Executive Summary: Key Legal and Evidentiary Issues

• The applicant’s failure to complete a professional boundaries course prior to the hearing was a significant factor in the denial of reinstatement, but not the sole reason.

• The Committee determined that the applicant had not sufficiently rehabilitated herself and lacked current skill and judgment to return to nursing practice.

• Expert psychiatric evidence indicated no medical reason preventing the applicant’s return, but the Committee considered this only one part of the broader assessment.

• Discrepancies in the applicant’s reported hours of nursing practice since 2018 were noted, but neither figure met the required 320 hours for currency of practice.

• The Committee’s decision was reviewed under the reasonableness standard, with deference to its expertise and statutory mandate.

• The Court upheld the Committee’s decision, finding it rational, coherent, and supported by the evidence and statutory framework.

Background and events leading to the dispute
Catherine Shanks became licensed as a registered nurse in 1999 and was employed as the Clinical Nursing Coordinator at Direction 180, a community-based methadone clinic in Halifax, in 2018. In October 2018, it came to light that Ms. Shanks had entered into an inappropriate and intimate relationship with a clinic client who had a pre-existing opioid use disorder and had relapsed in August 2018, allegedly due to conflict with Ms. Shanks. The client had also loaned money to Ms. Shanks, and there was evidence that she encouraged the client to transfer to a different clinic. This situation was reported to the Nova Scotia College of Nursing (NSCN), and a formal complaint process was initiated in November 2018. Ms. Shanks acknowledged the allegations and agreed that her registration as a registered nurse should be revoked, which was accepted by the Professional Conduct Committee on February 11, 2021. It was agreed that she would be ineligible to apply for reinstatement for two years following the decision.

Application for reinstatement and Committee decision
Ms. Shanks applied for reinstatement in August 2023 to the Reinstatement Committee. The NSCN did not contest her request for reinstatement, provided that certain conditions and restrictions were placed on her license, all of which Ms. Shanks agreed to in advance. The parties prepared a draft order for the Committee’s consideration. However, the Committee rejected her request for reinstatement by decision dated November 13, 2024, and stated that Ms. Shanks would need to wait a year before filing a new application for reinstatement, and only upon completion of a number of conditions. The Committee’s concerns included the lack of evidence that Ms. Shanks had completed a boundaries course prior to the hearing, insufficient demonstration of rehabilitation, lack of current skill and judgment, and lack of preparation for returning to nursing practice. The Committee also noted that Ms. Shanks had not reviewed the NSCN Boundaries Guidelines or completed any relevant education since her revocation, and that her recent work as a peer support worker with vulnerable individuals was concerning in light of the original misconduct.

Judicial review and standard applied
Ms. Shanks sought judicial review of the Committee’s decision, alleging that the decision was illogical, unjustified, and not supported by the evidence, particularly in light of uncontradicted expert psychiatric opinion. The parties agreed, and the Court confirmed, that the appropriate standard of review was reasonableness, as set out in Canada (Minister of Citizenship and Immigration) v. Vavilov, 2019 SCC 65. The Court found that the Committee’s decision was intelligible, rational, and followed a reasonable chain of logic. The Committee’s assessment included a holistic review of the evidence, including the applicant’s reflective essay, character references, work history, and oral evidence, as well as the expert psychiatric report.

Key policy terms and statutory framework
The Reinstatement Committee’s constitution and powers are set out in sections 109-115 of the Nursing Act, SNS 2019, c. 8, and the Nursing Regulations, N.S. Reg. 76/2019. The statutory framework requires that an applicant for reinstatement must meet criteria for registration and licensing, including proof of capacity, competence, and character to safely and ethically engage in practice, as well as currency of practice (320 hours within the last five licensing years). The Committee referenced relevant case law on reinstatement factors, such as insight, rehabilitation, and public protection. The applicant’s reported hours of practice were inconsistent: the original Agreed Statement of Facts stated 320 hours, later revised to 280 hours, and Ms. Shanks stated in oral evidence that she had practiced 151.5 hours in the last five years. The Committee noted that neither figure met the statutory requirement, and this did not affect the outcome.

Outcome
The Supreme Court of Nova Scotia upheld the Committee’s decision to deny reinstatement, concluding that it met the standard of reasonableness and was supported by the evidence. Ms. Shanks’ application for judicial review was dismissed, and the Committee’s decision remained in effect. The Court stated that if the parties could not agree on costs, concise written submissions could be made within 30 days of the decision. No specific monetary award was granted, as the matter concerned professional reinstatement and not damages.