According to the American Association of Nurse Anesthetists, certified registered nurse anesthetists (CRNAs) account for more than 80% of anesthesia providers in rural areas across the U.S. In North Dakota, rural hospitals and smaller communities rely heavily on CRNAs, also known as Advanced Practice Nurses, for anesthesia care. Independently practicing CRNAs often save patients long drives in communities with few physician providers available, providing pain management care and anesthesia for obstetric cases. All this is to say that CRNAs are a necessary part of North Dakota's health care system, not just in bigger cities like Grand Forks, Fargo, Bismark, and Minot, but also in small communities like Madora, Dawson, and Bottineau.
To become a CRNA in North Dakota, you've spent years working on your education, training, and professional skills. Developing a robust CRNA practice can take up to ten years of advanced education and critical care practice. It can put all that at risk if someone alleges professional misconduct against you. Even an allegation of wrongdoing can harm your professional reputation and career. That's why you need the Lento Law Firm's skilled Professional License Defense Team from the Lento Law Firm protecting your rights and your license. Call 888.535.3686 or contact us online to schedule a consultation as soon as possible.
Licensing for CRNAs in North Dakota
In North Dakota, the state Board of Nursing oversees the licensing and regulation of all registered nurses, licensed practical nurses, advanced practice nurses, UAC technicians, and medication assistants.
CRNA Licensing in North Dakota
In North Dakota, nurse anesthetists are Advanced Practice Nurses (APN). The Board of Nursing (BON) oversees the applications, licensing, and renewals for all nurse anesthetists in the state. To receive an APN license in North Dakota, you will need:
- A current license as a registered nurse in good standing,
- One year of experience in critical care,
- A master's or doctorate from a nurse anesthesia program certified by the American Association of Nurse Anesthetists (AANA) Council on Accreditation of Nurse Anesthesia Educational Programs,
- An application and fee, and
- A criminal background check.
In North Dakota, there is only one nurse anesthesia program. The University of North Dakota in Grand Forks offers a post-baccalaureate Doctor of Nursing Practice (DNP) degree. For admission to the DNP program at UND, you need:
- A baccalaureate degree or master's from an accredited nursing program,
- A current U.S. license placing you in good standing as a Registered Nurse,
- A minimum of one year experience in critical care nursing,
- A minimum grade point average of 3.0, with a minimum 3.0 average in your undergraduate science classes,
- A completed statistics course as either an undergraduate or graduate student,
- A completed organic chemistry or upper-division biochemistry course,
- A personal statement describing your professional goals, why you'd like to be a nurse anesthetist, and why you feel UND is suited for your professional goals,
- Three letters of recommendation addressing your professional skills,
- A professional CV or resume,
- Completion of the school's English language proficiency requirements,
- Completion of an interview,
- Passage of a criminal background check and drug screening test,
- Compliance with the Department of Nursing's health and immunization policy.
RN Licensing in North Dakota
To become a registered nurse in North Dakota, you must:
- Complete a bachelor of science in nursing, an associate degree in nursing, or an accelerated bachelor of science in nursing if you have a bachelor's degree in another field,
- Pass the National Council Licensure Examination (NLCEX-RN),
- Have a U.S. social security number,
- Complete the RN/LPN exam application, and
- Complete a criminal history record check.
After passing the NCLEX-RN, you may obtain a Work Authorization to begin working as a graduate nurse in North Dakota for up to 90 days until you receive official notification of your NCLEX results.
Professional Standards for CRNA and APNs in North Dakota
North Dakota holds nurses to high professional standards, and all nurses must comply with the Nurse Practices Act and any associated rules promulgated by the Board of Nursing and approved by the state Attorney General Office and the legislature's Rules Committee. Any nurse who violates a standard or rule under the Nurse Practice Act can face disciplinary action in North Dakota. Some of the most common disciplinary actions faced by CRNAs and APNs include:
- Working while impaired and violations such as drug or alcohol abuse,
- Diverting or stealing patient medication, writing unauthorized prescriptions, carelessly handling medication, and failing to follow drug administration rules,
- Sexual misconduct, such as sexual harassment of a patient, co-worker, or staff, inappropriate sexual behavior, and sexual assault,
- Having a sexual or romantic relationship with a patient,
- Mistreating, assaulting, neglecting, or abusing patients, endangering a patient, or failing to meet professional standards while caring for a patient,
- Fraud, such as improper insurance billing, billing a patient or insurance for procedures not performed, up billing or up charging,
- Misrepresenting your professional qualifications, fraud in your nursing board application, and exceeding the scope of your license.
If you fail to report an arrest or criminal charge, you can also face disciplinary action from the nursing board.
North Dakota's Disciplinary Process for CRNAs and APNs
The disciplinary process typically begins with a complaint to the BON. Anyone, including a co-worker, colleague, supervisor, employer, facility, patient, family member, or another regulatory agency, can initiate a complaint to the BON alleging that you've violated the Nurse Practices Act. However, others with a nursing license are obligated to report any misconduct they're aware of. Once the board receives a complaint, it must thoroughly investigate.
Board of Nursing CRNA Misconduct Allegations in North Dakota
Once someone files a complaint with the BON, the board will review the complaint to see if they have jurisdiction and whether the allegation, if true, would violate the Nurse Practices Act (NPA). If not, the BON will close the complaint. If the BON has jurisdiction and the allegation violates the NPA, the case will proceed.
Investigating CRNA BON Misconduct Complaints in North Dakota
If the BON decides to proceed with a complaint against you, they will first investigate. As part of the investigation, the BON investigator may speak with the complainant, your co-workers, and employers and ask to speak to you or ask you to complete answers to questions or interrogatories in writing. They may also collect evidence, patient records, and other witness statements. While many nurse anesthetists believe they can easily clear up a misunderstanding by simply answering the BON questions, it's important to remember that the board can use anything you say or submit in writing against you later in the disciplinary process. That's why you must get the skilled Professional License Defense Team at the Lento Law Firm involved in your case as soon as possible.
Informal CRNA Disciplinary Conferences in North Dakota
After an investigation, the BON will prepare a report of the evidence on the record. At this point, the BON may attempt to resolve the complaint through an informal negotiation. Many complaints are resolved at this stage with a consent order between the parties agreeing to the result and consequences such as suspension or a formal reprimand. However, you should never sign anything dispensing with your case without a review from the Lento Law Firm's experienced Professional License Defense Team. If you sign a consent order, you may waive your right to challenge the outcome later.
Formal CRNA Disciplinary Hearings in North Dakota
If you and the BON can't informally resolve a complaint, it can proceed to a formal hearing with the BON filing charges against you. The hearing will take place before an administrative law judge. The ALJ will hear evidence from the BON and you, and both sides may subpoena witnesses and evidence, present evidence in the hearing, and cross-examine the other party's witnesses. After the hearing, the ALJ will make findings of fact, conclusions of law, and a recommended order for any disciplinary action or sanctions for the BON. The BON will then be able to modify or accept the ALJ's recommendation.
BON Penalties for CRNA and APN Misconduct in North Dakota
It is possible to lose your license after a BON nursing investigation and hearing. However, the board has a wide range of consequences based on the severity of the allegations. The board is charged with protecting the “health, safety, and welfare of the public.” If the board finds a high risk of danger to the public, the sanctions may be more serious. Sanctions can include:
- A letter of reprimand,
- Probation,
- Suspension,
- Voluntary surrender of your license,
- Restrictions on your license and scope of practice,
- A cease and desist for violations, or
- Revocation of your nursing license.
All disciplinary actions taken by the BON are public records. That's why it's important that you allow the experienced Professional License Defense Team at the Lento Law Firmto mount a vigorous defense and protect your professional reputation.
Appealing a North Dakota CRNA or APN License Disciplinary Action from the BON
After the BON issues its final decision following a formal hearing before the ALJ, and you've exhausted your administrative remedies, you can appeal to the district court in your county under the state's Administrative Agencies Practice Act. Under the AAPA, you have thirty days to appeal after the BON's final decision. The court will review the appeal based solely on the record filed with the court from the formal administrative hearing. The court will affirm the agency's order unless:
- “The order is not in accordance with the law.
- The order is in violation of the constitutional rights of the appellant.
- The provisions of this chapter have not been complied with in the proceedings before the agency.
- The rules or procedure of the agency have not afforded the appellant a fair hearing.
- The findings of fact made by the agency are not supported by a preponderance of the evidence.
- The conclusions of law and order of the agency are not supported by its findings of fact.
- The findings of fact made by the agency do not sufficiently address the evidence presented to the agency by the appellant.
- The conclusions of law and order of the agency do not sufficiently explain the agency's rationale for not adopting any contrary recommendations by a hearing officer or an administrative law judge.”
If the court doesn't affirm the BON's decision, they can modify or reverse it and remand the case to the BON for “disposition in accordance with the order of the court.”
The Enhanced Nurse Licensure Compact Impacts Nursing Disciplinary Actions
Thirty-four states in the U.S., including North Dakota, belong to the Enhanced Nurse Licensure Compact (eNLC). The eNLC is a compact between many states to allow nurses, including CRNAs and advanced practice nurses, to obtain a license to practice in any other participating state. If you have a license in another state and face disciplinary action there, the North Dakota BON will also have access to that decision. Similarly, if you face sanctions for professional misconduct in North Dakota, other states will have access if you attempt to obtain a license to practice in another state.
Hire an Experienced Professional License Defense Team
If you are an advanced practice nurse or a certified registered nurse anesthetist in North Dakota facing professional misconduct allegations, don't try to handle this on your own. The consequences to your career and professional reputation are simply too severe. You need the experienced Professional License Defense Team at the Lento Law Firm to defend your professional license and reputation. They've been defending professionals like you nationwide for years in investigations, informal negotiations, consent order drafting, formal hearings, and appeals in court. Find out how they can help you, too. Call the Lento Law Firm's Professional License Defense Team today at 888.535.3686 or contact us online to schedule your consultation.
