DISCIPLINE COMMITTEE
OF THE COLLEGE OF NURSES OF ONTARIO
PANEL:
Margaret McGinn, RN
Marilyn McGill, RPN
Monica Seawright, RPN
Lyn Harrington
Gino Cucchi
Chairperson
Member
Member
Public Member
Public Member
BETWEEN:
COLLEGE OF NURSES OF ONTARIO
- and -
D LYNNE JALBERT
Registration No. GA11057
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GLYNNIS BURT for
College of Nurses of Ontario
MICHELLE BRODEY for
D Lynne Jalbert
Heard: November 23, 2009
DECISION AND REASONS
This matter came on for hearing before a panel of the Discipline Committee on November 23,
2009 at the College of Nurses of Ontario (“the College”) at Toronto. The Member was present
and was represented by legal counsel.
Publication Ban
In order to protect the identity of this young client, counsel requested that the panel order a ban
on publication of the name of the client and her [parent]. The panel ordered the ban and they
[may] be identified by initials only.
The Allegations
Counsel for the College advised the panel that the College was requesting leave to withdraw the
allegations set out in paragraph two of the Notice of Hearing dated October 20, 2009. The panel
granted this request. The remaining allegations as set out in the Notice of Hearing are as
follows.
1.
2.
You have committed an act of professional misconduct as provided by sub-section
51(1)(c) of the Health Professions Procedural Code and defined in paragraph 1.1 of
Ontario Regulation 799/93, in that, in the period September 1, 2007 to April 8, 2008,
while employed as a nurse by [the Agency], you contravened a standard of practice of the
profession or failed to meet the standards of practice of the profession in that you:
(a)
failed or neglected to suction your client, [ ], on a PRN or as-needed basis as
required by [the Client]’s care plan; and/or
(b)
asked [the Client]’s [parent] to identify specific hours of the day when you were
to suction [the Client] instead of suctioning her as her condition required; and/or
(c)
failed or neglected to provide appropriate supervision and/or monitoring of [the
Client] throughout the course of the day; and/or
(d)
failed or neglected to communicate in a manner consistent with the therapeutic
nurse-client relationship with your client, [ ], and/or [the Client]’s [parent], about:
(i)
[the Client]’s care plan; and/or
(ii)
when [the Client] was to be suctioned; and/or
(iii)
the need to accompany [the Client] outside at recess; and/or
(iv)
[the Client]’s inability to remember her birthday.
[Withdrawn]
Member’s Plea
Ms. Jalbert admitted the allegations set out in paragraph number 1 subsections (a), (b), (c) and
(d) of the Notice of Hearing. The panel conducted an oral plea inquiry and was satisfied that the
Member’s admission was voluntary, informed and unequivocal.
Overview
The Member is a Registered Practical Nurse who was employed by [the Agency] to provide
nursing care for a [six]-year-old client. The client attended school and the Member monitored
her there, providing nursing care including suctioning of her tracheostomy care on an “as
needed” or prn basis. The client’s [parent] found the Member was demanding, had poor
communication skills and was unwilling to follow the protocol as identified by the [parent].
Officials at the school also found the Member to be aloof, abrasive and neglectful of her duties.
They reported that the Member would spend most of her time reading and refused to go outside
with the client in cold weather. The [parent] terminated the nurse and notified the agency of her
concerns, precipitating the present proceedings.
The issues are as follows:
(a) did the Member commit professional misconduct by failing to provide appropriate
monitoring, care and supervision of her client; and
(b) did the Member neglect to communicate appropriately with the client’s [parent] and the staff
of the school her client attended?
Agreed Statement of Facts
Counsel for the College advised the panel that agreement had been reached on the facts and
introduced an Agreed Statement of Facts which has been reproduced below, without the
attachments that are referenced therein.
THE MEMBER
1. D. Lynne Jalbert (formerly D. Lynne Myers) (the “Member”) is a Registered
Practical Nurse (“RPN”). The Member received her diploma [ ] and has been
registered with the College of Nurses of Ontario (the “College”) since January
1971. She is up-to-date with her annual fees.
THE AGENCY
2. The Member began working as an RPN at [the Agency] in May 2000. The
Agency is a Canadian not-for-profit organization [which] provides health care
services and programs to clients in their homes and the community.
3. The Agency provides a pediatric-centered service that incorporates a school
program whereby nurses facilitate children’s ability to attend school while their
health issues are monitored. This service enables children to adapt to their
changing health issues by customizing care strategies to support their responses to
health and illness.
THE CLIENT
4. [The Client] was six years old and in grade one at the time the allegations took
place. [The Client] had a congenital condition known as Central Hypoventilation
Syndrome. The Member was responsible for providing one-to-one nursing care to
[the Client], while she was attending school. In particular, the Member was
required to supervise [the Client] and provide tracheostomy suctioning on an asneeded basis. A tracheostomy is a surgical opening to the neck that creates an
open direct airway through an incision in the trachea to assist with breathing.
[The Client] required nursing care and supervision during school hours to ensure
that the tracheostomy was free from blockages. [There was an Agency] Client
Care Plan for [the Client] as of August 28, 2007.
5. The Member worked with [the Client] in the school program between October
2007 and April 2008.
INCIDENTS RELEVANT TO ALLEGATIONS OF PROFESSIONAL
MISCONDUCT
6. On April 8, 2008, [the Client]’s [parent] called the Agency to advise that she had
terminated the Member. The concerns identified by [the Client]’s [parent]
occurred between October 2007 and April 2008 and included the following:
(a) the Member failed to supervise [the Client] at all times;
(b) the Member demanded specific times at which to suction [the Client]’s
tracheostomy, failed to suction [the Client]’s tracheostomy on an as-needed
basis and refused to suction [the Client]’s tracheostomy on an as-needed basis;
(c) the Member ignored discussions with [the Client]’s [parent] about her child
and her care;
(d) the Member criticized [the Client]’s [parent] in the presence of [the Client]
because [the Client] did not know her own birthday; and,
(e) the Member exhibited an intimidating and bullying attitude and pressured [the
Client]’s [parent] to concede to her requests for a suctioning schedule and
permission to stay indoors while [the Client] was outside during recess.
7. If [the Client]’s [parent] were to testify, she would say:
(a) the Member was a “bully” and she was intimidated by the Member;
(b) the Member asked when she was to suction [the Client] and [the Client]’s
[parent] explained that that was not how it worked and that [the Client] was to
be suctioned when she needed it;
(c) the Member complained about not wanting to go out for recess with [the
Client] because of the cold, and [the Client]’s [parent] compromised and said
it was alright if the Member stood in the school doorway and watched [the
Client];
(d) [the Client]’s [parent] felt she had to accommodate the Member because she
was afraid she would lose [the Client]’s nurse; and,
(e) in the spring, [the Client]’s [parent] asked the Member to go outside with [the
Client] again, and had to stand her ground that the Member do so over the
Member’s objections.
8. If [the Client]’s teacher [ ] were to testify, she would say:
(a) the Member frequently failed to supervise [the Client] when [the Client] was
participating in outside classroom activities such as choir or when classes
were combined due to bad weather days;
(b) when [the Client] went to other areas of the school and during recess and
lunch breaks, the Member did not accompany [the Client] through the school,
did not go outside with [the Client], and did not always have a clear view of
[the Client] when she was outside;
(c) the Member’s general routine was to get the client settled in the morning and
then sit all day and read in the classroom;
(d) the Member was rude to another Educational Assistant and shouted that she be
allowed to use the washroom at that exact time to suction [the Client] over
another child’s needs; and,
(e) the Member presented as aggressive and unprofessional.
9. If [the Client]’s school Principal [ ] were to testify, she would say:
(a) she was in [the Client]’s classroom about once a week, and every time she
was in the classroom the Member would just “read, read, read,” would not
look up from her book, and would not even know the Principal was in the
classroom;
(b) the Member was very aloof, abrasive and lacked empathy; and,
(c) the Member, when questioned about her behaviour with the Educational
Assistant, said words to the effect that “this is the time I suction”, and
vehemently denied the behaviour even though there were witnesses present.
10. If [the Client]’s school Vice-Principal [ ] were to testify, he would say:
(a) throughout the school year he was often in the classroom 2-3 times per day,
and he always saw the Member reading a book in the corner of the classroom;
(b) he also saw the Member read the paper or a book while she was standing in
the school doorway when [the Client] was outside; and,
(c) the Member’s communication style was “sharp and short.”
11. If the [the Agency’s] Clinical Resource Supervisor [ ] were to testify, she would
say:
(a) it is common nursing knowledge that suctioning is done on an as-needed
basis;
(b) [the Agency] trains its nurses that suctioning is to be done on an as-needed
basis; and,
(c) her investigation of the complaints made by [the Client]’s [parent] indicated
that the complaints had merit.
12. If the Member were to testify, she would say:
(a) no concerns about her communication with the client or others were brought
to her attention until the end of her involvement with [the Client] and [the
Client]’s family;
(b) she had a regular routine of performing suctioning after recess, although this
did not preclude suctioning at other times when required;
(c) she had sought and received the permission of [the Client]’s [parent] to read in
class, to leave the classroom briefly over the lunch hour, and to stand inside
the double doors at recess in direct sight of [the Client] during the coldest
months of the year (to avoid aggravating her arthritic back);
(d) she was unaware that she was being perceived as a “bully,” as intimidating or
as otherwise described above, until this was brought to her attention as a result
of the events giving rise to this matter.
13. On April 22, 2008 (following the cessation of the nurse/client relationship), the
Member was issued a written warning letter from the Agency regarding her
unsatisfactory performance. The letter advised that the Member’s performance
was “totally unacceptable” in that she failed to know that suctioning of the Client
was to be done on an as-needed basis and that she failed to provide one on one
care at all times. The letter further advised that the Member was required to
complete a Performance Improvement Plan and successfully complete the Plan,
failing which she would be subject to further discipline and/or termination from
the Agency. [ ]
14. On the same day, the Member was issued a second written warning from the
Agency regarding her inappropriate behaviour in relation to her care of [the
Client]. The letter indicated that a complaint had been received about aggressive,
intimidating, bullying and abusive behaviour, and advised that this was “totally
unacceptable.” The letter further advised that the Member was required to
complete a Performance Improvement Plan and successfully complete the Plan,
failing which she would be subject to further discipline and/or termination from
the Agency. [ ]
15. The Member successfully completed the Agency’s Performance Improvement
Plan.
ADMISSIONS OF PROFESSIONAL MISCONDUCT
16. The Member acknowledges that her conduct was unprofessional and recognizes
that it reflected poorly upon the nursing profession.
17. The Member admits that she committed an act of professional misconduct, as set
out in Allegation 1 of the Notice of Hearing, in that, in the period September 1,
2007 to April 8, 2008, while employed as a nurse by [the Agency], she
contravened a standard of practice of the profession or failed to meet the
standards of practice of the profession in that she:
(a) failed or neglected to suction her client, [ ], on a PRN or as-needed basis as
required by [the Client]’s care plan; and/or
(b) asked [the Client]’s [parent] to identify specific hours of the day when she
was to suction [the Client] instead of suctioning her as her condition required;
and/or
(c) failed or neglected to provide appropriate supervision and/or monitoring of
[the Client] throughout the course of the day; and/or
(d) failed or neglected to communicate in a manner consistent with the
therapeutic nurse-client relationship with her client, [ ], and/or [the Client]’s
[parent], about:
(i) [the Client]’s care plan; and/or
(ii) when [the Client] was to be suctioned ; and/or
(iii)the need to accompany [the Client] outside at recess; and/or
(iv) [the Client]’s inability to remember her birthday.
PREVIOUS DISCIPLINE HISTORY
18. On September 7, 2001, the Member was found to have committed numerous acts
of professional misconduct involving elderly clients. The incidents involved
unprofessional communication, failure to provide care that met the standards,
failure to meet the standards with respect to communication with clients and/or
family members of clients, abuse of clients including curt, abrupt and
inappropriate communication with clients and disgraceful, dishonourable and
unprofessional conduct. The Panel imposed a penalty including an oral
reprimand, a three month suspension and various terms, conditions and limitations
that included advising the College about certain matters and retaining and
attending sessions with a counselling expert to discuss matters at issue, including
communication with clients. [ ]
Decision
The panel considered the Agreed Statement of Facts and finds that the facts support a finding of
professional misconduct and, in particular, finds that the Member committed an act of
professional misconduct as alleged in paragraph 1, sub-paragraphs (a), (b), (c) and (d) in the
Notice of Hearing. The Member failed to meet the standards of practice of the profession with
respect to her care of her client and her communications with the client’s [parent].
Reasons for Decision
The Member admitted the allegation and the panel accepted that the Agreed Statement of Facts
and the statements of the witnesses contained therein support the allegations and the finding of
professional misconduct.
Penalty
Counsel for the College advised the panel that a Joint Submission as to Order had been agreed
upon. The Joint Submission as to Order provides as follows:
1. Requiring the Member to appear before the Panel to be reprimanded on a date to
be arranged but, in any event, within three (3) months of the date of the Order.
2. Directing the Executive Director to suspend the Member’s certificate of
registration for a period of three (3) months. This suspension shall take effect
from the date of this Order and shall continue to run without interruption so long
as the Member remits her annual membership fees on time. In the event that the
Member fails to pay her annual fees and her certificate of registration becomes
suspended for non-payment of fees, any portion of this suspension which has not
yet been served shall be served commencing on the day that the Member obtains a
new certificate of registration.
3. Directing the Executive Director to impose the following terms, conditions and
limitations on the Member’s certificate of registration:
a) Requiring the Member to return her current Annual Payment Card to the
College within fourteen (14) days of the date of the Order so that a new
Annual Payment Card, indicating that the Member’s certificate of registration
is subject to terms, conditions, and/or limitations, can be issued upon
completion of the suspension.
b) The Member shall, at her own expense, attend a remedial program (the
“Remedial Program”) with a Nursing Expert (“Expert”) that has expertise
with the College standards and therapeutic communication (the “Expert”) as
approved by the Director of Professional Conduct (the “Director”). The
number of sessions shall be determined by the Expert but in any event, should
include a minimum of three (3) sessions. The first session shall be completed
within two (2) months of the date of the Order. The second and third sessions
shall be completed within six (6) months of the date of the Order. If the
Expert determines that a greater number of sessions are required for the
successful completion of the Remedial Program, the Expert will advise the
Member and write to the Director 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 twenty-four
months of the date of the Order.
(c) Prior to the commencement of the meetings with the Expert referred to in subparagraph 3 (b) above, the Member shall:
(i) Provide the Expert with a copy of the Panel’s written Decision and
Reasons related to the Member’s prior findings of professional
misconduct, the Discipline Panel’s Order, Notice of Hearing, Agreed
Statement of Facts, Joint Submission on Order with any attachments, and,
if available, a copy of the Panel’s Decision and Reasons. If the Panel’s
Decision and Reasons are not available prior to the Member’s first
meeting with the Expert, the Member shall deliver to the Expert a copy of
the Panel’s Decision and Reasons within fourteen (14) days of it becoming
available.
(ii) Deliver to the Director a letter signed by the Expert confirming that the
Expert has received and reviewed the documents referred to in subparagraph 3 (c) (i) above and confirming the Expert’s agreement to
provide the Director with the report referred to in sub-paragraph 3 (h)
below.
(iii)Review the following College publications: Professional Standards
(Revised 2002); Therapeutic Nurse-Client Relationship (Revised 2006);
and Ethics. The Member shall complete a Reflective Questionnaire for
each publication and bring the completed Reflective Questionnaires to her
sessions with the Expert.
(iv) Complete the College’s online learning modules relating to Therapeutic
Nurse-Client Relationship, Professional Standards and Ethics and
complete the online participation form relevant to each module. The
Member shall print and bring a copy of the completed online participation
form to her sessions with the Expert.
(v) Review and complete the College’s self-directed learning package, One is
One Too Many, at her own expense, including the self-directed Nurses’
Workbook and bring the completed Nurses’ Workbook to her meeting with
the Expert.
(vi) Review and complete the Communication in Nursing Practice web module
at her own expense, including the Communication in Nursing Practice
workbook and bring the completed workbook to her meeting with the
Expert.
(d) The materials referred to in 3 (c) (iii) to (vi) above, should be delivered to the
Expert at least seven (7) days prior to her first session with the Expert. If the
materials referred to in 3 (c) (iii) to (vi) above are not received by the Expert,
the Expert can cancel the first session as scheduled.
(e) The subject of the sessions with the Expert shall include the following:
(i) The conduct for which the Member was found to have committed
professional misconduct;
(ii) An in-depth review of the materials referred to in sub-paragraphs 3 (c) (iii)
to (vi) above;
(iii) The Member’s understanding of the materials referred to in subparagraphs 3 (c) (iii) to (vi) above and in particular the materials relevant
to communication;
(iv) The potential consequences of that conduct to her clients, colleagues,
profession and herself;
(v) Strategies for preventing the unprofessional conduct from occurring again;
and,
(vi) The development of a learning plan.
(f) During the first session with the Expert, the Member shall develop a learning
plan in consultation with the Expert to address the subject of the meetings as
set out in sub-paragraphs 3 (e) (i) to (vi) above.
(g) During the second and third sessions with the Expert, the Member and the
Expert shall further discuss the subject of the meetings as set out in subparagraphs 3 (e) (i) to (vi) above and the implementation of the learning plan.
(h) Once the Member has completed all of the sessions with the Expert referred to
in sub-paragraph 3 (b) above, the Member shall ensure that the Director
receives from the Expert within forty-five (45) days of the last session a report
outlining the dates of the Member’s participation in the sessions, the
Member’s successful completion of the Remedial Program and the fact of her
completion of the sessions, together with the Expert’s assessment of the
Member’s insight into her behaviour.
(i) The Member shall not practi[s]e independently in the community until the
College has received the Expert report referred to in sub-paragraph 3 (h)
above.
(j) For a period of twenty-four (24) months following the date upon which the
Member returns to the practice of nursing, the Member shall:
(i)
Notify the Director of the name, address, and telephone number of all
employer(s) within fourteen (14) days of commencing or resuming
employment in any nursing position;
(ii)
Provide her employer(s) with a copy of the Panel’s Order, Notice of
Hearing, Agreed Statement of Facts, Joint Submission on Order, or, if
available, the Panel’s written Decision and Reasons, together with any
attachments. If the Decision and Reasons are not available on the day
the Member returns to nursing practice, the Member shall provide her
employer(s) with a copy of the Decision and Reasons within fourteen
(14) days of it becoming available;
(iii)
Only practi[s]e for an employer who agrees to, and does, write to the
Director, within fourteen (14) days of the commencement or
resumption of the Member’s employment in any nursing position, to
provide the Director with the following:
(a) Confirmation that the employer has received a copy of the
documents referred to in sub-paragraph 3 (j) (ii) above;
(b) Confirmation that the employer agrees to notify the Director
immediately upon receipt of any reasonable information that the
Member has breached the standards of practice of the profession;
(c) Confirmation that the employer agrees to conduct random spot
audits three (3) times annually by calling at least three of the
Member’s clients on each occasion to verify that the Member is
utilizing appropriate communication techniques which are
consistent with the therapeutic nurse-client relationship and the
employer(s) agree to notify the Director immediately upon receipt
of any reasonable information that the Member has breached the
standards of practice of the profession; and,
(d) Confirmation that the employer agrees to provide the Director with
performance appraisals regarding the Member’s nursing practice
completed by a member of the College as set out below in subparagraph 3 (k) after twelve (12) months and twenty-four (24)
months of employment.
(k) The Member shall only work for an employer who agrees to provide to the
Director performance appraisals completed by a member of the College after
twelve (12) months and twenty-four (24) months of employment regarding the
Member’s nursing practice, which performance appraisals shall confirm that
spot audits have been performed as indicated in sub-paragraph 3(j)(iii)(c),
above.
4. All deliveries and notifications to be given by or on behalf of the Member to the
College, the Expert and the employer(s) pursuant to these terms are to be made by
verifiable method of delivery, the proof of which the Member shall retain.
Penalty Submissions
The College submitted that the appropriate suspension in this matter is three months, bearing in
mind the Member’s admission and the overall Joint Submission on Order being proposed by the
parties. The suspension addresses general deterrence by indicating that the profession will not
tolerate unprofessional behaviour which demonstrates a serious misunderstanding of or lack of
insight into the power imbalance in the nurse/client relationship. The College believes that the
Member has acknowledged that her conduct was unprofessional and she has demonstrated this
through her cooperation with the College.
In addition, the proposed terms, conditions and limitations and in particular the remedial
program designed and agreed upon by the parties in the Joint Submission on Order address
specific deterrence.
The Member’s counsel submitted that the Member was shocked when she learned of comments
from the school and wants to use this opportunity to improve her communication skills. It will
also be a time of learning and self-reflection. The proposed terms are onerous but will be of
benefit to the Member’s understanding of why she is perceived in a way she does not intend.
Mitigating factors considered are:

the Member has admitted to the behaviour and cooperated with the College; and

the Member is open to remediation.
Aggravating factors:

this is repeated conduct; and

the Member was previously disciplined in 2001
Penalty Decision
The panel accepts the Joint Submission as to Penalty and accordingly orders:
1. The Member to appear before the Panel to be reprimanded on a date to be arranged but, in
any event, within three (3) months of the date of the Order.
2. The Executive Director to suspend the Member’s certificate of registration for a period of
three (3) months. This suspension shall take effect from the date of this Order and shall
continue to run without interruption so long as the Member remits her annual membership
fees on time. In the event that the Member fails to pay her annual fees and her certificate of
registration becomes suspended for non-payment of fees, any portion of this suspension
which has not yet been served shall be served commencing on the day that the Member
obtains a new certificate of registration.
3. The Executive Director to impose the following terms, conditions and limitations on the
Member’s certificate of registration:
a) Requiring the Member to return her current Annual Payment Card to the College within
fourteen (14) days of the date of the Order so that a new Annual Payment Card,
indicating that the Member’s certificate of registration is subject to terms, conditions,
and/or limitations, can be issued upon completion of the suspension.
b) The Member shall, at her own expense, attend a remedial program (the “Remedial
Program”) with a Nursing Expert (“Expert”) that has expertise with the College standards
and therapeutic communication (the “Expert”) as approved by the Director of
Professional Conduct (the “Director”). The number of sessions shall be determined by
the Expert but in any event, should include a minimum of three (3) sessions. The first
session shall be completed within two (2) months of the date of the Order. The second
and third sessions shall be completed within six (6) months of the date of the Order. If
the Expert determines that a greater number of sessions are required for the successful
completion of the Remedial Program, the Expert will advise the Member and write to the
Director 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 twenty-four months of the date of the Order.
c) Prior to the commencement of the meetings with the Expert referred to in sub- paragraph
3 (b) above, the Member shall:
(i) Provide the Expert with a copy of the Panel’s written Decision and Reasons
related to the Member’s prior findings of professional misconduct, the Discipline
Panel’s Order, Notice of Hearing, Agreed Statement of Facts, Joint Submission on
Order with any attachments, and, if available, a copy of the Panel’s Decision and
Reasons. If the Panel’s Decision and Reasons are not available prior to the
Member’s first meeting with the Expert, the Member shall deliver to the Expert a
copy of the Panel’s Decision and Reasons within fourteen (14) days of it
becoming available.
(ii) Deliver to the Director a letter signed by the Expert confirming that the Expert has
received and reviewed the documents referred to in sub-paragraph 3 (c) (i) above
and confirming the Expert’s agreement to provide the Director with the report
referred to in sub-paragraph 3 (h) below.
(iii)Review the following College publications: Professional Standards (Revised
2002); Therapeutic Nurse-Client Relationship (Revised 2006); and Ethics. The
Member shall complete a Reflective Questionnaire for each publication and bring
the completed Reflective Questionnaires to her sessions with the Expert.
(iv) Complete the College’s online learning modules relating to Therapeutic NurseClient Relationship, Professional Standards and Ethics and complete the online
participation form relevant to each module. The Member shall print and bring a
copy of the completed online participation form to her sessions with the Expert.
(v) Review and complete the College’s self-directed learning package, One is One
Too Many, at her own expense, including the self-directed Nurses’ Workbook and
bring the completed Nurses’ Workbook to her meeting with the Expert.
(vi) Review and complete the Communication in Nursing Practice web module at her
own expense, including the Communication in Nursing Practice workbook and
bring the completed workbook to her meeting with the Expert.
d) The materials referred to in 3 (c) (iii) to (vi) above, should be delivered to the Expert at
least seven (7) days prior to her first session with the Expert. If the materials referred to
in 3 (c) (iii) to (vi) above are not received by the Expert, the Expert can cancel the first
session as scheduled.
e) The subject of the sessions with the Expert shall include the following:
(i) The conduct for which the Member was found to have committed professional
misconduct;
(ii) An in-depth review of the materials referred to in sub-paragraphs 3 (c) (iii) to (vi)
above;
(iii) The Member’s understanding of the materials referred to in sub-paragraphs 3 (c) (iii)
to (vi) above and in particular the materials relevant to communication;
(iv) The potential consequences of that conduct to her clients, colleagues, profession and
herself;
(v) Strategies for preventing the unprofessional conduct from occurring again; and,
(vi) The development of a learning plan.
f) During the first session with the Expert, the Member shall develop a learning plan in
consultation with the Expert to address the subject of the meetings as set out in subparagraphs 3 (e) (i) to (vi) above.
g) During the second and third sessions with the Expert, the Member and the Expert shall
further discuss the subject of the meetings as set out in sub-paragraphs 3 (e) (i) to (vi)
above and the implementation of the learning plan.
h) Once the Member has completed all of the sessions with the Expert referred to in subparagraph 3 (b) above, the Member shall ensure that the Director receives from the
Expert within forty-five (45) days of the last session a report outlining the dates of the
Member’s participation in the sessions, the Member’s successful completion of the
Remedial Program and the fact of her completion of the sessions, together with the
Expert’s assessment of the Member’s insight into her behaviour.
i) The Member shall not practi[s]e independently in the community until the College has
received the Expert report referred to in sub-paragraph 3 (h) above.
j) For a period of twenty-four (24) months following the date upon which the Member
returns to the practice of nursing, the Member shall:
(i) Notify the Director of the name, address, and telephone number of all employer(s)
within fourteen (14) days of commencing or resuming employment in any nursing
position;
(ii) Provide her employer(s) with a copy of the Panel’s Order, Notice of Hearing, Agreed
Statement of Facts, Joint Submission on Order, or, if available, the Panel’s written
Decision and Reasons, together with any attachments. If the Decision and Reasons
are not available on the day the Member returns to nursing practice, the Member shall
provide her employer(s) with a copy of the Decision and Reasons within fourteen
(14) days of it becoming available;
(iii)Only practi[s]e for an employer who agrees to, and does, write to the Director, within
fourteen (14) days of the commencement or resumption of the Member’s employment
in any nursing position, to provide the Director with the following:
(a) Confirmation that the employer has received a copy of the documents referred to
in sub-paragraph 3 (j) (ii) above;
(b) Confirmation that the employer agrees to notify the Director immediately upon
receipt of any reasonable information that the Member has breached the standards
of practice of the profession;
(c) Confirmation that the employer agrees to conduct random spot audits three (3)
times annually by calling at least three of the Member’s clients on each occasion
to verify that the Member is utilizing appropriate communication techniques
which are consistent with the therapeutic nurse-client relationship and the
employer(s) agree to notify the Director immediately upon receipt of any
reasonable information that the Member has breached the standards of practice of
the profession; and,
(d) Confirmation that the employer agrees to provide the Director with performance
appraisals regarding the Member’s nursing practice completed by a member of
the College as set out below in sub-paragraph 3 (k) after twelve (12) months and
twenty-four (24) months of employment.
k) The Member shall only work for an employer who agrees to provide to the Director
performance appraisals completed by a member of the College after twelve (12) months
and twenty-four (24) months of employment regarding the Member’s nursing practice,
which performance appraisals shall confirm that spot audits have been performed as
indicated in sub-paragraph 3(j)(iii)(c), above.
4. All deliveries and notifications to be given by or on behalf of the Member to the College, the
Expert and the employer(s) pursuant to these terms are to be made by verifiable method of
delivery, the proof of which the Member shall retain.
Reasons for Penalty Decision
The panel concluded that the proposed penalty is reasonable and in the public interest. The
Member has cooperated with the College and, by agreeing to the facts and a proposed penalty,
has accepted responsibility for her actions. The suspension addresses general deterrence by
indicating that the profession will not tolerate unprofessional behaviour toward vulnerable
clients, and in particular, behaviour which demonstrates a serious misunderstanding of, or lack of
insight into the power imbalance in the nurse/client relationship.
While it is unusual for a Member who is being disciplined a second time to receive a suspension
of the same duration as she received the first time, the suspension must be placed in the context
of the overall penalty. The suspension does not stand alone. The terms, conditions and
limitations, and in particular, the remedial program, address specific deterrence. The remedial
program will enable the Member to review the College publications with a specific focus on
communication, engage in self-reflection and develop strategies for more effective
communication. The Member will only be permitted to return to independent nursing in the
community after the successful completion of the remedial program. This meets the College’s
mandate of protecting the public interest.
I, Margaret McGinn, 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 as listed below:
Chairperson
Panel Members:
Marilyn McGill, RPN
Monica Seawright, RPN
Lyn Harrington, Public Member
Gino Cucchi, Public Member
Date