CONSENT AGREEMENTS:LET US SHOW YOU HOW IT CAN WORK Rhonda OHagan Competence Assurance Coordinator, S

1
CONSENT AGREEMENTSLET US SHOW YOU HOW IT CAN
WORKRhonda OHaganCompetence Assurance
Coordinator, SASKATCHEWAN REGISTERED NURSES
ASSOCIATION

• Presented at the 2004 CLEAR Annual Conference
• September 30 October 2 Kansas City,
  Missouri

2
SRNA

• COMPLAINTS RESOLUTION PROCESS

3
SRNA MANDATE

• To ensure safe, competent nursing practice in the
  province of Saskatchewan
  
• Governed by
• 1. RN Act, 1988
• 2. SRNA Bylaws 2003
• 3. Standards Foundation Competencies
• 4. Internal Policies Procedures

4
OPERATING PRINCIPLES

• Competent Nursing Practice
• Transparency
• Due Process
• Timely Resolution
• Education
• Utilization of Lowest level of Resolution
• Fiscal Efficiency
• 8. Identification Referral of Risk Patterns

5
THE PROCESS

• Reports received
• Via telephone call, newspaper article
  (non-written format), informal inquiry
  
• Written Letter of Complaint, official
• Investigation completed\report developed

6
OPTIONS USED IN THE COMPLAINTS HANDLING PROCESS

• Dismissal
• 2. Low Level Resolution Process
• - Letter of Guidance
• - Consensual Complaint Resolution Agreement
• - Mediation
• 3. Referral to Discipline

7
CONSENSUAL AGREEMENTS

• Agreements include
• 1. history of complaint\relevant facts
• 2. issues for resolution
• 3. terms undertakings
• 4. compliance with agreement
• 5. disclosure notification
• 6. conclusions undertakings

8
COVER PAGE

• In the matter of a complaint pursuant to section
  28 of The Registered Nurses Act, 1988, as
  amended, and , Registered Nurse
  .
• Consensual Complaint Resolution Agreement
• This agreement is made under section 28 of The
  Registered Nurses Act, 1988 and the related
  bylaws and policy.
  
• Between
• MEMBERS NAME
• - and -
• THE INVESTIGATION COMMITTEE OF THE SRNA
• DATE

9
HISTORY OF COMPLAINT

• History of Complaint/Background and Relevant
  Fact
  
• 1.1 Is on the register and
  is a member of the Saskatchewan Registered
  Nurses Association (SRNA) and licensed by the
  SRNA to practice nursing in Saskatchewan.
• 1.2 Was employed as a
  registered nurse at __________________Saskatchewa
  n. at the time the complaint was received.
  
• 1.3 On , the
  SRNA received a letter of complaint dated _______
  , from ------------. Specifically the concerns
  identified involved
• falsifying narcotic count records
• theft of narcotics for personal use
• 1.4 This agreement relates to noncompliance with
  The Registered Nurses Act therefore resulting in
  professional incompetence as defined in the Act
  as
• 25 "the display by a nurse in the professional
  care of a client of a lack of knowledge, skill or
  judgment or a disregard for the welfare of a
  client of a nature or to an extent that
  demonstrates that the nurse is unfit
• to continue in the practice of nursing or
• to provide one or more services ordinarily
  provided as part of the practice of nursing"
  
• 1.5 This agreement relates to noncompliance with
  The Registered Nurses Act therefore resulting in
  professional misconduct as defined in the Act as
  
• 26(1) " any matter, conduct or thing, whether
  or not disgraceful or dishonorable, that is
  contrary to the best interests of the public or
  nurses or tends to harm the standing of the
  profession of nursing"
• 26(2)(n) - an addiction to the excessive or
  habitual use of intoxicating liquor, opiates,
  narcotics or other habit forming substances
  

10
ISSUES FOR RESOLUTION

• Issues for Resolution
• The member is willing to enter into this
  agreement to resolve the following issues
  
• Their addiction
• Their return to the practice of registered
  nursing without risk to the public.

11
TERMS UNDERTAKINGS

• Terms and Undertakings
• The member accepts responsibility for and
  acknowledges their disease of addiction.
  
• This agreement will become effective on the date
  of signing and will remain in effect for a period
  of two (2) years or until such time as the
  contract terms are completed if this date is
  after the (2) year timeframe.
• Regarding continuance of counselling and
  treatment for the addiction, the member
  undertakes to
  
• Etc. Ect. Ect.

12
COMPLIENCE WITH AGREEMENT

• Compliance with Agreement and Status of
  Compliance
  
• Upon this agreement taking effect and for so long
  as the member complies with the undertakings in
  this agreement, the Investigation Committee will
  take no further action with respect to the
  complaint and the conduct described in Part I of
  this agreement.
• Any breach will result in the complaint being
  referred back to the Investigation Committee for
  potential referral to the Discipline Committee.
  The paragraphs of the conduct described in Part I
  of this agreement are admissible in a discipline
  hearing.
• A breach by the member of any undertaking in this
  agreement may be professional misconduct. The
  member acknowledges and understands that if the
  Investigation Committee has reason to believe
  that they have breached an undertaking, the
  Investigation Committee may initiate a hearing
  before the Discipline Committee into their breach
  of the undertaking.
• All documents requested in the terms of this
  agreement must be sent to the Saskatchewan
  Registered Nurses Association (SRNA) directly
  from source, marked personal confidential, to
  the attention of the Registrar, c/o Assistant,
  Regulatory Services, SRNA, 2066 Retallack Street,
  Regina, SK, S4T 7X5.

13
DISCLOSURE NOTIFICATION

• Disclosure and Notification
• 5.1. Notification of this agreement shall be in
  accordance with SRNA Bylaw 5, section 1(b) and
  SRNA policies that may exist from time to time.
  
• 5.2 The complainant will be informed that the
  member has entered into an agreement and has
  made undertakings that satisfy the Investigation
  Committee that the public will be protected.
• 5.3 The existence of the Consensual Complaint
  Resolution Agreement with the member shall be
  recorded on the register.
  
• 5. 4The Investigation Committee and the
  Registrar of the SRNA shall receive and keep a
  signed copy of the agreement for their records.
  
• 5. 5 Canadian registered nursing regulatory
  bodies and all other nursing regulatory bodies
  that the nurse is presently registered in will be
  notified of the agreement.
• 5. 6 For so long as the undertakings remain in
  effect, the member shall reveal the agreement
  and the undertakings to prospective and existing
  employers. Employer notification shall occur
  immediately following the signing of this
  agreement. In the event that the member seeks a
  change in employment, the member shall notify
  the employer upon employment application. The
  member will provide the Registrar with written
  notification that the employer(s) has been
  notified of the agreement and undertakings.
• 5. 7 The members licence will indicate
  Licenced with Conditions for as long as the
  agreement remains in effect.
  

14
CONCLUSIONS UNDERTAKINGS

• Conclusion of Undertakings
• The Investigation Committee reserves the right to
  negotiate with the member an extension of the
  term of this agreement upon evidence of a
  relapse.
• When the Registrar is satisfied that the member
  has complied with the terms and undertakings in
  this agreement, the Investigation Committee will
  consider the undertakings to be concluded and
  shall inform the member that
• the members compliance with the terms and
  undertakings has been satisfactory
  
• the member no longer has the equivalent of
  conditions on his licence
  

15
OFFICIAL POLICY

• SASKATCHEWAN REGISTERED NURSES ASSOCIATION
• INVESTIGATION POLICY PROCEDURES
• POLICY CONSENSUAL
  NUMBER 1.13
  
• COMPLAINT RESOLUTION
  AGREEMENTS
  
• DATE August 14, 2003
• APPROVED August 16th, 2003 REVIEW DATE
  August 14, 2004
  
• The Association shall ensure that allegations of
  professional incompetence and\or professional
  misconduct are organized and conducted in a
  manner which ensures due process, duty of
  procedural fairness, transparency and timeliness
  and which strives for the lowest level of
  resolution possible, in the public interest.
  Processes shall be compliant with all provisions
  of The Canadian Charter of Rights and Freedoms,
  The Registered Nurses Act, 1988 and bylaws
  together with Council policy to protect the
  rights of the public and members.
• Evidence has been found to support concerns
  regarding the nurses practice and the
  Investigation Committee has made the decision to
  enter into an Consensual Complaint Resolution
  Agreement with the nurse. The nurse has the
  option to refuse participation in an Agreement.
  In the event that this occurs, the Case will then
  be moved to Discipline (see Policy 1.16) In
  addition the move to a Consensual Complaint
  Resolution Agreement can occur up to and during
  the initial stages of a Discipline Hearing.
• The Investigation Committee makes the
  determination if a case qualifies for a
  Consensual Complaint Resolution Agreement This
  determination is made based on the evidence
  gathered during the investigation, the nurses
  willingness to accept responsibility for her\his
  practice issues and agreement to enter into the
  legal contract with the SRNA.
• Relevant Documentation
• AS9.1
• Legal Opinion
• 1. ADR

16
Contact Information

• Rhonda OHagan, Competence Assurance Coordinator
• Saskatchewan Registered Nurses Assoc.
• 2066 Retallack St., Regina, Sask. S4T 7X5
• [phone]
• rohagan_at_srna.org
• www.srna.org