Filing A Complaint About an RN Employee

I recently became a manager. Most of the staff perform their roles competently and I have no concerns about their performance. But I have one RN on staff that concerns me greatly. How do I know if or when it is appropriate to file a complaint with the CRNS?

A complaint should be filed with the CRNS when any of the following occurs:

• The RN’s practice meets the threshold of professional incompetence or professional misconduct as defined in Sections 25 & 26 of The Registered Nurses Act, 1988. This could be because of repeated practice errors that pose an ongoing risk to client safety despite the provision of appropriate support and remediation (such as errors in medication management, pain management, documentation, etc.). Other examples can include theft from a workplace, misappropriation of drugs or an addiction that impairs the RN’s ability to practice safely and competently.
• The RN’s practice does not uphold the CRNS Practice Standards, 2019 or CNA Code of Ethics, 2017. An example of this could include a confidentiality breach or an issue with fitness to practice that impacts client safety.
• An RN is terminated from their employment on the grounds of professional incompetence or professional misconduct. [There is an employer obligation to report this according to Section 43(1) of The Registered Nurses Act, 1988]

RN Manager Responsibility

• RNs are attentive to signs that a colleague is unable, for whatever reason, to perform their duties. In such cases, RNs will take the necessary steps to protect the safety of persons receiving care (1).
• RNs, as members of a self-regulating profession, practice according to the values and responsibilities in the Code of Ethicsand in keeping with the professional standards, laws and regulations supporting ethical practice (2).
• RNs question, intervene, report and address unsafe, non-compassionate, unethical or incompetent practice or conditions that interfere with their ability to provide safe, compassionate, competent and ethical care; and they support those who do the same (3).
• RNs adhere to the duty to report (4).
• RNs are accountable and accept responsibility for their own actions and decisions (5).
• RNs use an ethical and reasoned decision-making process to address situations of ethical distress and dilemmas (6). 

Non-RN Manager Responsibility

• Depending on your professional designation and background, you may have responsibilities or obligations outlined by a regulatory body. All managers of facilities, departments or units where client care occurs, have an obligation to promote client safety and address safety concerns.
• Managers of RNs have an obligation to understand the practice standards and professional expectations that guide safe, competent and ethical RN practice.

Are there times when I should not report an RN to the CRNS?

At times, decision-making may be difficult. If you are unable to identify definitive evidence that a report must be filed, then you may need to consider and explore alternative routes of resolution. When employer policies or processes that are intended to address and remedy performance or safety issues exist, they should be utilized.

Employers should not file a complaint with the CRNS as:

• A replacement for internal performance management processes;
• A replacement for immediate action/intervention that must be taken to ensure the safety of clients;
• A mechanism to address discord in the relationships between staff members or the manager and staff;
• A replacement for enacting harassment policies/processes;
• A replacement to working through a client’s concern via the Client Representative/Patient Advocate process; or,
• A response/result of systemic organizational issues that are beyond the RN’s control.

At any point, if you are unsure if you should report an RN and require guidance, please contact the Complaints and Investigations team at professionalconduct@crns.ca. CRNS investigations can be parallel processes with employer processes when appropriate.

How can I learn more about the CRNS Complaints Process?

More information can be found here.

CRNS Resources

Registered Nurse Practice Standards (2019)

CNA Code of Ethics (2017)

Registered Nurse Entry-Level Competencies (2019)

Investigation and Discipline Infographic (2022)