Can I Be Disciplined for Providing Inadequate Patient Care?

Nurses face a wide array of challenges on the job every day. Your employer might task you with caring for an unreasonably large number of patients. Hospital administrators and patients’ families may not see eye to eye with the patient’s care team. Nursing is a stressful job performed by humans, not machines, and humans can make mistakes. Subsequently, you may find yourself accused of providing inadequate care to the patient even if you did not intend to do so.

If you are accused of inadequately caring for a patient, nursing boards take these allegations seriously. Such accusations are likely to lead to an investigation. The investigation’s findings may then lead to a disciplinary hearing and sanctions from the nursing board. Your nursing license could even be at risk.

You worked incredibly hard to build your nursing career, and the accusations of poor quality of care may stem from systemic problems rather than your job performance. However, state nursing boards may not presume your innocence, and you should not represent yourself. The LLF National Law Firm advocates for nurses nationwide. Our experienced Professional License Defense Team represents nurses facing potential disciplinary action, and we can represent you even if you have a complex case. Call us at 888-535-3686 or fill out our online intake form to tell us about your case.

What Constitutes Inadequate Patient Care?

People use the terms “medical neglect” and “inadequate patient care” interchangeably in everyday conversation, but they have different meanings legally.

Medical neglect denotes some degree of intent not to provide necessary care and may be considered a form of malpractice. The patient’s needs were expressly ignored. Providing inadequate care to the patient, on the other hand, is a situation where the patient’s care was below the baseline standard but may not have been intentional.

Examples include:

• Patient did not receive meals, medications, or bathroom assistance in a timely manner due to short-staffing

• Medication errors resultant of a change in recordkeeping systems

• Patient suffers an injury from the facility’s equipment due to insufficient staff training

• Lack of communication or follow-up with the patient after a major procedure

Inadequate patient care is a negative result of problems that are often systemic and beyond an individual nurse’s control. These systemic problems can be the result of underfunding, short-staffing, technological issues, poor training, or miscommunication from physicians and management.

Although nurses have a duty to care for their patients, you may be held equally accountable for detrimental impacts to the patient’s health, even if it was your employer’s failure to train staff and properly allocate resources. The LLF National Law Firm’s Professional License Defense Team is experienced in building defenses for such instances.

State Nurse Practice Acts and Other Guidelines

Every state has a Nurse Practice Act and a nursing board. This type of law is generally referred to as a Nurse Practice Act, but your state may call it a different name, like Nursing Statutes or Standards of Nursing Practice.

While systems like the National Nurse Licensure Compact aim to make U.S. nursing licenses more portable than they historically have been, you are generally held to the standards of the state-level Nurse Practice Act where the accusation took place. Travel nurses and nurses who regularly practice across state lines need to be particularly mindful of this. Depending on the rules of the state nursing board in which you received your original nursing license, you may face administrative inquiries from this board. You may also need to self-report any disciplinary inquiries, even if they do not result in probation, revocation, or other adverse outcomes.

While there is a general understanding of the difference between medical neglect and inadequate patient care in the legal realm, each state Nurse Practice Act may have differences in what constitutes a violation. There may be very little delineation between what constitutes neglect and what is inadequate patient care as a result of systemic problems.

Additionally, you may also be held to the code of conduct for any nursing societies and professional organizations you belong to. These organizations may suspend your membership while you are under investigation or sanctions.

Notable State Nursing Board Policies for Inadequate Patient Care

California

California nurses are subject to disciplinary action for failure to follow state laws and guidelines on the prevention of blood-borne infectious disease pathogens in healthcare settings. The California Board of Registered Nursing consults with other state medical boards to ensure nurses accused of violating this statute are judged fairly, and there is an exception for good cause, such as PPE failures. However, California nurses who do not work in clinical settings, such as home healthcare and prisons, are still subject to state health and safety code standards. Patients in these settings who file complaints for inadequate care or medical neglect if they contract a blood-borne disease may have the nursing board more firmly on their side.

Texas

Under Texas Standards of Nursing Practice, a 1983 landmark case, Lunsford v. Board of Nurse Examiners, codified into Texas law that nurses have a duty to care for patients, which cannot be superseded by hospital policies or doctors’ orders. Lunsford set a precedent that Texas nurses have a duty to assess a patient’s condition and provide any necessary stabilizing care, even if their employer’s policy is to transfer the patient to another facility and a supervising physician orders it. Texas nurses may be put into a difficult situation if their employers have policies and staffing practices that are at odds with providing a baseline level of care for their patients.

How Nurses Can Prepare for Board Actions

If you are accused of medical neglect or providing inadequate care, it is a serious matter that can impact your career for years to come.

While you may panic at this realization, there are steps you can take right now to increase your chances of a better outcome. Here’s what you should do once you receive communication from the nursing board:

• Arrange representation as early as possible. Once you receive notification of a complaint letter or investigation notice from the nursing board, contact the LLF National Law Firm right away. We can prepare your correspondence and guide you through every step of the disciplinary process. The earlier you obtain comprehensive representation like the Professional License Defense Team, the more likely you are to have the complaint dismissed or receive a lesser sanction than expected.

• Thoroughly examine your state’s Nurse Practice Act and other relevant regulations. You don’t need to read through the entire statute, but research what your state specifically outlines for inadequate patient care and neglect. How likely are they to hold individual nurses liable compared to healthcare organizations? Depending on the state, the language in your state’s Nurse Practice Act may be vague or not even mention neglect and what constitutes inadequate patient care. Read through the practice standards and regulations for your state nursing board, and any professional societies that they use as a model. This can lay the groundwork for how to strategize your defense.

• Gather as much evidence as possible that the issue is systemic. What ultimately separates inadequate patient care allegations from medical neglect is the intent: it’s generally understood that most nurses don’t intend to hurt their patients, but a lack of resources may have resulted in harm. Gather records like work schedules, emails, news articles, and internal communications that can help prove your circumstances were systemic. For instance, if your employer had a major reduction in staff due to loss of funding, but you had no prior history of similar complaints, this can help prove that the patient suffered as a result of short-staffing rather than your care standards.

• Write down your recollections and any other testimonies. In situations where the cause of a problem is less clear-cut, there is a lot of “he-said, she-said” when a party files a complaint against a healthcare professional. When building your defense, it’s still their word against yours. Write down anything at all that you remember about the incident or the time spent caring for this patient. What did you observe? How long were they in your care? What was their behavior like towards you, other staff, and any visitors? If possible, try to get other testimonies from co-workers or other parties present, as their testimony could help prove that you did not intentionally harm the patient.

• Stay calm and professional with the parties involved. This is a time when emotions are running high, as your career is on the line. You may be scared and angry. In your dealings with the nursing board, your employer, and any other parties involved in the complaint or investigation, remain calm, collected, and professional.

How the Professional License Defense Team Will Strive to Protect Your Nursing Career

You do not want to represent yourself if you are facing serious accusations of providing inadequate care. Even though it is well-known that healthcare organizations can be rife with staffing problems and poor management practices, state nursing boards still do not presume your innocence.

Here’s how the LLF National Law Firm’s Professional License Defense Team will advocate for you before any state nursing board:

• Initial Complaint: Getting a letter from the nursing board can be panic-inducing. However, the letter may simply be a notice that a complaint was filed against you. Depending on your nursing board’s policies, they may or may not tell you the contents of the complaint or who filed it. It’s best to seek representation as early in the process as possible, so it doesn’t hurt to give us a call and discuss your case and strategize for the worst-case scenario. There is also a chance that the board may dismiss the complaint instead of escalating it to an investigation.

• Nursing Board Correspondence: Whether or not the nursing board decides to open an investigation, you are usually mandated to respond to complaint letters and other board correspondence within 15-30 days, or risk sanctions. If you’re unsure how to structure your defense and what to write, the Professional License Defense Team is here to craft your defense and send an effective written appeal. Depending on the nature and severity of the accusation, the board may dismiss the complaint after you’ve responded. They may also dismiss the complaint after an investigation concludes that no statutes were violated.

• Stipulated Agreements: More complex or severe cases may not end in a dismissal post-investigation. If the board decides to escalate disciplinary proceedings into sanctions, we can negotiate a stipulated agreement. Stipulated agreements are the professional licensing board equivalent of out-of-court settlements, where we will negotiate the terms of your agreement and how to proceed with your nursing license intact. Stipulated agreements may include probation or temporary suspension with remedial education, rehabilitative treatment, counseling, or other remedies, depending on the nature of the case. This is a form of lesser sanctions than what the board originally had in mind.

• Adjudication: Most disciplinary proceedings for nurses remain at the board level and do not make it to a courtroom. However, there may be extreme cases, such as medical errors that lead to a patient’s disfigurement or premature death, where the nursing board escalates their findings to criminal charges. This results in having an adjudication hearing with an administrative law judge. We can represent you at this hearing with an aim to negotiate lesser charges.

The LLF National Law Firm’s Professional License Defense Team provides comprehensive representation at every step of the disciplinary process, from written responses to the initial complaint to adjudication if your case cannot be resolved at the board level.

The healthcare landscape is only expected to become more challenging in the coming years. Nurses may unfortunately be caught in the crossfire between mismanaged facilities and patients whose needs aren’t being met. The LLF National Law Firm is ready to advocate for our nation’s hard-working nurses and achieve the best outcome possible for your case. Call us today at 888-535-3686 or reach out via our online contact form.