College of Nurses of Ontario (CNO) Defence Lawyers

Donich Law is one of the few Firms to have litigated and defeated contested sexual abuse allegations before the College of Nurses of Ontario Disciplinary Committee. We have attended the CNO in person and regularly defend Nurses and members of the Health Care industry facing regulatory complaints or criminal charges. The Firm has also defeated CNO investigations where patient data has inappropriately been accessed and used by nurses without authorization.

Generally as part of the investigation, the patient’s personal health information will be obtained along with other evidence related to the investigation. The Firm defends Nurses facing allegations of sexual abuse and sexual exploitation against their patients which are often vigorously prosecuted by the College in Toronto. Other allegations the Firm handles include violations with respect to record management, incompetence and dishonorable conduct, sexual impropriety with patients, substance abuse at work, conduct unbecoming, unauthorized access of patient records, verbal and physical abuse allegations and other forms of misconduct. The Firm has appeared on Global News to discuss the implications of Nurses facing allegations of misconduct.

Nurses, like many professionals in Canada, must be adequately educated, licensed and regulated by the province in which they practice. Each province regulates their professionals in their own way. The Firm’s exceptional background in criminal defence pretrial resolution and litigation often resolves proceedings without any formal disciplinary action or sanctions by the regulatory body.

In 2022, the Firm represented a nurse after a complaint was filed against her with the College of Nurses on Ontario in Case No. 2******3. The complaint was filed with the CNO several months after the Member resigned from her nursing position at the hospital due to a toxic work environment. After a relationship breakdown with the other nurses on the unit, the Member began feeling targeted by her colleagues. After resigning, she was reported to the CNO for a variety of issues including failing to properly document in patient charts, failing to properly administer medication to patients and having negative interactions with patients. After reviewing the complaint material in full, the Firm argued that the hospital had presented little to no evidence to prove that the Member was guilty of any of the allegations. The Firm explained the toxic work environment that existed prior to the Member’s resignation and exposed fabrications in the complaint material provided by the Member’s previous employer. Ultimately, the College closed the file with no action taken against the Member.

In 2021, the Firm represented a Nurse Manager with ten years of experience, accused of engaging in an inappropriate sexual relationship with the family of one of his patients in its File No. 2****3. Almost ten years after the alleged incidents occurred, they were reported to the College of Nurses of Ontario, and an investigation was launched into the Member’s conduct. The complainant alleged that the Member had made sexual advances towards her for preferential treatment. The complainant further alleged that she met the Member outside of the hospital on several occasions including at her home, where sexual activity allegedly occurred. The Firm litigated the matter for roughly 3 years, successfully arguing that no inappropriate sexual activity ever occurred between the parties. A contested hearing was scheduled to allow the Firm an opportunity to cross-examine the complainant. Ultimately, the College withdrew the allegations.

In 2020, the Firm represented a Registered Nurse after a complaint was filed against her with the College of Nurses of Ontario in Case No. 4****7. An investigation was launched into the client’s nursing practice after her ex-spouse filed a vexatious complaint alleging drug abuse. The Firm produced court records proving that the client’s ex-spouse had been arrested numerous times for domestic assault prior to the end of their relationship. After reviewing the court records the CNO agreed to close the file without any disciplinary action against the client.

In Novemebr 2020, in the Firm’s Case No. 7****3, it defended a Nurse from northern Ontario who allegedly destroyed company property and electronic data prior to termination. The matter was initially proceeding towards the disciplinary committee, prior to the client retaining the Firm. We were able to have the matter reviewed a second time by the Inquiries, Complaints and Reports Committee and ultimately provided evidence exonerating the member. The defence was able to establish a theory based on the evidence that another person may have destroyed the property and used forensic data to dispute the timeline of events.

In October 2020, in the Firm’s Case No. 6****3, it defended a Nurse with two separate simultaneous complaints. The Firm was able to negotiate with the College and approval of the patient a resolution without any finding of professional misconduct. The Nurse was also falsely accused of using illicit substances by another vexatious party and referred to the Nurses’ Health Program. The Firm was able to provide sufficient evidence to prove the allegations were fabricated and the matter was unilaterally dismissed.

In the Firm’s Case No. 0****8, it defended a new Nurse accused of assaulting and uttering derogatory comments to a dementia patient. Further, that the member requested a physician to unreasonably sedate the patient. The Firm was ultimately able to resolve all allegations without a finding of professional misconduct.

In the Firm’s Case No. 5****9 it defended a Nurse Manager alleged to have assaulted a patient by physically restraining them. The Nurse was also alleged to have improperly wasted medication, failed to comply with patient privacy and documentation standards. The investigation took nearly 2 years to complete and all matters were disposed of without any finding of professional misconduct. The Firm was able to pull video surveillance to exonerate the member.

In the Firm’s Case No. 7*****3 it defended a Nurse approaching retirement facing allegations associated with improper disposal of medication and non-compliance with Professional, Medication and Documentation Standards, the matter was resolved without a finding of professional misconduct. In the Firm’s Case No. 9*****2 it defended a Nurse with a second complaint, alleged to have been conducting themselves unbecoming to the profession, the Firm resolved the matter without any finding of professional misconduct.

In the Firm’s Case No. 8*****2 it defended a Nurse Manager alleged to have unilaterally modified the care plan of a patient in a long-term care facility in 2018. It was also alleged the Nurse failed to report an allegation of sexual assault on the patient by a PSW. After a year of litigation, the matter was entirely dismissed with no action by the Inquiries, Complaints and Reports Committee (ICRC).

These allegations can often include non-compliance with a patient’s Care Plan. The matter was resolved entirely without a finding of professional misconduct. The College of Nurses may appoint an investigator to determine the scope of the alleged misconduct or request to meet with you in person. For more information on defending investigations before the College of Nurses in Ontario, click here.

Toronto Star: Nurse given 5-month suspension after removing patient from life support without doctor’s authorization.

Frequently Asked Questions

Who Regulates Nurses in Ontario?
How are Nurses Regulated?
The Complaint Process
What Happens when a Complaint is Filed?
What Happens at a Discipline Hearing?
What Types of Acts or Omissions Give Rise to Professional Misconduct Complaints?
What Penalties can Nurses Face as a Result of a Complaint?
When does the College of Nurses of Ontario Not have the Ability to Act on a Complaint?
How to Defend a Formal Complaint made to the College of Nurses of Ontario
The Resolution Process

Who Regulates Nurses in Ontario?

In Canada, the oversight of professionals falls under the jurisdiction of individual provinces. In Ontario, the task of regulating the nursing profession is entrusted to the College of Nurses of Ontario. The primary objective of this regulatory body is to uphold the highest standards of knowledge and integrity among nursing practitioners, ensuring the delivery of top-notch care.

The College of Nurses of Ontario is mandated to enforce the Nurses Act of 1991, a pivotal piece of legislation discussed in greater detail below. Its responsibilities encompass verifying that nurses undergo proper education from accredited institutions before commencing practice. Furthermore, the College ensures that practitioners stay current with ongoing education requirements and adhere to the regulations outlined in the Nursing Act of 1991, as well as other pertinent statutes such as the Regulated Health Professionals Act of 1991, which applies to healthcare professionals at large.

The overarching goal of these measures is to safeguard the public from professional misconduct. To this end, the College of Nurses of Ontario welcomes formal complaints against licensed members and conducts thorough investigations when necessary. In the event of confirmed professional misconduct, the College assumes the responsibility of meting out appropriate disciplinary actions against the offending nurse.

How are Nurses Regulated?

Nurses practicing in Ontario are subject to the regulations outlined in the Nursing Act of 1991, overseen and enforced by the College of Nurses of Ontario. This legislation comprises two integral sections: the first delineates general regulations, while the second addresses matters of professional misconduct.

The section pertaining to general regulations meticulously outlines the qualifications and prerequisites essential for registration as a nurse in Ontario. These encompass educational, training, and experiential requisites. Additionally, the section details regulations concerning resignation, suspension, termination from the nursing profession, and the process of reinstatement. It also specifies the ‘controlled acts’—medical procedures and treatments—that nurses are authorized to perform, including the dispensing and prescribing of medications. Conclusively, this section includes a subsection dedicated to quality assurance regulations, emphasizing the commitment to delivering consistently high-quality care to patients.

The subsequent section of the Nurses Act of 1991 enumerates various acts or omissions that the College deems to constitute professional misconduct. Thirty-seven specified actions or failures, if committed by a member of the College of Nurses of Ontario, are grounds for disciplinary measures. Examples include practicing the profession while impaired by any substance, verbal, physical, or emotional abuse of a client, failure to maintain required records, falsification of practice-related records, charging excessive fees for services, and engaging in conduct or acts deemed disgraceful, dishonorable, or unprofessional in the context of nursing practice. Violation of any of these professional misconduct regulations can lead to severe consequences. In the event of a formal complaint lodged with the College of Nurses of Ontario, seeking qualified legal counsel promptly is of utmost importance.

The Complaint Process

Nurses, like any professional, owe a duty of care to their patients. Failure to discharge this duty of care may result in a formal complaint being filed with the College of Nurses of Ontario against the practicing nurse. Virtually any member of the public can file a formal complaint against a nurse. Formal complaints can be filled with the College of Nurses of Ontario directly either by mail or email. The complaint must be made in writing or recorded (audio or video) and should include a concise statement outlining the complaint with as much detail as possible, the full legal name of the nurse as well as any other nurses, health care professionals or other persons who may have relevant information and the contact information of the complainant. There is no time limit on when a complaint can be filed.

What Happens when a Complaint is Filed?

After receiving a formal complaint in writing or through recorded means, the College of Nurses of Ontario initiates an investigation and promptly acknowledges the complainant with a confirmation letter. This correspondence may also request additional necessary information. The College meticulously gathers evidence from various sources, potentially including interviews with the complainant and other witnesses. Upon compiling all pertinent information, the College forwards a copy to the accused nurse, who then has a thirty-day window to provide a written response.

The nurse’s response encompasses background details, such as education, experience, and accomplishments, along with specific responses to the allegations. Subsequent to receiving the nurse’s written response, the College reviews it and conducts any further investigation deemed necessary. The nurse is afforded an opportunity to respond to any new evidence uncovered during this process. Once the investigation concludes, the file is submitted to the Inquiries, Complaints, and Reports Committee for comprehensive review.

This committee comprises experienced nurses, members of the public, and is chaired by a representative from the College Council. Deliberating on all evidence, the seriousness of allegations, and considering past decisions of the Council related to the nurse in question, the Council makes a determination regarding professional misconduct. The Council has various options for handling a complaint: closing the file if no misconduct is found, providing formal advice for practice improvement, issuing a formal caution, or requiring participation in a Remediation Program. In cases where serious professional misconduct is established, the file is forwarded to the Discipline Committee for further review. This necessitates the nurse’s appearance before the Committee for a discipline hearing. Regardless of the outcome, the nurse receives a comprehensive copy of the Council’s decision and the rationale behind it.

It is crucial to recognize that a finding of professional misconduct can significantly impact a nurse’s ability to practice. Upon learning of a filed complaint, members are strongly advised to seek legal counsel promptly. All members of the College of Nurses of Ontario have the right to legal representation throughout the entire complaint process. Our Firm is committed to guiding you through this process, ensuring the best possible outcome for your case.

What Happens at a Discipline Hearing?

If a complaint investigation advances to the Discipline Committee, the accused nurse is obligated to participate in a public discipline hearing. This hearing operates similarly to a court of law, being open to the public and featuring a panel of fact finders, akin to judges in a legal setting. The panel may, in certain instances, invite the complainant to testify during the hearing. Once all evidence has been presented, the panel deliberates and reaches a decision.

The Discipline Committee has various courses of action at its disposal, including mandating the nurse to undergo remedial education, requiring a personal appearance before the Committee for a formal reprimand, imposing a fine payable to the government of Ontario, placing specific conditions on the nurse’s practice, or suspending/revoking the nurse’s license to practice. Regardless of the hearing’s outcome, the Committee’s decision and the underlying rationale are made publicly accessible through the College of Nurses of Ontario website.

What Types of Acts or Omissions Give Rise to Professional Misconduct Complaints?

There are many different reasons a patient may wish to file a formal complaint against their nurse. Some examples include; practicing the profession while the member’s ability to do so is impaired by any substance, abusing a client verbally, physically or emotionally, failing to keep records as required, falsifying records relating to the member’s practice, charging a fee that is excessive in relation to the service for which it was charged and/or engaging in conduct or performing an act, relevant to the practice of nursing, that, having regard to all the circumstances, would reasonably be regarded by members as disgraceful, dishonourable or unprofessional.

What Penalties can Nurses Face as a Result of a Complaint?

As noted in previous sections, there are several courses of action the Committee may take including; requiring the nurse to complete remedial education, requiring the nurse to appear in person before the Committee for formal reprimand, requiring them to pay a fine to the government of Ontario, placing conditions on the nurses practice or suspending or revoking the nurses license to practice. Whatever the outcome of the hearing, the Committee’s decision along with their reasoning will be made available to the public through the College of Nurses of Ontario website.

When does the College of Nurses of Ontario Not have the Ability to Act on a Complaint?

The College of Nurses of Ontario has a statutory obligation to review all complaints it receives, however it does not have the legal authority to act on all of those complaints. There are several situations in which the College could offer no remedy for the complaint that was filed. Examples include; in situations where another organization is already handling the complaint, where the complaint is not about the nurses professional conduct (for example a complaint about the nurse personally), the complaint is about the care facility that employs the nurse and not specifically the nurse, the complaint is made in bad faith (for example a claim filed maliciously) and finally when the complaint has not been signed by the complainant (for example when a complaint is made anonymously).

How to Defend a Formal Complaint made to the College of Nurses of Ontario

As with any legal matter, the best defence will depend largely on the allegations being made and the facts surrounding the case. It is important to contact qualified legal counsel immediately upon receiving notice that a formal complaint has been filed. In some cases, the allegations against the nurse will be unfounded, or simply will not amount to professional misconduct. In these situations the nurse may state that they have not violated any of the rules or regulations surrounding the proper practice of nursing on Ontario. In situations where a more substantive response is required, a common way to defend a professional misconduct allegation is to argue that the nurse did not deviate from the applicable standard of care and that by doing so they sufficiently discharged their duty of care to the patient. This essentially means that the nurse did everything that was necessary and appropriate in the circumstances and as a result have not committed professional misconduct. In any case, the best plan of defence is to contact qualified legal counsel as soon as possible to assist in drafting a response to the particular complaint that has been filed against you.

The Resolution Process

Quick Facts

How to Defend CNO Complaints?

The College of Nurses of Ontario (CNO) will investigated most complaints made against a member. Many complaints arise in the context of the member being dismissed from employment and can surface long after termination. Like any successful defence, it is important to have a strong theory and provide defence evidence. In some cases, challenging witness observations or motives can also be provided to the regulator for consideration, if the misconduct is related to behavior. If the allegation(s) are related to nursing professional standards, evidence of compliance or a reasonable explanation for deviation can also be provided.

How to Respond to CNO Complaints?

For the most part the member will be required to provide a written reply. It is important to get legal advice prior to drafting a response because anything provided can be considered by investigations. Like any regulator, it is important to address the underlying concerns related to professional standards and avoid contaminating a reply with irrelevant information or emotion.

What if the CNO wants to meet with me?

In many cases the CNO will meet with the member and an investigator. The member will be required to provide written material which will also be considered by the regulator. Whether the matter proceeds will depend on how the member navigates this process.

How Long are CNO Investigations?

CNO proceedings can range from months to years. The duration can depend on the amount of evidence and time associated with producing it to the member. Once the member receives the disclosure, they will be required to provide a reply which will then be considered. If the matter is not properly addressed, it can be forwarded to prosecution.

What are Common Complaints?

Nurses often receive complaints related to professional standards. Common areas of concern relate to documentation, medication standards, patient care plans, time-management and behavior with co-workers.

Will my Investigation be Published Online?

Whether the investigation or outcome will be visible on the CNO member directory will depend on how the matter is resolved. In most cases if the allegation is properly defended and professional misconduct is not proven, it will not be visible online. However, in other cases where the member receives certain cautions, even though no misconduct was proven, it can be publicly visible.

Will my Employer Know?

The CNO will always expect the member to keep their employment up to date. In many cases, the member is terminated from work and by the time they have a new employer, the CNO investigation begins. The member is often worried their present employer will discover and/or take action. In many cases the CNO proceedings can be resolved without any further employment consequences.

How does CNO Investigate Complaints?

Like many regulators, the CNO employs skilled investigators who have a legal education. This is also the same with workplace investigations, where the employer will higher an independent lawyer to investigate potential misconduct. Investigators in most capacities will interview witnesses, review patient records, notes and formulate arguments within the rules governing nurses in Ontario.