Nurses have a duty of care not only to their patients but also to the general population. This includes mandatory reporting requirements to ensure not only patient safety but the safety of the larger community. If and when nurses fail to properly report, they may face disciplinary action and criminal charges, and may even lose their license.
What nurses must report, how they report, and any potential disciplinary action can vary by state. Most states, however, have mandatory reporting laws for child and elder abuse, substance abuse, and substandard patient care.
Nurses can be excellent at their jobs but face disciplinary action because of a failure to report or incorrect reporting. They may be blamed for not reporting when they didn't know or have reason to suspect an issue.
They may be disciplined overly harshly or accused as a way to shield other staff or administrators from their failure to act. In some cases, they may be punished for making a report.
If you're a nurse and you've been accused of failure to comply with mandatory reporting requirements, you're facing serious consequences that could derail your career. The Professional License Defense Team at the Lento Law Firm works with nurses throughout the United States to defend their licenses, their careers, and their futures. Call us at 888-535-3686 or fill out our online form.
Mandated Reporters
Mandatory reporting laws require individuals in certain professions, including nursing, to report certain actions or behavior, either systemic or affecting one person, to the necessary authorities. This authority may be law enforcement, a governing body, or another government department.
When mandated reporters either see or suspect a certain action or behavior, they must report it. Failure to report could result in disciplinary action.
The reason for mandatory reporting is to protect both individuals and society. One concern about mandated reporting is it can potentially conflict with protecting patient confidentiality. Reasons for mandatory reporting laws include:
- Gather information for statistics and other records
- Protect the public from communicable diseases
- Protect the public from harm related to a violent and/or criminal act
- Protect patients from future harm
- Protect patients from unqualified or unsafe medical personnel
- Assist law enforcement in investing and solving crimes
- Assist law enforcement in preventing crimes
Mandated reporting laws generally fall into two categories: protecting society and protecting individuals. If and when a nurse faces disciplinary action related to mandated reporting laws, knowing why these laws exist can help nurses better understand how to defend themselves against the allegations.
The Professional License Defense Team at the Lento Law Firm helps our clients understand the best defenses when facing disciplinary action.
What to Report
Each state has its own requirements for mandatory reporters, such as who qualifies as a mandated reporter. In general, nurses are considered mandated reporters.
States should make reporting requirements clear to mandatory reporters. Arizona, for example, provides a list of all conduct or behavior that must be reported. The list is extensive, but the Arizona State Board of Nursing highlights that it's not an exclusive list. The state puts the burden on nurses to clarify if and when they should report behavior or conduct, even if that behavior or conduct is not explicitly mentioned.
In Arizona, nurses are expected to report:
- When a nurse or certificate holder appears mentally or physically unable to safely practice nursing or perform their duties
- When a nurse or other individual is practicing beyond the scope of their license, certificate, or education, such as writing a prescription or changing medication dosage
- When a nurse is acting in a way that is unsafe or unprofessional
- When a nurse's conduct seems to be a contributing factor to a high risk or harm to a patient
- When a nurse's conduct might be a contributing factor to a patient's death
- When a nurse is misusing alcohol or other substances in a way that affects their ability to perform their job
- When a nurse is unable to account for medications, loses medications, or is otherwise unable to account for the waste or loss of controlled drugs
- When a nurse falsifies medical or treatment records
- When a nurse repeatedly exercises inappropriate judgment or insufficient nursing skill
- When a nurse fails to assess or intervene on behalf of a patient or patients
- When a nurse engages in sexual activities with a patient or a patient's family member or other close relationships
- When a nurse physically or verbally abuses a patient
- When a nurse's conduct amounts to misappropriating, stealing from, or exploiting a patient
- When someone practices nursing without a valid nursing license
- When a nurse engages in conduct that deceives, defrauds, or harms the public
As this list demonstrates, a nurse is responsible not just for their conduct and behavior but also for their fellow nurses. Nurses must report when and if they believe another nurse may pose a danger to patients' health and safety.
New Jersey's Health Care Professional Responsibility and Reporting Enhancement Act specifically addresses when nurses must report. This act focuses on when a nurse or other medical professional must report another medical professional's impairment, gross incompetence, or unprofessional conduct when this conduct presents an imminent danger to either an individual patient or public health and safety.
Substance Abuse
Substance abuse is an increasingly common problem with nurses. While some cases of substance abuse are clear threats to patient safety, others can be more difficult to determine.
Marijuana, for example, can be especially difficult to navigate. While some states have legalized the drug, it remains illegal at the federal level, and employees may still require drug testing.
Colorado, for example, has legalized marijuana, but employers in the state can still drug test and prohibit employees from using marijuana. The state also encourages reporting of drug use through its Let DPO Know program.
Illinois has specific laws for reporting nurses who appear to be impaired as a result of drug and/or alcohol use. Under this statute, even possessing mood-altering drugs may result in a report.
Nurses should ensure they know their state's laws for reporting and their employer's policies for drug use and reporting.
How to Report
Each state has its requirements for how nurses file reports. Reports may be mailed or submitted online.
Texas, for example, requires that all reports:
- Be written
- Be signed
- Include the identity of the nurse
- Include any additional information the Texas Board of Nursing requires
Reporting may also vary depending on the alleged conduct and actions. Nurses may have to report to a different agency for elder or child abuse. Reporting a co-worker or other medical professional may also involve an employer's policies.
If you're unsure of how to report, contact the Professional License Defense Team at the Lento Law Firm.
Failure to Report
For baseball fans, the 1919 Chicago White Sox, later nicknamed the Black Sox, remains famous because members of the team conspired with bookies to throw the World Series. Eight members of the team were given lifetime bans from playing in the major leagues.
One of those players, however, never accepted any money. Buck Weaver's crime was that he knew about the gambling deal and didn't inform the coaches or management about it. He received a lifetime ban for failing to report.
Similar to Buck Weaver, when a nurse fails to file a mandatory report, they may face disciplinary action and other punishments. In most states, these punishments are fines and disciplinary action.
Some states make a nurse's failure to report a crime. In Florida, not reporting child abuse is a third-degree felony. Not reporting sexual battery is a misdemeanor of the first degree.
It's a misdemeanor of the second degree to fail to report suspected abuse, neglect, or exploitation of a vulnerable adult. In addition, Florida law states that preventing someone else from making a report is also a misdemeanor in the second degree.
Similar to Florida, Massachusetts has different punishments depending on what conduct a nurse failed to report. The state has different criteria and punishments for child abuse, elder abuse, and disability-based abuse.
These punishments are generally fines but can include jail time. In the case of failing to report child abuse, a nurse faces up to two and a half years in jail. Massachusetts will also forward information to any relevant nursing boards.
Exceptions
States may have exceptions to mandatory reporting laws. For example, Georgia exempts nurses from making reports when they learn about conduct or behavior while treating another nurse. In this case, the other nurse is a patient, and nurse-patient confidentiality overrides mandatory reporting laws.
Nurses should be aware of not just mandatory reporting laws but also exceptions. In some cases, reporting may violate other laws, such as patient confidentiality, that could also result in a nurse facing disciplinary action.
Training
States often have training programs for mandated reporters. The purpose of these programs is to help nurses and other mandated reporters know when to report.
California's training program for child abuse reports, for example, covers the following topics:
- Identifying signs of abuse when evaluating child injuries
- Recognizing maltreatment in children who have developmental disabilities
- Knowing how to screen for domestic violence
- Talking to a child about suspected abuse
- Overcoming obstacles to make a report
- Learning how to report suspected abuse
In California, registered nurses can get continuing education credits for completing training.
This program is specific to a certain type of mandated reporting and a specific state. Other states allow nurses to complete more general mandated reporting training programs.
Nurses should be aware of any training requirements related to mandatory reporting. Failure to complete these requirements could result in their licenses being suspended.
Good Faith Immunity
Not all reports result in finding evidence of the alleged behavior or actions. In Pennsylvania, for example, the majority of child abuse reports end in a finding of no abuse found.
In general, mandated reporters who make a report that turns out to lack evidence of a violation shouldn't be subjected to disciplinary action if the report was made in good faith. This means that they made the report with the belief that some type of misbehavior was occurring.
A report isn't made in good faith when it was intended to punish a person or damage their reputation. They didn't make the report to take advantage of someone or create problems.
A person acts in good faith when they have an honest intent or reasons to believe abuse or other misbehavior is occurring. Most states have laws or regulations that prevent a person from making a report in good faith from lawsuits or disciplinary action. In Washington State, anyone who acts in good faith when making a report is immune from liability.
Frivolous Reporting
In comparison to the good faith exception, states may have disciplinary actions and punishments for reports that are made maliciously or knowing the allegation is false. Making a false report can result in disciplinary action.
Massachusetts refers to these types of reports as frivolous. The state also has different tiers of punishment for those who file frivolous child abuse reports more than once. While a first-time offender faces a fine of up to $2,000, anyone found to file a frivolous report more than three times can be fined up to $2,000 and jailed for up to two and a half years.
Don't Let a Failure to Report Derail Your Future
One of the key tenets of nursing is a duty of care, which includes not harming patients. This now extends to requiring nurses to report certain conduct or behavior that may negatively impact others.
Mandated reporting laws serve an important public purpose, but they can be misused. Reporting laws may be enforced arbitrarily. Overworked and burnt-out nurses may miss conduct or signs of behavior that should result in a report. A nurse may make a report in good faith but face disciplinary action regardless.
Whatever the reason, if you're facing disciplinary issues related to mandatory reporting, contact the Professional License Defense Team at the Lento Law Firm. We work with nurses throughout the United States in disciplinary hearings and related situations. We know the work and sacrifice you've undergone to get to this point in your life and your career, and you have a right to defend your future. Call us at 888-535-3686 or fill out our online form.
