What Nurses Need to Know About Discipline Hearings at the CNO

Following the formal investigation of a complaint to the College of Nurses of Ontario (CNO) the Inquiries, Complaints and Reports Committee (ICRC) will decide how to address a nurse’s conduct, and may make a referral to the Discipline Committee. This is the most serious disposition the ICRC can make, and can intensify what is likely an already stressful situation for a nurse. Referrals to the Discipline Committee can also be made by the Accreditation Committee or the Quality Assurance Committee. What follows is a brief guide to discipline hearings.

The Discipline Committee sits in panels comprised of both professional and public members, and fulfills a role that is somewhat comparable to a judge in a trial. The Discipline Committee hears allegations of professional misconduct or incompetence, and makes findings of fact as to whether the allegations against a nurse are proven.

Following referral to discipline from the ICRC, the Discipline Committee will send a nurse a Notice of Hearing, which will state the time, place, and purpose of the hearing, including the specific allegations.

Discipline hearings are recorded and transcripts can be ordered. A prosecutor will represent the CNO at the hearing, and Independent Legal Counsel to the Discipline Committee will typically also be present. In some cases, the complainant, a public interest group, or a professional association might also attend.

The CNO is required to provide nurses with copies of all documents and things that it will refer to or give in evidence at the hearing and to provide a witness statement or summary of evidence for any witness to be called prior to the hearing. A nurse must produce the same information before the commencement of the hearing. If a party intends to call an expert witness at the hearing, the party must serve an expert report on the other party.

Prior to a discipline Hearing, the CNO will hold a pre-hearing conference. The purpose of this facilitated conference is to reach an agreement on as many issues as possible and, if the nurse and the CNO cannot arrive at a resolution, schedule the hearing. Pre-hearing conferences are, in general, confidential and without prejudice.

The CNO will post on its website the names of nurses scheduled to appear before the Discipline Committee, the dates of their hearings, and summaries of the allegations against them. Discipline hearings are generally open to the public.

A discipline hearing is a formal, adversarial process that is similar to a trial, with nurses and the CNO each presenting their side of the case. The CNO prosecutor will have the burden of proving the allegations against a nurse. The Discipline Committee may proceed in a nurse’s absence.

Where the nurse is found guilty of professional misconduct or incompetence, the Discipline Committee will also rule on an appropriate penalty, which may include the following:

  • An in person reprimand before the panel;
  • A maximum fine of $35,000, to be paid to the Minister of Finance;
  • Terms, conditions, or limitations on a certificate of registration; and/or
  • Suspension or revocation of a certificate of registration.

The Discipline Committee may also order a nurse to pay all or part of the CNO’s costs and expenses. In rare cases, the Discipline Committee can order the CNO to pay costs to a nurse.

If a nurse is found guilty of professional misconduct following a discipline hearing, the CNO is required to publish a summary of the decision.

A nurse or the CNO may appeal a decision of the Discipline Committee to the Divisional Court.

Nurses are allowed to represent themselves before the Discipline Committee. However, because of the serious nature of discipline hearings, it is prudent for nurses to consider retaining experienced legal counsel.