If you're working as a nurse through a nurse staffing agency in Montana – whether assigned on a temporary or a semi-permanent basis, or as a travel nurse – you appreciate how important your nursing license is to your ability to make a living. It goes without saying that in almost every case, without your license, you would not be able to work as a nurse at the level you presently do. That's why it is so important that you take steps to effectively defend your license if a misconduct complaint has been filed against you with the Montana Board of Nursing. The Lento Law Firm Professional License Defense Team has helped nurses across the country, including Montana, protect their licenses, their reputations, and their careers during disciplinary investigations and proceedings. Call us today at 888.535.3686 or schedule a confidential consultation to learn more about how we can help.
Agency Nurses in Montana
Montana's Board of Nursing does not license agency-employed nurses any differently than it does nurses employed directly by any other organization. There are no specific requirements that a licensed nurse must meet to work through a nurse staffing agency, whether the work assignment is temporary, long-term, or as a travel nurse. In many cases, nurses working through an agency will stay at the same site for months or years; in others, the assignment may end after a week.
The temporary nature of many agency nurse assignments can make it more difficult for a nurse who is being investigated for misconduct to stay employed. Employers may be more willing to cut ties with a nurse who is under investigation even before a decision is made about whether the allegations made against the nurse have merit or should result in any disciplinary action. In many cases, the disciplinary action taken against a nurse will include a requirement that the employer monitor and report to the BON about the nurse's progress and compliance with disciplinary conditions. Many employers will find it easier to ask the nurse staffing agency to replace a disciplined nurse than to take the time and effort required to meet the BON's monitoring and reporting requirements for the agency nurse.
This can also be the case where a nurse has elected to enroll in the Montana Recovery Program for nurses and other healthcare professionals who have drug or alcohol dependency issues. In many cases, one of the conditions of the nurse returning to work after starting their recovery program is that their employer be willing to assign someone to monitor and report on their work and any incidents that may reflect a relapse of the dependency or mental health issues that caused the nurse to enroll in the program in the first place. Employers working through nurse staffing agencies may not be as willing as other employers to take on this responsibility, making it harder for a nurse working through a nurse staffing agency to find employment.
The Montana Board of Nursing
Nurses in Montana are licensed by the Montana Board of Nursing (BON). First-time licenses are issued to nurses who meet the educational requirements and pass the appropriate exam (such as the NCLEX exam) and a nationwide criminal background check. Nurses can also secure a license in Montana if they are licensed in another state.
Montana nursing licenses must be renewed every two years. Montana recently dropped its continuing education requirement for nurse license renewals, though the BON continues to provide free online continuing education for nurses through its website.
Nurses who work as agency nurses in Montana are licensed in the same way as other nurses; the BON does not distinguish between a nurse employed as an agency or travel nurse and a nurse employed in any other way when it comes to licensing.
Misconduct Registry in Montana for Nurses
The Montana BON uses the License Search tool of the state's Department of Labor & Industry (DLI) to make disciplinary and other nurse registration information available to the public. Anybody – including employers -- can use the tool to search for any disciplinary records for a specific nurse. This means that nurse staffing agencies, as well as their healthcare clients, can use the website to determine whether any nurse has ever been disciplined by the BON. Because disciplinary records stay with the nurse's registration information on the website for years after any discipline has ended, even a single disciplinary ruling can follow a nurse for the rest of their career.
Certification as an Agency Nurse in Montana
Montana doesn't have a separate certification requirement for agency or travel nurses. A nurse who is employed through a nurse staffing agency must still meet the requirements for the position they're assigned to. The Montana BON issues the following types of nursing licenses and certifications:
A nurse with an APRN license can be certified as a Nurse Practitioner (CNP), Nurse Midwife (CNM), Nurse Anesthetist (CRNA), or Nurse Specialist (CNS). APRNs can also apply for authority to write prescriptions. The Montana BON also separately licenses Medication Aides to work in assisted living and skilled nursing facilities.
The two main routes for nurses with the required educational backgrounds to secure a nursing license in Montana is by taking and passing the NCLEX, or by “endorsement” based on an existing nursing license from a state that is part of the nationwide Nurse License Compact. Nurses must also submit information and their fingerprints for a comprehensive criminal background check.
Once licensed, a nurse in Montana is eligible to be employed in any care job that requires the level of license that the nurse holds. This is the case for jobs where the nurse is working directly for the health care facility, and jobs secured through a nurse staffing agency.
Montana Board of Nursing Disciplinary Investigations
Anyone can file a complaint against a nurse by using the Montana BON's online complaint filing portal. Complaints against nurses are reviewed, investigated, and processed by the Montana Department of Labor & Industry's Employment Standards Division, which handles professional license complaints for a wide range of licensed positions in Montana, in addition to nurses.
Complaints will be investigated if they relate to the types of conduct that the BON regulates; in some cases, complaints are not investigated because the issue relates to something – such as a billing or personality dispute – that the BON doesn't cover. Complaints that do relate to professional misconduct are investigated. Investigations can take months, and may result in the complaint being dismissed, or with the BON deciding to bring charges against the nurse based on the information presented to the board by a department lawyer.
If the BON decides to discipline the nurse, a DLI attorney will send the nurse a Notice of Proposed Board Action and an Opportunity for a Hearing. The notice will summarize the facts behind the alleged misconduct, the violations of Montana law that the BON believes have occurred, and the disciplinary action that the BON intends to impose on the nurse. The nurse can accept the proposed discipline or can request a hearing.
When disciplinary matters reach this stage, having the help of an experienced attorney from the Lento Law Firm Professional License Defense Team can make all the difference between accepting a disciplinary result that can damage your career for years or decades to come, or a resolution that has little or no effect. You have a right to have an attorney advise you at any stage of the investigation and disciplinary process, including when you're being questioned by the DLI investigator. Your attorney can make sure that you only answer fair, clear questions that you understand and that your answers are complete and clear and understood by the investigator. This will help ensure that the process is fair and that you're not disciplined based on the investigator's misunderstanding of your answer to a poor or unfair question.
The fact is that most people don't regularly face the kind of situation where they are being interviewed by someone who is investigating them for alleged misconduct. These kinds of interviews can be very stressful. Working with an experienced attorney who can help prepare you for the experience in advance and who can be there to help you through it will make it more likely that you will provide clear and accurate responses to the investigator's questions.
Montana Nurse Disciplinary Standards
Montana has high expectations for licensed nurses. Both licensed practical nurses and registered nurses are expected to meet certain standards and to have knowledge of the “biological, physical, behavioral, psychological, and sociological sciences” as well as nursing procedures and theory. Registered nurses are responsible for “assessment, nursing analysis, planning, nursing intervention, and evaluation in the promotion and maintenance of health.” They are also responsible for “prevention, case finding, and management of illness, injury, or infirmity, and the restoration of optimum function.”
Montana has practice standards that licensed practical nurses and registered nurses are expected to follow. In addition, LPNs must follow more general standards that apply to the “nursing process,” while RNs are required to follow general standards that relate to their responsibilities as members. APRNs also have their own particular standards, though all APRNs are also registered nurses, and so are expected to follow the RN practice standards as well. These standards provide the framework that the BON uses when it evaluates the performance of a nurse who has been accused of misconduct.
Montana lists a number of types of “unprofessional conduct” that can result in a nurse being disciplined. Some of these are:
- Using poor judgment in “administering safe nursing practice”
- Lacking the technical competence to provide proper nursing care
- Not following established patient care practices or procedures
- Abusing patients, verbally or physically
- Making unauthorized changes to patient care records, including falsifying information
- Diverting a patient's medication for any reason
- Failing to properly supervise subordinates who are providing patient care
- Disregarding the patient's right to privacy
- Violating state or federal laws regarding drugs
- Leaving a work assignment without notifying the appropriate personnel
- Failing to report misconduct committed by another licensed nurse
- Refusing to cooperate with the BON in any investigation
Defending Yourself Against Montana BON Nurse Disciplinary Investigations
When you're being investigated by the DLI in connection with a nursing misconduct complaint, you have a right to the assistance of an experienced professional license defense attorney throughout the process. Investigations typically take months to complete and can be very stressful. In addition to being interviewed by the investigator – which can happen more than once – you may find that your co-workers have also been interviewed about you and the incident reported in the misconduct complaint and that your employer has been subpoenaed to provide the DLI with patient or work records as part of the investigation. It can be enormously helpful to be able to rely on an experienced attorney throughout this process to help prepare you for any interviews and to help you understand what's happening as the investigation continues.
Your license is the key to your ability to make a living as an agency or travel nurse. When it and your career are on the line because of a misconduct investigation, you owe it to yourself and to your future to defend yourself during that investigation as effectively as possible. Working with one of the attorneys from the Lento Law Firm Professional License Defense Team will help you rest easier at night, knowing that you have someone in your corner who has the experience and understanding to provide you with effective assistance throughout this difficult process.
Valuing Your Montana Nursing License
It's very simple – without a nursing license, you can't work as a nurse. However, the damage that professional discipline can have on your nursing license goes beyond that. Some forms of discipline will allow the nurse to keep their license – provided their employer provides periodic reports to the BON confirming that the nurse has met a condition of their professional discipline. When an employer learns that working with a nurse means taking on this added burden – whether the nurse is a full-time hire or is provided through a nurse staffing agency – the employer may be less likely to work with that nurse.
This problem can also occur if you decide to take advantage of the Montana Recover Program for nurses fighting substance abuse or mental illness challenges. In many cases, the program will only authorize an enrolled nurse to return to work if their employer agrees to provide the program with periodic updates about the nurse's work behavior. Here, too, the added burden of having to designate a specific person to supervise an agency nurse and periodically report to the BON about that nurse may discourage an employer from accepting that nurse from the staffing agency.
The Lento Law Firm Professional License Defense Team understands these challenges and how they may affect agency nurses more than nurses who have a long-term relationship with a specific employer. When we are retained by an agency nurse to represent them in a disciplinary investigation or proceeding, we will always keep in mind the fact that they are working as an agency nurse so we can focus our efforts on resolving the matter in a way that preserves the nurse's ability to continue to do the kind of work that they prefer.
Telling Your Side of the Story to Montana DLI Investigators
It is very natural for your first reaction upon learning that you're under investigation because of a misconduct complaint to be to reach out to the DLI investigator to explain the situation, to “set the record straight,” and to “clear up this big mistake.” Nobody likes to find themselves being investigated for misconduct, and the hope in contacting the investigator directly is that a quick conversation can make the whole thing go away.
This rarely works, unfortunately, and can even backfire. The DLI investigator has an obligation to the public to conduct a full and fair investigation of misconduct complaints, and the fact that you contact them directly before being asked to sit for an interview won't change that. In addition, the information you provide might even hurt you, especially if it's misunderstood by the investigator.
In any professional misconduct investigation, there will be a time when you can tell your side of the situation. That's typically during the interview with the investigator. This is something your attorney can help you prepare for, in addition to being there to make sure you're asked fair and clear questions that you understand, and that any information you may want to provide is (a) information that is relevant to the case; (b) is information that can help your case; and (c) is presented in a clear way so that the investigator doesn't misconstrue it and use it against you.
Allegations That Can Put Your Nursing License and Ability to Work as an Agency Nurse at Risk
As discussed above, Montana's nursing regulations include a long list of the general types of misconduct that can result in a nurse being disciplined by the BON. Some specific examples of misconduct that nurses are frequently disciplined for include:
- Physically abusing a patient
- Mentally abusing a patient, typically through verbal abuse
- Sexually abusing a patient
- Ignoring the patient-nurse boundary; this can include accepting large gifts or loans from patients, as well as entering into a physical relationship with a patient
- Stealing prescription drugs from the workplace, whether for others or for personal use
- Working while intoxicated or under the influence of legal or illegal drugs
- Failing to properly complete patient care records
- Fraud committed against an employer, which can include falsely reporting work hours or work performed during a shift
- Fraud committed against an insurance company by submitting false care reports
- Abandoning a patient by leaving without making sure the patient had someone else to care for them
These are just some of the more common examples; the BON has the authority to discipline for a wide range of nursing misconduct and won't hesitate to do so when an investigation uncovers a situation where a nurse has disregarded their obligation to provide a patient with proper care.
What is the Disciplinary Process for Montana Agency Nurses?
Agency nurses in Montana face the exact same disciplinary process as other licensed nurses. Misconduct complaints will be screened to make sure they allege misconduct that the BON can discipline for. Those that do are assigned to an investigator, who will typically take months to conduct an investigation of the allegations. The investigation will typically include interviews of the person who filed the complaint as well as the nurse accused of misconduct, and can include interviews of co-workers and others who the investigator believes may have helpful information, such as relatives of the patient who may have been present for a particular incident. Patient and employment records may be subpoenaed.
When the investigation is complete, a DLI attorney will present the results to the BON and the BON will decide whether to bring disciplinary charges against the nurse. If it does so, and the charges cannot be resolved through negotiation and an agreement between the BON and the nurse (as many are), a hearing will take place to determine whether the nurse should be disciplined.
Montana Agency Nurse Hearing Procedures
Nurse disciplinary hearings follow a standard set of procedures set forth in Montana law. The hearing will follow the rules set by Montana's Administrative Procedures Act as well as the state's Rules of Civil Procedure and Rules of Evidence. Working with one of the experienced attorneys from the Lento Law Firm Professional License Defense Team will help tremendously if you decide to take your misconduct complaint to a hearing. There are specific procedures that must be followed when it comes to what evidence can be introduced, as well as when it comes to questioning and cross-examining witnesses. Our attorneys have experience with these requirements and can help protect your rights throughout the entire proceeding.
After the hearing, the BON has a “reasonable amount of time” to issue a decision in the form of “findings of fact” and an order based on those findings. The standard of proof in disciplinary matters is lower than the “beyond a reasonable doubt” standard that applies in criminal cases; it's what is known as the “preponderance of the evidence” standard, which essentially means that the board must find it “more likely than not” that you committed the misconduct.
Appeals of Misconduct Findings After a Hearing
If you disagree with a disciplinary decision issued by the BON, you may appeal it to Montana's district court, which is the trial-level court in Montana. There are strict time limits and other requirements that apply to these types of appeals, including where the appeal is filed and what information it must include. The Lento Law Firm Professional License Defense Team can help you with an appeal of a disciplinary hearing decision, even in cases where we were not involved at the hearing stage. Our experienced attorneys understand the appeal requirements in Montana and, where appropriate, will be able to prepare, file, and argue a timely and forceful appeal on your behalf.
Montana BON Consent Agreements
Many disciplinary matters are resolved, typically after negotiation, with a consent agreement. The terms of these agreements often become part of the nurse's public record, so what they say and any discipline they impose are very important. The attorneys from the Lento Law Firm Professional License Defense Team have the experience with and understanding of Montana's nursing laws and regulations to effectively negotiate with the BON on behalf of our nursing clients. In cases where you regularly work as an agency nurse, we will pay particular attention to how any consent agreement reached could affect your livelihood and will attempt to resolve matters so that you can continue to work as an agency nurse with as little disruption as possible.
Why You Need an Agency Nurse Defense Attorney in Montana
Trying to handle a misconduct investigation or negotiate a resolution when the BON brings charges can be incredibly stressful, not to mention difficult. Working with one of the experienced attorneys from the Lento Law Firm Professional License Defense Team will give you the benefit of their years of experience with professional disciplinary investigations and proceedings and their understanding of the professional standards that apply to nurses in Montana. You will have someone on your side who has been through this kind of difficult situation before and who can bear much of the day-to-day burden for you. And because our experienced attorneys understand the unique needs that agency and travel nurses have, you are much more likely to be able to resolve the misconduct claims in a way that will allow you to continue to work as an agency nurse.
How an Agency Nurse Defense Attorney Helps in Montana
Some of the specific ways that the Lento Law Firm Professional License Defense Team can help you protect your ability to continue to work as an agency nurse in Montana include:
- Preparing you for being interviewed by the investigator assigned by DLI to review the misconduct allegations made against you
- Being with you when you're interviewed by the DLI investigator to help make sure the questions you're asked are fair, clear, and understandable
- Conducting a separate investigation, where doing so might help uncover helpful information, evidence, or witnesses that the DLI investigator missed
- Negotiating the possible resolution of misconduct claims with the BON
- Representing you aggressively and fairly at any hearing that may take place
- Preparing, filing, and arguing an appeal of an adverse hearing decision
It can be tremendously helpful to have someone working with you who understands what's required at each of these stages and is ready to step in and protect your rights at each step of the disciplinary process.
The Lento Law Firm Professional License Defense Team Can Help You Protect Your Nursing License in Montana
The Lento Law Firm Professional License Defense Team regularly helps nurses, medical professionals, and other professional license holders in Montana and across the country protect themselves when misconduct claims are brought against them. Our attorneys understand how important your nursing license is to you, and we are ready to work diligently for you to defend your rights throughout the entire misconduct process when a complaint threatens your ability to make a living.
Call the Lento Law Firm Professional License Defense Team today at 888.535.3686 or schedule a confidential consultation with one of our experienced professional license defense attorneys to learn more about how we can help. You have worked hard to earn your nursing license; let us help you protect it!
