNO v. Tatlonghari (Discipline Committee, 2024): This case proceeded by way of an Agreed Statement of Facts and a Joint Submission on Order. The allegations included that the member failed to cooperate with the Quality Assurance (“QA”) Committee by failing to complete QA assessment requirements for which the member was selected. As the member signed an undertaking to permanently resign her certificate of registration, the penalty included an oral reprimand. The mitigating factors in the case before this Panel were similar as the member did not have any prior discipline history with the College and co-operated with the College, sparing the College the expense and inconvenience of a contested hearing.

CNO v. Naval (Discipline Committee, 2016): This case proceeded by way of an Agreed Statement of Facts and a Joint Submission on Order. The allegations included that the member failed to cooperate with the QA Committee by failing to participate after being selected by the QA Committee for practice assessment. The member also permanently resigned his certificate of registration, and the penalty included an oral reprimand. The mitigating factors in the case before this Panel were similar to this case as the member did not have any prior discipline history with the College and co-operated with the College, sparing the College the expense and inconvenience of a contested hearing.

Member’s Submissions on Penalty

The Member’s Counsel indicated that he agreed with the College’s submissions.

The Member’s Counsel submitted that the aggravating factors were that the Member lost her Nurse Practitioner designation in December 2020, and while there is no evidence before the Panel of intentional or malicious intent to improperly use the Nurse Practitioner title, this still constituted misconduct. The fact that the Member signed an undertaking permanently resigning her certificate of registration should satisfy the Panel that the public is protected, even though the Member’s Counsel submitted that there was no evidence that the public was harmed by the Member’s conduct. The Member and the College have different views on ethics of the profession and the Member’s ethics and morals no longer align with the College, such that the Member has elected to permanently resign.

College’s Reply Submissions

College Counsel submitted that there was clear evidence set out in paragraphs 20 to 22 of the Agreed Statement of Facts which demonstrated the Member’s misrepresentation of the Nurse Practitioner title.

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.

In this case, because the Member has undertaken to permanently resign, the oral reprimand is a sufficient penalty, and no other specific deterrence is required.

Furthermore, because of the Member’s resignation, it is not necessary to consider remediation and rehabilitation in determining the appropriate penalty.

General deterrence is also addressed as the Panel concluded that had the Member’s situation been different and no Undertaking given, the Panel would have ordered a suspension, and terms, conditions and limitations on the Member’s certificate of registration which would have been in line with previous penalties.

Finally, the oral reprimand is an appropriate penalty because the public is already protected through the permanent resignation and the Undertaking to never apply for registration as a nurse in Ontario or engage in the practice of nursing in any capacity.

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

The penalty is in line with the range of what has been ordered in previous similar cases as demonstrated by the cases submitted and referred to by College Counsel.

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