The Charlotte metropolitan area has some of the highest concentrations of nurses in the Carolinas. If you work in this area, thousands of people from Rock Hill, Charlotte, Concord, and Gastonia rely on your nursing skills and experience to help them during their times of need. Yet despite your pivotal role in providing medical care and the hard work it took you to get here, your North Carolina or South Carolina nursing license could be at risk.
A confused patient or grief-stricken family member might claim you made a mistake while providing them or a loved one with care. Or a coworker or supervisor might accuse you of unprofessional or unethical conduct. Either way, you could find yourself facing disciplinary action by the South Carolina or North Carolina Board of Nursing. If you learn that such an action is pending, take immediate action by contacting the Lento Law Firm's Professional License Defense Team. We can guide you through this stressful time and minimize any damage to your professional reputation or Carolina nursing license. You can reach us using our online contact form or by calling 888-535-3686.
Carolina Board of Nursing Jurisdiction
Both the South Carolina Board of Nursing (SCBON) and the North Carolina Board of Nursing (NCBON) exist to protect the general public by ensuring nurses like you provide safe and effective medical care. This means their primary tasks involve administering initial nurse licensure. They also oversee the conditions for maintaining licensure, such as the license renewal process and continuing education requirements.
To carry out these goals, both the NCBON and SCBON have to carry out disciplinary action against licensed nurses who fail to meet these standards. In North Carolina, these standards are set out in the Nursing Practice Act and the applicable registered nurse and licensed practical nurse regulations.
South Carolina also has its own nursing law called the Nurse Practices Act. But SCBON doesn't handle all of the disciplinary process. Instead, much of it is administered by the South Carolina Department of Labor, Licensing and Regulation's (LLR) Office of Investigation and Enforcement (OIE).
The NCBON Disciplinary Process
Most disciplinary action by the NCBON will likely begin with the filing of a complaint. These will often come from the general public or the nurse's employer, but they can also come from the nurses themselves. A nurse must self-report a disciplinary issue to the NCBON within 30 days of any:
- Felony indictment or arrest;
- Arrest for driving under the influence of drugs or alcohol; or
- Indictment or arrest for the use, possession, or sale of a controlled substance.
North Carolina nurses have the option to self-report situations where they test positive for drugs or observe a deficiency in their nursing practice. Lastly, North Carolina is a mandatory reporting state, which requires anyone who has reasonable cause to suspect a nurse of misconduct or incapacity, to report that misconduct or incapacity to the NCBON.
After filing a complaint, the NCBON will confirm that it has jurisdiction over the matter by checking if the allegations violate the North Carolina Nursing Practice Act or the North Carolina Administrative Code. Assuming it has jurisdiction, the NCBON will assign the case to an investigator and notify the accused nurse (unless such notification will hinder the investigation). If applicable, relevant healthcare and law enforcement agencies will also be notified.
The investigator will collect information relating to the allegations, including interviewing witnesses and reviewing documents. The accused nurse has the right to provide the investigator with a written statement and an interview.
During the investigation, a nurse may hire an attorney at their own expense. If they do this, the nurse then has the responsibility of notifying the NCBON that they're being represented by counsel. After the investigation is complete, the NCBON will propose one of the following determinations:
- No action: This occurs if the investigation doesn't result in clear and convincing evidence that a violation of the Nursing Practice Act or applicable regulation has occurred.
- Letter of Concern: This is a non-disciplinary warning given to the nurse when the NCBON has a concern about the allegations, but there's not enough evidence to meet the clear and convincing evidentiary standard.
- Non-Disciplinary Consent Order: The NCBON offers an educational remedy to the nurse where a violation exists, but allows the nurse to continue practicing because it wouldn't endanger the general public.
- Published Consent Order: this is a formal disciplinary action against the nurse. This is available to the public and can include a range of sanctions, such as a reprimand, monitoring, practice limitations, and removal from practice (either with a suspension or revocation).
If the nurse disagrees with the proposal, they can either request a settlement committee or an administrative hearing.
The settlement committee is an information conference where the nurse has the opportunity to present any mitigating circumstances that they believe should reduce the imposed sanctions. If the nurse and the NCBON can reach a settlement, the nurse will pay $300.00. If no settlement is reached, there will be an administrative hearing.
The administrative hearing is a formal hearing that's open to the public. During the hearing, the NCBON presents evidence to support its claim that the nurse violated the Nursing Practice Act or applicable nursing regulations, and the accused nurse asserts any defenses. If the nurse chooses to have a hearing, they must pay a fee of $300.00 per hour.
The LRR OIE Disciplinary Process
The LRR receives a complaint by mail, fax, or through its website. Upon receipt, a complaint analyst will review it to ensure the OIE has jurisdiction and if more information is needed. In the latter situation, the complaint analyst will contact the person who filed a complaint for clarification or more information.
Assuming the OIE has jurisdiction to handle the matter, it goes to an investigator. Within 30 days of this referral, the investigator notifies the nurse of the complaint and provides an opportunity for the nurse to respond to the allegations. The nurse isn't required to respond, but if they do, it's common for the accused nurse to consult with an attorney for guidance.
The investigation usually takes less than 180 days to complete and includes witness interviews and requests for documentary and additional evidence through the use of subpoenas.
After the investigation is complete, there will be an Investigation Review Conference or IRC. This is an internal meeting where the investigator meets with a SCBON administrator and other officials to decide if further investigation is needed or if a formal complaint is warranted. If a formal complaint isn't recommended, the case could be dismissed, or the nurse might receive a letter of caution. The SCBON makes a final decision on how to move forward after receiving the recommendation from the IRC.
If the SCBON concludes the complaint should be dismissed, then the nurse will receive a letter notifying them that the case against them will be closed. If the SCBON wants to issue a letter of caution, the nurse receives a non-disciplinary letter informing them that no formal discipline is forthcoming and that the nurse should be careful of any future nursing law or regulatory violations. If the SCBON wants to proceed with a formal complaint, then the SCBON prepares a list of the accusations and alleged statutory or regulatory violations and serves this complaint on the accused nurse.
Upon receipt of the formal complaint, the accused nurse has two main options. First, they can sign a consent agreement admitting their violations and proposed sanctions. Second, they can request a hearing before the SCBON.
The hearing effectively serves as a trial where the state of South Carolina presents its case against the nurse, and the nurse sets out any defenses they might have. At the end of the hearing, the SCBON votes on how to rule on the case or withholds judgment for a later time.
After reaching a decision, the SCBON will issue an order that sets out its decision, findings of fact, and conclusions of law. These orders are part of the public record unless the SCBON deems them to be confidential or it's an order dismissing the charges. If the nurse disagrees with the order, they have 30 days to file an appeal with the South Carolina Administrative Law Court.
If the SCBON concludes the nurse violated the Nurse Practice Act, then the nurse could face a wide range of sanctions. These include license revocation, license suspension, probation, practice limitations, or special monitoring of the nurse.
Reasons for Charlotte Metropolitan Nurse License Defense
The NCBON may discipline a nurse for any violation of the NC Nursing Practice Act or the relevant nursing provisions of the NC Administrative Code. This could refer to:
- Lying to the NCBON during the initial licensure process.
- Receiving a conviction for any crime that relates to the nurse's ability to practice or involves defrauding the public.
- Demonstrating the lack of ability to safely practice nursing for reasons such as substance abuse, physical impairment, or mental abnormality.
- Engaging in behavior that puts the public's health in danger.
- Acting in an intentional, reckless, or negligent manner during the course of their professional duties.
- Acting in an unprofessional or unethical manner during the course of their professional duties.
- Committing acts of injustice, immorality, or dishonesty during the course of nursing practice.
- Having another state take adverse action against their nursing license.
- Failing to respond to the SCBON's inquiries in a reasonable manner.
Reasons a Nurse in Rock Hill, South Carolina Might Face Discipline
A nurse in South Carolina may be subject to disciplinary for a wide array of reasons, such as:
- Violating (even without a conviction) any local, state, or federal law relating to alcohol, controlled substances, or crime of moral turpitude.
- Allowing someone else to use the nurse's authorization to practice.
- Repeatedly or willfully engaging in conduct that indicates the nurse is not fit for duty, from either a professional or ethical perspective.
- Another state taking adverse against the nurse's nursing license creates the presumption that the SCBON should take similar action against the nurse.
- Failing to cooperate with the SCBON, whether it's an investigation or any other proceeding.
- Failing to obey an order or directive from the SCBON.
- Stealing money, drugs, or other property from a patient or employer.
- Improperly divulging confidential patient information obtained during the course of nursing practice.
- Falsifying or improperly altering patient records, employer records, or personnel records.
- Using deceit, fraud, or misrepresentation to obtain money for health care services provided to a patient.
- Helping someone violate a provision of the Nurse Practices Act or applicable regulation.
- Possessing, administering, or obtaining a controlled substance in a manner not authorized by law.
- Working as a nurse despite having impaired judgment or ability when such impairment was the result of alcohol or substance abuse.
- Suffering from a physical or mental disability or impairment that jeopardizes their ability to safely practice nursing.
- Negligently failing to record relevant patient information.
- Failing to keep accurate nursing records when required by law.
- Using fraud, deceit, or misrepresentation to obtain a nursing license, either for themselves or others.
- Practicing nursing without a valid nursing license.
- Helping someone else practice nursing without a valid nursing license.
- Practicing outside the scope of their nursing license.
- Failing to report unprofessional or incompetent nursing practices of another nurse to the SCBON.
- Delegating nursing duties to an unqualified individual.
- Failing to properly supervise someone who has been delegated nursing duties.
- Terminating the nurse-patient relationship without first providing appropriate notice so necessary medical care could continue once the nurse stopped providing care to the patient.
- Failing to use appropriate standards relating to stopping the spread of infectious or communicable diseases.
- Failing to notify the appropriate authorities of necessary changes to a nurse license renewal or initial licensure application.
- Engaging in another type of regulated medical practice without proper authorization.
- Knowingly allowing themselves to be misrepresented as a medical doctor.
Get Help with Your North Carolina Nurse License Defense
Whether you practice at Atrium Health, CaroMont Regional, Novant Health, or Piedmont Medical Center, any disciplinary action by the North or South Carolina Board of Nursing requires your immediate attention. Regardless of the allegations against you or where you're at in the disciplinary process, the Lento Law Firms Professional License Defense Team can help. We have years of experience defending nurses from disciplinary action from across the Carolinas and the rest of the United States. To schedule a consultation, use our online contact form or call 888-535-3686.
