It's no secret that the nursing profession is one of the most demanding in the world. Nurses are constantly called on to provide compassionate care while meeting high standards of professionalism and competence. For nurse anesthetists, this challenge is even greater, as they are responsible for administering anesthesia to patients undergoing surgery. It's an advanced practice requiring extensive training and a steady hand.
Given this level of responsibility, it's not surprising that as a licensed nurse anesthetist, you have a lot to live up to with regard to public trust. Unfortunately, all it may take is one allegation of misconduct to put your professional license in jeopardy. If you find yourself in this situation, it's important to know what your options are and how to protect your professional license.
Attorney Joseph D. Lento has assisted numerous nurses in New Jersey and New York who have found their licenses at risk. The following are some of the most frequently asked questions and answers from The Lento Law Firm to help you understand what to anticipate if you are notified by the Board of Nursing (BON) of possible disciplinary action.
Which Agency Addresses Accusations of Misconduct in My State?
Licensing and disciplinary issues for nurse anesthetists are handled by the state nursing board. So, for example, if you are licensed in New Jersey you'll answer to your respective State Board of Nursing; in New York, it's the Nursing division of the Office of the Professions. If allegations arise that call your license into question, your respective nursing board will notify you. They will also conduct the investigation and decide on any disciplinary actions.
What Accusations Could Put My Nurse Anesthetist License in Jeopardy?
Nurse anesthetists are held to high professional and ethical standards to maintain public trust. Thus, the most common allegations to jeopardize one's license will have to do with some violation of that trust or of established rules by the BON. Some common examples:
- Violations of the nurse-patient relationship. These include using one's position in order to manipulate the patient, breaching patient confidentiality, etc.
- Unprofessionalism. This broad category includes anything from using inappropriate/abusive language around patients to sexual harassment, engaging in unethical romantic relationships with patients, etc.
- Gross negligence or incompetence. When you're a nurse anesthetist, mistakes and oversights can literally cost someone their life. Acts that endanger or harm patients are grounds for losing your license.
- Substance abuse or addiction. If you are suspected of chemical dependency or addiction, your license may be revoked.
- Criminal convictions. Being convicted of certain crimes (e.g., DUI, theft, drug possession, or other crimes of moral turpitude) can put your license in jeopardy. So can failing to report any arrests or convictions to the BON.
- Mishandling medications. You could lose your nurse anesthetist license if you're accused of mishandling medications, keeping sloppy inventories/paperwork, or pilfering medications for personal use.
- Fraud. Examples may include billing for services not rendered, upcoding procedures with insurance companies, falsifying patient records, falsifying your credentials, etc.
What Does the Disciplinary Process Look Like if I Am Accused of Wrongdoing?
The disciplinary process may vary slightly from one board to another and from one state to the next. However, you can expect the process to go something like this:
Complaint
A formal complaint is filed against you by someone with the BON, whether it's a patient, a colleague, a coworker, or another healthcare professional. This is how most disciplinary actions begin.
Initial Review
The BON reviews the complaint to determine whether it has credibility and whether it falls under their authority to pursue.
Investigation
Investigating the complaint may take weeks or even months. During this time, you will likely be asked to respond in writing to the complaint and possibly appear informally before the BON to tell your side of the story. The BON may also visit your workplace, interview witnesses, or subpoena documents. If the board finds insufficient evidence to back the complaint, it may dismiss the case at this time. If they do find corroborating evidence, the process moves forward.
Consent decree
If the evidence seems compelling, the board may give you an opportunity to sign a consent decree to avoid the complication and embarrassment of a formal hearing. A consent decree is essentially an admission of guilt on your part, along with a voluntary agreement to submit to the BON's recommendations for discipline.
Formal hearing
If no consent decree has been signed, a full hearing will be held before the Board of Nursing or an Administrative Law Judge. You may have a lawyer represent you at this hearing, where you will present evidence to refute the complaint against you.
Final board determination
The board will determine your guilt or innocence and may impose any disciplinary action it deems necessary--up to and including revoking your nurse anesthetist license.
Appeal
You have the right to appeal an unfavorable decision to the appellate court in your state--but bear in mind that appeals are only to review the case for errors. In the majority of cases, the decision of the BON will be upheld.
The Board of Nursing can decide to dismiss the complaint at any point during the disciplinary process and not take any disciplinary action against your license. Having an experienced professional license defense attorney in your corner can greatly improve your chances for a dismissal of the complaint.
Can the BON Impose Other Penalties That Would at Least Allow Me To Keep My License?
Yes. Your license won't automatically be revoked for any offense. There are many ways the BON may impose discipline without impacting your ability to practice. You may be subject to any of these other penalties, depending on the facts of the case.
- License suspension. The board could ban you from practicing temporarily while leaving the door open to review and reinstatement.
- Restrictions to your license. The board may place limits on certain functions of your license.
- Fines. The board may fine you as a disciplinary action.
- De-certification. The board may allow you to continue practicing as a nurse but revoke your certification as a nurse anesthetist.
- Alternative-to-discipline program. As a condition of maintaining your license, the board may require that you complete continuing education or attend a treatment program.
- Formal reprimand. You may receive a written reprimand or censure in your file.
Can These Lesser Actions Still Harm My Career Even Though I Get To Keep My License?
Yes. Publicly searchable records will show any disciplinary actions taken against you. If employers or patients do a search on your license and see that you've been disciplined, they may be less inclined to work with you. If possible, getting the complaint dismissed is the best way to avoid this outcome.
Is It Possible for the Board To Suspend My License Without a Hearing?
Yes. If the BON believes you pose an imminent threat to the public, it can temporarily suspend your license while the investigation and hearing are ongoing. If you are cleared of wrongdoing, the suspension will be lifted.
Should I Agree to a Consent Decree if One Is Offered?
It depends on your situation and the terms of the agreement. If disciplinary action is inevitable and loss of license is imminent, a consent decree could be a viable option if the terms include a pathway to being reinstated. A consent decree, on the other hand, is an admission of guilt that becomes part of your permanent public record, so if there is a significant chance you could be exonerated and have the complaint dismissed, a consent decree might not be the best solution. Before you sign any consent decree, have a professional license defense attorney review it.
What Should I Do if the BON Sends Me a Letter Requesting Information or Notifying Me of an Investigation?
Don't be afraid to contact an attorney if you get any correspondence from the board, such as a request for information or notice of investigation. Even if you believe you can handle the matter on your own, having an attorney is always a good idea. A skilled professional license defense lawyer can help you gather the requested information and present it to the board in a manner that protects your rights.
Do I Really Need To Hire an Attorney? Can't I Just Settle the Matter Informally With the Board?
You always have the right to represent yourself before the board, but in most cases, it is not recommended. Don't make the mistake of presuming the board is on your side and that you settle the matter just by explaining it informally. The board exists to protect the public and not you--and the minute a complaint is filed against you, the board actively looks for evidence to support the complaint. Anything you say or do could ultimately work against you, including attempting to resolve the matter informally.
A professional license defense attorney who knows the workings of the board will make it easier for you to retain your nurse anesthetist license. An attorney can help you protect your rights and negotiate a better outcome.
Doesn't Hiring an Attorney Make Me Appear Guilty?
Absolutely not. Your nursing license is a legal agreement with the state, which means the investigation is a legal matter. You have every right to seek legal representation for legal matters, and the board knows this. They are accustomed to interacting with attorneys, and they will not presume you guilty if you hire one. If anything, hiring an attorney sends a message that you take the complaint seriously--as you should.
Can Any Attorney Help Me With This Matter? Or Should I Seek a Specific Kind of Attorney?
Any state-licensed attorney can represent you in a license defense matter, but an attorney with specific experience in license defense will get you the best results. Not every attorney understands how administration law works or what licensing boards are looking for. Your best chance at saving your license is by hiring a professional license defense attorney.
How Can a Professional License Defense Attorney Help Me Avoid Losing My License?
An attorney skilled in license defense can employ multiple strategies designed to convince the BON either to drop the complaint or agree to lesser penalties. In almost all cases, the outcome will be far better than if you tried to go it alone in front of the board. A skilled attorney will:
- Help you understand all the implications of the complaint and how to respond
- Develop a defense strategy with the highest chance of success
- Gather evidence and witnesses to corroborate your side of the story
- Negotiate with the BON at multiple points to have the complaint dismissed or penalties reduced--even avoiding a formal hearing, if possible
- Act as your official legal representative in all correspondence with the board
- Defend you aggressively at the formal hearing if there is one
- Appeal an adverse decision if there were noted errors in procedure
Is It Possible for the Attorney To Help Me Get My Nurse Anesthetist License Reinstated if It Was Revoked Already?
Yes. If you meet the criteria, most states will offer a process to reinstate your license after a sufficient amount of time has elapsed. To be eligible for reinstatement, you may need to do any/all of the following:
- Sending a request in writing for reinstatement with an explanation as to why you believe you should be reinstated
- Paying any filing fees and unpaid fines
- Show proof that you have met any requirements imposed by the board as a condition for reinstatement (e.g., continuing education or treatment program)
- Provide a list of all jobs that you held while your nurse anesthetist license was inactive
- Agree to any plan of action the nursing board has recommended for your reinstatement
I've Just Been Notified That Someone Has Filed a Complaint Against My Nurse Anesthetist License. When Should I Seek Legal Counsel?
As soon as possible after you become aware of the complaint. Don't wait for a formal hearing to hire an attorney because you will be starting off the process in a defensive posture since the BON will have already built its case against you. The sooner you involve a good attorney, the sooner the attorney can get to work to diffuse the situation, possibly getting the matter resolved even before a formal hearing becomes necessary.
You've paid a high price to be licensed and certified as a nurse anesthetist, and your professional license is now the key to your livelihood. You can't prevent someone from filing a complaint against you, but you can reduce the risk to your career by hiring a seasoned license defense attorney to help you answer the complaint. Attorney Joseph D. Lento helps licensed professionals across New Jersey or New York who are facing the possibility of disciplinary action. Contact the Lento Law Firm at (888) 535-3686 today to talk about your case and your options.
