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Bourque, Tony Michel

Tony Michel Bourque IC12240

Full Text for: Tony M. Bourque #IC-1224-0

Discipline Committee Of The College Of Nurses Of Ontario

Panel:

[Names of Panel Members]

BETWEEN

COLLEGE OF NURSES OF ONTARIO   Counsel for College of Nurses of Ontario
- and -    
TONY M. BOURQUE
#IC-1224-0
  Counsel for Tony M. Bourque
     
    Heard: March 30, 1999

REASONS FOR DECISION

A panel of the Discipline Committee of the College of Nurses of Ontario was convened on March 30, 1999, to commence a hearing concerning allegations brought by the College of Nurses against Tony Michel Bourque R.P.N.("the Member") The Member was present as was his defence counsel. The allegations as presented within the March 22, 1999, Notice of Hearing are fully set out below:

Counsel for the College reviewed the Notice of Hearing with the panel, indicating that the Member would admit a number of the allegations. College Counsel further indicated to the panel that the Member would deny allegations 1(b)(c)(d)(i), 2(b)(c)(d)(i) and 3(b)(c)(d)(i).

The panel was advised that the hearing would proceed by way of Agreed Statement of Fact and a Joint Submission on Penalty.

The following allegations were contained in the Notice of Hearing:

  1. You have committed an act of professional misconduct as provided by subsection 51(1)(c) of the Health Professions Procedural Code of the Nursing Act, 1991, S.O. 1991, c.32, as amended, and defined in subsection 1(1) of Ontario Regulation 799/93, in that from January 1, 1994 through to and including December 15, 1997, while working as a Registered Practical Nurse at the North Bay Psychiatric Hospital in North Bay, in the Province of Ontario, you contravened a standard of practice of the profession or failed to meet the standards of practice of the profession with respect to the following incidents:
    1. your care and treatment of [complainant #1], a client at [the institution], on or about November 16, 1996, and in particular you stated to the client, words to the effect of "Shut the fuck up, you are pretty stupid", and you placed your hand over the client's mouth and nose, you placed your arm around the client's neck and you grabbed the client's neck with both hands; and/or
    2. your care and treatment of [complainant #1], a client at [the institution], in or about the summer of 1996, and in particular you slapped the client on his head; and/or
    3. your care and treatment of [complainant #1], a client at [the institution], in or about 1996, and in particular you slapped the client on his head and you stated to the client, words to the effect of "No I won't hit you. You're not worth losing my job over"; and/or
    4. your care and treatment of [complainant #1], a client at [the institution], and in particular you dropped droplets of water on the client's head which agitated the client; and/or
    5. your care and treatment of [complainant #1] and other clients at [the institution], and in particular you tapped clients on the back of the head which agitated them; and/or
    6. your care and treatment of [complainant #1], a client at [the institution], in or about February, 1996, and in particular you yelled obscenities, including the word "fuck", at the client; and/or
    7. your care and treatment of [complainant #1], a client at [the institution], in or about March, 1997, and in particular you placed the client in an isolation room near an open window allowing cold wind and snow to blow in thereby upsetting the client; and/or
    8. your care and treatment of [complainant #1], a client at [the institution], in or about 1995, and in particular you tilted the geri-chair in which the client was sitting so that the client was almost lying flat on the floor; and/or
    9. your care and treatment of [complainant #2], a client at [the institution], in or about May, 1997, and in particular you grabbed the client by the head with both hands, and you laughed at the client, which caused the client to become upset; and/or
    10. your care and treatment of [complainant #3], a client at [the institution], in or about May or June, 1997, and in particular you stated to the client, words to the effect of "'[Complainant #3]', you fucked that little girl", you told the client that the "cops" had arrived to get him because "he fucked the little girl", and you told the client that if he took his medication you would tell the police that the client did not "fuck that little girl", causing the client to become angry; and/or
  2. You have committed an act of professional misconduct as provided by subsection 51(1)(c) of the Health Professions Procedural Code of the Nursing Act, 1991, S.O. 1991, c.32, as amended, and defined in subsection 1(7) of Ontario Regulation 799/93, in that from January 1, 1994 through to and including December 15, 1997, while working as a Registered Practical Nurse at [the institution] in [the city], in the Province of Ontario, you abused a client verbally and/or physically, and/or emotionally with respect to the following incidents:
    1. your care and treatment of [complainant #1], a client at [the institution], on or about November 16, 1996, and in particular you stated to the client, words to the effect of "Shut the fuck up, you are pretty stupid", and you placed your hand over the client's mouth and nose, you placed your arm around the client's neck and you grabbed the client's neck with both hands; and/or
    2. your care and treatment of [complainant #1], a client at [the institution], in or about the summer of 1996, and in particular you slapped the client on his head; and/or
    3. your care and treatment of [complainant #1], a client at [the institution], in or about 1996, and in particular you slapped the client on his head and you stated to the client, words to the effect of "No I won't hit you. You're not worth losing my job over"; and/or
    4. your care and treatment of [complainant #1], a client at [the institution], and in particular you dropped droplets of water on the client's head which agitated the client; and/or
    5. your care and treatment of [complainant #1] and other clients at [the institution], and in particular you tapped clients on the back of the head which agitated them; and/or
    6. your care and treatment of [complainant #1], a client at [the institution], in or about February, 1996, and in particular you yelled obscenities, including the word "fuck", at the client; and/or
    7. your care and treatment of [complainant #1], a client at [the institution], in or about March, 1997, and in particular you placed the client in an isolation room near an open window allowing cold wind and snow to blow in thereby upsetting the client; and/or
    8. your care and treatment of [complainant #1], a client at [the institution], in or about 1995, and in particular you tilted the geri-chair in which the client was sitting so that the client was almost lying flat on the floor; and/or
    9. your care and treatment of [complainant #2], a client at [the institution], in or about May, 1997, and in particular you grabbed the client by the head with both hands, and you laughed at the client, which caused the client to become upset; and/or
    10. your care and treatment of [complainant #3], a client at [the institution], in or about May or June, 1997, and in particular you stated to the client, words to the effect of "'[Complainant #3]', you fucked that little girl", you told the client that the "cops" had arrived to get him because "he fucked the little girl", and you told the client that if he took his medication you would tell the police that the client did not "fuck that little girl", causing the client to become angry; and/or
  3. You have committed an act of professional misconduct as provided by subsection 51(1)(c) of the Health Professions Procedural Code of the Nursing Act, 1991, S.O. 1991, c.32, as amended, and defined in subsection 1(37) of Ontario Regulation 799/93, in that from January 1, 1994 through to and including December 15, 1997, while working as a Registered Practical Nurse at [the institution] in [the city], in the Province of Ontario, you engaged in conduct or performed 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 with respect to the following incidents:
    1. your care and treatment of [complainant #1], a client at [the institution], on or about November 16, 1996, and in particular you stated to the client, words to the effect of "Shut the fuck up, you are pretty stupid", and you placed your hand over the client's mouth and nose, you placed your arm around the client's neck and you grabbed the client's neck with both hands; and/or
    2. your care and treatment of [complainant #1], a client at [the institution], in or about the summer of 1996, and in particular you slapped the client on his head; and/or
    3. your care and treatment of [complainant #1], a client at [the institution], in or about 1996, and in particular you slapped the client on his head and you stated to the client, words to the effect of "No I won't hit you. You're not worth losing my job over"; and/or
    4. your care and treatment of [complainant #1], a client at [the institution], and on particular you dropped droplets of water on the client's head which agitated the client; and/or
    5. your care and treatment of [complainant #1] and other clients at [the institution], and in particular you tapped clients on the back of the head which agitated them; and/or
    6. your care and treatment of [complainant #1], a client at [the institution], in or about February, 1996, and in particular you yelled obscenities, including the word "fuck", at the client; and/or
    7. your care and treatment of [complainant #1], a client at [the institution], in or about March, 1997, and in particular you placed the client in an isolation room near an open window allowing cold wind and snow to blow in thereby upsetting the client; and/or
    8. your care and treatment of [complainant #1], a client at [the institution], in or about 1995, and in particular you tilted the geri-chair in which the client was sitting so that the client was almost lying flat on the floor; and/or
    9. your care and treatment of [complainant #2], a client at [the institution], in or about May, 1997, and in particular you grabbed the client by the head with both hands, and you laughed at the client, which caused the client to become upset; and/or
    10. your care and treatment of [complainant #3], a client at [the institution], in or about May or June, 1997, and in particular you stated to the client, words to the effect of "'[Complainant #3]', you fucked that little girl", you told the client that the "cops" had arrived to get him because "he fucked the little girl", and you told the client that if he took his medication you would tell the police that the client did not "fuck that little girl", causing the client to become angry.

The panel conducted a plea inquiry to ensure that the Member's admissions of professional misconduct were both voluntary and informed.

The Agreed Statement of Fact entered into by the parties provided as follows:

AGREED STATEMENT OF FACT

  1. Tony Michel Bourque (the "Member") has been a Registered Practical Nurse with the College of Nurses of Ontario (the "College") since 1993. He received his training at West Nipissing nursing Training College in Ontario.
  2. The Member worked as an RPN at the [the institution] (the "Hospital") from July 21, 1993 until December 15, 1997. Initially he worked at the Hospital through a temporary placement agency, but he became an employee of the Hospital in the fall of 1993.
  3. The Member worked on Unit 3B for the duration of his placement and employment at the Hospital. Unit 3B is a male psychogeriatric ward. Clients on that ward suffer from both physical and psychological illnesses.
  4. The Member admits the allegations set out in the Notice of Hearing in paragraphs 1(a), (e), (f), (g), (h), (j), 2(a), (e), (f), (g), (h) (j) and 3A, (e), (f), (g), (h), (j), to the extent they are particularized in the following paragraphs.
  5. At approximately 9:15 p.m. on November ___, 1996 the Member was on Unit 3B with a client, [complainant #1] Clients were being put to bed at that time. The Member told [complainant #1] to "Shut the fuck up, you are pretty stupid". In an inappropriate attempt to quiet the client, the Member placed his hand over [complainant #1]'s mouth and nose.
  6. During the period January 1, 1994 to December 15, 1997, while working on Unit 3B the Member walked behind where the client [complainant #1] was seated. In an inappropriate attempt to tease the client, the Member tapped the client on the head. The Member also did this to other clients. This agitated the clients.
  7. On a morning in February, 1996 the Member yelled obscenities at the client [complainant #1] while they were on Unit 3B. this included the word "fuck".
  8. On an evening in March, 1997 the client [complainant #1] was being disruptive and yelling at other clients on Unit 3B. The Member took [complainant #1] in his geri-chair to a private room. He placed [complainant #1] close to an open window and exited the room. closing the door without properly adverting to the fact the window was open. Another nurse later heard [complainant #1] calling that he was cold, and found him alone in the room. Cold wind and snow was blowing in through the open window.
  9. On an occasion in 1995, the client [complainant #1] was in a geri-chair on Unit 3B. The client was yelling and swearing. The Member went behind the geri-chair and tilted it so that the client was lying almost prostrate on the floor.
  10. On a day in May, 1997 the Member said to [complainant #3], a client on Unit 3b, "[Complainant #3], you fucked that little girl". Later that day, the Member told the client that the "cops" had arrived to get him because he had "fucked the little girl". The Member also told the client that if he took his medication, the Member would tell the police that the client did not "fuck that little girl". The client became angry at the Member's comments.
  11. The Member admits that by this conduct particularized in the preceding paragraphs, he committed professional misconduct in that he contravened a standard of practice of the profession or failed to meet the standards of practice of the profession; he abused a client verbally, emotionally and physically; he engaged in conduct or performed 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.
  12. The matters described in the preceding paragraphs were the subject of investigation by an independent employee relations consultant retained by the Hospital. The consultant provided a written report to the Hospital in December, 1997. Following an internal discipline hearing, the Member's employment with the Hospital was terminated on December 15, 1997. The Member has filed a grievance regarding this termination.
  13. The Hospital made a formal complaint to the College. On September 24, 1998 an interim suspension was imposed on the Member, pending a discipline hearing before the College.
  14. The Member has not worked as an RPN since December 15, 1997.

The panel reviewed the Agreed Statement of fact and accepted it.

JOINT SUBMISSION ON PENALTY

The parties made the following Joint Submission as to Penalty:

Tony Michael Bourque (the "Member") and the College of Nurses of Ontario (the "College") jointly submitted that the panel of the Discipline Committee should make an order directing the Registrar to:

  1. Suspend the Member's certificate of registration for a period of 12 months.
  2. Impose the following terms, conditions or limitations on the Member's Certificate of Registration:
    1. During the 12 month period of suspension the Member shall:
      1. Successfully complete a course, to be approved by the Director of Investigations and Hearings of the College, on psychiatric nursing and anger management; and,
      2. View the abuse prevention video One is One Too Many and meet with a practice consultant or equivalent expert.
    2. Upon the Member's return to practice he shall:
      1. Provide to the Director of Investigations and Hearings of the College written notification of the address of each and every place of employment at which the Member is engaged in the practice of nursing for a period which is equivalent to two full years of employment; and,
      2. Provide the College with three written performance reports by the employer for a period equivalent to two full years of employment.

The Joint Submission as to Penalty also provided that the Member be required to appear before a panel of the Discipline Committee to be reprimanded and that the results of this disciplinary proceeding be included in the public portion of the Register of the College of Nurses of Ontario.

DECISION

The panel deliberated and decided that the 12-month suspension jointly submitted to be appropriate by the College and the Member, should become a 9-month suspension. In all other respects, the penalty ordered by the panel is in the terms of the Joint Submission as to Penalty.

Counsel for the College reiterated the College's position as to penalty. The panel considered the information presented to it. The decision as first presented by the panel will remain the same.

REASONS FOR DECISION

The panel gave careful consideration to the submissions of counsel. In doing so, the panel recognized that the penalty must not be interpreted as condonation of the Member's unacceptable and abusive conduct toward clients in his care. The nurse-client relationship is therapeutic; it is based on trust, respect for and intimacy with the client. It involves an imbalance of power. The Member's conduct demonstrates failure to consider the vulnerable position of clients in his care. The Member abused the power given to him in his position as a nurse.

The Joint Submission as to Penalty would require the Member to complete an approved psychiatric nursing and anger management course during the suspension. Upon return to practice, other safeguards for the public would be in place for monitoring purposes. The panel has no hesitation in accepting those aspects of the Joint Submission. What was of special concern to us was the length of the suspension of the Member's certificate of registration. In our opinion, the best way to foster nursing competency - the ability of a nurse to function safely and efficiently with aptitude, skill and knowledge - is to promote remediation while at the same time ensuring that the public interest is protected and the professional misconduct engaged in is denounced.

Counsel for the College significantly assisted us in their deliberations. However, we are unable to accept that the Member's interim suspension pending the discipline hearing should not be considered as a factor tending to reduce what would otherwise have been an entirely appropriate period of suspension.

The panel feels that its decision reflects the rationale underlying the Joint Submission on Penalty and will fulfill the College's mandate to protect the public.

I, [Panel Chair], 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]

Page mise à jour le septembre 28, 2010