Certified registered nurse anesthetists (CRNAs) play an important role in Montana health care. Like anesthesiologists, CRNAs can supply anesthesia services in any setting, from dental offices to hospitals. Because they are not required to work in conjunction with anesthesiologists, and because they charge a much lower fee for services, they save patients, institutions, and the state of Montana millions of dollars every year.
CRNAs are highly regulated, though. This is a career that's not open to just anyone, and those who work in the field are held to high standards. To become a CRNA, you must first complete a bachelor's degree in nursing. That's only the beginning of your education, though. You must also earn a doctorate degree. With that in hand, you must complete the CRNA National Certification Exam. And if you survive all of that, you still have to go through the initial Montana licensing process and renew your license every two years.
No wonder, then, that a complaint can strike immediate fear into the heart of any CRNA. Complaints can lead to investigations, investigations can lead to hearings, and hearings can lead to sanctions, including license revocation. Your license is your livelihood. Without it, you can't practice your profession, and all the time, energy, and hard work you've put into your career comes to nothing.
Complaints don't have to end this way, though. The Lento Law Firm's Professional License Defense Team believes in you and what you do, and we want to do everything we can to protect you and your career. We know the law. We also know the Montana healthcare system and how to navigate it. Most important of all, though, we're committed to making sure you're treated fairly and that you get the justice you deserve. If you're facing an investigation for any reason, contact the Lento Law Firm today to find out how we can help. Call 888-535-3686 or use our automated online form.
What can put your CRNA license at risk?
Montana CRNAs are under the direct jurisdiction of the Montana Board of Nursing, which is a part of the state's Department of Labor and Industry. As such, CRNA licensing is ultimately a matter of Montana state law.
Nursing conduct, including the conduct of CRNAs, is governed by Title 37, Chapter 8, and more specifically, Rule 24.159.2301. That rule identifies twenty-two separate offenses, any one of which can lead to disciplinary action. Among the most common:
- Patient abuse or neglect: Active verbal or physical abuse is among the most serious charges any CRNA can face. You can also be charged for patient neglect or simple negligence in your duties as a CRNA.
- Mishandling of drugs: As a CRNA, you are licensed to handle all types of medication. Any misuse of this privilege can lead to charges. That includes stealing medication, selling medication, and using medication for personal use. You can get into trouble for far less serious offenses, as well, though, such as administering the wrong medication or anesthesia, failing to properly document the drugs you dispense, or submitting the wrong paperwork to a pharmacy or insurer.
- Fraud: Any act of professional dishonesty committed for personal gain qualifies as fraud. Examples include filing inaccurate insurance claims, overstating your credentials as a CRNA, or falsifying patient records.
In addition, you can be investigated for “failing to utilize appropriate judgment” as a nurse, “failing to exercise technical competence,” or “failing to follow defined policies or procedures.” These are particularly common offenses simply because they are so broadly defined and can be used to justify almost any investigation.
No matter what specific charges may have been leveled against you, it's important that you take them seriously. Any charge can lead to license suspension or revocation. What does it mean to take a charge seriously? It means hiring the very best legal representation you can. The Lento Law Firm's Professional License Defense Team has dealt with hundreds of license defenses. They have the background and experience to protect your rights, and they give you the best chance of successfully defending yourself.
The Disciplinary Process for CRNAs in Montana
The Montana Nursing Board cannot simply issue a sanction. The state has clear rules and procedures that the Department of Labor and Industry must follow any time a licensed professional in the state is charged with misconduct. In addition, you are entitled to certain due process protections, such as the right to a presumption of innocence, the right to notification of the charges, the right to inspect all evidence against you and the right to legal representation.
Cases typically happen in four stages.
- First, someone lodges a complaint against you with the Montana Nursing Board or the Department of Labor and Industry.
- The Department then conducts an investigation into the complaint.
- If the Department determines the complaint has merit, it holds a formal hearing into the matter.
- Finally, the Department either clears you of charges or assigns an appropriate sanction.
Anyone may lodge a complaint against you as a professional with the Montana Department of Labor and Industry. In practice, complaints tend to originate with
- Supervised employees
- Other staff
Keep in mind, however, that a complaint is not an official charge. Before proceeding with an investigation, the Department of Labor and Industry must first determine whether the charge is credible and actionable. Generally speaking, the Department doesn't get involved in fee disputes, for instance, and you won't find yourself in trouble simply because someone dislikes your bedside manner.
Even at this early stage, a Lento Law Firm can be invaluable. Not only can they start building your defense based on the nature of the complaint, but they can sometimes intervene and convince the Department that the complaint doesn't warrant a full investigation.
Assuming it decides to move forward with the case, the Department then initiates an investigation to decide whether or not the complaint has merit, that is, whether there is some grounds to believe you are guilty of professional misconduct.
If you're being investigated, you are entitled to a Notice of the Charges. This notice provides details of the allegation as well as a full list of your due process rights. Ordinarily, investigators begin their work by asking you to respond to the allegations. Your Lento Law Firm attorney can help you to formulate this response.
Investigators have broad authority to pursue any and all avenues of investigation and can subpoena witnesses. They are likely to question anyone who might have knowledge of the case, including your supervisors and colleagues. In addition, they'll collect any physical evidence.
Once they've completed their investigation, investigators then submit a written report of their findings along with a recommendation as to whether or not the case should proceed to a formal hearing.
If you've seen a courtroom drama on television, you have some general idea of how a professional license hearing works. Both sides get an equal opportunity to make their cases, for instance. That means making arguments, presenting evidence, calling witnesses to testify, and cross-examining any witnesses against you. Both sides are entitled to legal representation, though the Department of Labor and Industry is not responsible for funding this representation. A Hearing Official or a panel of Department officials presides over the case and renders a final judgment.
However, a Department hearing is not the same as a criminal trial. For one thing, it doesn't generally happen in a courtroom. Rules are more informal. Some types of hearsay evidence may be admissible. And, perhaps most importantly, decision-makers don't have to find you guilty “beyond a reasonable doubt.” Instead, they use a lesser legal standard known as “preponderance of the evidence. According to this standard, they must find you guilty if they believe it is “more likely than not” that you committed an offense.
What this all means is that while you certainly need an attorney to represent you, not just any lawyer will do. You need someone from the Lento Law Firm. The attorneys at the Lento Law Firm work specifically in the field of license defense. They have courtroom experience, and they will bring it to bear on your case. They recognize, though, that rules of procedure are different in Department of Labor and Industry hearings. They know what to expect, and they know how to use the system to the best advantage.
A Hearing Official or panel has several options available to them should they find you guilty of an offense. Typical sanctions include
- Formal reprimand
- Conditions, limitations, or restrictions on your license
- Administrative fines
- License probation
- License suspension
- License revocation
Of course, your Lento Law Firm attorney's primary objective is an innocent verdict. Should the verdict go against you, though, they will work with you to file a request for judicial review. This takes place before a Montana District Court judge. Finally, should all other options fail, Lento Law Firm attorneys are skilled negotiators and can work with the Nursing Board to ensure your penalty is fair.
Why You Need Someone from the Lento Law Firm's Professional License Defense Team
Why do you need someone from the Lento Law Firm to represent you? Three reasons:
- First, everything is at stake. It's no exaggeration to say that if you should lose your license defense, it could be the end of your career. If the Nursing Board decides to revoke your license, you'll find it virtually impossible to find another job in the healthcare industry. In fact, you may very well struggle to continue in the industry even if you are only suspended.
- Nursing anesthetist conduct cases can be complicated. What you do isn't simple, and that means it can sometimes be difficult just to establish the facts of a case. In addition, defenses usually involve subtle readings of rules, policies, and the law. None of that takes into consideration the complexity of judicial procedures.
- Finally, you must recognize that the Montana Nursing Board isn't on your side. You may be used to thinking of the Nursing Board as an advocate, a state agency that keeps you apprised of changes in the law, that helps you renew your license, and that lobbies on your behalf with the state legislature. If you've been accused of misconduct, though, the Nursing Board is now your adversary.
For all these reasons, you should never go into a license defense on your own. You're good at what you do, but you're not an attorney, and when you're facing misconduct charges, you need an attorney.
Likewise, though, you don't want to hire a local or family attorney. Local attorneys are highly skilled at what they do, but professional license defense is a very particular area of the law. Local attorneys know their own local judicial system and can be valuable counselors if you've been accused of a DUI or some other minor charge. Your CRNA license, though, is granted by the Nursing Board, a state agency, and it's the Department of Labor and Industry that will ultimately decide your fate. You need someone to represent you who understands health care in Montana, who has worked directly with the Nursing Board, and who has an in-depth understanding of state law.
The Lento Law Firm was built to help professionals respond to charges. We've represented hundreds of healthcare professionals, defending them against every type of charge. No one is better qualified to take your case.
What Can the Lento Law Firm Do for You?
Your CRNA license means everything to you. It gives you the right to practice your profession. It certifies that you are qualified and experienced. It lets patients know that you can be trusted. If that license is being threatened in any way, you can't afford to take chances. You absolutely must do everything you can to defend yourself, and that starts with hiring the best legal representation you can.
The Lento Law Firm's Professional License Defense Team understands your situation. They have the background and experience to take on the Montana Department of Labor and Industry and the Nursing Board. Most importantly, though, they're committed to making sure your rights are protected.