If you've invested the time, effort, and resources to earn your Certified Registered Nurse Anesthetist (CRNA) license in Oklahoma, you understand how important it is to your practice and your livelihood to keep your license intact. A disciplinary sanction on your public record can damage your career as well as your reputation and, in some cases, can force you to stop practicing as a CRNA and as a nurse altogether. That's why it's important to take it seriously if you learn that a misconduct complaint has been filed against you. Retaining one of the experienced attorneys from the Lento Law Firm Professional License Defense Team to defend your rights can help significantly. Call us today at 888.535.3686, or use our contact form to find out more about how we can help.
The practice of nursing in Oklahoma is governed by the Oklahoma Board of Nursing (OBON), which classifies CRNAs as Advanced Practice Registered Nurses (APRNs). The powers, policies, and procedures that the OBON uses to regulate CRNAs, APRNs, and other nurses in Oklahoma come from the Oklahoma Nursing Practice Act and a detailed set of rules adopted by the OBON.
The Investigative Division of the OBON receives and investigates complaints filed against licensed CRNAs in Oklahoma. The OBON uses the information collected by the Investigative Division to determine whether to begin disciplinary actions against CRNAs and other nurses. In cases where the OBON determines that misconduct has occurred, it will make a public decision about what sanctions to impose on the license holder. These sanctions are published by the OBON in two ways: once, in reports available through the OBON's Investigation/Discipline page, and also as part of each nurse's public license page, available to the public through the OBON's License Verification Portal. This means that if you're disciplined by the OBON, the public will have access to detailed information about that discipline for as long as your license is active.
Ways the Oregon Board of Nursing Can Discipline CRNAs
Discipline against a CRNA occurs after someone files a complaint against the CRNA, or in some cases where the CRNA self-reports having violated the Nursing Practice Act. Complaints can be filed by anybody through the OBON's Complaint Portal. Most complaints are filed by employers, patients, or patient's families, but they can also be filed by co-workers or anyone else who believes they have information about a CRNA or other licensed nurse acting in an unprofessional manner.
The OBON can discipline CRNAs in a number of different ways, depending on the misconduct and how the allegations are resolved. Different types of discipline include:
- Reprimand. A reprimand is often issued in connection with an agreement, called a stipulation, that resolves a misconduct charge without a hearing. Typically, the stipulation will also require the CRNA to do something else, such as take one or more courses, pay a fine within a certain period of time, or risk further discipline.
- Suspension. The CRNA's license will be suspended for a set period of time. Here, too, the CRNA may also be required to take some additional action (courses or a fine) before their license is reactivated.
- Revocation. The CRNA's license is revoked, and the individual may not be allowed to reapply for a certain number of years.
The OBON also has the power to impose what's called a “corrective action” on a CRNA. This can be in place of disciplining them and can include “remedial education” as well as an “administrative penalty” (a fine). Technically speaking, an administrative action is not considered to be a formal disciplinary action, but if the CRNA has another complaint filed against them, the fact that they were already the subject of a corrective action can be considered by the OBON if the new misconduct allegations are substantiated and the OBON is considering how to discipline the CRNA. Corrective actions are limited to certain types of circumstances, such as where the nurse practiced with an expired license, failed to provide the OBON with accurate information on their license application, or failed to meet certain prescription requirements (CRNAs have the authority to prescribe), among others.
One other option that the OBON has is the Peer Assistance Program (PAP). The PAP is an “alternative-to-discipline” program that helps the nurse receive treatment for a dependency or abuse issue, with the goal of allowing the nurse to continue (or return to) work. CRNAs and other nursing license holders who have alcohol or drug abuse issues may self-refer, or elect to be referred, to the PAP. In such cases, the OBON may elect to defer disciplinary action pending the CRNA's completion of treatment.
What Standards Does the OBON Expect CRNAs to Uphold?
The OBON has a number of practice guides that it publishes on various care topics. These include:
- Continuing education or practice. All licensed nurses, including CRNAs, are expected to continue their education, either on the job (at least 520 work hours over a two-year period), with continuing education (at least 24 “contact hours” over two years), maintaining a certification such as a CRNA, completing a “Board-approved refresher course,” or completing 6 semester credit hours of qualified nursing coursework. In addition, CRNAs who have “prescriptive authority” must complete 15 “contact hours” or 1 “academic hour” of education relating to prescription drugs, and 2 hours of pain management or opioid abuse continuing education.
- Practicing within the nurse's “legal parameters of practice” and education. This includes, of course, not doing anything that's prohibited by the Nursing Practice Act. But it also includes making sure the care the nurse is providing is consistent with “current national nursing standards” as well as “evidence-based nursing literature and research.”
- Nurses are also expected to follow their employer's policies and procedures for patient care.
- CRNAs are expected to only provide anesthesia services that are consistent with their education and training.
- All nurses, including CRNAs, must practice within the “accepted ‘standard of care'” that would be provided “in similar circumstances by reasonable and prudent nurses” with “similar training and experience.”
- CRNAs should only order, select, obtain, or administer certain types of drugs, as specified by the OBON.
Grounds for CRNA Discipline in Oklahoma
Disciplinary proceedings against a CRNA can be based on a number of different types of misconduct. Some apply to all nurses, others only to CRNAs. Examples of some of these are:
- Providing false information to the OBON in connection with their license application
- Being convicted of any felony
- Being convicted of any offense “substantially related” to their license qualifications or practice or any offense involving “fraud, dishonesty, or an act or violence”
- Failing to “adequately care for patients” or otherwise failing to “conform to the minimum standards of acceptable nursing”
- Being under the influence of alcohol or drugs while on the job
- Engaging in “unprofessional conduct,” including:
- Inaccurately making, altering, or destroying patient records
- Abusing patients verbally or physically
- Stealing from work or from patients (including taking medications)
- Leaving an assignment without “advising appropriate personnel”
- Violating patient confidentiality
- Discriminating against a patient when providing care
- Forging prescriptions, or using a forged prescription
- Sexual contact with or abuse of a patient
- Using the patient-nurse relationship to take advantage of the patient, for example by accepting large sums of money or expensive gifts from the patient
- Engaging in fraudulent billing practices
- Any conduct that jeopardizes a patient's “life, health or safety”
There is a wide range of misconduct that can result in the OBON investigating you and filing disciplinary proceedings against you. If you've been notified that an investigation is underway against you, or that the OBON is starting disciplinary proceedings against you, contact the Lento Law Firm Professional License Defense Team as soon as possible – the sooner we learn about your situation, the more help we can provide.
Don't Assume the Truth Will Protect You from CRNA License Sanctions in Oklahoma
It's natural to want to “set the record straight” once you learn that a complaint has been filed against you. But it's a mistake to think that contacting the OBON to tell your side of the story will make a misconduct investigation go away. It rarely helps and, in some cases, will backfire. The OBON and its Investigative Division are required to protect the Oklahoma public, and they're very likely to continue with their investigation and disciplinary processes even if you provide them with what you believe is information that exonerates you.
That's not to say there isn't a time and a place to provide that kind of information. But generally it's better done through an experienced professional license defense attorney, who can make sure the information you believe helps you will actually do so, and can help deliver it in as clear and as complete a way as possible. The Lento Law Firm Professional License Defense Team will work with you to help provide the right person at the OBON with this kind of information at the right time and in the right way so that it can help you as much as possible.
The Process After Someone Files a Complaint Against You
Complaints received by the OBON will first be reviewed to make sure the subject matter of the complaint is one that the OBON regulates. Issues such as billing disputes or personality differences are typically not ones that the OBON will become involved with. Assuming that, on its face, the complaint does relate to CRNA conduct that the OBON is responsible for, it will be assigned to the Investigative Division. An investigator will review the complaint and, in most cases, will gather information about the issue described in the complaint.
The investigator may interview you, your co-workers, supervisors, and others who might have information about the matter. The person who filed the complaint may be interviewed as well, and if the complaint relates to patient care and the patient didn't file the complaint, the patient may also be interviewed. Depending on the situation, the investigator may get records from your employer.
In situations where referral to the Peer Assistance Program may be appropriate, you'll be contacted about that by the OBON before a complaint is filed against you. Generally, once a complaint is filed, you won't be given the opportunity to participate in the PAP.
In cases where there is sufficient evidence after an investigation and where a PAP referral isn't appropriate or has been refused, the OBON will prepare and file a sworn disciplinary complaint against you. The disciplinary complaint process will be overseen by the President of the Board of the OBON, or someone designated by the president, and will follow Oklahoma law for administrative procedures. Generally, things will progress as follows:
- Complaint and Response. The formal complaint will identify what laws or rules you're being accused of having violated and will provide a summary of the facts that the OBON says supports their argument that you've committed misconduct. It will also set a time and date for the hearing and a deadline for your response. In most cases, response dates may be extended if you or your attorney have a good reason for asking for the extension. Your response will be made under oath; if you don't respond, you risk being declared in default, and the OBON may simply adopt the complaint's allegations as being true.
- Informal Meetings. You will likely have the opportunity to meet with someone from the OBON to discuss resolving the disciplinary proceeding without a hearing. Typically, the OBON will want you to agree to a certain set of facts (such as those summarized in the complaint) and to accept a disciplinary penalty. If you're represented by one of the experienced attorneys from the Lento Law Firm Professional License Defense Team, we can represent you at these meetings and can negotiate with the OBON representative to provide you with the best outcome under your particular set of circumstances. If a settlement isn't accomplished, the disciplinary process will continue.
- Discovery. There may be a period of time where either side can obtain discovery – meaning documents and witness testimony – from the other side, as well as from third parties. The OBON will supervise this and will also set a deadline for discovery to be complete, which must be at least 10 days before the start of the hearing.
- Hearing. At the hearing, the OBON will be able to bring witnesses and introduce documents against you. Your lawyer will be able to cross-examine the OBON's witnesses and argue against introducing documentary evidence that fails to meet legal requirements for evidence under the Administrative Procedures Act. Then you (and your lawyer) will have a chance to put on your own witnesses and to introduce your own documentary evidence, though you aren't required to do either in order to defend yourself. After that, both sides will be able to make closing arguments to the Board of the OBON, which will, at some point after closing, make its decision.
- Final Order. The Board shall issue a final order following the hearing. It must include both fact findings and legal conclusions supporting the Board's decision.
- Rehearing or Appeal. In some cases, generally, where there is new evidence, you may be able to request a rehearing of a case where the ruling is against you. In other cases, you may be able to appeal the Board's decision to an Oklahoma district court.
Note that while the Lento Law Firm Professional License Defense Team strongly recommends contacting us at the earliest possible stage of any disciplinary investigation or proceeding, we can often also help in situations where the disciplinary proceeding is complete, and our client is considering filing an appeal.
What Happens if You're Disciplined by the Oklahoma Board of Nursing?
If you are reprimanded by the OBON, you'll be able to continue working as a CRNA, though you may also have to take some courses and report back to the OBON if you want to keep your license. In situations where your CRNA license is suspended or revoked, you won't be able to work as a CRNA or as a licensed nurse until the suspension is over or you are allowed to reapply for a new license. In any of these cases, the disciplinary action against you will be reflected in your license record for as long as you hold your license. Any other state in which you hold a license will also be notified of the actions taken against you in Oklahoma, which could result in further license problems in those states.
Referrals to the PAP, on the other hand, aren't considered discipline and aren't disclosed to the public unless there is another misconduct proceeding filed against you by the OBON.
How the Lento Law Firm Professional License Defense Team Can Help
Beginning with the investigation stage of disciplinary proceedings, our experienced professional license defense attorneys can help you protect your rights. We can investigate allegations on your behalf, often uncovering helpful evidence that we can use in your defense. We'll communicate on your behalf with the OBON, helping make sure that any information exchanged is clear and understood by both you and the OBON. We'll prepare the response to the OBON complaint for you, working with you to make sure it's accurate and as strong as possible. We can negotiate on your behalf with the OBON, where settlement is a possibility, and will represent you throughout the hearing process. In cases where an appeal may be appropriate, we can file and argue it on your behalf.
Whether you work as a CRNA in Oklahoma City, Tulsa, Lawton, Broken Arrow, Stillwater, Enid, or any other city or town in Oklahoma, the Lento Law Firm Professional License Defense Team can help you if you've been accused of misconduct. Call us today at 888.535.3686, or use our contact form to set up a confidential consultation. You have worked so hard to earn your CRNA license; let us help you keep it!