Addiction diagnosed several months after dismissal, but employer should have had an inkling performance issues were caused by it: Arbitrator
An Ontario nurse who claimed an addiction disability after she was dismissed for unprofessional conduct has been reinstated.
Sartcia Pinsonneault was a registered nurse hired in 2007 by Hamilton Health Sciences (HHS) in Hamilton. Early on in her tenure, she developed a conflict with some of her co-workers over her accusation of sexual assault against a co-worker’s husband. Eventually, things got to the point where Pinsonneault had to take a year off work for stress leave.
Pinsonneault returned in October 2010 and eventually found a position in the palliative care program. However, by early 2011 she was having performance issues, leading to a meeting on June 9 about deficient documentation for patient admissions. HHS developed a learning plan for her to improve her performance, but Pinsonneault failed to complete it. She also didn’t complete a nursing skills inventory as requested and failed to show up for a follow-up meeting.
Pinsonneault worked a shift on July 6 in which she failed to follow proper standards for the management of a patient’s death process, gave too much narcotic to a patient when the patient’s wife demanded it, failed to chart certain events properly, mishandled a chest tube drainage bag and IV pump, didn’t document additional medication doses for a patient and failed to properly chart the progress of patients. She recorded nothing at all in the charts of four patients she treated.
Employee suspended for misconduct
HHS questioned Pinsonneault about that shift and she had gaps in her memory with no real explanation for some of the events, other than she was very busy. HHS suspended Pinsonneault for 10 days without pay and required her to participate in a comprehensive learning plan. She was also restricted to working only when another registered nurse was present.
Over the next two months, Pinsonneault was sent home or went home on her own on several occasions for being unwell, groggy or having cold symptoms. She completed her learning plan by September. On Sept. 17, 2011, Pinsonneault told a registered practical nurse on duty she had a migraine headache. The nurse later observed her staggering and stumbling, red in the face and sometimes unmoving while staring off into space. Pinsonneault also had difficulty picking up a cup in a kitchen cupboard and trying to put a straw in the lid. The nurse also saw mucous coming out of Pinsonneault’s nose and mouth.
Pinsonneault’s behaviour was reported to the charge nurse, who interviewed Pinsonneault and sent her home. HHS investigated and discovered a number of errors Pinsonneault had made on her shift and even that the spouse of one patient asked that Pinsonneault not come near her husband.
HHS interviewed Pinsonneault about her behaviour and she said she had a migraine, high blood pressure and was experiencing stress outside of work. HHS was concerned Pinsonneault had chemical dependency issues and thought she might be responsible for the theft of some narcotics that had gone missing. Pinsonneault denied any substance abuse, saying she didn’t do drugs because was allergic to some narcotics and she only drank beer occasionally.
HHS accepted Pinsonneault’s denial and didn’t investigate further. It decided she wasn’t fit for duty as a nurse and terminated her employment on Oct. 3, 2011.
In March 2012, after Pinsonneault had worked briefly at a nursing home and was let go, she underwent an independent medical examination to determine her fitness to practice nursing. She tested positive for cocaine, morphine, opiates, Oxycodone and cannabis. A doctor’s report noted she suffered from substance abuse and her performance issues were “likely related to her active addiction.”
Pinsonneault followed the doctor’s recommendation to assist in her recovery and her efforts to become fit to practice nursing again, including attending a residential treatment program and Alcoholics Anonymous meetings. She didn’t initially fully abstain from drugs and alcohol and an addictions specialist diagnosed her in June 2013 with addictive disorders for which she was in deep denial. She was still in “active addiction” and not ready to return to work.
The Ontario Nurses’ Association filed a grievance for her suspension and dismissal, arguing her misconduct was the result of an addiction that HHS should have been aware of and accommodated.
The arbitrator noted that initially there was no reason for HHS to suspect addiction issues were the cause of Pinsonneault’s performance problems, but the nature of her problems on July 6, 2011, followed by her memory gaps might have raised the possibility. If anything, however, HHS was suspecting something was up after the shift when she had co-ordination problems and she exhibited “a demeanour and personal behaviour that were indicative of substance abuse of some sort.”
Though HHS said it had no choice but to accept Pinsonneault’s denial of substance abuse, the arbitrator noted that “denial is often a symptom of an addiction disability” and HHS had an obligation to investigate further. Because the hospital should have acted on the suspicion of an addiction, the duty to accommodate existed even though Pinsonneault wasn’t diagnosed until several months after her termination.
The arbitrator ordered HHS to reinstate Pinsonneault, although not to active employment since her addiction issues were still a problem and she was unable to work safely. However, the reinstatement allowed Pinsonneault access to long-term disability benefits and to regain lost seniority.
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