If you hold a valid Certified Registered Nurse Anesthetist's license from the state of Maryland and you have been accused of wrongdoing, you need to act. Your CRNA license and your ability to practice your specialty may be in jeopardy. A formal complaint from a patient, another healthcare practitioner, or a hospital can negatively impact your career, upending years of study and hard work. A complaint can lead the state of Maryland to investigate any allegations made against you and initiate disciplinary action. In Maryland, disciplinary action can include the loss of licensure, so it is important to take all accusations seriously. You may think an allegation is groundless, but you should not dismiss it. You must fight for your CRNA license, and the best way to do that is to work with a skilled law firm that can guide you through the maze of the state disciplinary process.
The Lento Law Firm's Professional License Defense Team is ready to assist you. The team has vast experience defending nurses, doctors, surgeons, and other licensed professionals who face disciplinary action. An attorney with the Professional License Defense Team will discuss the specifics of your case, explain what happens next, evaluate your options, answer your questions, and work with you to reach the most advantageous outcome. Talent and knowledge matter and the Lento Law Firm is ready to advocate on your behalf, regardless of where you are in Maryland. From Annapolis to Baltimore, to Frederick to Glen Burnie, and any other area within the state and nationwide, the Lento Law Firm is your best choice for assistance. Call us at 888-535-3686 or contact us online.
CRNA Licensing in Maryland
The Maryland Board of Nursing (MBON) handles the licensing process for nurses within the state. Maryland is also part of the Nurse Licensure Compact and, as a member, allows nurses who hold a license from another state to practice within the state. Nurses who desire to become a CRNA must obtain certification from the state. After receiving certification, Maryland considers a CRNA to be an advanced practice registered nurse. Anyone holding a CRNA certification must renew that certification every other year. To obtain recertification, a CRNA must attend at least 40 hours of continuing education classes every two years, maintain a current state license, document a substantial anesthesia practice, and affirm that they have not developed a condition that could negatively impact their ability to practice anesthesia.
A CRNA's Scope of Practice in Maryland
In Maryland, a CRNA frequently works with physicians, surgeons, anesthesiologists, and other medical professionals such as dentists, ophthalmologists, pain management specialists, and podiatrists. CRNAs practice their specialty in every setting where anesthesia is used. For example, CRNAs work in hospital surgical suites, maternity delivery rooms, and ambulatory surgical centers.
CRNAs in Maryland can make perioperative assessments of patients who require anesthesia, administer anesthetic agents, manage fluids used in intravenous therapy, and handle respiratory care.
Standards of Practice for CRNAs in Maryland
CRNAs hold great responsibility when practicing their specialty. As a result, Maryland law sets forth standards of practice for nurse anesthetists. According to the law, when a CRNA is handling anesthesia for a patient, an anesthesiologist, licensed physician, or dentist must be physically present and available for consultation during the administration phase as well as during the recovery period. An anesthesiologist must also be available for consultation during other aspects of a CRNA's practice of anesthesia. If an anesthesiologist is not available, a licensed physician or dentist must be available.
A CRNA must ensure that an anesthesia provider performs a thorough and complete patient assessment before anesthesia is administered. A CRNA must also obtain informed consent for the planned anesthesia usage from the patient or another individual who is responsible for the patient. In addition, a CRNA is required to develop a plan for anesthesia care that is specific to an individual patient. A CRNA must implement the care plan and adjust it when necessary to adapt to a patient's response to the anesthesia. A CRNA also has to monitor the patient for unexpected reactions to anesthesia and take corrective measures.
Maryland law also provides that a CRNA must:
- Promptly and completely place all pertinent information on the patient's record;
- Assess anesthesia care to ensure quality;
- Ensure safety and continuity of care when transferring responsibility for patient care to another qualified provider;
- Take appropriate safety precautions to minimize the risk of fire, explosion, electrical shock, and malfunctioning equipment;
- Maintain appropriate infection control standards;
- Maintain continuing competence in the practice of anesthesia; and
- Respect and maintain a patient's rights.
Note that a CRNA has the right to refuse to perform any unsafe act, an act that is beyond their clinical skills, or a medical act that is improperly prescribed.
Prohibited Acts for CRNAs in Maryland
As Maryland aims to protect the public's health and safety, the law prohibits CRNAs and other healthcare license holders from engaging in a number of acts. In Maryland, an individual is not permitted to practice nurse anesthesia unless they are certified. Further, an individual who is not certified cannot use the title “nurse anesthetist” or use any other words, letters, or symbols to represent that they are a CRNA.
The following are some of the additional prohibitions that apply to CRNAs and other healthcare licensees in the state:
- No one can practice, attempt to practice, or offer to practice registered nursing, advanced practice registered nursing, or licensed practical nursing unless they hold the appropriate license from the MBON. An individual may not practice, attempt to practice, or offer to practice registered nursing, advanced practice registered nursing, or licensed practical nursing beyond the scope of their license or certificate;
- An individual cannot fraudulently obtain any record, nursing diploma, license, or license certificate renewal; and
- An individual cannot require a licensee to perform an act that is beyond the licensee's knowledge and skill levels. In addition, when an individual believes a nurse lacks the knowledge and skills to perform a certain nursing task, that individual cannot tell a licensee to delegate the task to the nurse. Also, when a patient's condition does not allow for the delegation of a nursing task, an individual cannot tell a licensee to delegate the task to a nurse.
If someone violates one of these provisions, the state can obtain a court order directing the person to stop the illegal action. Anyone who violates one of these provisions faces a civil fine of up to $20,000. The MBON may also suspend or revoke a violator's license or certificate. In less serious situations, the board may issue a reprimand or place a licensee or certificate holder into probationary status. In some circumstances, Maryland prosecutors will bring criminal charges against an individual who violates one of the prohibitions. The charges can result in a criminal fine of up to $10,000 and a prison term of up to five years.
Discipline of CRNA License Holders in Maryland
Maryland law allows the MBON to take disciplinary action against a CRNA's license in situations when the health and safety of patients and the public are at risk. These actions include suspension or revocation of licensure, denial of licensure, a reprimand, and the placement of a licensee on probationary status. The MBON does not bring criminal charges or lawsuits for damages. It only acts against a healthcare practitioner's license.
The MBON may act against a CRNA's license if an individual:
- Obtains or tries to obtain a license for themselves or another by fraud or deception;
- Fraudulently or deceptively uses a license;
- Is convicted of, or pleads guilty to, a felony or offense of moral turpitude, even if an appeal is pending;
- Is disciplined by a licensing authority within Maryland or any other state or country, or is convicted by a court within the state or in another state or country, for an act that would be grounds for discipline from the MBON;
- Willfully and knowingly files a false report or record regarding a patient under care, or fails to file any required health record;
- Puts false or misleading information on a job application;
- Provides professional services while under the influence of alcohol or drugs, or has a substance abuse disorder;
- Performs an act that is not consistent with generally accepted professional nursing standards, or is grossly negligent in the practice of nursing;
- Is mentally, physically, or professionally incompetent;
- Knowingly fails to report suspected child abuse;
- Discriminates against an HIV positive individual when providing professional services;
- Practices without a license; or
- Takes possession of a property belonging to a patient or healthcare facility.
The MBON has to follow a specific legal process in order to subject a CRNA to discipline and take action against a license. This legal process ensures that a CRNA's rights are preserved and provides an opportunity to raise a defense. In most situations, the process starts when someone files a complaint with the MBON. Anyone can file a complaint. Patients, their family members, other healthcare practitioners, and members of the public can file. The person filing the complaint must provide their name and explain the issue giving rise to the complaint. The complaining party can attach documentary evidence, such as witness statements and medical records, to the complaint.
When the MBON receives a complaint, it assigns an investigator to check into the allegations. The investigator will notify the CRNA that a complaint is pending. The notice will also inform the nurse that they have the right to respond to the allegations. The investigator will talk to witnesses, review documents, and write up a report for the board. The MBON will then decide whether to dismiss the complaint, take action against the nurse's license, or choose an alternative to formal discipline.
In some situations, the MBON will issue an advisory letter instead of pursuing formal discipline against a CRNA's license. Although this option is favorable, the board can disclose the letter to the public.
Maryland offers another alternative to discipline when a CRNA has a substance abuse disorder or mental health issue. An individual can participate in the MBON's Nursing Rehabilitation Program. Maryland, however, will deny participation to anyone who has taken part in behavior that had the potential to cause harm to a patient, has been arrested or convicted for an offense involving a controlled substance, or has been expelled from another alternative disciplinary program.
If the MBON decides to pursue disciplinary action against a CRNA and their license, the nurse has the right to receive notice of the action and to request a hearing before an administrative judge. At the hearing, the CRNA has the chance to present their side of the story, submit evidence, and cross-examine the board's witnesses. The CRNA can also challenge the board's evidence.
The judge will then decide whether to dismiss the complaint or impose a sanction against the CRNA's license. The judge may suspend or revoke the license, place the license into probationary status, or issue a formal reprimand. A CRNA can appeal the decision and continue the fight for their license.
Maryland also has the power to issue an immediate emergency suspension, also known as a summary suspension, of a nursing license when necessary to protect the public. If a CRNA is subject to a summary suspension, the MBON holds a hearing to determine whether the suspension will continue. If the board decides that the suspension will continue, a CRNA can request another hearing to challenge the decision.
The MBON's rulings are available to the public, and interested persons can look up the status of a nurse's license. License status and discipline information are also available from the Nursys national database.
Retain The Lento Law Firm for CRNA License Defense in Maryland
There is a lot at stake when a nursing license and CRNA certificate are called into question. Not only is your livelihood at risk, but your reputation is as well. If you or a family member are facing accusations of wrongdoing, there are many decisions to be made, and the best decision is to consult with The Lento Law Firm. The firm's attorneys know what to do when a CRNA faces a complaint and possible discipline in Maryland, and they can also help if the state has already acted against your license. The Lento Law Firm's Professional License Defense Team can help nurses in every town in Maryland and nationwide. From Chesapeake City to Hagerstown, Mount Airy to Vienna, the Lento Law Firm is ready to help. Reach out to us at 888-535-3686 or use this online form.