Agency and travel nurses play a critical role in United States healthcare. These professionals, including Certified Nursing Assistants (or CNAs) as well as LPNs and RNs, work for nursing agencies, which means they can provide services to different healthcare facilities or other organizations on a flexible basis as needed.
If you're an agency or travel nurse working in California, you know what this means: Your assignments could be short-term only, helping out facilities in need of a temporary fix, or you could be given a longer-term appointment, just with the flexibility to be re-assigned at any time. This can lead to unique dynamics in your working relationship with your colleagues. Being an agency nurse can also pose distinct challenges, as you may be expected to travel frequently (and you'll constantly be asked to adapt to new, diverse working environments).
California's healthcare policies have a particular influence on the rising demand for agency nurses. California is the only state in the U.S. to have passed legislation mandating nurse-to-patient ratios across all units and specialties. While most tend to believe that these mandated ratios result in better patient care and outcomes as well as improved nurse retention, the policies may cause difficulties in the ways California agency nurses approach their roles. And, despite these and other policies put in place to improve nurse retention, California is experiencing a nurse shortage that isn't expected to resolve for several years.
Agency nurses in California may be called upon to fill staffing gaps while navigating The Golden State's specific professional standards. Understanding the regulatory landscape is critical if you're an agency nurse working in California. It's also important to realize what you can do if you're in a sticky situation that could result in disciplinary action taken against you and your nursing license. The Professional License Defense Team at the Lento Law Firm is prepared to help you assess any complex conditions you may be facing and support you as you take any actions required to retain your license and protect your career. Retain the premier services of the Professional License Defense Team today by calling 888.535.3686 or by filling out this brief form.
The Nature and Dynamics of Agency Nursing in California
Agency nursing in California can be a flexible, adaptable solution to help California healthcare institutions meet their mandated ratios—resulting in, theoretically, a win-win setup for everyone involved.
Unfortunately, this system may work well on paper and for some people, but as the agency nurse getting placed in various settings for indeterminate amounts of time, you may (justifiably) have some concerns.
As an agency or travel nurse, whether you're a CNA, LPN, or RN, you may perform healthcare duties similar to staff nurses. Generally speaking, you'll focus on patient care, and you'll be expected to acclimate quickly to new work environments and organizational structures. Once that has occurred, you may be responsible for:
- Attending to patients
- Administering treatments
- Monitoring patient progress
- Assisting with emergency medical treatment
- Assisting physicians
- Discussing patient status with families
- Ensuring the availability of medical supplies
However, that list is incomplete and may vary considerably depending on your specific assignment.
You may also work in a wide range of settings, including traditional clinics and hospitals, but also rehabilitation centers, nursing homes, and community outreach programs. Your pay will typically be on an hourly basis, though that depends on your agency's policies, and you may receive a stipend for required living arrangements if you're a travel nurse.
While your on-the-job duties on paper may not seem to vary that much from those of a staff nurse, or nursing professionals hired directly and permanently by a medical facility, there are several key differences in the experiences of staff and agency nurses. These differences include:
- A lack of continuity. As an agency or travel nurse, you may not care for the same patients, work with the same teams for any reliable period of time, or get reassigned abruptly with little notice.
- Different types of benefits. A staff nurse will receive benefits, including PTO, directly from the healthcare organization for which they work. These may include anything from health insurance to tuition reimbursement. Staff nurse benefits may differ from the benefits you get as an agency nurse—perhaps considerably if you're hired by your agency as a 1099 contractor.
- Different methods of pay. Staff nurses are typically salaried W2 employees. Agency nurses tend to be compensated at an hourly rate. In both cases, nurses may be eligible for higher pay for certain shifts, but the way they receive that increased compensation may vary considerably.
- Different types of flexibility. Staff nurses tend to work shifts arranged by an in-house nursing management team. They may be able to communicate any blocked-off times prior to schedule formation, but once a shift is set, they may not have much flexibility. Agency nurses may be able to sign up for shifts as they choose but could be more at the beck and call of their agency around any blocked-off time.
If you're an agency nurse, the differences in the way you and your on-staff colleagues are treated could result in miscommunications or even mistakes. Since you aren't a long-term part of the team, people may assume things about you, or be overly ready to assign you responsibility for things that you didn't do. If you realize that you're in a situation where you, as an agency nurse in California, could be at risk of disciplinary action, you need to get the Professional License Defense Team involved sooner rather than later. License-related issues for nurses can spiral out of control far more quickly than you may think.
Legal and Professional Challenges Faced by Agency Nurses
Although agency nurses provide a vital service, they're far from immune to professional challenges and even legal obstacles. And, worse, as a nurse, if one of these challenges results in action taken against your license, you could very quickly lose your ability to work as an agency nurse. This can happen even if the allegation against you is unfair or completely unfounded.
Some common challenges that agency nurses tend to face include:
- False accusations of misconduct, which can range from patient abuse to stealing medications and many other possible offenses
- Documentation errors, such as charting errors, are quite prevalent in high-pressure environments but can lead to big mistakes or difficulties in accurate patient care
- Chain of command issues, such as disagreements with management or the incorrect executions of orders you've been given
- Sexual misconduct allegations, especially if you're called upon to assist with invasive procedures on patients you're unfamiliar with
- HIPAA violations, which can involve breaches in patient confidentiality, even if the breach was unintentional
- Contract cancellation implications, which occur if agency nurses or other involved parties cancel an assignment, and can include financial penalties and ineligibility for rehire
Any of the above issues can result in investigations against agency nurses and resultant disciplinary action. To figure out what happened and who might be responsible for any issues, healthcare organizations and agencies (as well as California state nursing regulatory bodies, like the California Board of Registered Nursing) will start an investigation, which will include lots of interviews, paperwork, and intrusive and stressful conversations.
The moment you're aware that you could be involved in a Board of Nursing investigation or disciplinary due processes at your agency or at your healthcare institution, retain the Professional License Defense Team at the Lento Law Firm. We'll be ready to help you mitigate the consequences of that investigation for you and your career.
Navigating the Legal Landscape: How to Handle Board Complaints and Professional Discipline
Once the California Board of Registered Nursing learns about your possible infraction, whether from your healthcare institution, a colleague, a patient, or any other party, it'll initiate the following events to learn more about what happened.
- The Board of Registered Nursing will evaluate your specific complaint to see if it merits further investigation. If the Board decides that it wants to learn more, the Board will send you a notification about your participation in an ongoing investigation. This notification should contain information about the specific complaint against you as well as the law, regulation, or guideline you have allegedly violated.
- If the Board finds enough evidence in its investigation to substantiate the complaint against you, you may be invited to a hearing. At this hearing, you may have a chance to tell your side of the story. (The Lento Law Firm can help you do this as effectively as possible.) During this hearing, a panel of representatives from the Board will review evidence, discuss your case with witnesses, and ultimately come to a conclusion regarding your alleged involvement in misconduct or concerning behavior.
- After the Board interprets your level of responsibility for the central rule violation or disputed event, it will also recommend consequences. Depending on the severity of your alleged infraction, you may face anything from a written warning up to and including license suspension or revocation.
If your license gets suspended, that will have immediate consequences on your ability to work, and it could have long-term and even permanent ramifications for your reputation. The Professional License Defense Team is here to help you avoid long-term damage to your career, but it's important to get started as quickly as possible.
The Importance of Early Legal Intervention
Partnering with the Lento Law Firm to handle your case sooner rather than later will come with several benefits. While it may seem like an overreaction to pursue representation if you're “just” dealing with a tersely-worded notification from work, agency nursing disciplinary processes can spiral out of control very quickly. You need to act fast to avoid any outsized actions against you and your license.
Here are a few more benefits associated with early legal intervention:
- Damage mitigation. Taking prompt action after an accusation can help you head big problems off while they're still manageable. If you're hoping for a favorable outcome after a work issue, working fast can prevent the escalation of that issue.
- Understanding the process. The California nursing regulation landscape is complex, and you're going to be too stressed to read the fine print. By working with the experienced professionals from the Lento Law Firm early on, you'll be equipped to understand the allegations against you, navigate the intricacies of your investigation with confidence, and pursue your rights throughout the entire process.
- Collecting your own evidence. If you're able to work with the experienced Professional License Defense Team from the Lento Law Firm early on, you'll have more time to gather critical evidence and identify key witnesses. This can go a long way toward building out your robust defense.
- Negotiation. Often, getting to the result that you want doesn't require legal action; sometimes, speaking directly to the board or to the healthcare facility's legal counsel can achieve your sought-after result far more smoothly. However, you need to have deft persuasion skills and know the right people to talk to in order to make that happen. The Lento Law Firm will be pleased to assist with any early negotiation or settlement discussions.
Legal Assistance at Every Stage: From Prevention to Appeals
How can the Lento Law Firm assist agency nurses in California? At every stage of your administrative and legal issues, having the seasoned professionals of the Lento Law Firm Team at your side will reduce your stress and help you boost your chances of experiencing a successful outcome.
For example, we can help you with:
- Understanding the best ways to comply with California's regulations that apply to agency nurses to support avoiding legal issues in the first place
- Going through your contract and employment terms to make sure that you understand the expectations of you, the options you have if something doesn't go the way you think it will, and your rights
- Preparing for testimonies, pulling together a strong legal defense, and both gathering and presenting your evidence in the most compelling way possible
- Managing the aftermath of any appeals, including handling your paperwork and making sure you don't miss any important appeal deadlines
- Assisting with the often-challenging appeals process to help you make the most of California's established due process system for nurses accused of misconduct
- Helping you understand whether remedial actions in support of license reinstatement, such as undergoing professional assessments or additional training, are worth it
- Supporting you as you manage any license reinstatement processes to help you make a timely return to your professional practice
…as well as any other actions that arise during your disciplinary experience.
Addressing Specific Concerns of Agency Nurses in California
If you're an agency nurse working in California, being the subject of misconduct investigations can be very stressful. We understand that you have concerns about your employment and your future. The Lento Law Firm is here to help you mitigate those concerns. We'll start by providing some succinct, practical answers to questions you may have at this time.
Q: I've just been accused of misconduct as an agency nurse in California. What should I do first?
If you've been accused of misconduct, especially if you're in a new job situation and don't know your colleagues very well, do your best to remain calm. Don't panic. You aren't alone—with one quick call, the experienced Professional License Defense Team at the Lento Law Firm will be ready to help.
Once you've called our team, return to the notice about your allegation. Read it thoroughly. Try to understand what you're being accused of, and start gathering any documentation or evidence related to the accusation and your side of the story as you can.
Finally, avoid discussing the case. You may wish to confide in someone, apologize, or ask questions, but talking to people—especially people who are directly involved in your alleged violation—may hurt your case.
Q: How do I respond to a notice of investigation?
You were called into a stressful meeting at work, you got home and found an unassuming envelope in your mail, or you checked your email and found a message with a terse subject line: Regardless of the specific way you learned that you were going to be subject to an investigation, the experience likely wasn't fun.
Your action items are vital but streamlined: First, call 888.535.3686 to retain the premier services of the Lento Law Firm. Share details about your case, including the wording of the notice of investigation. Then, read your notice of investigation carefully (or write down everything you remember from any conversations you had). If you have any deadlines to meet, mark them in your calendar. Ask our team if there is anything you need to do to meet that deadline. Then, let our team guide you through your next steps.
Q: What should I expect during the investigation?
Your investigation may bring a lot of intrusive, time-consuming, and disorienting activities. You may be questioned; you may be asked to provide statements about your actions, and you may start to wonder about the accuracy of your own story.
Here's the most important thing to remember: You have rights. Even though you may feel very vulnerable as you're being investigated, there are specific things that investigators can and cannot do—and specific protections that you have a right to claim. The Lento Law Firm will help you understand those rights and help you manage your investigation so it's as minimally disruptive and damaging as possible.
Q: How can I protect my license during the investigatory and disciplinary process?
While you're under investigation, either by your healthcare facility or the California Board of Registered Nurses, make sure to follow all relevant legal and procedural regulations. The Lento Law Firm can help you understand what those are and how they relate to your everyday actions. When you're under intense scrutiny, the last thing you want is to unintentionally be associated with another violation. Remain as professional as possible with your nursing practice, and talk to the Lento Law Firm about any specific remedying actions you should take (e.g., training or counseling).
Q: My license has been suspended! What steps can I take for reinstatement?
If the Board or your specific healthcare institution has finished its deliberations and recommended license suspension or revocation, it's important to realize that that's not the end of the road. For example, if your license has been temporarily suspended, you may be able to complete the recommended conditions to get your license back. (Don't assume that this will be a simple process, though—work with the Lento Law Firm to be 100% sure what is expected of you.)
Q: How can I avoid more misconduct allegations in the future?
Once you have ironed out your current difficulties, there's a very good chance you'll want to avoid getting into trouble with your employer or the state of California's nurse licensing board ever again! By following the regulations relevant to your position, attending continuing education courses, and staying informed about any changes in nursing regulations or ethical practices, you can put yourself in the best possible position to avoid misconduct allegations in the future.
Retain the Professional License Defense Team to Protect Yourself and Your Future
If your California agency nursing license seems to be in danger, that's something you need to take seriously. While it may be tempting to wait and see if the state can't find evidence to proceed with discipline or if the problem will otherwise melt away, that's not a very strategic way to approach this issue.
Administrative license defense proceedings can be difficult to manage, but with the right experienced lawyers at your side, you should be able to work toward a successful outcome. The Professional License Defense Team at the Lento Law Firm has years of experience nationwide and in California defending healthcare professionals like yourself in license proceedings.
Whether you require assistance and representation while communicating and negotiating with your agency, a state regulatory body, a healthcare facility community, or any other interested party, the Professional License Defense Team is prepared to support you and your optimal outcome. If you require assistance now, call 888.535.3686 today or fill out this brief online form to tell us more about your case.
