We Can Help If Your Nurse's License Is In Jeopardy
Attorney Joseph D. Lento and his Professional License Defense Team helps nurses whose professional licenses are threatened by allegations of misconduct or wrongdoing. Contact the Lento Law Firm at (888) 535-3686 or use our online form today to schedule a consultation.
It's no secret that nurses are at the heart of our healthcare system. They provide more direct, "hands-on" patient care than any other healthcare worker, and they act as the gatekeeper for the entire system, providing education, support, and triage services on the frontlines. Nurses are the "glue" that keeps our healthcare system running smoothly, and this becomes especially true in less-populated states like Nebraska, where the majority of residents live in rural locations spread out across larger sections of open land.
As a result, many residents don't have easy access to advanced healthcare facilities and treatments and rely on registered nurses and other certified medical professionals to provide a variety of care.
It's crucial, then, that licensed nurses in Nebraska have the resources they need to defend themselves against accusations of wrongdoing. The Division of Public Health Investigators in the Nebraska Department of Health & Human Services (DHHS) is responsible for investigating allegations of this kind, and they do take the job seriously. Having an experienced defense attorney who understands the Nebraska disciplinary process can help you defend your license and protect your career.
Attorney Joseph D. Lento and the Lento Law Firm Professional License Defense Team have both the skill and knowledge needed to navigate this process and help you achieve the best possible outcome. The Lento Law Firm has worked with nurses and other professionals across the country in similar situations, and they are ready to help you too. Contact the Lento Law Firm today at 888-535-3686 to discuss your case and talk about your options.
How Are Nurses Regulated in Nebraska?
Like most licensed professionals, nurses are regulated by a governmental agency. This regulation includes several methods of oversight, ranging from the initial review of credentials to managing competency exams and verifying continuing education requirements. Responding to complaints of negligence and other types of wrongdoing fall under this heading as well, helping to protect the public from inadequate or incompetent care.
The United States utilizes what is known as the professionally led model, a governing method that grants regulatory authority to the states and jurisdictional territories (known as Nursing Regulatory Bodies, or NRBs). Each NRB then adopts and enforces its own version of the Nurse Practice Act, a legal document that outlines everything about the nursing profession and how it will be managed within a specific jurisdiction.
In Nebraska, nursing regulation begins with the Nebraska State Board of Nursing, which acts as an Advisory committee on issues relating to the practice of nursing, while also providing licensing instruction, information, and education to nurses. The Board is part of DHHS, which provides additional oversight as well as the investigation of complaints against licensed professionals.
In addition to this local regulation, the NRBs joined together to form an additional layer of oversight and governing known as the National Council of State Boards of Nursing (NCSBN). The NCSBN is a not-for-profit organization that allows the nursing regulatory bodies to collaborate on the many aspects associated with governing the nursing profession.
This council includes the NRBs from all 50 states, Washington DC, and four US territories, and it's why you'll find similar licensing requirements and procedures across the country.
What Types of Nursing Licenses Are At Risk?
The state of Nebraska issues three primary types of nursing licenses:
- Licensed Practical Nurse (LPN)
- Registered Nurse (RN)
- Advanced Practice Registered Nurse (APRN)
- There are also several specialties within the APRN classification:
- Certified Nurse Midwife (APRN-CNM)
- Clinical Nurse Specialist (APRN-CNS)
- Certified Registered Nurse Anesthetists (APRN-CRNA)
- Nurse Practitioner (APRN-NP)
All of these licenses would fall under the Nebraska Nurse Practice Act, and would be subject to the regulations, statutes, and disciplinary actions set out by the state. It's also worth noting that there are multiple regulations and statutes that could apply here, depending on your specific practice.
What Types of Allegations Can Endanger A Nursing License?
As with all medical professionals, nurses are held to a high standard of care. Violations of those high standards include a wide range of actions and behaviors but often fall into one of the following groups:
- Unprofessional conduct. This can include a variety of allegations, from something as simple as using unsuitable language to more serious allegations, such as having an inappropriate relationship with a patient or coworker.
- Patient abuse or neglect. Failing to provide proper care to a patient or mistreating a patient, be it physically, verbally, or emotionally, can result in a suspension or revocation of a nursing license.
- Mishandling/misuse of drugs. Proper administration of medication is an important function of nursing. Misuse and mishandling of these medications is a serious allegation and could cause a loss of privileges if proven to be true.
- Substance abuse. In addition to mishandling a patient's medication, excessive use or abuse of drugs and alcohol raise a red flag and could result in disciplinary action. Also, note this allegation isn't limited to use on the job; excessive use outside the scope of your practice could also cause you to come under scrutiny.
- Theft/Fraud. This includes intentionally falsifying a patient's records, billing insurance companies for services that were not provided, and stealing from a patient, be it physical items (such as money and jewelry) or electronically appropriating the patient's identity.
- Convictions and judgments. Certain criminal convictions can limit or revoke a nursing license. Civil judgments can also affect your license if they are awarded in conjunction with allegations of negligence, malpractice, or other professional wrongdoing.
Allegations of this kind can be reported by just about anyone if they have direct knowledge of the action or behavior in question. In fact, Nebraska has mandatory reporting requirements that apply to all healthcare professionals, facilities, peers, organizations, and insurance companies, meaning that it isn't just the patient that can make an accusation of wrongdoing; your coworkers, colleagues, and employers can make a formal complaint as well.
How Does the Disciplinary Process for Nurses Work in Nebraska?
Allegations of nursing misconduct must generally be proven before disciplinary actions are taken (the caveat to this is extreme circumstances, which we'll discuss below). In Nebraska, this requires a standard of proof known as "clear and convincing evidence." This standard requires more than just "a preponderance of the evidence" but does not need to meet the standard of "beyond a reasonable doubt." In layman's terms, clear and convincing suggests that the allegations are most likely true and that the evidence presented makes it difficult for there to be another reasonable explanation.
When a complaint is filed against a nurse in Nebraska, there are several possible outcomes:
The Division of Public Health Investigators within DHHS will look to see if the allegations warrant a formal investigation. This process can include a number of considerations, such as determining whether the complaint is within the Department's scope of investigation, whether the acts alleged are within a timeframe that would allow an investigation (as prescribed in the statutes), and whether the allegations have some merit on their face that would necessitate a deeper look.
DHHS will also look to see if the allegations can be corroborated, either through witnesses or physical evidence or both, and try to determine if the actions or behavior in question would justify some level of disciplinary action should they prove to be true. And be prepared — depending upon the allegations; this investigation can take a considerable amount of time.
If there's not enough evidence to support the allegations (or to warrant action), DHHS will dismiss the complaint.
If the Department believes there is good cause to proceed, it will submit its findings to the Board of Nursing. The Board can choose to dismiss the complaint, attempt to resolve the complaint directly with the nursing professional or make disciplinary recommendations to the Attorney General.
Attorney General Review
If the Attorney General agrees that 1) there is clear and convincing evidence that the allegations are true and 2) that some sort of action should be taken, one of three things can happen:
- Hearing. The Attorney General can file a petition with DHHS to instigate formal disciplinary action. In this instance, your license will be temporarily suspended, and you will have to appear at an Administrative Hearing before DHHS to present your case.
- Consent. The Attorney General can negotiate a voluntary surrender of the license or a limitation of the privileges it grants. In this instance, you would admit to the allegations and agree to surrender your license or abide by a limited set of privileges for a certain amount of time.
- Compliance. The Attorney General can negotiate an "assurance of compliance." This is the equivalent of a "warning" and requires you to agree to improve the areas of concern.
The State of Nebraska provides a useful flowchart to illustrate this disciplinary process.
Please note that a complaint filed through DHHS is not directly tied to any separate legal actions that may have been filed in relation to the allegations in question. That means that a favorable finding from DHHS does not prevent criminal charges or a civil suit from being filed against you. It could, however, help contribute to your defense.
Can The State Suspend Your License Without Notifying You First?
The short answer is yes, but only under certain circumstances.
Revocation (that is, a complete loss of your license) typically requires a formal hearing, and that means notification will be sent to you. It is, however, possible for DHHS to temporarily suspended your license while the disciplinary process unfolds, and you might not receive notification until after this has occurred.
The laws governing nurses in Nebraska do not require DHHS to notify you of an initial complaint unless 1) the person reporting the complaint agrees or 2) notification is necessary to complete the investigation. That means that you may not immediately know that a complaint was filed, and in cases where the Board of Nursing or the Investigating Department believes that there is an ongoing threat of harm or danger, Section 38-183 of the Uniform Credentialing Act permits DHHS to temporarily suspend or limit a license without advanced notice.
The Department must simultaneously set a hearing with you, and such a hearing should occur within the next 15 days, but at that point, you would not be able to work as a nurse.
Will A Suspension Affect A Multistate (Compact) Nursing License?
The Nurse Licensure Compact is a multistate agreement initiated by the NCSBN to allow nurses to move between member states and go where they are needed most without having to obtain new, stand-alone licenses for each state.
Most jurisdictions are already part of this Compact initiative – Nebraska included – while another handful of jurisdictions has legislation pending, and this greatly expands your mobility as a nurse. It also opens several new practice opportunities, including telemedicine services and the ability to travel extensively without losing any time off from work.
But if your nursing license is suspended or revoked for wrongdoing in Nebraska, it will affect your ability to practice in other states under the Compact agreement.
That's because multistate licenses rely heavily on the credentialing process of the home state. In fact, the first requirement for a multistate license is to "meet the requirements for licensure in the home state (state of residency)." Another requirement is that the license holder is "eligible for or holds an active, unencumbered license (i.e., without active discipline)."
Having your Nebraska nursing license suspended or revoked would make it impossible to meet those requirements, and you would be ineligible to retain your multistate privileges.
How Can I Verify My Nursing License Is In Good Standing?
Registered Nurses (RNs) and Practical Nurses (LPNs) in Nebraska can check their credentials at any time using Nursys, a national database that provides licensing verification, as well as confirmation of disciplinary actions and practice privileges.
It is the official repository of license and disciplinary data from the NCSBN and its member nursing boards.
Nursys also provides status updates and license expiration alerts via email (signup required) and should you want to pursue licensing in another state, Nursys will send your collective credentials to the new Board of choice.
Can A Revoked License Be Reinstated?
There are several reasons that a nursing license can be revoked and while they all equate to violations of the Nebraska Nurse Practice Act, not all infractions are equal. Some allegations, while technically true, are more the result of a momentary lapse in judgment, inexperience, or just plain human error, rather than the career-ending character flaw it is often portrayed to be. Even the more serious cases can have mitigating circumstances, making it even more crucial that you have an experienced attorney by your side as you defend your nursing license against revocation.
If your license has already been revoked, however, all is not lost. Reinstating a revoked nursing license is possible in Nebraska, but understand that it will likely be a lengthy and trying process.
Where the original hearing for misconduct centered around the state presenting evidence to prove the allegations, a hearing for reinstatement will require you to prove your "fitness" as a practicing nurse. Depending on the reason(s) for the revocation, this can require some evidence on your part - participation in training classes, specialty certifications, and graduation from a substance abuse treatment program are all good examples - as well as witness testimony and a well-presented argument to state your case.
Facing a reinstatement process alone can be overwhelming and may not result in the outcome you desire. Working with an attorney experienced in license defense gives you the best chance of reinstating your license. The Lento Law Firm Professional License Defense Team has that experience and can help you negotiate a reinstatement so you can start practicing medicine again.
What Can I Do To Make My License "Legally Defensible?"
When you are called before the Board to defend your license, you are essentially explaining why you should be allowed to continue practicing as a nurse. Your "evidence," in this instance, can often include the training you've received, the experience you have, and the certifications you've been awarded.
Making your license "legally defensible" means that you've made an effort to participate in well-recognized training and educational programs and that you've ensured this training and education is documented. It's a statement to the Board that says your credentials are above reproach and, equally as important, you take your career as a nurse seriously.
In a bombshell 2023 case, for example, the Department of Justice filed charges against multiple nursing schools in Florida for selling fake credentials. As a result, nurses who graduated from those schools were called upon to "defend their license" and prove they were not involved in the widespread fraud. Having a legally defensible license doesn't eliminate this kind of conflict, but it can help you defend against it, and there are several ways to achieve it.
The NCSBN provides access to enhanced nursing exams that are designed to help nurses "think more critically and make the right decisions." The organization also provides several online resources to assist nurses in navigating common challenges and situations, such as substance abuse, setting boundaries, and the use of social media. In addition, simple measures such as detailed patient documentation and regular verification of instructions, observations, and even having the right patient chart can help as well.
Should I Sign A Consent Order?
A Consent Agreement (also sometimes called a Consent Order) is a legally binding contract between you and the Nebraska Board of Nursing. This contract states that you are admitting to the actions or behaviors alleged in the document, you acknowledge that they violated the Nurse Practice Act, and you agree to accept whatever disciplinary actions the Board has laid out.
In some cases, this type of voluntary agreement may truly be the best course of action, but there are things to consider before you sign.
A Consent Agreement also typically includes a waiver of your right to a hearing, for example, and because this is a formal disciplinary action, it becomes part of your permanent nursing record. That means your multistate license is now also at risk, and depending upon the actions taken, you may or may not be able to continue working as a nurse in Nebraska.
Disciplinary actions are also public record since the board itself is a public entity, so it's important that you understand all your options before signing this type of Agreement.
Having an attorney with experience defending against nursing disciplinary actions is essential and could help you save your license. Fortunately, Attorney Joseph D. Lento and the Lento Law Firm Team know how to work with nursing boards and can help you negotiate the best possible outcome.
How a Nebraska Nursing License Defense Attorney Can Help
If you have been accused of wrongdoing while working as a nurse, the best time to protect your license is now, before the complaint against you escalates any further. A Nebraska nursing license defense attorney can help you do exactly that by working on your behalf to prepare a proper defense for every stage of the disciplinary process. This can include a variety of actions, including:
- Filing a response to the complaint
- Gathering evidence and witnesses to support your case
- Negotiating for a dismissal of the complaint
- Negotiating for leniency in disciplinary actions
- Representing you in all interactions with DHHS, the Board, and the Attorney General
- Negotiating the best possible terms of a consent order
- Defending you at a formal hearing, if necessary
Remember, everything you do and say going forward can help or hurt your case. The sooner you contact the Lento Law Firm Team, the sooner you'll have an experienced attorney on your side to guide you through this process and help you achieve the best possible outcome.
What Areas Does The Lento Law Firm Serve?
While Nebraska does have some densely populated areas with large healthcare facilities, many nurses work in more rural areas with smaller facilities or via telehealth options. The Lento Law Firm Team works with nurses across the country and can help you protect your license, regardless of your location or employer.
This includes metropolitan hospitals such as the University of Nebraska Medical Center and Methodist Hospital, both in Omaha, as well as the Nebraska Heart Hospital in Lincoln and the Tri-County Area Hospital in Lexington.
Contact The Lento Law Firm To Protect Your Nursing License
You know how hard you worked to obtain your Nebraska nursing license; the Lento Law Firm Team will work just as hard to defend it. If your nursing license is under investigation, your career and your future are on the line.
Having an attorney who understands the Nebraska disciplinary process can help you level the playing field and improve your chances of keeping your license.
You don't have to face this process alone, and you don't have to risk your livelihood by waiting and hoping that everything will just "work out." Contact attorney Joseph D. Lento and the Lento Law Firm Team today at (888) 535-3686, or go online to schedule a consultation.