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The care home had a duty to accommodate the nurse’s unquestioned diagnosis of severe opioid use disorder and mild to moderate sedative-hypnotic use disorder, ruled arbitrator Larry Steinberg. This disease had left her with “a complete inability or a diminished capacity” to resist the urge to feed her addiction.

She would, for example, file paperwork falsely showing a resident had requested a narcotic, then falsify charts to show they had received it, when in fact she used it herself. She would also keep the unused portion of narcotics, rather than discarding them.

Confronted by management, the nurse, a 50-year-old mother of three, initially denied but later admitted her actions, which she said were related to abuse of painkillers that began when she was treated for a kidney condition. She had become heavily addicted, appeared physically ill, and was isolating herself from her family. About a month later, Sunnyside fired her for gross misconduct and theft.

At her hearing, DS testified she has not used narcotics since this time in late summer 2016, when she entered a residential rehab.

Her nursing licence was suspended for about nine months, and reinstated with a series of conditions including that she have no access to controlled substances and be supervised at all times.

Lawyers for the care home argued that letting her return to work with these conditions would impose “undue hardship” on the care home. Every nurse has access to narcotics, for example, and some patients are in advanced dementia, so they would not notice if a nurse removed their fentanyl patches. Furthermore, nurses need to work independently, not be supervised constantly.