If you're a licensed nurse, you've probably heard of the Nursing Practice Act. It's a name that's commonly used to describe the laws that each state has in place to regulate the licensing and discipline of nurses in that particular state. While each state's Nursing Practice Act is different, and some use different names, they all do essentially the same things: define the types of nursing licenses the state issues, the requirements for those licenses, the types of care licensed nurses are authorized to provide, and the standards that nurses are expected to meet.
In addition, each state's Nursing Practice Act will list the types of misconduct that nurses can be disciplined for and the procedures that the state's Board of Nursing (BON) (or equivalent body) uses to investigate and discipline nurses. If you've been notified by your BON that a misconduct complaint has been filed against you and you're under investigation, you need the help of an experienced attorney from the Lento Law Firm's Professional License Defense Team. Call us at 888.535.3686 or use our contact link to schedule a confidential consultation to learn how we can defend you and your license during what can be a lengthy and stressful process.
The Nursing Practice Act
As noted above, each state has a set of laws in place that govern the practice of nursing. These go by various names depending on the state but are commonly referred to as the Nursing Practice Act or Nurse Practice Act. Depending on the state, though, these laws may have different names, such as:
- Nursing Statutes and Regulations
- Board of Nursing Laws
- Nursing Statutes
- Professions, Vocations, and Businesses: Nursing
- Board of Nursing Administrative Code
- Nursing Board Statutes
- Professional & Occupational Standards: Nursing
- State Board of Nursing Rules
- Board of Registration and Nursing Laws
- Board of Nursing Statutes and Rules
- Board of Nursing Rules and Statutes
- Nursing Provisions
- Nursing Laws and Rules
- Nursing Laws and Statutes
- Code of Occupations and Professions: Nursing
- Standards of Nursing Practice
Whatever they're called by any particular state, the laws and regulations that make up the Nursing Practice Act for any given state will generally cover the same types of issues.
Nursing License Requirements
Nursing Practice Acts will include a provision that requires anyone practicing nursing in the state to be licensed by the state to do so. They may also restrict someone from holding themselves out as a “nurse” unless they have a nursing license from the state.
Nursing License Definitions
Nursing Practice Acts will typically broadly define the types of care that each type of licensed nurse is able to offer. Registered nurses, for example, will be able to provide more and different types of care and to operate with less direct supervision than will licensed practical nurses. Advanced practice nurses will have the ability to deliver more types of care than registered nurses.
In many cases, the precise details of what each type of licensed nurse can and cannot do as part of their nursing practice aren't specifically described in the Nursing Practice Act itself but are left to rules or regulations that the Nursing Practice Act authorizes. Depending on the state, these rules or regulations may be issued by a commission established by the state, by the state's Department of Health, by its Board of Nursing, or by some other designated body.
Licensing Requirements
Nursing Practice Acts will often either specifically state what the requirements are for a nurse to be licensed to practice by the state or, more typically, will authorize the Board of Nursing or some other entity to establish criteria that nursing license applicants must meet in order to be licensed. These requirements include what type of educational background and practical experience the nurse must have, what exam or exams the nurse must pass, and what other information, including submission to a criminal background check, the nurse must provide in order to be eligible for a nursing license in that state. When it comes to learning what exactly any particular state's nursing license requirements are, the best source is generally the website of that states' Board of Nursing or equivalent.
License Renewal Requirements
Many states require nurses to take approved continuing education in certain subjects and to certify or prove that they have taken the required courses when they renew their licenses. Some states also require nurses renewing their licenses to submit to criminal background checks, even if they submitted to a background check when they were first licensed. These and other renewal requirements often appear in the Nursing Practice Act or are imposed by the Board of Nursing or similar entity under the authority of the state's Nursing Practice Act.
Anesthesia and Prescription Drugs
Nurses who are authorized to administer anesthesia or to prescribe drugs typically must meet additional educational and training requirements that are either set forth in the state's Nursing Practice Act or are established by the state's Board of Nursing or other state health care agency. Some Nursing Practice Acts also include laws that apply to prescriptions of certain categories of drugs, such as opioids.
Multistate Licenses
Many nurses hold licenses in more than one state. Nursing Practice Acts will often set forth that state's requirements for a nurse who is originally licensed in another state to be licensed to practice in that state without having to take an examination. Many states are members of the Nurse Licensure Compact, a multistate agreement that coordinates and regulates multistate nursing license standards among its more than 40 member states.
Reasons for Disciplining Nurses
All Nursing Practice Acts include provisions that govern how nurses are disciplined. These will either be specified in the law itself, or the Board of Nursing or an equivalent entity will be authorized by the Nursing Practice Act to set disciplinary standards for licensed nurses. The Nursing Practice Act may list specific types of misconduct that is prohibited by the act, and will typically leave the procedures to be used for nurse discipline to be set by the state's Board of Nursing or another regulatory body.
Examples of the types of conduct that Nursing Practice Acts typically prohibit include:
- Being convicted of certain crimes, particularly felonies
- Alcohol or drug use, abuse, or dependency
- Negligent practice of nursing
- Deliberately providing false information in connection with the application or renewal of the nursing license
- Immoral conduct, including sexual misconduct, that is derogatory to the standards of the practice of nursing
- Improper prescription or dispensing of prescription drugs
- Diverting drugs or other supplies for unauthorized purposes
- Failing to properly record information in patient or other required medical reports
- Exploiting the nurse-patient relationship
- Stealing from an employer or a patient
- Failing to report another nurse's misconduct violations
- Abandoning a patient (leaving a patient without ensuring that another nurse is there to care for them)
- Failing to report discipline imposed by another state in which the nurse is licensed
These are by no means all of the types of conduct that a state's Board of Nursing can cite when disciplining a licensed nurse. Generally, any conduct that could put a patient at risk can be the basis for disciplining a nurse, even if the patient wasn't actually in any danger.
Procedures for Disciplining Nurses
The procedures that are used to investigate misconduct complaints filed against licensed nurses also will differ from one state to another. All Nursing Licensing Compacts provide for some form of discipline, and as with other provisions, the laws may be more or less detailed when it comes to describing these procedures. In many cases, the procedures are left to the Board of Nursing or another state-authorized entity to set.
The Lento Law Firm's Professional License Defense Team regularly defends nurses accused of misconduct in states all across the country. And while each state's disciplinary procedures are somewhat different, most of them will feature the same steps. These include:
- Internal Review of the Complaint. The Board of Nursing (or the entity assigned to administer nurse disciplinary complaints in that state) will examine the incoming complaint to make sure it alleges the kind of misconduct that the state's Nursing Practice Act regulates. For example, billing disputes or personality differences are typically not considered reasons to discipline a nurse. In those cases, the BON would likely take no further action on the complaint. However, a complaint that alleges a nurse was intoxicated on the job or stole prescription drugs from their employer would move on to the next stage.
- Investigation of the Complaint. Complaints that appear to cite the kinds of misconduct that the state's Nursing Practice Act prohibits will be assigned to an investigator. The investigator will typically interview both the complainant and the nurse. They may also talk to co-workers and others who might have information about the incident alleged in the complaint. The BON will normally also have the power to issue subpoenas to care facilities as well as witnesses (including the accused nurse) for documents, communications, and other records that relate to the allegations made in the complaint. At the close of the investigation, which may have gone on for months, the investigator will usually prepare a report that is submitted to the BON for review.
- Dismissal or Formal Complaint. If, after reviewing the investigator's report, the BON doesn't believe there is evidence to support the allegations in the complaint, the matter will be dismissed. If the investigator's report does provide evidence that the nurse committed misconduct, the BON will issue a formal complaint or another type of document that will include a description of the evidence of misconduct that supports a proposed sanction against the nurse. The nurse will typically have a chance to respond to this document.
- Negotiated Resolution. Most nursing disciplinary cases settle without going to the hearing stage. The nurse either accepts the sanction that the BON has proposed or negotiates for a more favorable consequence. This is where working with an experienced professional license defense attorney can be extremely helpful. Your attorney can often provide the BON with additional evidence or legal grounds to support arguments that your penalty should be less than what the BON proposes or, in some cases, that the matter should be dismissed entirely.
- Hearing. If the matter isn't resolved through negotiations, it will move to a hearing stage. Each state will have a slightly different hearing procedure, but generally, both the BON and the nurse will be able to put witnesses on the stand and cross-examine the other side's witnesses. They'll also be able to introduce documentary evidence, including electronic records, and both sides will be able to make arguments in support of their respective positions.
- Ruling. The state's Nursing Practice Act will usually require disciplinary rulings to be in writing. They will normally have to give the reasons supporting the decision of the BON, and will also specify the sanction that is to be imposed on the nurse in cases where the hearing finds that the nurse committed misconduct.
- Appeals. States will also have an appeal process that nurses can use in cases where the disciplinary ruling goes against them. Bases for appeals are typically limited and won't result in a rehearing except under special circumstances.
The Lento Law Firm's Professional License Defense Team will know what specific disciplinary procedures are set by the Nursing Practice Act in your state and will use their knowledge and experience gained from defending other nurses, health care professionals, and professional license holders to provide you with as strong a defense as possible.
Types of Discipline Possible
The Nursing Practice Act or rules authorized by the state's Nursing Practice Act will typically also give the Board of Nursing broad powers to sanction nurses. The types of sanctions will vary considerably depending on the type of misconduct and the state's requirements but can include:
- Verbal warnings
- Written warnings
- Probation periods, with or without a requirement that the nurse complete specified education programs
- Suspension periods, with or without the same types of education requirements
- Revocation of the license
The Lento Law Firm's Professional License Defense Team Can Help Protect Your Nursing License
If you are facing discipline under your state's Nursing Practice Act, contact the Lento Law Firm's Professional License Defense Team for help today. Our experienced attorneys appreciate how important your nursing license is to you and your livelihood, and we are ready to help you protect it from day one. In many cases, for example, we can conduct our own investigation of the allegations to attempt to uncover facts supporting your defense that the Board of Nursing's investigator missed. We can often use that and other information to negotiate favorably on your behalf, reducing or eliminating penalties and fighting to keep your license active so that you can continue to practice.
If you've been notified that a misconduct complaint has been filed against you with your state's Board of Nursing, call the Lento Law Firm's Professional License Defense Team today at 888.535.3686 or use our contact link to schedule a confidential consultation. We've helped nurses all across the country defend their licenses, and we're ready to help you too.
