The Discipline Committee of the College of Nurses of Ontario, in a decision dated April 15, 2025, has ordered the immediate revocation of Tammy Berkers’ certificate of registration1. The ruling followed Ms. Berkers’ admission to committing professional misconduct and sexual abuse involving a vulnerable patient at the Brockville Mental Health Centre, where she was employed as a Registered Practical Nurse. The panel’s decision was based on an Agreed Statement of Facts that detailed a prolonged personal and sexual relationship, a breach of another patient’s privacy, and continued non-professional contact after Ms. Berkers’ employment was terminated.
The hearing was conducted via videoconference before a panel that included three nursing members and two public members. Ms. Berkers, who had resigned her registration on January 2, 2023, was not represented by legal counsel. The College of Nurses of Ontario (CNO) was represented by counsel Sarah Corman. Before the plea was entered, the College withdrew several redundant allegations, and Ms. Berkers then admitted to the remaining allegations, which included contravening the standards of practice, sexual abuse, and engaging in conduct that would be regarded by nursing members as disgraceful, dishonourable, or unprofessional. The panel conducted a plea inquiry and was satisfied that Ms. Berkers’ admissions were voluntary, informed, and unequivocal. A publication ban was ordered to protect the identities of the patients mentioned in the proceedings.
According to the agreed facts, Tammy Berkers first registered as a Registered Practical Nurse in 2003 and began working part-time at the Brockville Mental Health Centre in October 2020. She was assigned to the Forensic Treatment Unit, which provides care to inpatients who have been found not criminally responsible on account of mental disorder or unfit to stand trial. The patient at the center of the most serious allegations, identified as Patient A, was an inpatient in this unit to whom Ms. Berkers regularly provided care. The professional relationship began to break down around March 2022, when Ms. Berkers and Patient A started a personal relationship.
This relationship involved Ms. Berkers spending excessive time with Patient A during her shifts for no therapeutic purpose, such as watching videos or discussing shared interests. The personal connection extended beyond the facility’s walls, with the two exchanging personal text messages and speaking on the telephone when Ms. Berkers was not at work. The panel found that this conduct breached the boundaries of the therapeutic nurse-patient relationship and contravened the profession’s standards, which explicitly state that a nurse’s personal needs must be met outside of the therapeutic relationship.
The misconduct escalated significantly on the night of July 7, 2022. Ms. Berkers was working a night shift when, at approximately 9:20 PM, another nurse (Colleague 1) observed her on a video monitor entering Patient A’s room. This action was noted as suspicious because all clinical duties for that time, including the evening snack, medication pass, and rounds, had already been completed. When Ms. Berkers did not exit the room after a reasonable amount of time, Colleague 1 proceeded to the room to investigate. The colleague found the door nearly closed and the room’s lights off. After knocking and opening the door, Colleague 1 “observed the Member and Patient A engaged in sexual intercourse.”
The colleague immediately instructed Tammy Berkers and Patient A to stop and directed Ms. Berkers to the nursing station. Ms. Berkers was sent home from her shift with her belongings shortly thereafter. Following an internal investigation by the Brockville Mental Health Centre, Ms. Berkers’ employment was terminated one week later, on July 14, 2022. This specific act of sexual intercourse formed the basis for the panel’s finding of sexual abuse, as defined by the Health Professions Procedural Code.
The Agreed Statement of Facts further detailed that Ms. Berkers’ relationship with Patient A continued even after she was fired. Patient A was permitted to leave the facility for community visits as part of his regular programming, provided he followed a pre-approved itinerary. On September 28, 2022, two Centre staff members (Colleague 2 and Colleague 3) who were on their lunch break observed Ms. Berkers driving near the YMCA, a location Patient A was scheduled to walk to. They saw Patient A sitting in her front passenger seat, which was not part of his approved itinerary. The colleagues followed Ms. Berkers’ vehicle, which eventually stopped on a dead-end road. The staff members reported Patient A as being off-itinerary, and he was subsequently picked up and returned to the Centre. Ms. Berkers was observed meeting with Patient A on five additional occasions between October 2022 and January 2023, though on those dates Patient A did not deviate from his approved schedule.
A separate and serious instance of misconduct occurred in late 2022. In November, another patient at the facility, Patient B, alleged to a nurse (Colleague 4) that he had experienced unprofessional interactions with Ms. Berkers. The Centre reported these allegations to the CNO as part of its ongoing investigation. On or around December 7, 2022, the CNO provided Ms. Berkers with an updated Record of Investigation which contained documents related to Patient B’s allegations, including confidential information about Patient B. Ms. Berkers had been cautioned that these documents were confidential and that using them for any purpose other than preparing her response could be considered professional misconduct.
Despite this warning, Ms. Berkers disclosed the confidential information about Patient B’s allegations to Patient A. This breach of privacy had direct consequences within the facility. On December 27, 2022, Patient A approached another nurse to express that he was upset about the report, stating that he “cared about the Member and knew Patient B’s allegations were false.” This incident raised significant safety concerns among staff for both Patient B and Colleague 4, who had initially reported Patient B’s complaint.
The Agreed Statement of Facts noted that if Ms. Berkers were to testify, she would attribute her actions to “serious lapses of judgment during an extremely difficult time in her life.” She cited personal challenges, including the breakdown of her marriage and feelings of depression, isolation, and loneliness. While offering this context, she also expressed that she took full responsibility for her “serious unethical misconduct” and acknowledged her professional obligations. She stated she was remorseful, had since sought support, and felt confident she would not repeat such lapses in judgment.
In its decision, the panel found that Ms. Berkers’ conduct contravened numerous practice standards. By engaging in the relationship, she breached the Therapeutic Nurse-Client Relationship standard, which places the responsibility on the nurse to establish and maintain professional boundaries. Her actions also violated the CNO’s Code of Conduct, which requires nurses to act with integrity, protect patient privacy, and explicitly forbids sexual relationships with patients. The panel also found she failed to meet the Professional Standards related to accountability and ethics.
The panel concluded that her conduct was reasonably regarded by members of the profession as disgraceful, dishonourable, and unprofessional. It found the conduct unprofessional due to the “serious and persistent disregard for her professional obligations.” It was deemed dishonourable because it “demonstrated an element of dishonesty and deceit” in maintaining the relationship and meeting Patient A off-itinerary. Finally, the panel found the conduct disgraceful, stating that it “shames the Member and by extension the profession” and “casts serious doubt on the Member’s moral fitness” to meet the high standards expected of a health professional.
College Counsel and Ms. Berkers proposed a Joint Submission on Order, which the panel accepted. The penalty requires Ms. Berkers to appear before the panel within three months for a formal oral reprimand. It also mandates that she reimburse the CNO for any funding provided to Patient A for therapy under the program for patients who have been sexually abused, up to a maximum of $5,000, should Patient A access that fund. The final and most significant component of the order was the immediate revocation of Ms. Berkers’ certificate of registration.
In its reasons for the penalty, the panel noted that under the Health Professions Procedural Code, a finding of sexual abuse involving conduct such as sexual intercourse requires a mandatory minimum penalty of revocation. The panel balanced mitigating factors, such as Ms. Berkers’ lack of a prior disciplinary history and her cooperation in the proceeding, against aggravating factors. These included the seriousness of the conduct, its repetition over time, and the “significant disregard for her professional obligations, particularly in a mental health inpatient facility which should have increased vigilance surrounding boundaries.” The panel found the penalty reasonable, in the public interest, and consistent with similar cases. With revocation, Tammy Berkers is no longer entitled to practice nursing in Ontario.
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