DISCIPLINE COMMITTEE OF THE COLLEGE OF NURSES OF ONTARIO. PANEL: Michael Hogard, RPN Chairperson Lindsay Hyslop, NP Member

Transcription

1 DISCIPLINE COMMITTEE OF THE COLLEGE OF NURSES OF ONTARIO PANEL: Michael Hogard, RPN Chairperson Lindsay Hyslop, NP Member Bill Dowson Public Member BETWEEN: COLLEGE OF NURSES OF ONTARIO ) JEAN CLAUDE KILLEY for ) College of Nurses of Ontario - and - ) ) TANIS BAKER ) NO REPRESENTATION for Registration No. IB02201 ) Tanis Baker ) ) ) ) Heard: March 16, 2012 DECISION AND REASONS This matter came on for hearing before a panel of the Discipline Committee on March 16, 2012 at the College of Nurses of Ontario ( the College ) at Toronto. The Allegations The allegations against Tanis Baker (the Member ) as stated in the Notice of Hearing dated February 15, 2012 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 engaged in the practice of nursing as a Registered Practical Nurse at [the Facility], you contravened a standard of practice of the profession or failed to meet the standards of practice of the profession, in respect of the following incident:

2 a) at some time after November 13, 2009, and before April 10, 2010, you engaged in an intimate personal relationship with the husband of a client, while providing care to the client. 2. You have committed an act of professional misconduct as provided by subsection 51(1)(c) of the Health Professions Procedural Code of the Nursing Act, 1991, S.O. 1991, c. 32, as amended, and defined in subsection 1(7) of Ontario Regulation 799/93, in that, while engaged in the practice of nursing as a Registered Practical Nurse at the Facility, you abused a client emotionally in respect of the following incident: a) at some time after November 13, 2009, and before April 10, 2010, you engaged in an intimate personal relationship with the husband of a client, while providing care to the client. 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 engaged in the practice of nursing as a Registered Practical Nurse at the Facility, 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 respect of the following incident: a) at some time after November 13, 2009, and before April 10, 2010, you engaged in an intimate personal relationship with the husband of a client, while providing care to the client. Member s Plea The Member admitted the allegations set out in paragraphs numbered 1 (a), 2 (a), and 3 (a) 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 admission was voluntary, informed and unequivocal. Agreed Statement of Facts Counsel for the College advised the panel that an agreement had been reached on the facts and introduced an Agreed Statement of Facts [ ] which provided as follows. THE MEMBER 1. Tanis Sherida Baker (the Member ) attended nursing school [and] graduated in The Member registered with the College of Nurses of Ontario (the College ) as a Registered Practical Nurse ( RPN ) on January 21, 1992.

3 3. The Member was employed at [the Facility] between April 19, 2009 and April 5, THE FACILITY 4. The Facility is located in [ ], Ontario. 5. The Facility is a full-service retirement facility for seniors[]. The Facility provides a variety of services for clients, including housekeeping, assistance with activities of daily living and meeting dietary needs. 6. The Facility employs Registered Nurses, RPNs, and Personal Support Workers. 7. Approximately 80 percent of residents at the Facility have some form of dementia. THE CLIENT 8. [The Client] was admitted to the Facility [in] She suffered from Alzheimer s disease. 9. At the time, the Client had been married to [the spouse] for approximately 60 years. Their two sons, [ ] are both married. ([The sons] and their wives are hereinafter referred to as the Family ). 10. [The spouse] was 83 years old at the time of the allegations. The Family described [the spouse] as vulnerable and distraught as a result of the rapid onset of [the Client] s condition. 11. The Family selected the Facility after looking into various options. The Facility was also located in close proximity to the Client s former home where the [spouse] was living. 12. The Member provided care to the Client from November 2009 until April Her role included administering medications, conducting assessments and intervening with behavioural concerns, as required. INCIDENT RELEVANT TO ALLEGATIONS OF PROFESSIONAL MISCONDUCT 13. [The spouse] began to discuss his personal life with the Member in December She said [the spouse] told her that he was lonely and lived in an empty house. The Member said she and [the spouse] developed a friendship and that the friendship developed into an intimate relationship in March 2010.

4 Decision 14. On April 10, 2010, [one of the sons] visited his father, [the spouse], at his home. When [the son] entered the living room, he saw the Member sitting on the sofa. At the time, [the spouse] told his son that he was having a personal relationship with the Member. 15. [The son] left [the] house and returned the next day with the Family. The Family confronted [the spouse] about the relationship. [The spouse] confirmed that he was having a relationship with the Member. He stated that he was not sleeping with the Member but intended on doing so soon. 16. [The spouse] explained that he and the Member had discussed the Member moving into his house, as well as having [ ] the Client move back into [the spouse] s home to continue being cared for by the Member. 17. The Member resigned from the Facility on April 5, The Client remains at the Facility. ADMISSIONS OF PROFESSIONAL MISCONDUCT 18. The Member admits that she committed the acts of professional misconduct as alleged in paragraphs 1(a), 2(a) and 3(a) of the Notice of Hearing, as described in paragraphs 13 to 17 above. The panel considered the Agreed Statement of Facts and the Member s plea. The panel finds that the plea and facts support a finding of professional misconduct and, in particular, finds that the Member committed an act of professional misconduct as alleged in paragraphs 1(a), 2(a) and 3(a) of the Notice of Hearing in that, by engaging in an intimate personal relationship with the husband of a client, while providing care to the client, the Member failed to meet the standards of the profession, abused a client emotionally and acted dishonourably and unprofessionally. Reasons for Decision The Agreed Statement of Facts are clear. The panel accepted the facts as presented. In particular the panel found that the Member s conduct was dishonourable, and unprofessional in that it involved abuse of a vulnerable client, and took place over an extended period of time; and would reasonably be regarded by members of the profession as such. 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:

5 1. Requiring the Member to appear before the Panel to be reprimanded within three (3) months of the date of this Order. 2. Directing the Executive Director to suspend the Member s certificate of registration for three (3) months. This suspension shall take effect from the date the Member obtains an active certificate of registration. 3. Directing the Executive Director to impose the following terms, conditions and limitations on the Member s certificate of registration, when she obtains an active certificate of registration: a) The Member will attend two (2) sessions with a Nursing Expert (the Expert ), at her own expense. To comply, the Member is required to ensure that: i. The Expert has expertise in the therapeutic nurse-client relationship, has been approved by the Director of Professional Conduct (the Director ) in advance of the meetings, and has confirmed that he/she will provide a report following the sessions; ii. At least 7 days before the first meeting, 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, and 4. this Joint Submission on Penalty iii. Before the first meeting, the Member reviews the following College publications and completes the associated Reflective Questionnaires and online learning modules: 1. Professional Standards (Revised 2002), and; 2. Therapeutic Nurse-Client Relationship (Revised 2006). iv. Before the first meeting, the Member reviews and completes the College s self-directed learning package, One Is One Too Many, at her own expense, including the self-directed Nurses Workbook; v. At least seven (7) days before the first meeting, the Member provides the Expert with a copy of the completed Reflective Questionnaires, online participation forms and Nurses Workbook; vi. The subject of the sessions with the Expert will include: 1. the acts or omissions for which the Member was found to have committed professional misconduct,

6 2. the potential consequences of the misconduct to the Member s clients, colleagues, profession and self, 3. strategies for preventing the misconduct from recurring, and, 4. the publications, questionnaires and modules set out above. vii. Within 30 days after the Member has completed the last session, the Expert forwards his/her report to the Director, 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 her behaviour; viii. If the Member does not comply with any 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 her certificate of registration; b) For a period of 12 months from the day the Member obtains an active certificate of registration n, the Member will notify her employers of this decision. To comply, the Member is required to ensure that: (i) (ii) The Director is notified of the name, address, and telephone number of all employer(s) within fourteen (14) days of commencing or resuming employment in any nursing position; Provide her employer(s) with a copy of: 1. the Panel s Order, 2. the Notice of Hearing, 3. the Agreed Statement of Facts, 4. this Joint Submission on Penalty, and (iii) Within fourteen (14) days of the commencement or resumption of the Member s employment in any nursing position, the employer(s) forward(s) a report to the Director, in which it will confirm: 1. that it received a copy of the required documents, and 2. that [it] agrees to notify the Director immediately upon receipt of any information that the Member has breached the standards of practice of the profession; and (iv) All documents delivered by the Member to the College, the Expert or the employer(s) will be made by verifiable method of delivery, the proof of which the Member will retain.

7 Penalty Submissions Counsel for the College advised the panel that the Member has resigned her membership with the College. Counsel also stated that the penalty proposed considers both protection of the public while recognizing the Member s specific circumstances. Counsel also presented the following aggravating and mitigating factors: Aggravating Factors The misconduct represented a serious breach of trust; The misconduct involved a vulnerable client; The misconduct continued over a protracted period of months. Mitigating Factors The Member has no prior discipline history with the College; The Member took responsibility for her actions. Counsel submitted that the proposed penalty meets the objective of general and specific deterrence. The proposed penalty sends a message to the public that this type of behaviour will not be tolerated and will be treated severely by members of the profession and the public as a whole, while specifically, the suspension, remediation, and reprimand send[ ] a clear message to the Member that her behaviour was unacceptable. The Member submitted that she has been practi[s]ing nursing for 23 years and has no desire to return to the practice of nursing. Penalty Decision The panel accepts the Joint Submission as to Order and accordingly orders: 1. Requiring the Member to appear before the Panel to be reprimanded within three (3) months of the date of this Order. 2. Directing the Executive Director to suspend the Member s certificate of registration for three (3) months. This suspension shall take effect from the date the Member obtains an active certificate of registration. 3. Directing the Executive Director to impose the following terms, conditions and limitations on the Member s certificate of registration, when she obtains an active certificate of registration: a) The Member will attend two (2) sessions with a Nursing Expert (the Expert ), at her own expense. To comply, the Member is required to ensure that: i. The Expert has expertise in the therapeutic nurse-client relationship, has been approved by the Director of Professional Conduct (the Director ) in

8 advance of the meetings, and has confirmed that he/she will provide a report following the sessions; ii. At least 7 days before the first meeting, 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, and 4. this Joint Submission on Penalty iii. Before the first meeting, the Member reviews the following College publications and completes the associated Reflective Questionnaires and online learning modules: 1. Professional Standards (Revised 2002), and; 2. Therapeutic Nurse-Client Relationship (Revised 2006). iv. Before the first meeting, the Member reviews and completes the College s self-directed learning package, One Is One Too Many, at her own expense, including the self-directed Nurses Workbook; v. At least seven (7) days before the first meeting, the Member provides the Expert with a copy of the completed Reflective Questionnaires, online participation forms and Nurses Workbook; vi. The subject of the sessions with the Expert will include: 1. the acts or omissions for which the Member was found to have committed professional misconduct; 2. the potential consequences of the misconduct to the Member s clients, colleagues, profession and self; 3. strategies for preventing the misconduct from recurring; and 4. the publications, questionnaires and modules set out above. vii. Within 30 days after the Member has completed the last session, the Expert forwards his/her report to the Director, 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 her behaviour; viii. If the Member does not comply with any 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 her certificate of registration;

9 b) For a period of 12 months from the day the Member obtains an active certificate of registration, the Member will notify her employers of this decision. To comply, the Member is required to ensure that: (i) (ii) The Director is notified of the name, address, and telephone number of all employer(s) within fourteen (14) days of commencing or resuming employment in any nursing position; Provide her employer(s) with a copy of: 1. the Panel s Order, 2. the Notice of Hearing, 3. the Agreed Statement of Facts, 4. this Joint Submission on Penalty, and (iii) Within fourteen (14) days of the commencement or resumption of the Member s employment in any nursing position, the employer(s) forward(s) a report to the Director, in which it will confirm: 1. that it received a copy of the required documents, and 2. that [it] agrees to notify the Director immediately upon receipt of any information that the Member has breached the standards of practice of the profession; and (iv) All documents delivered by the Member to the College, the Expert or the employer(s) will be made by verifiable method of delivery, the proof of which the Member will 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 order, has accepted responsibility for her actions. The panel considered [ ] the submissions by [both] College Counsel and the Member, and found that the proposed order is acceptable and in the public interest. The proposed order sends a message to the profession that abuse of vulnerable clients is totally unacceptable and will not be tolerated. Specifically for the Member, the period of suspension (should she choose to return to practice), the oral reprimand, and program of remediation all send a message denouncing her behaviour and allow for her to learn from her conduct and take action to prevent it in the future. 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 as listed below:

10 Chairperson Date Names of panel members Lindsay Hyslop, NP Bill Dowson, Public Member