As a dedicated agency nurse in Massachusetts, losing your carer due to misconduct allegations can feel paralyzing. From the sudden termination of a contract with a medical facility to the termination of your nursing agency for misconduct allegations, a disciplinary hearing before the Massachusetts State Board of Nursing may be closer than you realize.
Regardless of what phase you find yourself in, the Lento Law Firm Professional License Defense Team can help. We understand the nuances of Massachusetts Nursing Board proceedings and nursing agency investigations. Contact 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 Massachusetts
In Massachusetts, agency nurses commonly work as independent contractors through nursing agencies rather than as full-time employees in hospitals or medical groups. While agency nurses are granted a lot of autonomy, career choice has risks such as job security, minimized professional development support, and unpredictable income. To build and maintain a career as an agency nurse in Massachusetts, nurses must have a solid foundation of nursing skills, be capable of operating without minimal supervision, and have an entrepreneurial spirit that allows them to thrive as independent contractors. Some well-known Massachusetts agencies include AMN Healthcare, Aureus Medical Group, and CompHealth.
A Path to Flexibility, Autonomy, and Professional Growth
Agency nurses benefit from considerable flexibility and experience broad professional responsibilities and roles. While some nurses may thrive with this responsibility, others may suffer without the experienced support of a supervisor. In Massachusetts, nursing agencies often partner with staffing agencies to support medical providers in addressing short-term vacancies or staffing deficits. This collaboration creates a unique work experience for agency nurses, giving them opportunities for a more diverse career path than traditional registered nurses. Some reasons a nurse may pursue a nursing career are discussed below.
Flexibility
Agency nurses benefit from a high degree of flexibility and professional autonomy, making it a desirable career choice for parents, spouses, or professionals pursuing other travel or entrepreneurial opportunities. This flexibility isn't limited to scheduling freedom. Many agency nurses also pursue career choices because they enjoy accepting contracts in various departments and fields. This can range from general supportive roles in hospitals to positions requiring specialized expertise.
Pay
While agency nurses might face less predictability regarding job security, they often benefit from higher pay when compared to their non-agency colleagues. Agency nurses must be more financially astute as they may not receive similar benefits such as IRA contributions, healthcare, paid leave, etc.
Massachusetts Nursing Standards
At a minimum, agency nurses must complete all nursing license prerequisites under the Massachusetts Nurse Practice Act. Some basic requirements to achieve a Massachusetts nursing license include:
- Educational Requirements: Graduation from a board-approved nursing program.
- Examination: Passing scores on the National Council Licensure Examination (NCLEX) – a nationwide examination for licensing nurses in the United States.
- Good Moral Character: Under the Massachusetts Nurse Practice Act, applicants must demonstrate good moral character. This requirement ensures that applicants uphold the integrity and ethics expected in healthcare.
Agency Standards
In addition to holding a valid nursing license, Massachusetts nursing agencies generally require applicants to have significant clinical experience that allows them to seamlessly work in supportive roles in contracting hospitals. Clinical experience will make it easier for agency nurses to plug into new environments without little to no training, and it will also expand the agency's reach and potential contracts with possible hospitals.
Some agency nurses may also be required to pay for their professional liability insurance – a safeguard that aligns with the autonomous nature of working as an independent contractor. Agency nurses are also typically responsible for funding their Continuing Education Units (CEUs), ensuring they remain adept and current in their field.
What Additional Skills Makes Someone a Good Agency Nurse Candidate?
Adaptability
Successful agency nurses typically succeed in dynamic and varied work settings. While all Registered Nurses possess remarkable talents and skills that enable them to work in the healthcare industry, agency nurses are distinguished by their exceptional adaptability, eagerness for continuous learning, and capacity to assimilate swiftly and effectively into new assignments.
Communication Skills
Agency nurses, who often support existing hospital teams, must possess outstanding written and oral communication skills. Because agency nurses are expected not only to “blend in” but “support” existing organizational structures, they must be able to provide efficient collaboration without causing delays or misunderstandings. This is especially true when since agency nurses often don't receive formal training at their contracting hospitals and don't benefit from the predictability of knowing a coworker's communication “style.”
Stress Management
Given the demands of new environments, unknown coworkers, and demanding schedules, agency nurses must be sufficient at managing stress within unfamiliar environments. While good communication skills can support their stress management, agency nurses must also rely on a thorough foundation of nursing skills that allows them to remain composed under pressure.
Critical Thinking Skills
Agency nurses must also be able to make rapid, well-informed decisions in new environments. While non-agency colleagues may benefit from a supervisor or organizational structure that helps them during times of uncertainty, agency nurses are often left to their own devices when evaluating patient needs and identifying the most appropriate course of action. While many nurses may possess academic knowledge about nursing, agency nurses are set apart by a deep understanding of each unique clinical experience they may be facing.
Reliability and Organizational Skills
As independent contractors, agency nurses must be reliable, organized, and responsible. While many non-agency nurses may rely on supervisors or colleagues to disguise some performance issues, agency nurses do not have this benefit. Because of this, agencies seek candidates with solid self-motivation, independence, and superior organizational skills. This makes sense when considering that agency nurses are often expected to balance varied work schedules at multiple locations. While salaried nurses may receive continuing education opportunities or updates on licensure requirements from their employer, agency nurses must often meet their ongoing educational needs without direct supervision.
What Misconduct Allegations Can Threaten My Agency Nursing Career?
Agency nurses are bound by the same ethical, moral, and professional responsibilities contained within the Massachusetts Nursing Practice Act as non-agency colleagues. While 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 Massachusetts Board of Nursing.
Ethical and Moral Misconduct
Ethical misconduct in nursing can manifest in various forms, such as fraud. Examples of fraudulent activities can include cheating or assisting in the cheating of a nursing licensure exam, providing false information on resumes or references, or overstating one's achievements and capabilities in job applications. Nurses can also commit fraud if they claim superior results in patient care without the performance to back their claims up.
Ethical violations can also extend to more severe issues, such as sexual misconduct or inappropriate patient interactions, mainly when conflicts of interest are involved. Unethical behavior can even include speaking down to patients or treating them unjustly based on their sex, ideologies, nationality, ethnicity, religion, or sexual orientation, all of which undermine the respect and dignity of their patients.
Professional Misconduct
Professional misconduct in nursing encompasses a range of actions that deviate from established standards of care that are required under the Massachusetts Nurse Practice Act. While professional misconduct allegations can vary in nature and severity, the Board of Nursing examines each and every misconduct occurrence to review whether it affects a nurse's ability to provide appropriate and safe patient care. Some examples of professional misconduct include:
- Negligent Performance: Negligent performance can include any departure from the accepted standards of the nursing profession, mainly when practicing without the necessary skill and capability. Some examples of negligent acts can consist of surgical errors, medication errors, charting errors, and negligent supervision of patients.
- Practicing Under Compromising Conditions: This can extend to practicing with developmental disabilities, mental incompetencies, chemical dependencies, physical disabilities, or having a history of sexually predatory behavior.
- Substance Abuse: Practicing under the use of illicit substances, certain prescription medications, or alcohol is a severe violation, impacting the nurse's ability to provide safe care. Depending on the action, nurses who practice while under the influence may also face criminal charges as well as civil penalties or lawsuits.
- Past Disciplinary Actions: If nurses have been investigated by other states or jurisdictions and fail to report the investigation to the Massachusetts Board of Nursing, they can face revocation or suspension of their nursing license.
- Conduct Harmful to the Public: This can include engaging in any behavior that endangers public safety, such as careless performance of duties or practicing medical procedures beyond one's competence.
- Improper Management of Medical Records: This includes failing to document patient information accurately or not providing medical records as legally required.
- Inappropriate Fee Practices: While fee-splitting practices may be allowed under certain circumstances, agency nurses must not engage in irregular financial practices such as disproportionate fee splitting or profiting from the sale of drugs outside of acceptable partnerships. Some other examples of fraudulent fee splitting may also include benefiting from attorney referral checks in personal injury matters.
- Fraudulent Billing: Fraudulent billing can include deceitful billing practices, particularly involving Medicare or Medicaid billing.
- Non-Compliance: Non-compliance can range from mere reporting failures to the Board of Nursing, failure to pay license fees, or failure to engage in disciplinary investigations, even against oneself.
Challenges That Are Unique to Agency Nurses
As a registered nurse in Massachusetts, being aware of the disciplinary processes and potential consequences of ethical, professional, and moral misconduct is crucial. The Board of Nursing's disciplinary procedures can be intricate, especially for agency nurses, where communication challenges between their contracting hospital and employment agency are common.
While nurses in full-time positions at healthcare facilities generally benefit from a more structured communication system, which may include early alerts about potential professional misconduct complaints through direct interactions with superiors or administrative staff, agency nurses are often not given this benefit. It is not uncommon for an agency nurse to first lose a contract at a hospital and then quickly face termination from their agency without much explanation.
The Importance of Early Legal Representation
Without the benefit of prior notice, agency nurses may face sudden and unanticipated dismissals, significantly impacting their professional stability and future contracting prospects. In some instances, agency nurses might only become aware of a misconduct issue when it escalates to a formal investigation by the Massachusetts Board of Nursing.
At this juncture, the importance of early legal assistance cannot be overstated. Because misconduct allegations at the agency level can often arise from misunderstandings or errors, early intervention can help. Early intervention in these investigations can include developing a strategic defense, which can sometimes mitigate the escalation. Prompt representation is also vital when preserving the nurse's professional reputation, safeguarding their nursing license, and ensuring continued employment with their agency.
The Disciplinary Process for Agency Nurses in Massachusetts
The state's Board of Nursing governs and administers the disciplinary process for agency nurses. It is also subject to the state's Administrative Laws and Chapter 66 of its General Laws. While the Board of Nursing treats each complaint as a unique investigatory matter, they clarify that disciplinary action may be used to “ensure that a nurse's unsafe behaviors or practice deficiencies are renumerated.” The general phases of the disciplinary process are summarized below.
The Complaint and Investigatory Phase
According to the Board's published information on the complaint process, 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.
During an investigation, investigators can use a variety of tools and methods to gather helpful information. Investigators may ask to speak to colleagues, patients, and the agency to gain any perspectives on the alleged occurrence of misconduct. Nurses who are the subject of the investigation may be requested to contribute to the process by providing written or oral statements. It is important to note that failure to comply with the Board's request for information can result in further allegations of professional misconduct.
The Resolution or Hearing Phase
Following the completion of an investigation, the Board may choose either to dismiss the complaint or to advance the disciplinary process by issuing a formal complaint. If a formal complaint is filed, it can be "resolved" through a voluntary settlement agreement or may proceed to a formal hearing.
In the case of a settlement agreement, the nurse in question is typically required to agree to specific disciplinary actions. These may include license suspension, the completion of mandatory education units, or the payment of fines. Sometimes, a settlement opportunity may be wiser if the chances of succeeding at a hearing are unpredictable. In other words, the known disciplinary consequences of a settlement agreement may far outweigh the unknown and potentially harsher consequences issued by a hearing officer.
Should a settlement not be reached, the matter may escalate to a formal hearing before an administrative law judge. These hearings resemble a small trial, allowing both parties the opportunity to present evidence, testimonies, witnesses, and legal arguments. Given the complexity of these proceedings, self-representation can be an extremely large risk to take.
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 hearing officer can determine to dismiss the allegations.
The Possible Appeal Phase
If you choose to pursue an appeal against the decision, you must comply with the state's strict guidelines and timeframes for appeal requests. While each case is different, an appeal may be successful if you can demonstrate that the hearing officer's decision was clearly contrary to law and evidence, that newly discovered evidence has been found that may be sufficient to reverse the board's decision, or that the hearing officer did not thoroughly examine the case close enough, whether that be in terms of the evidence, legal arguments, or public interest.
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, the Lento Law Firm's Professional License Defense Team members have successfully navigated nursing appeals for nurses across Massachusetts.
Areas We Serve in Massachusetts
Our Team can help you craft a defense regardless of what nursing agency you are employed with. We provide strategic representation throughout Massachusetts, including for nurses with active contracts and agencies such as Northeast Med Staff, Mindful HealthCare Agency, Ryben Staffing, IntenlyCare Inc., K&A Nursing Staffing Agency, and Allegiance Nursing.
Boston
As the capital of the state and the most populous city, Boston is the first thought of by many people when talking about Massachusetts. The city is critical to the state's history and traces back to the American Revolution as one of the country's first official cities. Due to its proximity to Harvard and many other Ivy League universities, Boston's financial, healthcare, and educational infrastructure is second to none. Prominent healthcare centers include Massachusetts General Hospital, Bringham and Woman's Hospital, UMass Memorial Medical Care, and Baystate Medical Center.
Worcester
Worcester is the second most populous city in the state and sits approximately 40 miles west of Boston. Prominent manufacturing centers and the healthcare and insurance industries drive the city's economy. Many agency nurses commute to large healthcare centers in Boston but can also stay local and accept contracts at Adcare Hospital or Athol Hospital.
Cambridge
Located in Middlesex County, Cambridge is home to Harvard University as well as Kendall Square, an up-and-coming area of the town known for its home to many start-up companies. In addition to the countless tech companies, consulting agencies, financial firms, and pharmaceutical development companies, many healthcare agencies and hospitals provide contract opportunities for agency nurses.
Brockton
Commonly referred to as “the City of Champions,” Brockton sits between Boston and Rhode Island. The city further supports a significantly developed healthcare system, noting three hospitals: Signature Healthcare Brockton Hospital, Veterans Administration Healthcare Hospital, and Good Samaritan Medical Center.
How Can the Lento Law Firm Professional License Defense Team Help Me?
The Lento Law Firm's Professional License Defense Team is equipped with the reputation and experience essential for safeguarding your nursing license. If you find yourself abruptly released from a contract, perhaps without fair notice and the opportunity to explain your side to your agency, this could signify that potential misconduct allegations are brewing at the state level. While it's understandable to feel discouraged, you may be able to challenge the misconduct allegations that are threatening your career successfully. Our Team is standing by to devise a strategic defense plan tailored to your unique challenges.
When an investigation by the state Board is underway, our Team will help you navigate the complex processes of complaints and inquiries. We provide representation in settlement negotiations and, when required, during administrative hearings. Our respective approach is comprehensive because we take the time to understand the detailed factual and legal arguments that will support your defense.
If you have already received disciplinary results from the Board or administrative judge, we can offer guidance and support you in filing an appeal request.
Contact the Lento Law Firm's Professional License Defense Team Today
If you're dealing with contract termination from your hospital, agency dismissal, or an investigation before the Massachusetts Board of Nursing, you may have more resources and support than you think you do. For help discussing your next steps, contact the experienced Lento Law Firm's Professional License Defense Team today. We can provide the essential support and advocacy you need. Contact us today at 888-535-3686 or use our convenient online contact form.
