1. “CONSENT AGREEMENTS:LET US SHOW YOU HOW IT CAN WORK” Rhonda O’Hagan Competence 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. Presented at the 2004 CLEAR Annual Conference September 30 – October 2 Kansas City, Missouri 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. Presented at the 2004 CLEAR Annual Conference September 30 – October 2 Kansas City, Missouri OPERATING PRINCIPLES 1.Competent Nursing Practice 2.Transparency 3.Due Process 4.Timely Resolution 5.Education 6.Utilization of Lowest level of Resolution 7.Fiscal Efficiency 8. Identification & Referral of Risk Patterns

5. Presented at the 2004 CLEAR Annual Conference September 30 – October 2 Kansas City, Missouri THE PROCESS Reports received: 1.Via telephone call, newspaper article (non-written format), informal inquiry 2.Written Letter of Complaint, official 3.Investigation completed\report developed

6. Presented at the 2004 CLEAR Annual Conference September 30 – October 2 Kansas City, Missouri OPTIONS USED IN THE COMPLAINTS HANDLING PROCESS 1.Dismissal 2. Low Level Resolution Process - Letter of Guidance - Consensual Complaint Resolution Agreement - Mediation 3. Referral to Discipline

7. Presented at the 2004 CLEAR Annual Conference September 30 – October 2 Kansas City, Missouri 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. Presented at the 2004 CLEAR Annual Conference September 30 – October 2 Kansas City, Missouri 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. Presented at the 2004 CLEAR Annual Conference September 30 – October 2 Kansas City, Missouri 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 __________________Saskatchewan. 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 1.4This 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…" 1.5This 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. Presented at the 2004 CLEAR Annual Conference September 30 – October 2 Kansas City, Missouri 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. Presented at the 2004 CLEAR Annual Conference September 30 – October 2 Kansas City, Missouri 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. Presented at the 2004 CLEAR Annual Conference September 30 – October 2 Kansas City, Missouri 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. Presented at the 2004 CLEAR Annual Conference September 30 – October 2 Kansas City, Missouri 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. 5.2The 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. 5Canadian registered nursing regulatory bodies and all other nursing regulatory bodies that the nurse is presently registered in will be notified of the agreement. 5. 6For 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. 7The member’s licence will indicate “Licenced with Conditions” for as long as the agreement remains in effect.

14. Presented at the 2004 CLEAR Annual Conference September 30 – October 2 Kansas City, Missouri 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 member’s compliance with the terms and undertakings has been satisfactory; the member no longer has the equivalent of conditions on his licence;

15. Presented at the 2004 CLEAR Annual Conference September 30 – October 2 Kansas City, Missouri OFFICIAL POLICY SASKATCHEWAN REGISTERED NURSES ASSOCIATION INVESTIGATION POLICY & PROCEDURES POLICY : CONSENSUAL NUMBER: 1.13 COMPLAINT RESOLUTION AGREEMENTS DATE: August 14, 2003 APPROVED: August 16 th, 2003REVIEW 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. Presented at the 2004 CLEAR Annual Conference September 30 – October 2 Kansas City, Missouri Contact Information Rhonda O’Hagan, Competence Assurance Coordinator Saskatchewan Registered Nurses Assoc. 2066 Retallack St., Regina, Sask. S4T 7X5 (306) 384-6968 rohagan@srna.org www.srna.org