Can I Be Disciplined for Unprofessional Conduct or Behavior?

As a nurse, you must interact with the public on a daily basis. Nursing is a very physical and demanding hands-on job, whether it’s in a hospital, a long-term care facility, a small medical practice, or any other clinical setting.

However, patients are at their most vulnerable when they are under your care. You may say or do something that didn’t intend to cause distress, but the patient or their family may not see it that way. You and your co-workers may feel the need to let off steam because of a stressful work environment, but what you believe is a harmless prank for social media can look like more than a legal and PR disaster for your employer, and potentially alert the state nursing board.

Yes, you may face discipline for unprofessional conduct. State nursing boards take complaints seriously, and these complaints may lead to an investigation. If you are under investigation by a state nursing board, there is a possibility that the board will escalate the matter to a formal disciplinary hearing and even impose sanctions. Your nursing license could even be at risk.

You worked incredibly hard to build your nursing career, and accusations of unprofessional behavior can impact your ability to work. State nursing boards do not presume your innocence, and you should not represent yourself if you are facing, or expect to face, board proceedings. 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 Unprofessional Conduct in Nursing?

“Unprofessional conduct” is a wide umbrella term that is interchangeably used with “unprofessional behavior” in a disciplinary context. On a granular level, every state nursing board has different definitions of unprofessional conduct and the degree of severity to which those actions would result in disciplinary action.

Terms like “unprofessional” and “inappropriate” can be subjective, and no two parties may fully agree on what is or is not unprofessional or inappropriate. However, nursing board regulations and state Nurse Practice Acts often provide the framework for what constitutes unprofessional conduct, although some states leave this part open to interpretation. Generally speaking, unprofessional conduct for nurses often encompasses the following:

• Patient neglect or abandonment that is willful

• Abusive behavior towards a patient that is physical, emotional, or sexual

• Actions that make patients and/or the general public feel unsafe

• Exhibiting signs of drug or alcohol use to the point that it is interfering with your ability to care for patients

• Recreational drug or alcohol use outside of work

• Sexual misconduct in the workplace, particularly with patients

• Violent behavior towards patients or their families

• Medication diversion and theft of controlled substances

• HIPAA violations

• Hateful conduct or inappropriate behavior on social media

• Falsifying records

• Practicing care outside of your scope as a nurse

• Failure to follow infection control protocols

• Lies or omissions to state nursing boards

• Committing a crime of moral turpitude, such as a DUI

While this list is not exhaustive, it provides a basic idea of what most state nursing boards consider unprofessional conduct. There is usually an alleged ethical or moral violation, if not a legal violation, outlined in your state’s Nurse Practice Act.

You may be accused of such a violation, but not necessarily in violation of these frameworks. The LLF National Law Firm’s Professional License Defense Team can build a defense tailored to your situation and the norms for your state nursing board.

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 did not result in probation, revocation, or other adverse outcomes. Many state nursing boards consider it unprofessional conduct if you fail to self-report criminal or disciplinary history.

Your state’s Nurse Practice Act may have very clear definitions of unprofessional conduct. Whether it does or not, a board inquiry may be based more on a moral or ethical imperative rather than a legal violation. While moral and ethical inquiries require a nuanced defense since they can result in sanctions, they will not result in criminal charges if they did not violate any laws.

Board sanctions and legal violations at the state and federal levels aside, accusations of unprofessional conduct may violate 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 Regulations’ Definitions of Unprofessional Conduct

One would expect that unprofessional conduct would be limited to what happens in clinical and administrative contexts at the workplace. But some state nursing boards have surprising definitions for what constitutes unprofessional conduct:

California

California nurses can be disciplined by the state Board of Registered Nurses (CBRN) for failing to act as a mandated reporter. If a California nurse is convicted of child, elder, or dependent adult abuse, or is convicted of crimes that resulted in being a registered sex offender, the  CBRN also considers this unprofessional conduct subject to sanctions.

Florida

Florida nurses may not accept gifts from patients that exceed their employer’s policy on gifts. This is a board rule, rather than codified in the Florida Nurse Practice Act. However, accepting such a gift constitutes unprofessional conduct and grounds for disciplinary action depending on the value of the gift.

Texas

Texas nurses who owe child support payments under the Texas Family Code and fail to make these payments are subject to sanctions under the Texas Nursing Practice Act. It is considered unprofessional conduct to miss too many child support payments.

How Nurses Can Prepare for Board Actions

If you are accused of unprofessional conduct, it is a serious matter that can have far-reaching impacts on your nursing career.

This is a sobering realization. However, there are steps you can take right now to increase your chances of achieving a more favorable outcome with the nursing board. Here’s what you should do once you receive a letter from the board:

• Arrange representation as early as possible. Most state nursing boards will notify you in writing if a party filed an unprofessional conduct complaint against you. A complaint doesn’t automatically mean you will face sanctions: it could get dismissed. But you do not want to delay arranging representation once you receive this letter. Contact the LLF National Law Firm right away so we can prepare your response and advocate for you through every step of the disciplinary process. The earlier you arrange representation, the more likely you are to successfully get the complaint dismissed or a lesser sanction if an investigation proceeds and then escalates.

• Thoroughly examine your state’s Nurse Practice Act, employer policies, and board regulations. You need not comb through every single statute, but look at your state Nurse Practice Act and other relevant regulations. Some board regulations are incredibly subjective and will take your employer’s policies into account. Review your employer’s policies and what they consider to be unprofessional conduct versus what the board constitutes as unprofessional conduct. Is their definition vague or open to interpretation? This part is crucial for building your defense.

• Gather as much evidence as possible that you did not intend to cause harm. Unprofessional conduct has a large scope that encompasses clinical incidents, the administrative side of nursing, and your personal life. You may have made an honest mistake in failing to report any criminal records to the board because they were expunged. Social media is now a contentious area in unprofessional conduct cases, as a seemingly harmless post could violate privacy laws by accidentally having identifying information in a photo. Gather as much evidence as you can that you did not intend to cause harm, such as testimony from patients and co-workers, photos, emails, internal communications, and other potential corroborating evidence.

• If your accusation is related to activity outside of work, discuss your personal life and what you did or are actively doing to address it. If you are accused of substance abuse that is affecting your ability to safely serve the public, many states have programs for nurses to receive treatment, counseling, and a path towards retaining your license. If you have a criminal record, discuss what your circumstances were at the time of conviction and the rehabilitative actions you have taken since.

• Stay calm and professional. It is reasonable to be angry and afraid right now. Emotions are running high because your career is on the line. Despite this, it’s crucial to remain calm and professional in your interactions with the nursing board, your employer, and any other parties involved in the complaint or investigation.

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

Unprofessional conduct is a wide umbrella. Sanctions may be severe, or you may only face a minor reprimand. Regardless of the severity of the accusations against you, you do not want to represent yourself. Nursing boards do not presume your innocence as a court of law does.

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

• Initial Complaint: The state nursing board will notify you if a complaint was filed against you. Depending on state laws and how your specific nursing board handles complaints and enforcement, you may receive several details about the complaint, including who filed it. Regardless of how much information you receive, you should contact the LLF National Law Firm right away. There is a chance the board will dismiss the complaint, but arranging a defense in advance improves your chances of a better outcome if an investigation opens.

• Nursing Board Correspondence: In most states, it constitutes unprofessional conduct if you do not respond to board correspondence within 15-30 days. Regardless of the complaint’s nature and status, you risk further sanctions. If you are unsure how to respond to the board, the Professional License Defense Team can help with an effective written appeal. Depending on the nature and severity of the accusation, the board may dismiss the complaint after your response. They may also dismiss the complaint after an investigation concludes that no violations occurred.

• Stipulated Agreements: If the complaint escalates to an investigation, and the complaint is not dismissed afterwards, you will have a more complex case. Complex, unprofessional conduct cases like this can lead to disciplinary hearings, where the Professional License Defense Team 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, if there are legal violations, such as violations of state and federal privacy laws or severe Nurse Practice Act violations, you will face a formal hearing before an administrative law judge. We can represent you at this hearing and negotiate for 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.

Healthcare settings are already a highly litigious environment. The challenges will only compound as AI, social media, and other technologies complicate nurses’ relationships to patients, their employers, and the public as the social fabric tatters. Nurses may face more accusations of unprofessional conduct than they historically have.

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