In a recent review, the Health Professions Appeal and Review Board (the “Board”) found that the decision of the Inquiries, Complaints and Reports Committee (the “Committee”) of the College of Nurses of Ontario to require a retired nurse to receive an oral caution to be unreasonable and substituted advice for the nurse instead.
The complaint arose out of concerns that the nurse did not properly assess a patient’s breathing pattern when notified of a change by a family member. The Committee investigated the complaint and decided to require the nurse to appear before it to receive an oral caution. The Committee emphasized in its reasons that it would caution the nurse “to provide guidance and assistance in her future practice”. However, as noted in the record before the Committee, the nurse had already retired from practice.
On review, the Board observed that the “primary difference between an oral caution and an advice is that the former is public and the latter is private. The oral caution is often considered among the most significant forms of remedial action that a Committee can take”.
In assessing the appropriate disposition in a complaint, a Committee should consider many factors, including the seriousness of the deficiency, whether there is a single concern or a number of concerns about the care at issue, the content of a member’s response, his or her insight as to areas for improvement, and the member’s complaints or discipline history.
The fact that the nurse had retired from practice and she had no conduct history over a decades-long nursing career mitigated against the provision of an oral caution, according to the Board.
The Board decided to remove the oral caution issued to the nurse and to substitute an advice.
This case confirms the seriousness of a decision to issue an oral caution and when such a caution may not be appropriate.
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