How to Defend CNO Complaints 

As a Registered Nurse (RN), Registered Practical Nurse (RPN), or Nurse Practitioner (NP) in Ontario, having a formal complaint filed with the College of Nurses of Ontario (CNO) can have very serious implications on a member’s license and their ability to continue the practice of nursing. Unless obviously without merit, the College must investigate all formal complaints it receives in regard to its members. As such, receiving a formal complaint can be a stressful experience, compounded by the fact that the process may seem complex and overwhelming.

Regardless of whether or not the nurse feels as though the complaint against them has any merit, they will almost always have to provide the College with a written response to the allegations being made against them. All nurse members of the College have an obligation to cooperate fully with any and all College investigations and failure to do so may result in further disciplinary action being taken against the nurse. To assist in guiding members of the College through the complaint process, our Firm has developed this guide that can be utilized by nurses when preparing responses to complaints filed with the College of Nurses of Ontario.

When a formal complaint is filed against a nurse by a member of the public or another member of the College, the College will promptly provide the impugned nurse with a copy of the complaint. A letter detailing the allegations against the nurse as well as any other relevant supporting documentation and records of any previous investigations or decisions against the nurse will be mailed to the member. The letter will also contain information regarding the next steps in the complaint process, which generally involves the nurse submitting a written response to the allegations against them within thirty days of receiving the complaint. This response is essentially the nurses defence to the allegations against them. As such, it is imperative that the response address all aspects of the complaint in a meaningful way. Nurses who are inexperienced with drafting such responses are encouraged to contact qualified legal counsel prior to submitting the response to ensure the best possible outcome.

If you are a Nurse and would like more information on professional misconduct investigations at the College of Nurses in Ontario, click here.

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Responding to CNO Complaints and Investigations

When drafting a response, nurses should ensure they address all aspects of the allegations. If more than one allegation is made, each allegation must be addressed separately and in full. Additionally, it is helpful to address allegations and incidents in chronological order, as this makes the sequence of events easier for those reading the response to follow. It is important to read and understand all appropriate legislation and regulations prior to drafting a response to ensure that the nurse is aware of what exactly is expected of them in their practice. This will also help nurses identify possible shortcomings in their practice.

Where there is merit to the allegations made, it is important for the nurse to take responsibility for their deficiencies as this is the only way to learn from one’s mistakes. It is important to the College that members learn from their mistakes in order to avoid repeating the same behaviour in future practice. It is also necessary to consider any possible civil liability that could stem from the actions of the nurse. Our Firm can help you navigate the sometimes-complex process of drafting a response to a complaint filed with the College of Nurses of Ontario. Once a nurse has retained legal counsel, the College will correspond directly with the nurse’s legal representative with all further communications. In addition to the written response to the complaint, the nurse should also include any other relevant information or documents that may bolster their defence or the claims they have made in their response.

Once the College has received the nurses written response to the allegations against them, the investigator appointed to the case will review the complaint and the response and determine whether any further investigation is warranted. The investigator may require the nurse or other witnesses participate in interviews. When the investigator is satisfied that all of the relevant information has been collected, they will write a report outlining the results of their investigation.

This report is then forwarded to the Complaints, Inquiries and Reports Committee for review. The Committee will then make a determination on how to best resolve the situation. Specifically, the Committee may choose to; take no further action against the nurse where no misconduct or unprofessionalism is found, make further inquiry into the nurses capacity to practice, require that the nurse appear before the Committee to be cautioned, require that the nurse undergo continuing education, refer the nurse to the Discipline Committee for further action or any other action that the College deems appropriate under the circumstances and in accordance with applicable legislation.

In cases involving minor allegations, Alternative Dispute Resolution (ADR) may be utilized at the consent of both parties. ADR is a mediation process used by the College to deal with complaints of a less serious nature. It should be noted that complaints that allege sexual abuse, any type of professional misconduct, fraud or dishonesty on the part of the nurse will not be eligible to participate in the ADR process. Generally, if ADR mediation is utilized, a facilitator appointed by the College will work with both parties to attempt to resolve the matter. If an agreement can be reached between the parties, it must be ratified by the Complaints, Inquiries and Reports Committee before it is official. If an agreement cannot be reached, the complaint will follow the regular complaint process.

In more serious situations where the Complaints, Inquiries and Reports Committee deems it necessary to refer the nurse the Discipline Committee, the nurse in question will be required to appear for a public hearing. This hearing works in much the same way as a civil trial would, with both sides being given the opportunity to present evidence and make arguments. Depending on the outcome of the hearing, there are several possible courses of action the Committee make take including; requiring the nurse complete further education, requiring the that nurse appear before the Committee to be formally reprimanded, fining the nurse, placing restrictions on the nurse’s license or suspending or revoking the nurses license. The Complaints, Inquiries and Reports Committee may also place an Interim order on the nurse’s license in these cases. This Interim order places conditions on the nurse’s ability to practice and can include a suspension of the nurse’s license until the investigation has concluded.

Decisions by the Complaints, Inquiries and Reports Committee are reviewable by the Health Professions Appeal and Review Board (HPARB). Both the nurse and the complainant are free to appeal a decision of the Committee.

If you have had a formal complaint filed against you with the College of Nurses of Ontario and are overwhelmed and unsure of how to proceed, contact our Firm and we can guide you through the process. It is of the utmost importance that the written response to the College is complete, concise and addresses all aspects of the complaint in full.

Our Firm can help ensure you return a well drafted response to help protect your license and ability to continue the practice of nursing in Ontario.