As a committed agency nurse in Louisiana, facing accusations of professional misconduct and unemployment can come as a fast surprise. After unexpectedly losing an employment contract with a medical facility, you may quickly find yourself terminated from your agency without any future agreements or employment opportunities. The subsequent anticipation of an investigation and hearing before the Louisiana State Board of Nursing can only worsen your anxiety and fear.
Regardless of what phase you are in of this escalated termination and investigation process, the Lento Law Firm Professional License Defense Team can help. We understand the nuances of Louisiana Nursing Board proceedings and nursing agency investigations. We can help you craft a robust defense with the goal of safeguarding your financial security and professional reputation. Reach a member of our Team today by calling us at 888-535-3686 or by using our online contact form.
The Unique Role of Agency Nurses in Louisiana
Louisiana agency nurses are employed through a nursing agency and typically work as individual contractors rather than full-time employees. Although agency nurses are often independent contractors, they generally are assigned contracts and minimally managed by their respective agencies. Some well-known nursing agencies in the state include Advantage Medical Professionals, GIFTED Healthcare, and Pulse Medical Staffing of Louisiana.
Agency nurses are afforded great flexibility and enjoy a diverse range of responsibilities and roles. Employment contracts can range from working at multiple healthcare facilities at once to working limited, more focused contracts. Nursing agencies typically collaborate with staffing agencies that assist medical providers in Louisiana in their efforts to fill short-term absences or staffing shortages. Agency nurses enjoy a unique work experience, allowing them a more varied career path than a typical registered nurse in Louisiana. Some of the advantages and disadvantages they experience are discussed below.
Flexibility
Agency nurses enjoy a great deal of flexibility and professional autonomy, making it much easier to balance professional responsibilities with personal commitments. Not only can agency nurses select their own work schedule and location by accepting or declining contract offers from their agency, but they can also seek out contracts that suit their professional interests, ranging from supportive roles at hospitals to more specialized positions.
Diverse Work Experience
Agency nurses also experience a diverse range of work contracts, exposing them to a broad spectrum of healthcare settings that help develop their professional skill sets. Nurses who seek broad exposure to various clinical settings can find employment contracts in hectic hospital settings to more intimate and specialized care units at community health clinics. This variety not only enriches a nurse's professional repertoire but also fosters a nurse's adaptability and comprehensive understanding of various fields.
Pay
Although agency nurses may experience less stability in terms of job security, they may receive better pay than their non-agency colleagues through higher hourly wages. Agency nurses can earn more than their counterparts in non-agency roles, particularly when healthcare facilities urgently need to address staffing shortages. Staffing shortages may occur in peak demand seasons, such as holidays, or in response to significant healthcare emergencies, like a natural disaster or the COVID-19 Pandemic.
Management of Louisiana Agency Nurses
Louisiana Nursing Requirements
At a minimum, agency nurses must complete all nursing license prerequisites under the Louisiana Nurse Practice Act. However, many agencies will have additional requirements for nurses to gain employment. After earning their nursing degree and passing the NCLEX examination, agency nurses must apply for a Louisiana state nursing license. In Louisiana, all licensed nurses receive a license through the Nursing Licensure Compact Agreement. This multistate license allows nurses to practice in their home state and other compact states without licensing issues.
Agencies typically require agency nurses to have prior clinical experience, ensuring they can serve competently in various healthcare settings. Having broad clinical experience can also help agency nurses receive more contracts across different healthcare settings that may not be available to less experienced agency nurses.
Despite opportunities for higher pay, agency nurses must be financially astute. It is not uncommon for agencies to require these nurses to carry their own professional liability insurance. Agency nurses are often responsible for financing their own continuing education units (CEUs) to maintain and update their professional skills and qualifications.
Louisiana's Bureau of Primary Care and Rural Health
The Louisiana Bureau of Primary Care and Rural Health (the “Bureau”) operates under the state's Department of Health with initiatives and programs that aim to elevate and oversee healthcare accessibility within the state. Because the Bureau further works to ensure that rural hospitals are adequately staffed and trained, the division also oversees staffing agencies that provide agency nurses in particularly understaffed rural areas.
The Bureau's Program Monitoring and Evaluation Standards for nursing agencies are contained in Title 48, Part I, §7613 of the state's Healthcare Standards and Statutes. Under these standards, the state defines a Nurse Staffing Agency as “any person, partnership, corporation, unincorporated association, or other legal entity, including a digital website/platform, that employs, assigns, or refers nurses or certified nurse aides to render healthcare services in a healthcare facility for a fee.”
The Louisiana Nursing Practice Act
While the Bureau oversees and issues licenses to the agencies that employ agency nurses, Louisiana nursing licenses are issued by the Louisiana State Board of Nursing (the “Board.”) Under the authority of the 1950 Louisiana Nursing Practice Act, the Board holds the authority to investigate complaints, conduct disciplinary hearings, and impose sanctions for agency nurses who commit ethical, moral, or professional misconduct.
What Additional Skills Makes Someone a Good Agency Nurse Candidate?
Adaptability
A career in agency nursing, though less conventional, presents a unique set of challenges and rewards for nurses who are particularly suited to thrive in fast-paced and diverse employment environments. Although any Registered Nurse is exceptionally talented, agency nurses are particularly marked by adaptability, a keenness to learn, and an ability to integrate into new assignments seamlessly.
Communication
Because agency nurses often work in a supportive environment for existing hospital teams, they must also possess exemplary communication skills that allow them to plug into organizational structures without delay or offense. Beyond flexibility, successful agency nurses are often adept at managing stress in unfamiliar settings. Of course, this confidence to manage stress in new environments is built upon a solid foundation of nursing skills.
Reliability
Finally, professionalism and reliability are paramount for agency nurses, as they represent both themselves and their agency. Agencies typically seek candidates with self-motivation, independence, and advanced organizational skills. Unlike colleagues in more stable roles, agency nurses must be trusted to juggle multiple work schedules, locations, licensure, and continuing education requirements without oversight.
What Misconduct Allegations Can Threaten My Agency Nursing Career?
Agency nurses are bound by the ethical, moral, and professional responsibilities contained within the Louisiana Nursing Practice Act. Although any departure from the Act's requirements can jeopardize your license and career as an agency nurse, there are some forms of misconduct that can be taken more seriously by the Louisiana Board of Nursing.
Ethical and Moral Misconduct
Ethical misconduct often encompasses various forms of fraud, such as cheating on a nursing exam license, providing misleading statements on resumes or references, or embellishing successes and abilities on employment applications. Other examples of ethical violations can include sexual misconduct and crossing ethical boundaries with patients despite conflicts of interest.
False or misleading advertising can also be an ethical violation in instances where an agency nurse makes false or misleading claims to the public. Examples of this behavior can include unsubstantiated claims of medical performance or excellence or claiming superior skills without evidence.
Criminal Misconduct
Criminal charges, convictions, and even arrests carry significant consequences for agency nurses. Under § 37:911 of the Louisiana Nursing Practice Act, nursing licenses can be suspended, revoked, or denied due to criminal felony convictions.
Professional Misconduct
Professional misconduct violations come in many shapes and sizes, but generally, all relate to a failure to provide the proper standard of care. Some examples of professional misconduct violations include:
- Negligent Performance: Professional performance that departs from or fails to conform with standards of the nursing profession, including the ability to practice medicine with reasonable skill and safety.
- Practicing Despite Dangerous Conditions: Practicing medicine despite conditions such as developmental disabilities, mental incompetencies, chemical dependence, deterioration through the aging process, physical disabilities, sexual predator history, including sexual psychopathic personality types.
- Use of Illicit Substances or Practicing Under the Influence of Drugs or Alcohol.
- Former Disciplinary Actions: Encompasses disciplinary actions undertaken in another state or jurisdiction, such as revocation, suspension, restriction, or limitation of a nursing license. Agency nurses may also face disciplinary conduct for failure to inform the board about charges brought against the person's license in other states or jurisdictions, including instances where they were denied admission to nursing boards.
- Posing Harm to the Public: Engaging in any conduct that is likely to harm the public, such as carelessly performing job duties, engaging in medical practices that the provider is not competent enough to complete, and creating unnecessary danger to a patient's health and safety.
- Failure to Supervise: Failure to adequately supervise junior nurses or other licensed or unlicensed health care providers when necessary. This also extends to aiding or abetting unlicensed individuals in medicine when a license is required.
- Improper Management of Medical Records: Such as failure to adequately record patient conditions, information, diagnosis, medication, etc. This also extends to failure to furnish medical records as required by law.
- Improper or Unlimited Fee Splitting: Including paying, offering to pay, or agreement to receive payments, including commissions, in a manner disproportionate to the services performed or not properly disclosed as an area of economic interest. Improper payment of fees also includes dispensing drugs, pharmaceuticals, or medical devices for profit, outside of an acceptable partnership, group practice, etc.
- Fraudulent Billing Practices: Engaging in fraudulent billing practices such as Medicare or Medicaid billing.
- Failure to Comply: The failure to report professional misconduct of peers or the inability to participate in misconduct investigations.
Challenges That Are Unique to Agency Nurses
As a registered nurse in Louisiana, you already know that you can face disciplinary consequences and even a potential hearing before the Louisiana Nursing Board for various forms of ethical, professional, and moral misconduct. While the disciplinary process for any registered nurse is complex, the disciplinary process for agency nurses is exceptionally nuanced and characterized by gaps in communication.
Nurses employed in full-time roles at healthcare facilities often have the advantage of anticipating professional misconduct complaints, thanks to direct communication with their superiors or hospital administration staff. Advanced warning may not be as accessible for agency nurses, who lack a more formal, communicative employment environment.
It is not unusual for agency nurses to encounter disciplinary measures unexpectedly, often unaware of the escalating concerns. An agency nurse might find themselves "reassigned" or "removed" from their position at a facility and may be left out of critical discussions about their performance between the facility and the agency. This lack of direct communication can lead to a sudden dismissal from the agency without adequate warning. Such abrupt termination disrupts their immediate professional engagements and impairs their ability to secure contracts at other hospitals, posing a significant challenge to their livelihood and career continuity.
Agency nurses may not become aware of a misconduct violation until it has progressed to a formal investigation by the Louisiana Nursing Board. This situation underscores the importance of early legal help. Often, violations at the agency level stem from misconceptions, errors, or misunderstandings. Navigating investigations and formulating strategic defenses at this stage can prevent further escalation in some cases. Acting early can also help safeguard the nurse's professional reputation, nursing license, and continued employment at their agency.
The Disciplinary Process for Agency Nurses in Louisiana
The disciplinary process for agency nurses is governed and administered by the state's Board of Nursing by the state's Nursing Practice Act and Administrative Code. Within this framework, the disciplinary process must ensure that agency nurses receive “due process,” – a legal term that translates into the right to be notified about allegations against you and present your side of the story before a neutral decision-maker. Due process typically takes place in the following phases discussed below.
The Complaint and Investigatory Phase
According to the Board's Disciplinary Procedures, after receiving a complaint about a nurse for issues such as unethical behavior or professional misconduct, the Board must notify the accused nurse of the allegations against them. The Board then assigns an investigator who will conduct a formal investigation. Although every inquiry will vary, the state's compliance procedures indicate that these investigations can range from 3 to 18 months to complete.
Throughout the investigation, the investigator can use various methods to gather information, such as speaking to a nurse's colleagues, patients, and employers. Accused nurses may also be asked to comply with the investigation by providing a written or oral statement. Failure to comply with investigation complaints may trigger additional professional misconduct violations.
The Resolution or Hearing Phase
After the investigation, the Board can either dismiss the complaint or proceed with the disciplinary process by filing a formal complaint. A formal complaint can be “resolved” via a voluntary settlement agreement or move to a formal hearing. If the parties agree to a settlement agreement, the accused nurse must typically consent to some disciplinary consequences such as a license suspension, mandatory education units, or fines.
If the parties cannot agree on settlement terms, they can proceed to a formal hearing before an administrative law judge. Administrative hearings operate like a small trial, allowing both sides to present evidence, testimony, witnesses, and arguments of law and fact. While some agency nurses may be tempted to represent themselves at these hearings, this is not advised. These proceedings require an in-depth knowledge of legal procedures and timelines and extensive knowledge of state evidence laws and the rules and regulations surrounding Louisiana's Nursing Practice Act.
After the hearing, the accused nurse is mailed a copy of the official decision. The Board's disciplinary consequences can include formal reprimand, suspension with a probationary period, suspension without a probationary period, or even revocation. Alternatively, the Administrative Law Judge may decide to dismiss the allegations.
Appeal
If you choose to appeal the decision, you must comply with the state's strict guidelines and timeframes for appeal requests. Appeals may be granted in the following types of instances:
- The decision was clearly contrary to the law and the evidence.
- Newly discovered evidence may be sufficient to reverse the board's decision.
- Some issues presented were not thoroughly examined “to dispose of the case properly.”
- Public interest weighs in favor of further consideration.
It's important to note that appeals are quite demanding and require the experience and strategy of counsel who is well-equipped and familiar with the state's bureaucratic system. Fortunately, our Professional License Defense Team members have successfully navigated nursing appeals for nurses across Louisiana.
Areas We Serve in Louisiana
Our Team can help you craft a defense regardless of what nursing agency you are employed with. We provide strategic representation throughout Louisiana, including for nurses employed through Interim HealthCare Staffing or Maxim Services based out of Minneapolis, Interim Healthcare based in Bloomington, or Favorite Healthcare Staffing near Roseville.
New Orleans
Famous for its cobblestone streets, food, and Mardi Gras celebrations, New Orleans is the largest city in the state of Louisiana. Agency nurses in or near the metropolitan area may work in contracts at top hospitals such as Our Lady of the Lake Regional Medical Center, Ochsner Medical Centre, University Medical Centre, and East Jefferson General Hospital.
Baton Rouge
Located along the eastern part of the Mississippi River, Baton Rouge is the state's second-largest city and capital. The area is home to many medical and pharmaceutical corporations, medical centers, and hospitals. Agency nurses in the area may also commute to Our Lady of the Lake Reginal Center, Baton Rouge General Medical Center, or Accord Rehabilitation Hospital.
Shreveport
Located in the northwestern part of the state, Shreveport is typically noted as an educational and cultural hub for Louisiana, Arkansas, and Texas. Notable medical employers in the area include Louisiana State University Hospital, Highland Clinic, and the Christus Schumpert Health System.
Metairie
The fourth most populous city in the state, Metairie, is located on the south shore of Lake Pontchartrain near the state's French Quarter. Located close to New Orleans, the city also boasts a rich cuisine history and a love for Mardi Gras celebrations. While agency nurses in the area may choose to commute outside the city, they may also have contracts with East Jefferson General Hospital, Charity Hospital and Medical Center, and St. Charles Parish Hospital.
How Can the Lento Law Firm Professional License Defense Team Help Me?
Our skilled and committed Professional License Defense Team has the experience necessary to protect your professional license. If you find yourself unexpectedly released from a contract with little to no explanation from your agency and facing difficulties securing further assignments, it may indicate underlying misconduct allegations. While you may feel there is no point in fighting back, our Team can intervene on your behalf and develop a strategic defense before matters escalate to the state level.
In cases where you are already under investigation by the state Board, our Team can guide you through the intricacies of the complaint and investigation process. We offer representation during settlement discussions and, if necessary, at administrative hearings. Our approach includes presenting detailed arguments of fact and law to support your defense, handling evidence submission and assessment, subpoenaing and examining witnesses, and conducting thorough cross-examinations.
If you are interested in pursuing an appeal, our Team can assist you with filing an appeal request. We aim to provide comprehensive legal support to safeguard your career and professional reputation as an agency nurse.
Contact our Professional License Defense Team Today
If you're dealing with contract termination, agency dismissal, or a Louisiana Nursing Board investigation, our experienced Professional License Defense Team can provide the essential support and advocacy you need. Contact us today at 888-535-3686 or use our online contact form.
