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DISCIPLINE COMMITTEE
OF THE COLLEGE OF NURSES OF ONTARIO
PANEL: Lori McInerney, RN Chairperson
Jim Attwood, RN Member
Dennis Curry, RN Member Grace Isgro-Topping Public Member
Joan King Public Member
BETWEEN:
) GLYNNIS BURT for
COLLEGE OF NURSES OF ONTARIO ) for College of Nurses of Ontario
)
- and - ) CAROL STEPHENSON for
) Brenda Lee Lacroix
)
)
BRENDA LACROIX )
Registration No. 8200453 )
)
) Heard: June11-14, 2007
AMENDED DECISION AND REASONS
This matter came on for hearing before a panel of the Discipline Committee on Monday, June
11, 2007 at the College of Nurses of Ontario (the “College”) at Toronto.
The Allegations
The allegations against Brenda Lacroix (the “Member”) as stated in the Notice of Hearing dated
December 6, 2005 (Exhibit #1) are as follows:
1. You have committed an act or acts of professional misconduct as provided by subsection
51(1)(a) of the Health Professions Procedural Code in that you have been found guilty of
an offence or offences relevant to your suitability to practise, in that you:
(a) were convicted of breaking and entering the home of [A] in circumstances
involving:
(i) a physical assault by you of [A] involving a weapon, namely, a syringe;
and/or
(ii) [withdrawn];
(b) were convicted of breach of a recognizance which required that you refrain from
communication with [A], among other things; and,
(c) were convicted of mischief in circumstances where you drove a motor vehicle
while impaired as a result of alcohol and drug ingestion.
2. You have committed an act or acts of professional misconduct as provided by subsection
51(1)(c) of the Health Professions Procedural Code and defined in paragraph 1.37 of
Ontario Regulation 799/93, in that on or about November 7, 2002, you engaged in
conduct or performed an act or acts 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 you:
(a) broke into the private home of [A] and [B]; and/or
(b) physically assaulted [A] in her home using your body; and/or
(c) physically assaulted [A] in her home using a weapon, namely, a syringe; and/or
(d) [withdrawn]; and/or
(e) [withdrawn].
3. You have committed an act or acts of professional misconduct as provided by subsection
51(1)(c) of the Health Professions Procedural Code and defined in paragraph 1.37 of
Ontario Regulation 799/93, in that on or about December 15 and 16, 2002, you engaged
in conduct or performed an act or acts 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 you:
(a) communicated with [A] and/or [B] in circumstances where you were the subject
of a recognizance which required that you refrain from communication with them,
among other things; and/or
(b) you drove a motor vehicle while impaired as a result of alcohol and drug
ingestion.
College Counsel requested that allegations 1 (a) (ii) and 2 (d) and (e) of the Notice of Hearing be
withdrawn.
Member’s Plea
The Member admitted the allegations set out in paragraphs #1, #2 and #3 in the Notice of
Hearing. The panel conducted a plea inquiry and was satisfied that the Member’s admission was
voluntary, informed and unequivocal. In addition the panel received a written plea inquiry,
signed by the Member (Exhibit # 2).
Procedural History
Counsel for the College and Counsel for the Member jointly made a motion for a partial
publication/broadcasting ban, specifically:
a) paragraph [ ] of the Agreed Statement of Facts with respect to Professional
Misconduct allegations, such that the words [ ] are redacted in the public version of
the Decision and Reasons; and
b) appendix A of the Agreed Statement of Facts with respect to professional misconduct
Allegations not be included in the public version of the Decision and Reasons.
The panel deliberated and made an order granting the relief sought by the parties because the
information concerned the Member’s health records and was of a confidential nature.
Agreed Statement of Facts
NOTE: References to exhibits and appendices were inserted by Counsel prior to the hearing and
do not reflect actual exhibit numbers assigned in the hearing.
Counsel for the College advised the panel that agreement had been reached on the facts and
introduced an Agreed Statement of Facts with Respect to Professional Misconduct Allegations,
as follows:
MEMBER’S BACKGROUND
1. The Member obtained her Diploma in Nursing from [ ] College in 1981 and her
registration at the College of Nurses of Ontario ("College of Nurses") that same year.
She has completed certificates in Nursing Assessment Skills and Critical Care and
Emergency Care, as well various courses in the Bachelor of Science in Nursing program
at the University of [ ].
2. Since 1981 the Member has worked at [the Hospital] where she continues to work to the
present. In 1984 she became a full time employee. Her work history can be summarized
as follows:
(a) from 1983 to 1994, the Member worked as a staff nurse in the Intensive Care
Unit and on a medical floor;
(b) from 1994 to August 2000, and then February 2001 to July 2001, the Member
worked as a staff nurse in the Intensive Care Unit and emergency department;
(c) up until 2000, in addition to working full time at the Hospital, the Member was
also employed by 4 companies to perform insurance medical assessments;
(d) from September 2000 to January 2001, the Member was on a six month medical
leave of absence;
(e) from August 2001 until December 2003, the Member took a second medical
leave of absence.
3. From 1986 until going on medical leave in August 2001, the Member assumed the
following additional responsibilities at the Hospital:
(a) preceptor to nursing students, as well as a mentor/orientator of new staff to the
hospital unit;
(b) member of the following hospital committees from time to time: [ ];
(c) team leader of a four member team which served as instructors/mentors for the
new Cardiac-Telemetry Monitoring System;
(d) WHIMIS unit representative at the hospital;
(e) organiser of public relations and social events for [the Hospital] Staff
Association; and
(f) representative for her employer at the French Language Association of [ ].
4. In addition, from 1986 – 2000, the Member held the position of treasurer of the
local/bargaining unit of the Ontario Nurses' Association.
5. [ ]. She has been involved in [ ] community activities outside nursing [ ].
6. The Member has practised nursing for 25 years. During that time she has not had any
complaints made against her at the College, she does not have any history of discipline or
fitness to practise problems, and she has no prior criminal convictions prior to the events
giving rise to the present allegations.
EVENTS RELATING TO THE ALLEGATION
7. From September 2000 to February 2001, the Member took a six month leave of absence
from her duties at [the Hospital] due to [medical] and personal difficulties [ ].
8. In February 2001, the Member returned to work in the ICU and emergency department at
the Hospital. During this month the Member and her [spouse] legally separated after a
20-year marriage.
9. In August 2001, the Member took another extended medical leave of absence from the
hospital due to depression. The Member was abusing alcohol but did not recognize her
addiction at the time, and was having difficulty coping with the numerous stresses in her
life.
10. Throughout 2001 and 2002, the Member continued on her medical leave of absence from
work, and was under the care of physicians. She continued to suffer depression, abused
alcohol, and was unable to cope.
11. In late November 2001, the Member began an affair with a married man, [B]. The affair
ended for a brief period in February 2002 when [B’s spouse (A)] learned about it, but
resumed thereafter.
12. In November 2002, the Member was drinking heavily. If the Member were to testify, she
would say that she believed that [A] was suspicious that the affair with [B] was ongoing,
and feared that [A] had been involved in the Member's car being stolen, some items being
taken from her home and hang-up phone calls she had received.
13. On November 7, 2002, the Member went to the home of [A and B]. As a result of events
which occurred at the house that day the Member was arrested and charged with various
criminal offences as will be described in greater detail below.
14. At the Member's criminal trials, the Member did not dispute the following facts as
described by the Crown:
(a) On November 7, 2002, the Member went to the home of [A and B]. The
Member had previously made arrangements with [B] to meet him that morning
at an area motel. She knew that [B] planned to leave home at about 7:30 a.m.
(b) [A and B] lived in a reasonably remote, rural location about one kilometre from
the nearest town, at the end of a long driveway approximately one-half kilometre
in length. Their nearest neighbour was about ¾ of a kilometre away.
(c) The day before, the Member had marked a path to [A and B’s] house through
some nearby woods using marking tape.
(d) Sometime prior to 7:30 a.m. on November 7, 2002, the Member parked her car
on a nearby road and made her way along the path which she had marked
through the bush to the [ ] home.
(e) The Member had with her various items including camouflage cloth, plastic
handcuffs, latex gloves, syringes, two small bottles of Lorazepam, rope, a Swiss
Army knife, green flagging tape, medical supplies, pliers, a black handled filet
knife in a sheath, and a blue balaclava.
(f) The Member entered the [ ] house, which was unlocked. The Member was
wearing a Halloween mask. [A] saw the Member enter the house.
(g) The Member attempted to order [A] to the floor and to put her hands behind her
back. [A] refused.
(h) The Member had a plastic toy gun which [A] grabbed. The plastic gun broke in
the struggle. [A] pulled off the Halloween mask and recognized the Member.
(i) A physical altercation between [A] and the Member ensued. [A] described the
Member as being extremely agitated, preoccupied, constantly looking over her
shoulder, and at times appearing distraught with a crazed look in her eyes during
the physical altercation. The physical struggle went on for approximately two
hours. During this struggle, the Member told [A], among other things, that she
had an accomplice who was cutting phone lines.
(j) Eventually, [A] agreed to sit on the floor and place her hands behind her neck.
The Member then tricked [A] into looking away, claiming she had brought some
videos with disturbing material on them. When [A] looked away, the Member
pulled a syringe from her bag and stuck [A] in the leg with it. [A] pulled the
syringe out of her leg and attempted to stab the Member with it, resulting in the
syringe breaking. The syringe contained a saline solution with trace amounts of
Lorazepam.
(k) [A] suffered various injuries from the struggle, which were not of a permanent
nature. The Member suffered physical injuries in the altercation as well.
(l) At approximately 9:20 a.m., someone knocked on the residence door to inquire
about buying a trailer. This diversion allowed [A] to call 911. The police
arrived. The Member was still present and was arrested.
(m) The Member was charged with various criminal offences and released on terms,
including a recognizance which prohibited her from communicating with [A and
B] and from being in [ ] unless accompanied by a family member.
(n) Blood tests performed on [A] revealed trace amounts of Lorazepam in [A’s]
blood.
(o) Approximately six weeks after the assault, on December 15, 2002, [B] received
a telephone call which he suspected was from the Member. The caller hung up,
but [B] called the number displayed on his telephone. The first time, the female
answerer said she didn’t believe she was speaking with [B] and that he was an
impostor and hung up. Given the bizarre nature of the first telephone call [B]
called back a second time. On this occasion, the male answerer identified
himself by his first name and said that the Member had just stepped out, or was
not there. He asked [B] to forget about the call.
(p) The next day, December 16, 2002, the Member telephoned [B] saying that she
wanted to explain the telephone call of the previous day. [B] told the Member
that she was not to call his residence and hung up. The Member then sent a fax
apologizing for any distress the call may have caused and said that it had been
placed by [ ] as a prank. [B] contacted the police. The police spoke with the
Member on the telephone that same morning and asked her to surrender herself
at the police station.
(q) The police went to the residence where the Member was staying to check on her
well-being. She had been scheduled to attend in court and had not appeared.
The police found a note on a napkin on the table indicating she had gone to [ ]
expecting to be arrested.
(r) As the police left the residence they saw the Member’s vehicle travelling on the
road about three houses away from the residence. They turned to stop the
vehicle and saw it turn into the driveway of the residence. The police followed
the vehicle into the driveway. As they approached, the Member drove her
vehicle into the backyard area and stopped the car. The Member verbally
identified herself to the police. The police observed that the Member was very
disoriented and rummaging around inside the vehicle trying to retrieve her
wallet, papers, and her cigarettes. The Member would not look at the police.
(s) The police observed and retrieved an open bottle of wine from the centre console
of the car and arrested the Member. The Member did not want to exit her
vehicle despite numerous instructions to do so. The Member had difficulty
exiting the vehicle and had to be assisted in order to stand up. When they
searched the Member, the police found on her person a pill bottle and white pills
marked Lorazepam. The Member had to be assisted to walk to the police cruiser
because she was staggering. She had difficulty getting into the back of the
cruiser, and a strong odour of alcohol emanated from the back seat area. The
Member told police she had taken eight Lorazepam and five Percocet, as well as
alcohol. The police found two more pill bottles in the vehicle which the
Member indicated were Gravol.
(t) The police took the Member directly to [the Hospital] where she was seen by
someone from the Acute Mental Health section of the hospital because she said
she had intended to kill herself. The Member was very unsteady on her feet, her
eyes were bloodshot, and she had difficulty focussing. She appeared very
groggy and her speech was slurred. Following the Member’s assessment, the
police noted that she had been crying and had difficulty sitting up in bed. A test
for the Member’s blood alcohol level indicated a reading of 40 milligrams of
alcohol in 100 millilitres of blood. The Member was admitted to hospital.
15. As a result of the events of December 16, 2002, the Member was charged with breaches
of her recognizance and impaired driving.
16. The Member remained in [the Hospital] for four weeks from December 16, 2002 to
January 17, 2003. The Member was seen by a psychiatrist while at the Hospital and a
referral was made to the [a health centre].
17. The Member was held in detention following her discharge from [the Hospital].
18. The Member was admitted to [the health centre] on February 11, 2003 and was
discharged on May 13, 2003. At [the health centre] the Member was treated for
substance abuse and completed a three month residential treatment program. During this
admission, the Member received psychiatric treatment, rehabilitation and assessments,
and participated in the addictions rehabilitation program. Her treating psychiatrist at [the
health centre] made a discharge diagnosis prognosis and recommended follow-up
aftercare and support. A copy of the discharge summary was attached as Appendix “A”
to the Agreed Statement of Facts with Respect to Professional Misconduct.
CRIMINAL CONVICTIONS
19. On February 6, 2003 the Member pleaded guilty to break and enter, contrary to section
348(1)(b) of the Criminal Code of Canada (hereinafter "Criminal Code"), in respect of
the events of November 7, 2002, as described in paragraphs 14(a) to 14(l) herein.
20. On July 17, 2003, the Member pleaded guilty to breach of her recognizance, contrary to
section 145(3) of the Criminal Code, in respect of the events of December 15 and 16,
2003, as described in paragraphs 14(o) to 14(r) herein.
21. In respect of the convictions described in paragraphs 19 to 20, the Member received a
conditional sentence of 10 months imprisonment to be served in the community, seven
months of which she was confined to residence, and 24 months probation. Additional
conditions included a requirement that she attend and comply with a treatment program
for substance abuse and mental health issues.
22. In July 2003, court-imposed restrictions, which did not permit the Member to leave her
home unaccompanied, were varied to permit her to travel to receive treatment and
support.
23. On November 5, 2003, the Member pleaded guilty to mischief, contrary to subsection
430(4) of the Criminal Code, in respect of the December 16, 2002 incident when she was
stopped while driving under the influence of alcohol and drugs. She was sentenced to a
fine of $600.00 and 12 months probation.
24. The Member served the "house arrest" portion of her conditional sentence from
September 2003 to April 12, 2004. She complied with all of the terms of her Conditional
Sentence Order in respect of the convictions for break and enter and breach of
recognizance which ended July 11, 2004. The concurrent 12 month Probation Order in
respect of the conviction for mischief expired on November 4, 2004. The probation
order related to the convictions for break and enter and breach of recognizance expired on
July 11, 2006. The Member's Conditional Sentence Supervisor and Probation Officers
have confirmed that the Member has been compliant with all terms of her conditional
sentence and probation.
MEMBER’S RETURN TO WORK
25. In December 2003, the Member’s medical leave of absence from work ended and she
returned to work at the Hospital as follows:
(a) Commencing in December 2003 the Member worked on a medical floor for 5
months as a staff nurse in a temporary fulltime position;
(b) In May 2004 she applied for her present position of "Clinical Care and
Discharge Resource Nurse" and was the successful candidate;
(c) In January 2007, the Member assumed the role of Clinical Resource Charge
Nurse for a newly created Geriatric Medical Unit at the Hospital, in addition to
her position as Clinical Care and Discharge Resource Nurse; and
(d) Since January 2006 the Member has acted as Wound Care Team Champion
(team leader) at the Hospital.
EXPERT OPINION
26. The College of Nurses of Ontario has had this matter reviewed by an expert, [ ]. [The
expert] obtained her Bachelor of Science in Nursing from [ ] and has been a member of
the College of Nurses of Ontario since January 1, 1965. [The expert] obtained her
Masters of Science in Nursing in 1983 from [ ], and her Ph.D. in 1989 from [ ]. [The
expert] began work as a staff nurse in the Psychiatric Unit at [a hospital] in 1965 and
ultimately became a Professor in the Department of Psychiatry and the Faculty of
Nursing at [ ].
27. If [the expert] were to testify, she would opine that, based on the facts set out above, the
Member’s criminal convictions for break and enter, breach of recognizance and mischief
are relevant to both the practice of nursing and to the Member’s suitability to practice
nursing, and that the Member has engaged in conduct in all of the circumstances that
would reasonably be regarded by members of the profession as disgraceful,
dishonourable or unprofessional. [The expert] would say that based on the facts set out
above, the Member’s behaviour represents a fundamental violation of the values
espoused by the nursing profession in that the Member’s conduct was, among other
things, violent and abusive.
MISCELLANEOUS
28. If the Member were to testify, she would express great remorse for her actions. In July
2003, she provided [A] with a written letter of apology, which she read to [A] in open
Court.
ADMISSIONS
29. The Member admits that she committed acts of professional misconduct as provided by
subsection 51(1)(a) of the Health Professions Procedural Code of the Nursing Act, 1991,
c. 32 as amended in that she was convicted of the following offences which are relevant
to her suitability to practice:
(a) on February 6, 2003, she was convicted of break and enter into the home of [B
and A] on November 7, 2002, contrary to section 348(1)(b) of the Criminal
Code, in circumstances which involved a physical assault of [A] with both her
body and with a syringe which contained traces of Lorazepam;
(b) on July 17, 2003, she was convicted of breach of a recognizance which required
that she refrain from communication with [A] or any member of her immediate
family, contrary to subsection 145(3) of the Criminal Code; and
(c) on November 5, 2003, she was convicted of mischief, contrary to subsection
430(4) of the Criminal Code, in circumstances where she drove a motor vehicle
while impaired as a result of alcohol and drug ingestion.
30. The Member further admits that she committed acts of professional misconduct as
provided by subsection 51(c) of the Health Professions Procedural Code of the Nursing
Act, 1991, c. 32 as amended, in that she committed the following acts which would
reasonably be regarded by members of the profession as disgraceful, dishonourable or
unprofessional:
(a) on November 7, 2002 she broke into the private home of [B and A] and
physically assaulted [A], including an assault with her body and assault with a
syringe which contained traces of Lorazepam;
(b) on December 16, 2002 she communicated with [B] in breach of her
recognizance which required that she refrain from communication with him,
among other things; and
(c) on December 16, 2002 she drove a motor vehicle while impaired as a result of
alcohol and drug ingestion.
Decision
The panel deliberated and finds that the Member committed acts of professional misconduct in
that the Member has been found guilty of offences relevant to her suitability to practise, namely:
breaking and entering the home of [A] in circumstances which involved a physical
assault of [A] involving a weapon, namely a syringe;
breach of a recognizance which required that she refrain from communication with
[A], among other things; and
conviction of mischief, in circumstances where she drove a motor vehicle while
impaired as a result of alcohol and drug ingestion.
The panel further finds that the Member committed acts of misconduct, in that the Member
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 and
unprofessional, in that the Member:
broke into the private home of [A] and [B];
physically assaulted [A] in her home using her body;
physically assaulted [A] in her home using a weapon, namely, a syringe; and
drove a motor vehicle while impaired as a result of alcohol and drug ingestion.
The panel further finds that the Member committed an act of misconduct, in that the Member
engaged in conduct relevant to the practice of nursing that, having regard to all the
circumstances, would reasonably be regarded by members as unprofessional, specifically, that
the Member:
communicated with [A] and/or [B] in circumstances where she was the subject of a
recognizance which required her to refrain from communicating with them .
The panel grants leave to the College to withdraw the allegations set out at paragraphs 1a(ii) and
2(d) and 2(e) of the Notice of Hearing.
The panel further orders that paragraph [ ] of the Agreed Statement of Facts with respect to
professional misconduct allegations, such that the words [ ] are redacted in the public version of
the Decision and Reasons; and that appendix A of the Agreed Statement of Facts with respect to
professional misconduct allegations not be included in the public version of the Decision and
Reasons.
Reasons for Decision
The Panel agrees that the facts related to the break and enter, the physical assault involving a
weapon, namely a syringe, and the impaired driving conviction are clear and uncontested and
that the Member’s conduct in this regard would reasonably be regarded by members as
disgraceful, dishonourable and unprofessional. As such, the Panel finds the Member committed
acts of professional misconduct as provided by subsection 51(1)(c) of the Health Professions
Procedural Code and defined in paragraph 1.37 of Ontario Regulation 799/93.
The Member’s intent regarding the communications with [A] and [B], detailed in allegation 3(a),
is not as clear. The panel finds that the fax sent by the Member was an effort to apologize and
therefore not disgraceful or dishonourable. However, the panel finds the Member’s actions
unprofessional in that she breached a court order to refrain from communicating with [A] and
[B].
Penalty
NOTE: References to exhibits and appendices were inserted by Counsel prior to the hearing and
do not reflect actual exhibit numbers assigned in the hearing.
The Member and the College made a Joint Submission as to Penalty as follows:
MS LACROIX AND THE COLLEGE JOINTLY SUBMIT that, in view of Ms Lacroix’s
admissions of professional misconduct, the circumstances set out in the Agreed Statement of
Facts with respect to professional misconduct, and the circumstances set out in the Agreed
Statement of Facts with respect to penalty, the Panel of the Discipline Committee (“the Panel”)
should make an Order as follows:
1. Requiring the Member to appear before the Panel to be reprimanded at a date to be
arranged but, in any event, within three (3) months of the date this Order becomes
final.
2. Directing the Executive Director to suspend the Member’s Certificate of Registration
for five (5) months. The suspension shall take effect on the date that this Order
becomes final and shall run continuously without interruption.
3. Directing the Executive Director to impose the following terms, conditions and
limitations on the Member’s Certificate of Registration:
(a) Commencing immediately, and until such time as [Dr. A] is satisfied that the
Member does not pose a threat of safety to clients, and in any event for a
period of not less than eighteen months, the Member shall:
(i) only practice nursing for an employer where other registered nurses
are employed, and will not practice independently or in the
community; and
(ii) attend for forensic psychiatric treatment and monitoring with [Dr. A]
at such frequency as [Dr. A] deems appropriate, but in any event no
less than four times per year (once each quarter); and
(iii) personally bear the cost of the sessions with [Dr. A] (in the sense that
she will be personally responsible to ensure that [Dr. A] is paid for
the sessions referred to in paragraph 3.(a)(ii) herein, whether by
herself or by a third party, but in no event shall The College of
Nurses of Ontario be responsible for this cost); and
(iv) follow the treatment advice and direction of [Dr. A] and shall attend
for treatment and/or counselling by other healthcare professionals
should [Dr. A] consider it appropriate; and
(v) not abuse any substances and shall remain free of alcohol and any
controlled or mood altering drug unless such drug is prescribed by a
treating physician, and the Member shall only take such prescribed
drug after consultation with and the approval of [Dr. A]; and
(vi) consent to undergo random, supervised urine testing whenever
requested by her family physician, to occur not less than once per
month; and
(vii) advise anyone responsible for the collection and testing of the urine
samples referred to in sub-paragraph 3(a)(vi) above, that:
A. all urine samples obtained should be immediately measured for
a body core temperature of 37 degrees and if not found to be
temperature specific then a directly witnessed urine sample
must be obtained to replace the sample originally given; and
B. all samples must be tested for all psycho-active substances,
including alcohol; and
C. a second test of the sample is to be done in the event of a
positive result; and
(viii) authorize the results of any random urine testing performed pursuant
to paragraph 3.(a)(vi) to be released to both the College, and the
Member’s family physician;
(b) provide to [Dr. A] copies of the following documents:
(i) [Dr. B]’s reports dated May 29 and July 11, 2003; and
(ii) [Dr. C]’s report dated March 13, 2006; and
(iii) transcripts of the 2003 criminal court proceedings for each of February
6, July 7, July 17, July 29, August 7, September 12, and November 5,
2003; and
(iv) a copy of the Member’s certificates of conviction; and
(v) the Panel’s Penalty Order with the attached Notice of Hearing, Agreed
Statement of Facts, Joint Submission on Penalty and any attachments to
those documents and, if available, the panel’s written Decision and
Reasons;
(c) the Member shall obtain and deliver to the Director of Investigations and
Hearings (“the Director”) of the College, within thirty (30) days from the day
the Member’s appeal rights end as a result of exhaustion, expiry or waiver, a
letter signed by [Dr. A]:
(i) confirming receipt of the documents referred to in 3(b) above; and
(ii) agreeing, during the time period set out in paragraph 3(a) above, to
notify the Director immediately, in writing, if:
A. in his opinion the Member’s health (mental, emotional or
physical) may interfere with her ability to practice nursing safely;
and/or
B. in his opinion the Member has failed to comply with treatment
recommendations made by him; and/or
C. in his opinion or based upon information which he receives the
Member has failed to comply with any of the terms, conditions
and limitations imposed upon her certificate of registration;
and/or
D. in his opinion, the Member is showing signs of substance abuse;
and;
(iii) agreeing to cooperate with the College by providing such information as
the Director may require to ensure that the Member is complying with
the terms, conditions and limitations on her certificate of registration;
and
(d) the Member shall sign a Consent and/or a Release in the College’s favour to
enable the College to communicate with [Dr. A] regarding the Member’s
treatment and her compliance with the terms, conditions and limitations; and
(e) the Member shall not substitute another physician for [Dr. A] without first
obtaining the agreement of the Director to do so; and
(f) the Member shall advise the Director of the name of the Member’s family
physician; and
(g) the Member shall provide her family physician with copies of the following
documents:
(i) [Dr. B’s] reports dated May 29 and July 11, 2003; and
(ii) [Dr. A’s] report dated October 25, 2005; and
(iii) [Dr. C’s] report dated March 13, 2006; and
(iv) the panel’s Penalty Order with the attached Notice of Hearing, Agreed
Statement of Facts, Joint Submission on Penalty and any attachments to
those documents and, if available, the panel’s written Decision and
Reasons; and
(h) the Member shall obtain and deliver to the Director, within thirty (30) days
from the day the Member’s appeal rights end as a result of exhaustion, expiry
or waiver, a letter signed by the Member’s family physician:
(i) confirming receipt of the documents referred to in 3(g) above;
(ii) in which the Member’s family physician agrees to:
A. request and conduct supervised urine tests from the Member to be
conducted once per month on a random basis; and
B. immediately test all urine samples obtained from the Member for a
body core temperature of 37 degrees and, if not found to be
temperature specific, then to obtain a directly-witnessed urine
sample from the Member to replace the sample originally given;
and
C. order a test for all urine samples obtained from the Member for all
psycho-active substances, including alcohol; and
(iii) order that a second test of the urine sample be performed in the event that
a positive result is obtained with the first sample; and
(iv) advise the Director within a reasonable time in the event:
A. any of the Member’s urine samples obtained pursuant to sub-
paragraphs 3(a)(vi) and 3(h)(ii) and (iii) above test positive for any
psycho-active substance or alcohol, and to advise on what date the
sample(s) was obtained and whether it tested positive for any
substance on one or two tests; and/or
B. in his or her opinion the Member’s health (mental, emotional or
physical) may interfere with her ability to practice nursing safely;
and/or
C. in his or her opinion the Member has failed to comply with
treatment recommendations made by him or her; and/or
D. in his or her opinion, the Member is showing signs of substance
abuse; and/or
E. in his or her opinion or based upon information which he receives
the Member has failed to comply with any of the terms, conditions
and limitations imposed upon her certificate of registration; and
(v) cooperate with the College by providing such information as the Director
may require to ensure that the Member is complying with the terms,
conditions and limitations on her certificate of registration; and
(i) the Member shall sign a Consent and/or a Release in the College’s favour to
enable the College to communicate with the Member’s family physician
regarding the Member’s treatment and her compliance with the terms,
conditions and limitations; and
(j) the Member shall not substitute another physician for the Member’s current
family physician as identified to the Director without first obtaining the
agreement of the Director to do so; and
(k) for a period of eighteen months following completion of the suspension
imposed by the Discipline Committee:
(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. Notification shall be in writing and
sent by verifiable form of delivery, such as courier, the proof of which
delivery the Member shall retain; and
(ii) only practice nursing for an employer who agrees:
A. to receive, in advance of the Member accepting or resuming a
nursing position with that employer, the panel’s Penalty Order with
the attached Notice of Hearing, the Agreed Statement of Facts with
respect to Professional Misconduct (without appendices), copies of
the Certificates of Conviction pertaining to this matter (appendices
“B”, “C” and “D” to the previous document), the Agreed
Statement of Facts with respect to Penalty (without exhibits), the
Joint Submission on Penalty, and, if available, the panel’s written
Decision and Reasons; and
B. to write to the Director within 14 days of the Member commencing
employment to:
a) confirm the date the member’s employment commenced;
and
b) confirm the employer’s receipt and review of the
documents referred to in 3(k)(ii)A, above; and
c) acknowledge that the employer, and any staff the employer
deems necessary, are aware of the restrictions on the
Member’s certificate of registration; and
d) to notify the Director immediately upon receipt of any
reasonable information that the Member has failed to meet
the professional standards expected of her (including any
boundary violation) and/or has demonstrated any signs or
symptoms of substance abuse, including and in particular
any signs of unusual or repeated absenteeism and/or
lateness; and
(l) in the event the Director or his or her delegate receives information from
which she or he forms a reasonable belief that the Member’s health may be
affecting her ability to practice nursing safely or that she has failed to comply
with any of the terms, conditions and limitation imposed on her certificate of
registration, the Member shall consent to the Director or his or her delegate
contacting the Member’s employer(s) and/or [Dr. A] and/or the Member’s
family physician to obtain information to determine whether the Member’s
health is affecting her ability to practice nursing safely; and
(m) the Member shall authorize employer(s) and/or [Dr. A] and/or the Member’s
family physician to speak freely with the Director or his or her delegate about
any issue or topic, including any issue or topic which would otherwise be
confidential; and
(n) the Member shall not do anything which would detrimentally affect her
employer’s or physicians’ ability to comply with the agreement(s) referred to
above.
In addition, College Counsel and the Counsel for the Member presented the following Agreed
Statement of Facts with Respect to Penalty (Exhibit #4 – Tab A).
Member’s After-Care & Recovery Program
1. Since her discharge from [the health centre] in May 2003, the Member has received the
following treatment and counselling:
(a) From July 2003, to approximately March 2004 the Member received individual
counselling with an addictions counsellor at [ ], initially on a bi-weekly basis,
and subsequently monthly;
(b) From July 2003 to approximately March 2004, the Member attended sessions
with a social worker on a bi-weekly basis until the fall of 2003 and subsequently
monthly;
(c) The Member has attended for family counselling;
(d) From July 2003 to April 2004, the Member attended every two weeks for
individual psychotherapy from [Dr. D], a physician who specializes in addiction
counselling for health professionals. Since May 2004, she continues to see [Dr.
D] as needed;
(e) From July 2003 to November 2006, the Member attended sessions of the [ ]
which provides group therapy restricted to health professionals. From July 2003
to April 2004, she attended weekly sessions, and thereafter bi-weekly sessions
until November 2006;
(f) Since July 2003, she has attended meetings of a substance abuse support group
on a regular basis, and continues to attend these meetings approximately three to
four times per week. She is currently very involved in the program and is active
in her group chairing meetings and speaking when asked at open meetings; and
(g) Since February 2006, the Member has attended counselling sessions with
psychiatrist [Dr. A] approximately once per month.
2. If [Dr. D] were to testify he would confirm the information and opinion he has
provided in two letters dated April 15, 2004 and May 30, 2007. Copies of these letters
were attached to the Agreed Statement of Facts with Respect to Penalty as Exhibits “1” &
“2”, respectively.
The Member's Return to Work
3. By letter dated December 15, 2003, psychiatrist [Dr. E] provided his opinion that the
Member was stable enough from a psychiatric point of view to return to work. Attached
to the Agreed Statement of Facts with Respect to Penalty was Exhibit “3” is a copy of a
letter dated December 15, 2003, from [Dr. E].
4. On December 30, 2003, the Member resumed working at [the Hospital] as a staff nurse
on a medical floor in a temporary full time position. A performance appraisal by her
supervisor/manager dated April 26, 2004 confirmed she met all expectations in this
position.
5. In approximately May 2004, the Member applied for the position of Clinical Care and
Discharge Resource Nurse and was the successful candidate. In May 2004, she began
working in this position, which is a senior leadership position with focus on coordination
of care of medical patients, resource person for staff members and discharge planning of
patients. A performance appraisal by her supervisor dated March 26, 2006 confirmed she
met all expectations in this position. In addition, the Member is an active member on a
number of hospital committees, including medical committees.
6. [ ], the Member’s Manager at the Hospital since September 2004, has provided a letter
dated April 20, 2007, confirming that the Member is working within the standards
expected of her as a nurse since she returned to work in December 2003. A copy of that
letter, dated April 20, 2007, was attached to Agreed Statement of Facts with Respect to
Penalty as Exhibit “4”.
Member’s Apology Letter
7. The Member apologized to [A] during the course of the criminal proceedings in 2003.
Attached to the Agreed Statement of Facts with Respect to Penalty as Exhibit “5” was a
copy of the Member’s apology letter dated July 2003.
Member’s Probationary Period
8. The Member’s Probation Officers, [ ] and [ ], have confirmed that the Member has been
compliant with all terms of her conditional sentence and probation, and all probation
orders have now expired.
Expert Opinions
9. The Member was assessed by [Dr. A] on April 12 and May 12, 2005. [Dr. A] provided a
written opinion of his assessment of Ms Lacroix dated October 24, 2005. If [Dr. A] were
to testify he would provide the opinion set out in a copy of his October 24, 2005 report
which was attached to the Agreed Statement of Facts with Respect to Penalty as Exhibit
“6”. A copy of [Dr. A’s] CV was attached as Exhibit “7”.
10. The Member’s conduct and the written opinion of [Dr. A’s] has been reviewed and
considered by [Dr. C]. If [Dr. C] were to testify he would provide his opinion set out in
his report dated March 13, 2006, a copy of which was attached to the Agreed Statement
of Facts with Respect to Penalty as Exhibit as “8”. A copy of [Dr. C]’s CV was attached
as Exhibit “9”.
11. In considering [Dr. A]’s opinion, [Dr. C] also took into consideration the reports of [Dr.
B] dated May 29 and July 11, 2003, which reports were provided in the course of the
criminal proceedings with respect to Ms Lacroix’s criminal convictions. If [Dr. B] were
to testify he would provide his opinion set out in his reports dated May 29 and July 11,
2003, copies of which are attached to the Agreed Statement of Facts with Respect to
Penalty as Exhibits “10” and “11”, respectively.
12. [Dr. A] has provided two recent reports dated May 14 and May 15, 2007, respectively. If
[Dr. A] were to testify he would confirm the information and provide his opinion set out
in these two reports. Copies of these reports were attached to the Agreed Statement of
Facts with Respect to Penalty as Exhibits “12” and “13”, respectively.
Member’s Documents
13. Attached to the Agreed Statement of Facts with Respect to Penalty were the following
documents bearing “exhibit” numbers to that document as indicated:
14. i) Letters from Treating Professionals
Exhibit “14” Letter: [ ], Social Work Department, [ ]
Hospital.
March 23, 2004
Exhibit “15” [Addiction Treatment Services] Discharge
Summary for Case Base, [ ]
April 2, 2004
Exhibit “16” Letter: [ ], Family and Child Therapist January 15, 2007
15. ii) Letters from Probation Officers
Exhibit “17” Letter: [ ], Conditional Sentence Supervisor December 15, 2003
Exhibit “18” Letter: [ ], Conditional Sentence
Supervisor, Probation and Parole Officer
March 31, 2004
Exhibit “19” Letter: [ ], Probation and Parole Officer November 21, 2005
Exhibit “20” Letter: [ ], Probation and Parole Officer December 12, 2006
iii) Documents from [the Hospital] (Performance Appraisals and/or Letters from
Colleagues and/or Other)
Exhibit “21” Letter: [Colleague A] August 4, 2003
Exhibit “22” Letter: [ ], Vice President, Clinical
Programs
April 2, 2004
Exhibit “23” Report of Performance Appraisal April 6, 2004
Exhibit “24” Letter: [ ], Clinical Director Medical
Program, [the Hospital]
November 24, 2005
Exhibit “25” Letter: [ ], Clinical Care and Discharge
Resource Registered Nurse, [the Hospital]
December 20, 2005
Exhibit “26” [Hospital] Certificate of Recognition (one
year perfect attendance record)
2005
Exhibit “27” Letter: [Colleague A] January 2, 2006
Exhibit “28” Letter: [ ], Vice President, Patient Services January 13, 2006
Exhibit “29” Performance Appraisal including Director’s
Performance Planning Worksheet and Self-
evaluation component (12 pages)
March 28, 2006
Exhibit “30” Memorandum: [ ] May 11, 2006
Exhibit “31” Letter: [ ], Clinical Manager – Medical
Program
November 9, 2006
Exhibit “32” Letter: [ ] February 5, 2007
Exhibit “33” Letter: [Colleague B] (nurse) March 5, 2007
Exhibit “34” Letter: [ ], Clinical Manager – Medical
Programs, [the Hospital]
April 28, 2007
Exhibit “35” [Hospital] Certificate of Recognition (two
years’ perfect attendance)
Fax date May 18, 2007
Exhibit “36” Letter (peer evaluation): [Colleague C],
Reg. N.
Undated
Exhibit “37” Letter: [Colleague C], R.N. Undated
iv) Member’s Professional Development
Exhibit “38” Typed summary of Member’s professional
development activities in the years 2004 to
2007 and related certificates of attendance
2004 to 2007
Exhibit “39” Algonquin College transcript of Academic
Record and attached program description
for the Ontario Management Development
Business Management Skills Certificate
program.
May 26, 2006
v) Miscellaneous
Exhibit “40” Letter: [ ], Nursing Professor, [ ] College June 17, 2004
Exhibit “41” E-mail: Thank you to Brenda Lacroix re
treatment of [ ].
July 19, 2005
Exhibit “42” Letter: [client A] November 15, 2005
Exhibit “43” Letter: [client B] December 5, 2005
Exhibit “44” Letter: [client C] December 5, 2005
Exhibit “45” Thank you card: [client D] September 2006
Exhibit “46” Letter: [Client B] January 2007
Exhibit “47” Thank you letter: [ ] and [ ] March 2007
Exhibit “48” Card: Thank you to Brenda for caring for
[ ].
Undated
Exhibit “49” Handwritten note: Thank you to Brenda
while [ ] was in hospital.
Undated
Exhibit “50” Card: Thank you to Brenda and [ ] Undated
Exhibit “51” Thank you card: Family of [client F] Undated
It was the submission of College Counsel that the penalty provides specific deterrence to the
Member and general deterrence to the membership. It ensures protection of the public and
provides for remediation, rehabilitation and monitoring of the Member’s behaviour. College
Counsel submitted that the criminal acts the Member engaged in were egregious and contrary to
the ethics of nursing which are based on helping not hurting. Counsel referred to four previous
discipline decisions to demonstrate that the five month suspension was within the appropriate
range. College Counsel submitted the following aggravating factors for the panel’s consideration
in assessing the Joint Submission as to Penalty:
the events of Nov. 7, 2002 were pre-planned. The Member had marked a route through
the woods to the [A and B’s] home the previous evening and had ensured that [B] would
be away from the house. She brought a number of items including a syringe and then
entered the house wearing a mask;
the attack on [A] was a violent, physical assault; and
the Member used a syringe, which she was able to access through her nursing workplace,
as a weapon.
College Counsel also submitted a number of mitigating factors for the panel’s consideration of
the Joint Submission as to Penalty, which included the fact that the Member:
had no previous criminal history or findings at the College;
the Member had admitted her professional misconduct and was cooperating fully with the
College;
the Member had shown remorse by her letter to [A] (Exhibit #4, tab 5);
the member had served her criminal sentence without incident;
continues to live with a measure of public scrutiny;
had made considerable efforts to rehabilitate (Exhibit #4, tab A); and
has returned to work at the hospital where she had worked for over 25 years and has had
3 ½ years with good performance appraisals, including a promotion.
Additionally, College Counsel submitted that this was a single incident involving the member
and at the time of the incident the Member suffered from depression and [substance abuse
issues].
College Counsel cautioned the panel against putting too much weight on the reference letters
which were included in Agreed Statement of Fact with Respect to Penalty (Exhibit #4). She
stated that letters of reference should legitimately speak to the Member’s character but not to the
penalty.
Counsel for the Member agreed that the penalty was appropriate for these particular
circumstances considering the Member’s background, personal circumstances at the time of the
event, mental health at the time of the events, and the treatment, counselling and remediation
undertaken by the Member. Counsel for the Member submitted that the experts’ opinions
regarding the Member’s current mental health and work performance should be considered by
the panel.
Counsel for the Member submitted mitigating factors should be taken into account by the panel
in considering the Joint Submission as to Penalty, such factors included the fact that the Member:
had no previous history with the College or the Courts;
has co-operated fully with the College;
was suffering from depression and [substance abuse issues] at the time of the event.
Counsel made extensive reference to the opinions [Dr. A], a forensic psychiatrist, and
[Dr. D], an addictive disorders specialist;
has had a 25 year career at [the Hospital] although she was on leave at the time of the
event;
had acknowledged her guilt both to the Courts and the College;
had served her sentence without incident; 10 month conditional sentence, 2 year
probation and $600 fine;
has engaged in a significant After-Care and Recovery Program; (Exhibit #4, Tab A);
has had 3 ½ years of successful work performance at [the Hospital] since the incident;
and
current health status, as reported in a letter dated May 30, 2007 from [Dr. D] in which he
found the Member fit to practise nursing responsibly, safely and ethically.
Additionally, Counsel for the Member submitted that the incident was out of character both
professionally and personally. Counsel referred the panel to letters written by [Colleague A] and
[Colleague B,] who have worked with the Member for over 25 years. As well, four and one-half
years have passed since the incident and the Member has maintained sobriety.
After considerable deliberation, the panel requested both Counsels to make further submission
respecting the appropriateness of the lengthy 5 month suspension proposed in the Joint
Submission as to Penalty
College Counsel stressed the seriousness of the offence, stating the importance of sending a
strong message, through penalty, to the Member and to the membership at large. She reminded
the panel that this was a Discipline, and not a Fitness to Practice, hearing. In her submission, she
submitted it would be the wrong approach to suspend all or part of a suspension for the reason
that a member suffered from mental illness at the time of the offence, but, by the time of the
hearing, had been rehabilitated. She said there was nothing in this penalty detrimental to the
Member’s recovery and that the Member would be able to continue her nursing career after
serving the suspension.
College Counsel drew the attention of the panel to the case of R. v. Dewald, [2001] O.J. No.
1716 (QL), in which the Ontario Court of Appeal considered the benchmark to be used when
considering changes to the terms of a Joint Submission as to Penalty. The key point made by the
Court in that case was at para. 29, “….Judges may reject a joint submission if accepting it would
be contrary to the public interest or would otherwise put the administration of justice into
disrepute.”
In summary, College Counsel reinforced the point that the Panel had a joint submission before it,
signed by the Member.
Counsel for the Member also reiterated that the penalty was submitted by both parties. However,
she did remind the members of the panel that they were to weigh all the facts when considering
the penalty.
With regard to the Dewald case, Counsel for the Member drew attention to a point made in
dissent by the Judge J.A. Carthy at para. 24:
“General deterrence becomes a modest concern because parents in
this state of depression do not think rationally about the
consequences of their acts. Rehabilitation becomes a more
prominent concern than individual deterrence once the cause of the
crime is identified as a mental health problem”
Counsel for the Member then paraphrased [Dr. A]’s evidence, in which he opined that the
Member’s psychiatric “state” drove her behaviour.
Penalty Decision
The Panel has deliberated carefully and thoroughly, recognizing the seriousness of the
allegations and the proposed penalty.
The panel believes that the suspension of five months would more appropriately be suspended
but finds that the proposed penalty would not meet the bar of being contrary to the public interest
or otherwise bring the administration of justice into disrepute.
Therefore, the panel accepts the Joint Submission as to Penalty and makes an order:
1. That the member shall appear before the panel to be reprimanded at a date to be arranged
but, in any event, within three (3) months of the date this Order becomes final;
2. The Executive Director shall suspend the Member’s Certificate of Registration for five
(5) months. The suspension shall take effect on the date that this Order becomes final and
shall run continuously without interruption;
3. The Executive Director shall impose the following terms, conditions and limitations on
the Member’s Certificate of Registration:
a. commencing immediately, and until such time as [Dr. A] is satisfied that the Member
does not pose a threat of safety to clients, and in any event for a period of not less
than eighteen months, the Member shall:
i. only practice nursing for an employer where other registered nurses are
employed, and will not practice independently or in the community; and
ii. attend for forensic psychiatric treatment and monitoring with [Dr. A] at
such frequency as [Dr. A] deems appropriate, but in any event no less than
four times per year (once each quarter); and
iii. personally bear the cost of the sessions with [Dr. A] (in the sense that she
will be personally responsible to ensure that [Dr. A] is paid for the
sessions referred to in paragraph 3.(a)(ii) herein, whether by herself or by
a third party, but in no event shall The College of Nurses of Ontario be
responsible for this cost); and
iv. follow the treatment advice and direction of [Dr. A] and shall attend for
treatment and/or counselling by other healthcare professionals should [Dr.
A] consider it appropriate; and
v. not abuse any substances and shall remain free of alcohol and any
controlled or mood altering drug unless such drug is prescribed by a
treating physician, and the Member shall only take such prescribed drug
after consultation with and the approval of [Dr. A]; and
vi. consent to undergo random, supervised urine testing whenever requested
by her family physician, to occur not less than once per month; and
vii. advise anyone responsible for the collection and testing of the urine
samples referred to in sub-paragraph 3.(a)(vi) above, that:
1. all urine samples obtained should be immediately measured for a
body core temperature of 37 degrees and if not found to be
temperature specific then a directly witnessed urine sample must
be obtained to replace the sample originally given; and
2. all samples must be tested for all psycho-active substances,
including alcohol; and
3. a second test of the sample is to be done in the event of a positive
result; and
viii. authorize the results of any random urine testing performed pursuant to
paragraph 3.(a)(vi) to be released to both the College, and the Member’s
family physician;
b. the Member shall provide to [Dr. A] copies of the following documents:
i. [Dr. B’s] reports dated May 29 and July 11, 2003; and
ii. [Dr. C’s] report dated March 13, 2006; and
iii. transcripts of the 2003 criminal court proceedings for each of February 6,
July 7, July 17, July 29, August 7, September 12, and November 5, 2003;
and
iv. a copy of the Member’s certificates of conviction; and
v. the Panel’s Penalty Order with the attached Notice of Hearing, Agreed
Statement of Facts, Joint Submission on Penalty and any attachments to
those documents and, if available, the panel’s written Decision and
Reasons;
c. the Member shall obtain and deliver to the Director of Investigations and Hearings
(“the Director”) of the College, within thirty (30) days from the day the Member’s
appeal rights end as a result of exhaustion, expiry or waiver, a letter signed by [Dr.
A]:
i. confirming receipt of the documents referred to in 3(b) above; and
ii. agreeing, during the time period set out in paragraph 3(a) above, to notify
the Director immediately, in writing, if:
1. in his opinion the Member’s health (mental, emotional or physical)
may interfere with her ability to practice nursing safely; and/or
2. in his opinion the Member has failed to comply with treatment
recommendations made by him; and/or
3. in his opinion or based upon information which he receives the
Member has failed to comply with any of the terms, conditions and
limitations imposed upon her certificate of registration; and/or
4. in his opinion, the Member is showing signs of substance abuse;
and
iii. agreeing to cooperate with the College by providing such information as
the Director may require to ensure that the Member is complying with the
terms, conditions and limitations on her certificate of registration; and
d. the Member shall sign a Consent and/or a Release in the College’s favour to enable
the College to communicate with [Dr. A] regarding the Member’s treatment and her
compliance with the terms, conditions and limitations; and
e. the Member shall not substitute another physician for [Dr. A] without first obtaining
the agreement of the Director to do so; and
f. the Member shall advise the Director of the name of the Member’s family physician;
and
g. the Member shall provide her family physician with copies of the following
documents:
i. [Dr. B’s] reports dated May 29 and July 11, 2003; and
ii. [Dr. A’s] report dated October 25, 2005; and
iii. [Dr. C’s] report dated March 13, 2006; and
iv. the panel’s Penalty Order with the attached Notice of Hearing, Agreed
Statement of Facts, Joint Submission on Penalty and any attachments to
those documents and, if available, the panel’s written Decision and
Reasons; and
h. the Member shall obtain and deliver to the Director, within thirty (30) days from the
day the Member’s appeal rights end as a result of exhaustion, expiry or waiver, a
letter signed by the Member’s family physician:
i. confirming receipt of the documents referred to in 3(g) above;
ii. in which the Member’s family physician agrees to:
1. request and conduct supervised urine tests from the Member to be
conducted once per month on a random basis; and
2. immediately test all urine samples obtained from the Member for a
body core temperature of 37 degrees and, if not found to be
temperature specific, then to obtain a directly-witnessed urine
sample from the Member to replace the sample originally given;
and
3. order a test for all urine samples obtained from the Member for all
psycho-active substances, including alcohol; and
iii. order that a second test of the urine sample be performed in the event that
a positive result is obtained with the first sample; and
iv. advise the Director within a reasonable time in the event:
1. any of the Member’s urine samples obtained pursuant to sub-
paragraphs 3(a)(vi) and 3(h)(ii) and (iii) above test positive for any
psycho-active substance or alcohol, and to advise on what date the
sample(s) was obtained and whether it tested positive for any
substance on one or two tests; and/or
2. in his or her opinion the Member’s health (mental, emotional or
physical) may interfere with her ability to practice nursing safely;
and/or
3. in his or her opinion the Member has failed to comply with
treatment recommendations made by him or her; and/or
4. in his or her opinion, the Member is showing signs of substance
abuse; and/or
5. in his or her opinion or based upon information which he receives
the Member has failed to comply with any of the terms, conditions
and limitations imposed upon her certificate of registration; and
v. cooperate with the College by providing such information as the Director
may require to ensure that the Member is complying with the terms,
conditions and limitations on her certificate of registration; and
i. the Member shall sign a Consent and/or a Release in the College’s favour to enable
the College to communicate with the Member’s family physician regarding the
Member’s treatment and her compliance with the terms, conditions and limitations;
and
j. the Member shall not substitute another physician for the Member’s current family
physician as identified to the Director without first obtaining the agreement of the
Director to do so; and
k. for a period of eighteen months following completion of the suspension imposed by
the Discipline Committee, 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. Notification shall be in writing and
sent by verifiable form of delivery, such as courier, the proof of which
delivery the Member shall retain; and
ii. only practice nursing for an employer who agrees:
1. to receive, in advance of the Member accepting or resuming a
nursing position with that employer, the panel’s Penalty Order with
the attached Notice of Hearing, the Agreed Statement of Facts with
respect to Professional Misconduct (without appendices), copies of
the Certificates of Conviction pertaining to this matter (appendices
“B”, “C” and “D” to the previous document), the Agreed
Statement of Facts with respect to Penalty (without exhibits), the
Joint Submission on Penalty, and, if available, the panel’s written
Decision and Reasons; and
2. to write to the Director within 14 days of the Member commencing
employment to:
a. confirm the date the member’s employment commenced;
and
b. confirm the employer’s receipt and review of the
documents referred to in 3(k)(ii)A, above; and
c. acknowledge that the employer, and any staff the employer
deems necessary, are aware of the restrictions on the
Member’s certificate of registration; and
d. to notify the Director immediately upon receipt of any
reasonable information that the Member has failed to meet
the professional standards expected of her (including any
boundary violation) and/or has demonstrated any signs or
symptoms of substance abuse, including and in particular
any signs of unusual or repeated absenteeism and/or
lateness; and
l. in the event the Director or his or her delegate receives information from which she
or he forms a reasonable belief that the Member’s health may be affecting her ability
to practice nursing safely or that she has failed to comply with any of the terms,
conditions and limitation imposed on her certificate of registration, the Member shall
consent to the Director or his or her delegate contacting the Member’s employer(s)
and/or [Dr. A] and/or the Member’s family physician to obtain information to
determine whether the Member’s health is affecting her ability to practice nursing
safely; and
m. the Member shall authorize employer(s) and/or [Dr. A] and/or the Member’s family
physician to speak freely with the Director or his or her delegate about any issue or
topic, including any issue or topic which would otherwise be confidential; and
n. the Member shall not do anything which would detrimentally affect her employer’s or
physicians’ ability to comply with the agreement(s) referred to above.
Reasons for Penalty Decision
The oral reprimand is a specific deterrent for the Member. The terms, limits and conditions are
general deterrents for both the Member and the membership. The monitoring and rehabilitation
of the Member will protect the public.
The issue of concern for the panel was the lengthy five month suspension. Considering the
circumstances of this case, including the length of time since the event, the completion of the
sentence from the Court, the Member’s successful rehabilitation, the Member’s three and one-
half years of productive work as an RN and the reports from the treating doctors, the panel
believed that a suspended five month suspension would have been sufficient to serve the goals of
general and specific deterrence. However, the panel recognised that this change to the Joint
Submission on Penalty would fall short of the judicial bar in that it would not be contrary to the
public interest or otherwise bring the administration of justice into disrepute.
Procedural History
After the panel’s decision was recorded, three motions were made regarding the
publication/broadcasting ban of some of the evidence, which had been before the panel.
First, Counsel for the College and Counsel for the Member jointly requested a
publication/broadcasting ban on Tabs 1, 2, 3, 6, 8, 10, 11, 12, 13, 14, 15, 16, 21, 27, 42, 43, 44,
45, and 46 of the Agreed Statement of Fact with Regards to Penalty (Exhibit #4). The documents
appearing in these tabs contained detailed health records. The motion was considered by the
panel and was granted under the authority of section 45(2)(b) of the Regulated Health
Professions Act, 1991, in that the Member’s right to confidentiality outweighed the public
interest in this instance.
Second, Counsel for the Member made a motion for numerous redactions from the Agreed
Statement of Facts with Respect to Penalty, Exhibit #4, and the redaction of names of Doctors
and counselling programs contained within the Index of Exhibit # 4 be made. The panel declined
the Member’s request as it did not believe that the Member’s right to privacy outweighed the
public’s right to access this information. However, there was one exception. The panel granted
the relief sought in connection with paragraph 1(f) of the Agreed Statement of Facts with
Respect to Penalty, as requested.
Third, Counsel for the College requested that the victim and the victim’s spouse be identified
only by initials. Counsel for the Member did not oppose this request. The motion was granted
under subsection 45(3) of the Regulated Health Professions Act, 1991.
I, Lori McInerney, 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 Date
Panel Members:
Jim Attwood, RN
Dennis Curry, RN
Grace Isgro-Topping, Public Member
Joan King, Public Member