Interim Orders at the College of Nurses of Ontario

You are a Registered Nurse (RN), Registered Practical Nurse (RPN) or Nurse Practitioner (NP) and are worried about what the College of Nurses of Ontario (“CNO”) may do after it receives a complaint or report. In most cases, the Inquiries, Complaints, and Reports Committee (“ICRC”) will conduct an investigation or the complaint and/or report and the matter will be reviewed by a panel of the ICRC on the merits. 

In circumstances where the CNO believes that a nurse’s alleged conduct exposes or is likely to expose patients to harm or injury, it may issue an interim order before the ICRC reviews the matter on the merits. Under an interim order, the Executive Director may suspend a nurse’s certificate of registration, or impose terms, conditions and/or limitations that may restrict the nurse’s ability to practice nursing.

Pursuant to the CNO’s governing legislation, which includes the Health Professions Procedural Code (“HPPC”), it has the ability to impose an interim order without holding a hearing and before a matter is referred to the Discipline Committee (“DC”) or Fitness to Practice Committee (“FTPC”). The Court has held that the ICRC cannot impose interim orders on the basis of mere speculation, but will require evidence of probable harm to patients. See Fingerote v. The College of Physicians and Surgeons of Ontario (2018).

If an interim order is being contemplated by the CNO, the nurse will typically receive notice about the CNO’s intention to impose an interim order. The nurses will normally be given at least 14 days to respond to the notice with submissions on why an interim order is unnecessary and ought not to be imposed. In certain circumstances, the CNO may also impose an interim order without notice. It may do so where the College believes that urgent intervention is required. If an interim order is made without prior notice, the nurse must be given an opportunity to make submission after the fact. 

Where an interim order is made, certain information about the interim order will be posted on public register, which is accessible on the CNO’s website under the “Find a Nurse” feature. 

A nurse may seek a judicial review of a decision by the CNO’s to impose an interim order. Judicial review proceedings are governed in part by the Judicial Review Procedure Act (“JRPA”), the Rules of Civil Procedure, and the common law relevant to judicial reviews, and are typically heard by a three judge panel of Ontario Divisional Court of Ontario. In urgent cases, nurses may be able to make an Application for judicial review to be heard by a single judge of the Superior Court. 

Cases where interim order are proposed by the CNO tend to be considered of a more serious nature and a nurse would be well-advised to seek assistance and representation from a lawyer in both College and/or a related judicial review process.