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Accountability to report
Q. I am a frontline RPN and I recently witnessed a nursing colleague provide care to a client that I perceive to be unprofessional. The nurse’s actions compromised the client’s safety and well-being. When I reviewed the College’s mandatory reporting document, I noticed it only states that nurses are required to report sexual abuse of a client. Although this situation does not involve sexual abuse, I feel as though this is something I need to report but I am concerned about client confidentiality and my professional relationships. What are my accountabilities?
A: When a client’s safety and well-being are compromised, your primary responsibility is to the client. As a nurse, you are accountable for reporting to the appropriate authority, any team member or colleague whose actions or behaviours toward clients are abusive in any manner. Abuse may be physical, verbal, emotional, financial, sexual, or take the form of neglect. Any type of client abuse is considered professional misconduct.
Depending on the nature of the abuse, examples of an appropriate authority you can report to include the College of Nurses of Ontario, another health regulatory body or your employer.
Also remember that you are accountable for ensuring that your practice and conduct are in alignment with the standards of the profession and other legislation that applies to your specific practice setting.
At times, nurses will learn information which, if not revealed or reported, will result in serious harm to the client. Some legislation requires that nurses reveal confidential information to others. This duty supersedes other accountabilities regarding client confidentiality.
Below are examples of College documents, and legislation related to specific practice settings, that all nurses must keep in mind when considering their reporting requirements.
Some expectations of the profession
CNO’s Code of Conduct states that nurses take action in situations where a colleague’s actions or behaviours put clients at risk or are perceived to be abusive toward a client in any way.
The Therapeutic Nurse-Client Relationship practice standard, says that nurses have a commitment to clients to act in their best interest by providing safe, effective and ethical care, and their actions must promote trust and respect of the profession – this would include reporting any form of abuse to an appropriate authority as explained above.
Some applicable legislation
An example of specific legislation that informs nurses’ reporting requirements is the Fixing Long-Term Care Act, 2021, which outlines the obligation for nurses to report improper or incompetent care of a client, or abuse that results in harm or a risk of harm.
If the client abuse involves a child or youth, the Child, Youth and Family Services Act, 2017 requires all health care professionals to report the suspected abuse.
For more information, please see the following resources:
Code of Conduct
Preventing Client Abuse
Professional Misconduct
Confidentiality and Privacy: Personal Health Information
