Even the best nurses receive complaints against them to the College of Nurses of Ontario (“CNO”). The potential outcomes of a complaint can be serious. In many cases, a nurse’s response to the complaint is the best opportunity to ensure a favourable result. Given the importance of an effective response, we outline the top 5 things nurses need to know when responding to complaints.  

(1) The CNO will investigate the complaint 

When a complaint is made, the nurse will be given notice of the complaint and provided 30 days to respond to the complaint in writing. The complaint is then considered by the Inquiries, Complaints and Reports Committee (“ICRC”) who may direct further investigation. The investigation may include the gathering of relevant documents, taking statements from witnesses, and interviewing the nurse. If an investigator is appointed, the CNO can compel a nurse to provide records and documents. Where additional investigation is conducted, the nurse may be given an opportunity to submit a supplemental response to any new information.  

(2) The entire process is in writing 

Because the ICRC is a screening committee, it only considers a paper record and cannot make credibility assessments. There is no right to make oral submissions or for a lawyer to cross-examine the complainant or other witnesses. For this reason, records and documentation are critical. When a nurse receives a complaint, they should carefully review their records and submit records with their written response where appropriate.  

(3) The consequences of a complaint can be serious 

Once the ICRC has had an opportunity to review the complaint, the nurse’s response, and the results of any investigation, the ICRC can: 

• Refer allegations of professional misconduct or incompetence to the Discipline Committee for a hearing; 
• Require the nurse to appear before the ICRC to be cautioned; 
• Require the nurse to complete an educational or remediation program; or 
• Take no action.  

If the complaint is referred to the Discipline Committee and allegations of professional misconduct are proven, the Discipline Committee may make a variety of more serious orders, including an order revoking, suspending, or placing terms, conditions, and limitations on the nurse’s certificate of registration. Because a complaint can result in significant personal, professional, and financial consequences, it is important to take every complaint seriously.  

(4) Many ICRC decisions are made public 

Even if a complaint is not referred to the Discipline Committee, the outcome of the complaint may still be made public. A decision of the ICRC to caution a nurse or to require a nurse to complete an educational/remediation program must be published on the CNO’s public register. The public nature of these decisions makes it critical to respond appropriately to all complaints, even those that may not warrant a discipline hearing, so as to avoid a public outcome.    

(5) An effective response is vital 

A nurse’s written response is their best opportunity to mitigate the potential adverse effects of a complaint. Responding to a complaint is a nuanced and difficult task that requires persuasive writing, careful analysis, and an understanding of how the CNO is likely to respond. Nurses may wish to consider retaining a lawyer experienced in professional regulation and discipline to draft their response and assist them in navigating the CNO’s complaints process.  

GlickLaw is a boutique law firm focused on professional regulation, complaints, investigations, and discipline. If you have received notice of a complaint or investigation and would like to speak to a lawyer, please contact us.