The Maryland Board of Nursing (referred to from this point on as “the Board”) is responsible for licensing and disciplining nurses in the state. The Board derives its authority from the Maryland Nurse Practice Act (NPA), several statutes that collectively address such nursing matters as nurse licensing processes, Board disciplinary processes, and other relevant topics.
The Maryland NPA also establishes the various unethical and illegal activities a nurse may not engage in. If a nurse violates the Maryland NPA, they may be subject to disciplinary action by the Board.
Some forms of disciplinary action, like a formal reprimand, are essentially warnings. They don't limit a nurse's ability to practice, but because they're public information, they could influence whether future potential employers decide to hire them.
Other forms of disciplinary action the Board may take are more significant. For example, the Board can place various restrictions on a nurse's privilege to practice nursing. The Board can even revoke a nurse's license if it determines doing so is necessary to ensure the health and safety of the public.
If you're ever subject to a Board investigation because of an alleged violation of the Maryland NPA, you need representation from qualified attorneys who specifically work with clients like you. At the Lento Law Firm, our Professional License Defense Team offers services designed to serve the unique needs of professionals like yourself facing potential action against their licenses. Learn more about what we can do for you by submitting your information through our online form today or by calling us at 888-535-3686.
The Ethical Responsibilities of Nurses Under the Nurse Practice Act in Maryland
A subsection of the Maryland NPA serves as the code of ethics for nurses in the state. It describes the ethical responsibilities of Maryland nurses, which are as follows:
- Serving clients/patients in a manner that demonstrates respect for them as humans and unique individuals, without any restrictions based on factors like socioeconomic status, religion, or other protected personal attributes
- Respecting a patient's right to privacy and safeguarding their confidential information accordingly
- Taking steps to safeguard the health and safety of individual patients and the public in general when one is aware that such health and safety may be at risk due to the “incompetent, unethical, or illegal practice of any person.”
- Promptly reporting confidentiality or privacy breaches to the Board, one's supervisors/employers, or other relevant authorities
- Assuming appropriate responsibility and accountability for the judgments and actions one makes in the capacity of a nurse
- Taking necessary and appropriate steps to maintain one's competency as a nurse
- Properly accounting for one's qualifications, experience, comfort, and other relevant factors when accepting duties and tasks, when delegating duties and tasks to others, and when providing insights during consultations
- Informing the Board when one is aware another licensed nurse is engaging in or has engaged in unethical conduct
The above points indicate a nurse's own discretion often plays a role in determining whether certain behavior aligns with the Maryland NPA's code of ethics. For example, a nurse must exercise their judgment when deciding if they're qualified to accept certain responsibilities. It's possible to have good intentions and nevertheless make an error in judgment.
Such errors could theoretically get you in trouble with the Board. If you're facing licensing issues because of an alleged breach of the Maryland NPA's code of ethics, our Professional License Defense Team at the Lento Law Firm can help.
Prohibited Activities for Licensed Nurses Under the Nurse Practice Act in Maryland
The section of the Maryland NPA describes what constitutes ethical behavior among nurses in the state and details specific activities that licensed nurses may not engage in. When acting as a licensed nurse in Maryland, one may not:
- Knowingly participate in various forms of deceit or dishonesty, such as fraud or misrepresentation
- Knowingly condone the above forms of dishonesty
- Engage or otherwise participate in any activity that violates or otherwise disrespects a patient's civil rights
- Perform techniques or procedures one is unfamiliar with without adequate training/education and practice
- Assume nursing duties or responsibilities with insufficient preparation and/or without properly maintaining competency
- Practice nursing when one is aware that their ability to perform necessary procedures or make sound decisions is limited due to a mental or physical impairment, which can include the effects of drugs or alcohol
- Pressure or coerce the subject of a research study to participate in said research or to continue participating in it
- Abandon clients without ensuring someone else is available to take over their care
Again, although the purpose of the law is to protect the vulnerable, its wording is arguably vague in certain instances.
For example, as a nurse, you may feel you've undergone sufficient training and have adequate experience to perform an otherwise “new” procedure or technique. However, if a patient is harmed in any capacity when you attempt to perform said technique, or if they don't receive the care they need because you performed the technique or procedure incorrectly, the Board might take action.
In these circumstances, the Board could argue that a licensed nurse should have exercised better judgment. You may feel you exercised proper judgment, given the situation you were in. This is another example of a scenario in which the Professional License Defense Team at the Lento Law Firm can offer valuable assistance.
Prohibited Activities that ‘Dishonor the Profession of Nursing' Under the Nurse Practice Act in Maryland
The Maryland NPA prohibits the above activities when one is acting in the capacity or identity of a licensed nurse in the state. The NPA also prohibits licensed nurses from engaging in certain activities that could arguably dishonor the profession of nursing, regardless of whether they're acting in the capacity or identity of a nurse at the time they do so.
These activities are:
- Verbally abusing (which can include using ethnic slurs against) coworkers, employers, Board staff members, clients, or the family members of clients
- Physically abusing, threatening, or intimidating any of the above individuals/parties
- Defrauding, stealing from, or otherwise engaging in deceitful practices against a coworker, employer, client, or family member of a client
- Diverting medication or providing a pharmacist or other authorized prescriber with false or misleading information in an attempt to unethically obtain any medication
- Knowingly employing someone who doesn't have the proper qualifications and license to practice nursing or any other relevant nursing-related occupation
- Performing acts that fall outside of the scope of nursing practice one is authorized and qualified to engage in
- Using, having possession of, providing, or administering (or attempting to use, possess, supply, or administer) prescription drugs or other potentially dangerous controlled substances without the necessary medical indication
- Arriving to work while under the influence of alcohol or a controlled dangerous substance, or getting a positive result for alcohol or other controlled dangerous substances from a pre-work sample without having shown prescriptions for any controlled dangerous substances that might show up in the sample
- Arriving to work while under the influence of an illicit drug or submitting a pre-employment sample that tests positive for the presence of illicit drugs
- Improperly using the power, knowledge, or influence one naturally has as a result of the nurse-patient relationship for one's own personal advantage, gratification, benefit, etc.
- Engaging in conduct that may qualify as unprofessional or immoral
- Misrepresenting or attempting to conceal a relevant fact when applying for a license, renewing a nursing license, or applying for reinstatement of a license that was suspended
- Engaging in acts that qualify as forms of dishonesty, corruption, or moral turpitude when said acts either directly or indirectly affect the health, safety, welfare, etc., of patients and/or the public
This section of the Maryland NPA also prohibits nurses from obtaining or making copies of client health records except for certain approved purposes. These purposes are:
- Providing a client with the necessary care
- Conducting “quality improvement” activities to boost the level of care clients receive
- Complying with subpoenas or other legal requirements
- Letting nursing students use client records for educational purposes, as long as a client's name and other identifying information have been properly redacted or disguised within the records
Once more, the language leaves room for interpretation. For example, “quality improvement” is a general approach to nursing that aims to, as the name implies, improve the overall quality of care that patients receive. A nurse may thus obtain patient records out of the belief that doing so is genuinely necessary for valid quality improvement purposes.
A client, coworker, employer, or the Board might feel differently about a nurse's decision in these circumstances. To protect their ability to continue practicing nursing in Maryland without restrictions, a nurse needs a proper defense when this happens. That's exactly what we at the Lento Law Firm's Professional License Defense Team Offer.
Prohibited Forms of Sexual Misconduct Under the Nurse Practice Act in Maryland
The Maryland NPA also specifies the various activities and behaviors that may qualify as sexual misconduct. Under the law, nurses in Maryland may not engage in:
- Any form of sexual behavior with a client, regardless of the environment, when one is providing a client with any nursing service or related service
- Any form of sexual behavior with a client when using the pretext of said behavior serving a valid diagnostic or therapeutic purpose
- Solicitation of a sexual relationship with a client, regardless of whether said relationship would be consensual
- Making sexual advances toward coworkers, students, employers, clients, or the family members of clients
- Requesting sexual favors from coworkers, students, employers, clients, or the family members of clients
- Discussing sexual matters with a client if those sexual matters are nontherapeutic in nature
- Photographing or otherwise recording a client for sexual purposes
- Sexual harassment of a coworker, student, employer, client, or family member of a client
- Sexual contact with a client who is unconscious or otherwise incapacitated
- Intentional exposure of one's sexual body parts
- Intentional exposure of a client's sexual body parts for nontherapeutic purposes
Yet again, this section of the Maryland NPA protects the public while nevertheless leaving the possibility open for nurses to face disciplinary action due to misunderstandings. For example, a patient might report a nurse for making sexual advances because they misunderstood a nurse's intentions. Such an instance is another case in which our Lento Law Firm Professional License Defense Team can be of service.
What the Nurse Practice Act in Maryland Says About the Use of Electronic Devices to Record Patient Records or Patients
The Maryland NPA also prohibits nurses from using phones or other such electronic devices to photograph or record patients and/or medical records without first receiving authorization from a relevant client.
The law specifically states that a nurse can't use electronic devices or social media to transmit any client information over the Internet. Additionally, the law states a nurse must adhere to the following principles regarding social media and electronic device usage:
- Nurses are generally required to understand both the benefits and consequences of electronic device usage and social media networking.
- Nurses must protect and preserve client-nurse boundaries in any environment, including online.
- On both personal computers and online, client records must be stored in separate encrypted files.
- When a nurse is aware of any electronically generated material that could harm the privacy rights of a client, they have an obligation to report the matter accordingly.
- When using electronic devices or social media, nurses must adhere to the same standards of professionalism that they would in any other context.
In some circumstances, it can be easy to make a social media mistake (or similar error) that could represent a violation of a patient's rights or privacy. Get in touch with our Professional License Defense Team at the Lento Law Firm if you're ever accused of such a violation.
Contact the Lento Law Firm for Help with an Alleged Violation of the Maryland Nurse Practice Act
None of this has been meant to suggest the Maryland NPA is excessively strict. Remember, the law exists to keep the public safe.
However, due to such factors as the wording of the law, it's possible for a nurse to be accused of a Maryland NPA violation even when no wrongdoing has occurred. Even if a violation does happen, it doesn't necessarily mean a nurse should lose their license.
Our attorneys with the Lento Law Firm's Professional License Defense Team are thoroughly familiar with the law. We can provide the defense you need when your license is at risk because of a potential breach. Get started today by calling us at 888-535-3686 or submitting your information via our online contact form.