Student# 822-974-028

NURS 217 SCHOLARLY ASSIGNMENT: ETHICS

Student: Senarath Rathnayake

Student No: 822 974 028
Date submitted: Nov 04, 2014
NURS217 (366): Scholarly Assignment
Teacher: Rosemary
Humber College ITAL

Student# 822-974-028

Introduction
The purpose of writing this paper is to reveal my understandings about a professional
misconduct that resulted in an investigation by the discipline committee of the College of Nurses
of Ontario (CNO). For this, I selected a case from the list of discipline committee decisions
under protect the public in cno.org.ca web site. The case is about a Registered Practical Nurse
(RPN) who engaged in an intimate relationship with the husband of a client who is under her
care in a full-service retirement facility for seniors. So, she has committed to a professional
misconduct by failing to meet the standards of the profession, abusing a client emotionally, and
acting dishonorably and unprofessionally.
This elderly client was suffering from Alzheimers disease, and she had been married to her
husband for approximately 60 years. In fact, not only the RPN is responsible for this alleged
professional misconduct behaviour but also the clients husband. According to the hearing report,
clients husband has discussed his personal life with the RPN and, has told her that he is lonely
and live in an empty house. There is neither any contributing factors affecting the nurse nor in
the environment. By considering the Agreed Statement of Facts and the RPNs plea, the
discipline committee has decided that this RPN has committed an act of professional misconduct
since she has failed to meet the standards of the profession, abused a client emotionally and acted
dishonorably and unprofessionally. After studying the case, I agree with the decision of the
discipline committee because she should be punished for her unacceptable behaviour. In
addition, the decision leads her to get proper understanding, and adhere to the practice standards
by reviewing college publications. Further, imposing working conditions persuades her to be in

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the right tract at the practice settings, and allow her employers to keep eye on her behaviour.
Finally, this penalty sends a message to the public that this type of behaviour will not be tolerated
and will be severely treated by members of the profession and the public as a whole.
Body
This RPN has violated two ethical values described in the Ethics 2008 standards: client wellbeing and maintaining commitments. Client well-being is to secure clients from harm and
support the clients health and welfare. By maintaining a therapeutic nurse- client relationship,
and using knowledge and skill to promote clients best interests in an empathic manner, nurses
can achieve the goal of the Client well-being. Instead of doing so, this RPN, however, developed
an intimate relationship with the husband of the client. In addition, she emotionally abused the
client even though she was supposed to promote and preserve her self-esteem and selfconfidence in order to promote her well-being.
The other ethical value violated by this nurse is maintaining commitments. Maintaining
commitments means to me is to keep promises, be honest and meet clear, direct or indirect
influence on clients, themselves and each other. Further, it extends towards the nursing
profession, other members of the health care team, and quality practice settings too. In addition,
under this ethical value, nurses are supposed to prioritize the needs and wishes of clients first,
advocate for maintaining quality client care, and try their best to make sure the clients safety and
well being is maintained in every task. Maintaining commitments is a big area and, it divides into
several types, such as maintaining commitments: to clients, to oneself, to nursing colleagues, to
the nursing profession, to team members and to quality practice settings. The CNO practice
standards Ethics (2008) describes, Nurses as self regulated professionals, implicitly promise

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to provide safe, effective and ethical care. Because of their commitment to clients, nurses try to
act in the best interest of clients according to clients wishes and the standards of practice. Nurses
are obliged to refrain from abandoning, abusing or neglecting clients, and to provide empathic
and knowledgeable care. The commitment to clients also includes a commitment to respect
family members and/or significant other(s), some of whose needs may conflict with those of
clients. In this case, this RPN has not been honest to the client, to the nursing profession, or to
any other members of the health care team.
Strategies
I would like to choose two strategies to prevent the re-occurance of such a situation. First is to
impose some working conditions on this Member for a period of time - 12 months. Working
conditions make her aware that she has been circumscribed, has been kept under supervision.
And also, as this sounds some sorts of threat to lose her job permanently, she might more
conscious about her actions. If she wants to keep her reputed profession, she must reach the
standards of practice of the profession, and show the appropriately adjusted behaviour through
her actions. Moreover, since it is mandatory to provide her employers with a copy of the panel
order, the notice of hearing, the Agreed Statements of Facts, and the joint submission on penalty,
her employers will definitely keep their vigilant eyes on her actions and the behaviour. Hence,
the penalty as en exact effect on preventing the same misconduct again and again.
The second is to order her to enhance her knowledge about the CNOs practice standards paying
more attention on professional standards and the therapeutic nurse- client relationship. Further,
she needs to complete relevant reflective questionnaires and online learning modules to check

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the level of the knowledge gained. The CNOs reference document- professional
conduct/professional misconduct (2009) states that All standards of practice provide a guide to
the knowledge, skills, judgement and attitudes that are needed to practice safely. Nurses are
expected to adhere to the standards of practice in carrying out their professional responsibilities.
These standards are the reasonable expectations placed on nurses by the College and by the
profession to ensure that nurses provide responsible, safe and adequate care to clients.
Professional misconduct occurs when these standards are breached. So, it is essential her to
review these documents. For instance, by reviewing the therapeutic nurse-client relationship, she
will get deep understanding of the five components of the relationship: trust, respect,
professional intimacy, empathy and power. This will help her to set boundaries for the
relationship. If she had mastered what the therapeutic relationship was, she could have solved the
ethical dilemma when her clients husband told her that he was lonely and lived in an empty
house. Moreover, she needs to pay more attention on ethics. It helps her to avoid such incidents
further. Canadian Fundamental of Nursing (2014) states that Ethics is the standard of good
conduct, character, and motives. It is concerned with determining what is good or valuable for all
people. Essentially, ethics requires you to be critically reflective, exploring your values,
behaviours, actions, judgements, and justifications ( Perry & Potter 2014, p. 82). So, reviewing
practice standards improve her knowledge, shape her behaviour, and prevent her from such a
professional misconduct.
Conclusion
The RPN in this case, has engaged in an unacceptable intimate personal relationship with the
husband of a client, while providing care to her. The discipline committee of the College of
Nurses of Ontario decided that this is unprofessional and dishonourable. And also, it involves

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abuse of a vulnerable client, and takes place over an extended period of time. She has violated
two ethical values: client well-being, and maintaining commitments. I have suggested to impose
working conditions for 12 months, and order her to enhance her knowledge reviewing College
publications. These will help her to update her knowledge, shape her attitudes and behaviour, and
adhere to the standards of practice. Eventually, she will be potential enough to be a guiding
figure in the force of highly recognized self regulated profession working towards to protect the
public and promote the best interest of the public.
References
College of Nurses of Ontario. (CNO). (2013). Reference Document: Professional Misconduct.
Retrieved from www.cno.org
College of Nurses of Ontario. (CNO). (2009). Practice Standard: Ethics. Retrieved from
www.cno.org
Potter, P., Perry, A.G., (2014). Chapter 7. Canadian Fundamentals of Nursing (5th ed). Toronto:
Mosby