Nursing is a valuable career in New Jersey, just as it is elsewhere. Yet New Jersey has nursing licensing laws much like other states do. And those laws require nurses not only to get a license but to keep the license. Any number of unexpected and unfortunate events and circumstances, some having to do with your nursing and others having more to do with your personal life, can threaten your nursing license in New Jersey. If you face a nursing license issue in New Jersey, then know that skilled and experienced attorney help is available to you. Professional license defense attorney Joseph D. Lento wants you to have the best information and representation to preserve your nursing career in New Jersey.
New Jersey Board of Nursing Authority
Section 45:11-24 of New Jersey's Nurse Practice Act provides for a ten-member New Jersey Board of Nursing to govern the practice of nursing in the state. The ten board members include six registered professional nurses (RPNs), two licensed practical nurses (LPNs), and one advanced practice nurse, plus a public representative. Section 45:11-24d grants the Board of Nursing the power not only to license New Jersey nurses but also to revoke and suspend licenses. Section 45:11-50 of New Jersey's Nurse Practice Act also authorizes the New Jersey Board of Nursing to enact regulations governing nurses in New Jersey. The New Jersey Board of Nursing has done so, although its nursing regulations do not address professional misconduct grounds or procedures in substantial detail.
You Need a New Jersey Nursing License
Section 45:11-37 of New Jersey's Nurse Practice Act requires that anyone practicing nursing in New Jersey have a valid and current license or certification under the Act. The same section imposes a penalty of $200 for each violation, increased to $500 for each violation after a prior conviction. Don't practice nursing in New Jersey without a valid and current license. Doing so will also jeopardize your ability to gain reinstatement of a suspended or revoked nursing license. New Jersey's Nurse Practice Act and its accompanying nursing regulations describe the terms, conditions, and procedures for obtaining a license as a registered professional nurse (RPN), licensed practical nurse (LPN), or nursing-related certifications.
Prosecuting Professional Discipline in New Jersey
New Jersey's Office of the Attorney General maintains a Professional Boards Prosecution section to bring discipline charges before the New Jersey Board of Nursing and other professional boards. Nurses facing discipline in New Jersey contend with a professional prosecutor. N.J.S.A. §45:1-18 authorizes the Attorney General to investigate professional violations of codes and standards. The statute gives the Attorney General's prosecutor the power to require license holders to state and write under oath the circumstances relating to any suspected violation. The prosecutor may also examine and impound records and items as evidence of violations. The Attorney General can even require a licensed professional to submit to a skills assessment to ensure competence to practice.
Duty to Cooperate with Discipline Officials
New Jersey law requires nurses and other licensed professionals to cooperate with discipline officials. New Jersey Administrative Code Section 13:45C-1.2 imposes a duty to “cooperate in any inquiry, inspection, or investigation … into a licensee's conduct, fitness, or capacity to engage in a licensed profession….” The same regulation provides that the board may deem a failure to cooperate as professional misconduct subject to discipline.
Be Prepared. Cooperation, though, does not in any way suggest that a licensed nurse should speak with discipline officials when unprepared to do so. Discipline investigators may call or drop by unannounced at inconvenient moments, acting as if the nurse under investigation should drop everything to answer questions. Doing so could be foolish if the nurse is distracted and unprepared. Discipline officials need accurate information, not rushed, incomplete, or inaccurate information. If discipline officials contact you for information, promptly retain professional license defense counsel to advise and prepare you on how best to cooperate with those officials.
Colleague Reporting of Grounds for Nursing Discipline
New Jersey professionals, including nurses licensed in New Jersey, are their brother's keeper. New Jersey law requires nurses and other licensed professionals to report fellow licensed professionals whose professional misconduct threatens patients or the public. N.J.S.A. §45.1-37 requires a report whenever the professional colleague “demonstrated an impairment, gross incompetence, or unprofessional conduct which would present an imminent danger to an individual patient or to the public health, safety or welfare.” The same statute makes it professional misconduct for a New Jersey nurse or other licensed professional not to report on a colleague's professional misconduct. Your concern isn't solely that a patient or patient's family member may observe your misconduct. Your professional colleagues are just as likely, and in many cases far more likely, to report misconduct.
Self-Reporting of Grounds for Discipline
Many nurse disciplinary proceedings in New Jersey and other states begin with the complaint of a patient, patient's family member, employer, or colleague. But the regulations accompanying New Jersey's Nurse Practice Act require a licensed nurse to self-report discipline grounds to the Board of Nursing. The question isn't solely whether someone else will report you for misconduct or unfitness to practice nursing. New Jersey law requires a licensed nurse to self-report if the nurse:
- is incapable, for medical or other cause, of discharging the functions of a licensee in a manner consistent with the public's health, safety, and welfare
- is indicted or convicted of a crime involving moral turpitude or a crime adversely relating to his or her practice
- is a defendant in a civil, criminal, or administrative matter involving alleged malpractice, negligence, or misconduct relating to nursing practice
- is the subject of any voluntary license or certification surrender or disciplinary action or order by any state or federal agency
- fails to maintain or renew any certification which is required by law as a condition of practice or of license or certification renewal
Grounds to Revoke or Suspend a New Jersey Nursing License
N.J.S.A. §45:1-21 states the grounds on which the New Jersey Board of Nursing and other professional boards may revoke or suspend a professional license. The statute defines each of the following as professional misconduct subjecting the license holder to license revocation or suspension:
- obtained the license through fraud, deception, or misrepresentation
- employed dishonesty, fraud, deception, misrepresentation, false promise, or false pretense relating to professional practice
- engaged in gross negligence, gross malpractice, or gross incompetence damaging or endangering life, health, welfare, safety, or property
- engaged in repeated acts of negligence, malpractice, or incompetence
- engaged in professional misconduct as determined by the board
- engaged in any crime or offense involving moral turpitude
- had another state's board revoke or suspend a license under similar grounds
- failed to comply with licensing statutes or board regulations
- is incapable, for medical or other cause, of discharging the functions of a licensee in a manner consistent with public health, safety, and welfare
- committed insurance fraud
- has within the past year engaged in drug or alcohol use likely to impair the ability to practice with reasonable skill and safety
- prescribed or dispensed controlled dangerous substances indiscriminately or without good cause, or where the holder knew or should have known that the substances were to be used for unauthorized consumption or distribution
- permitted an unlicensed person to perform an act for which the law requires a license
- advertised fraudulently in any manner
Alternative Penalties Against a New Jersey Nursing License
N.J.S.A. §45:1-22 authorizes the New Jersey Board of Nursing and other professional boards not only to revoke or suspend a license but also to impose other forms of discipline. The long list of additional or alternative forms of discipline may seem daunting. But alternative forms of discipline could be an attractive option for the nurse whose conduct would otherwise warrant license revocation or suspension. With a skilled and experienced professional license defense attorney, you may be able to negotiate a consent agreement that saves your license and employment. Alternative discipline under the statute includes:
- a letter of warning, reprimand, or censure with regard to any act, conduct or practice the board considers unworthy of more severe discipline
- civil penalties in accordance with the law
- an order to cease and desist from future violations or to take corrective action
- an order to restore money or property acquired by means of a violation
- an order to secure medical or other professional treatment necessary to remove impaired function
- an order to submit to medical or diagnostic testing, monitoring, or psychological evaluation to evaluate whether continued practice may jeopardize public safety and welfare
- an order to submit to a skills assessment to determine whether the licensee can continue to practice with reasonable skill and safety
- an order to take and successfully complete necessary educational training
- an order to submit to supervision, monitoring, or limitation on practice
Examples of New Jersey Nurse Discipline
New Jersey publishes the results of nursing discipline cases. Those cases show some common causes of nurse discipline. Common causes can include patient abuse or neglect, incompetent nursing practice, unfitness to practice because of drug or alcohol abuse, and criminal convictions for violence or property damage. New Jersey's published cases also show some of the missteps along the way that can cause a nurse to suffer license discipline when discipline may not have occurred without the misstep. The most recent New Jersey nurse discipline cases include these examples:
- a nurse with a substance abuse disorder who failed to comply with treatment conditions and who suffered an arrest for drug possession
- a nurse referred to the alternative drug recovery program after two drug arrests but who failed to activate a required online monitoring account and participate in required peer support programs
- a nurse whose hospital employer suspected drug diversion and who accepted referral to the recovery program but who failed to comply with program conditions
- a nurse who failed to care for a vulnerable child patient resulting in missed prescriptions and lack of hygiene, who used wrong equipment resulting in patient injury, and whose neglect related to positive drug tests
- a nurse who suffered a criminal conviction for property damage while ignoring board requests to explain the circumstances and update renewal applications
- a nurse who failed to update renewal applications disclosing arrest for possession of a controlled dangerous substance
- a nurse who indicated on a license renewal application an arrest or conviction for an undisclosed crime but who failed or refused to update the application with a disclosure of the crime
Alternatives to New Jersey License Proceedings
New Jersey, like many other states, offers a voluntary nurse Recovery and Monitoring Program (RAMP) that qualifying nurses can enter to avoid formal disciplinary proceedings. Voluntary recovery programs like New Jersey's RAMP can certainly help a nurse who suffers from a substance abuse disorder. Qualifying for the program typically depends on showing a diagnosed disorder and that the qualifying nurse hasn't yet harmed anyone in the course of practice because of the disorder. Voluntary recovery programs, though, are not for everyone. As the above example New Jersey discipline cases show, the RAMP program creates a complex set of requirements that many nurses cannot or will not meet. Don't jump for RAMP if discipline officials offer it without first consulting your professional license defense attorney to sensibly evaluate the alternative. Retain professional license defense attorney Joseph D. Lento to help you decide the best way forward to retain or recover your nursing license.
New Jersey Nursing License Disciplinary Procedures
Section 45:1-18 of New Jersey's Uniform Enforcement Act authorizes the State Board of Nursing and other professional boards to investigate professional misconduct and require license holders to respond to charges. The same statute authorizes the Attorney General's professional prosecutor to obtain evidence to present at a hearing on the professional misconduct charge. The statute requires the Board to complete the proceeding within 120 days of initiation unless the Attorney General's prosecutor finds cause to extend the proceeding. The statute also authorizes the prosecutor or Board to issue subpoenas to compel attendance at the hearing. In practice, some proceedings resolve without hearing if an investigation shows no misconduct or only minor misconduct that the Board can resolve with a warning or other terms and conditions that the license holder accepts. Your professional license defense attorney can be key in advocating for and negotiating these informal resolutions.
State Board of Nursing Hearings
Contested hearings before the State Board of Nursing have a significant level of formality. Under Section 52:14B-9 of New Jersey's Administrative Procedure Act, agencies like the State Board of Nursing must afford the parties opportunity for hearing after reasonable notice of the charges in writing. If your license matter proceeds to a formal hearing on substantial evidence of serious misconduct, then expect the hearing to involve witnesses testifying under oath and presentation of documents and other evidence. The hearing panel may permit your professional license defense attorney to cross-examine witnesses. With your attorney's assistance, you may also present witnesses on your own behalf to exonerate you from misconduct or to explain any misconduct and mitigate the potential penalty.
On the other hand, under Section 52:14B-10 of New Jersey's Administrative Procedure Act, formal evidence rules do not bind agencies like the State Board of Nursing in contested hearings. Instead, the Board will generally admit all relevant evidence in contested cases, even if it involves hearsay or other matters inadmissible in a court of law. Once again, you must retain a skilled and experienced professional license defense attorney if you are to give yourself the best opportunity for an acceptable outcome that preserves your nursing license. The hearing panel will issue a written decision with specific findings that you and your attorney may review.
Court Challenge of New Jersey Nursing Discipline
New Jersey's Administrative Procedure Act permits judicial review of final agency decisions, including a State Board of Nursing decision on discipline. With skilled attorney representation, you may challenge in court an adverse discipline decision. But New Jersey's Administrative Procedure Act and applicable New Jersey case law limit the grounds for court review. The New Jersey Supreme Court in the case In re Herrmann, 192 N.J. 19, 27-28 (2007), held that the court must sustain the agency's decision “unless there is a clear showing that it is arbitrary, capricious, or unreasonable, or that it lacks fair support in the record.” The court will look at (1) whether the decision violated the law, (2) whether the record contains substantial evidence supporting the agency's findings, and (3) whether the agency clearly erred in a decision not reasonably made on a showing of the relevant factors.
Appellate Representation. While court review is another chance to avoid discipline, court review requires skilled and experienced professional license defense representation. The errors a license holder must prove require close examination of the transcript and evidentiary record. Court review also requires legal research and briefing. Do not retain a general practitioner attorney for these technical, administrative skills. Instead, retain professional license defense attorney Joseph D. Lento for his substantial skill and experience in these matters.
Reporting of New Jersey Nursing Discipline
The National Council of State Boards of Nursing keeps a national licensing database Nursys.com to which licensing boards in thirty-eight states contribute discipline decisions. To participate in the national database of nursing discipline decisions, a state must join the Nurse Licensure Compact. New Jersey recently began meeting Compact requirements, meaning that nursing discipline decisions will enter the national database. New Jersey's Consumer Affairs Division also publishes nursing license discipline, which is thus a matter of online public record. If you suffer nursing license discipline in New Jersey, that discipline will be public. You are far better to contest discipline charges by retaining a skilled and experienced professional license defense attorney than to hope that employers, licensing boards, patients, and colleagues won't discover your discipline.
How to Face New Jersey Nursing License Issues
As a professional, you are not helpless, even when the issue you face is your own potential professional discipline. As a professional, you know how to assess your situation, locate the necessary resources, and respond proactively to make the best of difficult situations. Here are several steps you can take to best respond to your New Jersey nursing license issue:
- If you anticipate a complaint against your nursing license, then don't stand idly by. Instead, let your employer know about the issue. Your employer has likely dealt with complaints of professional misconduct in the past. Your employer may take the initiative with the patient, patient's family member, or colleague whom you expect to allege your professional misconduct. Your retained attorney can help you discern how best to gain the support and assistance of your employer.
- Collect and save any record, communication, report, or other document or items having to do with the professional misconduct of which you expect to be accused. Save emails, texts, notes, and anything else that might explain your situation, exonerate you from misconduct, or mitigate any wrong you may have committed. Do not obstruct an investigation in any way. Interfering with a witness or investigation is itself misconduct.
- Timely answer any complaint, inquiry, or other requests from discipline officials with your retained attorney's help. Don't feel as if you must respond on the fly or informally to every unannounced visit or telephone call. Instead, take the time to prepare thoughtful, truthful, and complete answers to any request, relying on your attorney's review and guidance.
- Above all, promptly retain a skilled and experienced professional license defense attorney and then rely on that attorney. You know nursing, but you don't know administrative law and procedure. Disciplinary proceedings are adversarial. Discipline officials won't be helping you along, except to attempt to gain your admission to misconduct. Listen to your attorney and follow your attorney's advice. You may have a strong defense. Don't carelessly throw it away. Professionals are smarter than that.
New Jersey Nursing License Defense Attorney Available
Professional license defense attorney Joseph D. Lento of the Lento Law Firm is licensed and located in New Jersey to help you. Attorney Lento has effectively represented countless professionals nationwide in license proceedings. He knows what you face and can help you. Your best move is to trust a skilled and experienced professional license defense attorney who knows New Jersey administrative rules and practice. Call 888.535.3686 now or use the online service to retain professional license defense attorney Joseph D. Lento and the Lento Law Firm for your nursing license defense in New Jersey.