When the College of Nurses Contacts You
Many nursing matters begin at work. An employer that terminates a nurse’s employment, or a facility that revokes, suspends or restricts a nurse’s privileges, for reasons of professional misconduct, incompetence or incapacity must report it to the College within 30 days (Code, s. 85.5). Other matters begin with a complaint from a patient or family member, or with a nurse’s own mandatory self-report, such as a report of a finding of guilt for an offence (Code, s. 85.6.1).
Illustrative example, not an actual CNO letter
“The College has received a report from your former employer advising that your employment ended following concerns about medication administration and documentation on your unit. The Registrar has appointed investigators to look into these concerns. An investigator will contact you to arrange an interview.”
If you have already been through an internal workplace investigation, a grievance or a termination, the College process is separate. The College decides for itself whether the concerns raise issues of professional misconduct, incompetence or incapacity.
Who Investigates and Who Decides
- Regulator
- The College of Nurses of Ontario, continued under the Nursing Act, 1991, regulates RNs, RPNs and NPs. Its complaint, investigation and discipline procedures come from the Health Professions Procedural Code, Schedule 2 to the Regulated Health Professions Act, 1991 (“the Code”).
- Complaint or report?
- A complaint is filed by someone such as a patient or family member. A report follows a Registrar’s investigation, which is often prompted by an employer report. Both are considered by the same committee, but HPARB review rights are tied to complaints (Code, s. 29).
- Who investigates
- College investigators. They commonly speak with the employer and witnesses as well as the nurse. In a Registrar’s investigation, you must co-operate fully with the investigator (Code, s. 76(3.1)).
- Who decides at the investigation stage
- A panel of CNO’s Inquiries, Complaints and Reports Committee (ICRC) (Code, s. 26).
- Who holds hearings
- The Discipline Committee hears allegations of professional misconduct or incompetence. The Fitness to Practise Committee deals with incapacity, such as a health condition that affects safe practice.
- Who reviews or hears appeals
- The Health Professions Appeal and Review Board (HPARB) reviews ICRC decisions on complaints. Appeals from hearing decisions go to the Divisional Court (Code, s. 70).
Key timelines in the Code
- The Registrar must notify you within 14 days of receiving a complaint or report (Code, s. 25(6)).
- You may make written submissions to the ICRC within 30 days of receiving that notice, unless the committee shortens the time because of a risk of harm to patients (Code, s. 25.2).
- Complaints are expected to be disposed of within 150 days, with a new expected date given to the complainant if that is missed (Code, s. 28).
Your employer and your union
Your employer’s process and the College’s process run independently. A union grievance or settlement does not end a College investigation, and an employer’s decision not to discipline you does not prevent one. Keep copies of what you said and filed in the workplace process; the College may ask for the same records.
Common Issues in Nursing Investigations
Documentation
Missing or late entries, charting care before it was given, documenting assessments that were not done, or changing an entry after the fact. CNO’s Documentation practice standard is usually the starting point, and electronic charting audit trails are often part of the file.
Medication administration
Medication errors, omitted or duplicated doses, narcotic count discrepancies, waste not witnessed, or suspected diversion. CNO’s Medication practice standard applies; CNO has published a revised version that takes effect March 1, 2027, so check which version governs the events in question.
Professional boundaries and abuse
Allegations of verbal, physical, emotional or sexual abuse of a client, or relationships that cross professional boundaries. CNO’s Professional Boundaries and Nurse-Client Relationships standard and Code of Conduct apply. Sexual abuse findings carry mandatory penalties (Code, s. 51(5)).
Consent and scope of practice
Treating without valid consent, performing a procedure the nurse was not authorized to perform, or prescribing outside what an RN or NP may prescribe. CNO’s Consent practice guideline and its RN and NP prescribing resources are relevant.
Health and fitness to practise
Where the concern is impairment, for example substance use or a health condition, the College may look at incapacity rather than misconduct. That route aims at safe practice and monitoring rather than punishment, but it can still restrict your certificate.
What Can Happen Next
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Investigation and ICRC decision
After considering the investigation and your submissions, an ICRC panel may take no action, provide advice or recommendations, require a specified continuing education or remediation program (SCERP), require you to appear to be cautioned, refer specified allegations to the Discipline Committee, or refer you for incapacity proceedings (Code, s. 26). Matters are sometimes resolved through an undertaking, such as an agreement to practise with conditions.
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Interim order
If the committee believes your conduct exposes or is likely to expose patients to harm or injury, it can suspend your certificate or impose terms, conditions or limitations while the matter continues (Code, s. 25.4(1)). You must usually get notice and at least 14 days to respond in writing, unless the risk is urgent (s. 25.4(6)–(7)).
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Discipline hearing
A panel of the Discipline Committee hears evidence from both sides and decides whether to dismiss the allegations or find professional misconduct or incompetence (Code, ss. 51, 52). Possible orders include revocation, suspension, terms, conditions and limitations, a reprimand and a fine of up to $35,000 (s. 51(2)). CNO hearings are usually held virtually, and members of the public can ask to observe; a panel can order a publication ban or close parts of a hearing in sensitive cases.
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Review or appeal
HPARB review: you or the complainant may request a review of an ICRC decision on a complaint, other than a referral to discipline or for incapacity proceedings, within 30 days after receiving the notice of the right to a review (Code, s. 29(2)–(3)).
Divisional Court: discipline and fitness to practise decisions can be appealed on questions of law, fact or both (Code, s. 70). Orders based on incompetence, incapacity or certain sexual abuse findings take effect immediately despite an appeal (ss. 71, 71.1).
Losing a job is not losing a licence. An employer report starts an investigation. It is not a College finding, and many reports end without a referral to discipline.
Checklist: Responding to a CNO Complaint or Report
Documents to gather
- The College’s letter and the date you received it
- Termination, suspension or discipline letters from your employer, and any workplace investigation report
- Your own notes or statements given in the workplace process
- Relevant charting, medication administration records, narcotic count sheets and dispensing-cabinet reports, if available to you
- Assignment sheets, staffing levels and unit policies in effect at the time
- Grievance and settlement documents, if any
- Education, orientation and competency records
Details to check in the notice
- Is it a complaint or a report from an employer or other source?
- The deadline for written submissions, and whether it has been shortened
- Whether an interim order is being considered
- Which patients, shifts and dates are identified
- Whether the investigator wants an interview, and in what format
Rules and resources to consult
- Health Professions Procedural Code, ss. 25–29, 51–52, 70–71, 75–76 and 85.5
- CNO Code of Conduct, Documentation, Medication, and Professional Boundaries and Nurse-Client Relationships practice standards
- CNO Consent practice guideline
- HPARB’s Consolidated Rules of Practice and Procedure, if a review is involved
- Your union or professional liability protection provider, to ask what assistance is available for College matters
Do not remove records from your workplace or access patient charts you no longer have a professional reason to view. Ask your employer, the College or your representative to obtain them through proper channels.
Frequently Asked Questions
My employer already dealt with this. Why is the College investigating?
Employers must report terminations, and facilities must report privilege revocations, suspensions and restrictions, made for reasons of misconduct, incompetence or incapacity (Code, s. 85.5). The College has its own public-protection mandate and must decide independently whether the concerns affect your fitness to practise nursing.
Can I keep working as a nurse while CNO investigates?
Generally yes, unless an interim order is made or you agree to an undertaking that limits your practice. Some employers have their own rules about nurses under investigation, so check those as well.
What is the difference between a complaint and a report?
A complaint comes from a member of the public or another person and follows the complaint process in the Code. A report follows an investigation the Registrar starts, often after an employer report. The same committee decides both, but HPARB review rights under s. 29 are tied to complaints.
Is a caution public?
Yes. The Code requires the public register to note cautions, SCERPs and undertakings, as well as allegations referred to discipline (s. 23(2)).
Sources
Statutory references are to the provisions listed below, as consolidated on e-Laws when this page was prepared.
- Regulated Health Professions Act, 1991, S.O. 1991, c. 18, Schedule 2 (Health Professions Procedural Code), ss. 23, 25–29, 51–52, 70–71, 75–76, 85.5, 85.6.1 — e-Laws consolidation period beginning January 1, 2026; checked November 10, 2026.
- Nursing Act, 1991, S.O. 1991, c. 32, ss. 6, 11 — Checked November 10, 2026.
- CNO, “Discipline Hearings” — Checked November 10, 2026.
- CNO, “Standards & Guidelines” (Code of Conduct; Documentation; Medication, including the version in effect March 1, 2027; Professional Boundaries and Nurse-Client Relationships; Consent) — Checked November 10, 2026.
- CNO, “Employer Guide to Reports, Complaints and Outcomes” — Section titles reviewed November 10, 2026.
- Health Professions Appeal and Review Board — Checked November 10, 2026.