The Member engaged in professional misconduct when she failed to accurately follow and document a verbal order from a Nurse Practitioner with respect to increasing and monitoring a patient’s oxygen levels, inappropriately delegated the controlled act of administering a blood glucometer skin test to a personal support worker (PSW) without ensuring the PSW was capable of performing the controlled act, and made numerous medication administration errors, including administering overdoses of hydromorphone through dosage miscalculation. The Member altered a patient’s health record to obscure medication errors and falsely documented that she had changed a wound dressing when she had not done so. The Member also failed to give a medication to the right patient, and failed to properly assess a patient who fell.
Based on the Member’s admissions, the Panel found the Member:
- contravened a standard of practice of the profession or failed to meet the standards of practice of the profession;
- delegated a controlled act as set out in subsection 27(2) of the Regulated Health Professions Act, 1991, in contravention of section 5 of the Nursing Act, 1991;
- directed a member, student or other healthcare team member to perform nursing functions for which he or she was not adequately trained or that he or she was not competent to perform;
- failed to keep records as required;
- falsified a record relating to her practice; and
- engaged in conduct, relevant to the practice of nursing, that, having regard to all the circumstances, would reasonably be regarded by members as dishonourable and unprofessional.
Aggravating factors considered by the Panel included:
- the number and variety of allegations and the vulnerable patients involved;
- the Member caused harm, particularly to one patient who had suffered a fall that was not properly assessed, causing a fractured hip to go undiagnosed;
- the Member was supposed to change a dressing on a patient and although she documented that it had been done, it had not; and
- the Member made numerous medication errors on several patients and failed to document appropriately.
Mitigating factors considered by the Panel included:
- the Member had no prior disciplinary history with the College of Nurses of Ontario (“CNO”); and
- the Member attended the hearing, took responsibility for her actions, did not contest the allegations, and agreed to the Agreed Statement of Facts and the Joint Submission on Order.
The Member signed an undertaking to permanently resign as a member of the CNO and agreed not to apply for membership with CNO at any time in the future.
In light of the Member’s undertaking, CNO and the Member jointly sought an order requiring the Member to appear before the Panel for an oral reprimand.
The Panel accepted the Joint Submission on Order, concluding that the proposed penalty was reasonable and in the public interest.