You have just learned that your state nursing board has begun an investigation into allegations that you violated a nursing rule or standard, subjecting your nursing license to discipline. You should call 888.535.3686 or complete this contact form now to retain the Lento Law Firm's premier Professional License Defense Team to help you properly respond to the investigation. Read our answers to questions about state nursing board disciplinary investigations and how we can help you obtain your best possible disciplinary outcome, beginning with the investigation.
What Does the State Nursing Board Investigate?
Your state nursing board has the statutory duty to protect patients and the public against incompetent, unsafe, and untrustworthy nursing care. Your state nursing board does so by licensing only qualified nurses and by suspending, revoking, or otherwise disciplining the licenses of nurses demonstrating unfitness. See, for example, the mission statement of the Tennessee Board of Nursing, which is “to safeguard the health, safety and welfare of Tennesseans by requiring that all who practice nursing within this state are qualified and licensed to practice.” State nursing practice acts create state nursing boards to carry out those public protection duties. Your state nursing board is investigating a complaint, indication, or concern that you may be unsafe or unfit for nursing.
Who Gives the State Board Authority to Investigate?
State legislatures, through their enacted nursing practice acts, authorize state nursing boards to investigate complaints or concerns over the fitness of licensed nurses. See, for example, Section 63-7-115 of the Tennessee Nurse Practice Act, authorizing the Tennessee Board of Nursing to suspend, revoke, or otherwise discipline the license of a Tennessee nurse after investigation and hearing shows that the nurse violated one of Section 63-7-115's disciplinary grounds. Section 63-7-115 states expressly that the Board of Nursing may rely on a screening panel's investigation of the complaint against the nurse charged with discipline. Your state legislature doubtless afforded your state nursing board similar authority. Nursing is a subject for state, not federal, regulation, given state reserved powers over the general welfare.
Why Am I Facing a State Board License Investigation?
Put simply, you are facing your state nursing board's investigation because information reached state board disciplinary officials that you may have violated one or more of the state's nursing rules and standards. Anyone may complain against a licensed nurse. State nursing boards generally maintain online patient and consumer complaint portals, allowing anyone to register a complaint against a licensed nurse. See, for example, the consumer complaint webpage that the Kentucky Board of Nursing maintains, encouraging individuals to share their concerns. The Kentucky Board of Nursing information also encourages concerned individuals to contact the Board of Nursing's Investigation Branch Team or email a KBN discipline alert.
Plainly, state nursing boards take their patient and public protection duties seriously. Rather than question your state nursing board's authority or responsibility to investigate your actions as a licensed nurse, let us help you respond appropriately to the investigation. We may be able to head off formal disciplinary charges.
Who Are the Common Complainants?
Patients and their family members are common complainants, especially when the patient suffers a medical injury or worsening medical condition while under the nurse's care or other indications suggest that the nurse may have been incompetent, careless, dangerous, or vindictive. Patients experience nursing care. Family members often observe it or hear about it from the patient. Patients and their family members are natural and common reporters.
Nursing colleagues, supervising nurses, subordinate nurses or aides, treating physicians, and other healthcare professionals involved in your nursing care can be other common reporters. Some of those professionals in some states have the duty to report violations of nursing standards under certain conditions. Patient abuse or neglect and child abuse or neglect are two examples where mandatory reporting may come into play. For example, Michigan has several mandatory reporting requirements for healthcare and other professionals. Whether or not your healthcare colleagues actually have a duty to report your suspected substandard nursing care may not matter if they believe they have such a duty.
Your employer representatives may also have a duty to report your suspected nursing violations or may decide that they are better off to do so. However, disciplinary officials can also learn of a nurse's disciplinary wrongs, such as criminal convictions or domestic violence restraining orders, through press reports, social media, and other public sources. They may also learn about suspected wrongdoing through court and agency records, as well as from other state nursing boards or the national Nursys database.
Which Complaints Does the State Board Investigate?
You are right to wonder who made the complaint against you. The role, relationship, personal knowledge, direct observations, and credibility of the complainant can make a difference as to whether a state nursing board will decide to investigate. In general, state nursing boards are more likely to investigate credible complaints of serious violations made by mentally competent and otherwise trustworthy individuals who made direct observations of the alleged nursing wrong. Patients and their family members and professional colleagues are among the most likely complainants to fit those criteria.
But state nursing boards may also investigate matters not having a complainant or having only untrustworthy complainants or complainants lacking observations, mental competence, or personal knowledge if the allegations are public and notorious, raising public outcry and concern over the integrity of the nursing profession. Officials may also investigate matters indicating little or no evidence of any nurse wrongdoing, where the nurse's patient nonetheless suffered an inexplicable serious injury or sudden demise. Officials may also investigate if someone has filed a malpractice lawsuit alleging substandard nursing care, although officials may also await the lawsuit's resolution rather than make their own exhaustive investigation of a complex case involving the nursing standard of care.
How Does the State Board Decide to Investigate?
State nursing board disciplinary officials typically make a preliminary review of the complaint or other information, making allegations or raising disciplinary concerns over a nurse's fitness, competence, or conduct. The board's investigators may gather periodically with other disciplinary officials to discuss and decide which complaints warrant investigation based on the factors discussed in the prior answer. Board officials may assign some complaints for preliminary investigation, suspecting that they are without basis but needing to confirm so. Board officials may promptly assign other complaints for full investigation because of the complaint's credibility and the seriousness of the allegations.
Who Conducts a State Board Investigation?
A state board of nursing staff member trained in and devoted to investigations generally conducts an authorized investigation. Board officials generally assign a single investigator or team of investigators to each complaint warranting investigation, sometimes out of one of several field offices spread around a larger state. A California State Auditor's report indicates that the California Board of Nursing employs between eighty and ninety investigators, with about twenty of those investigators processing complaints, twenty implementing disciplinary sanctions, and the rest presumably investigating complaints.
What Information Is the Investigator Looking for?
Investigators look for information and documentation regarding the disciplinary complaint and suspected nursing rules and standards violations. Investigators should not generally be out on so-called fishing expeditions, trolling for any evidence of any potential disciplinary violations unrelated to the alleged misconduct. They should instead focus their investigation on discovering evidence supporting the complaint's allegations. However, investigators may definitely record and use evidence of other unsuspected violations onto which they stumble in the course of their authorized investigation. That is one reason why you should retain us to assist you in responding to an investigation so that we can keep you and the investigator focused on what the investigator is legitimately looking for based on the allegations. No fishing expeditions, if possible.
What Evidence May Investigation Discover?
Investigators may discover both incriminating evidence, tending to prove the complaint's allegations, and exonerating evidence, tending to disprove the complaint's allegations.
Incriminating evidence may include such things as medical records documenting patient abuse or neglect, patient falls or injuries due to incompetent nursing care or disobeying physician orders, and patient medication issues due to nurse inattention or error. Incriminating evidence may also include witness statements from patients, family members, colleagues, employer representatives, and others tending to confirm the complaint's allegations of nurse incompetence, unfitness, substance abuse, and the like.
Exonerating evidence may include medical records and witness statements tending to contradict and disprove the complaint's allegations. When you retain us to assist you in responding to an investigation, we can help you identify, gather, and present your exonerating evidence.
What Can I Do Right in an Investigation?
The best thing you can do right in an investigation is to immediately retain us and then follow our advice. Your biggest concern in responding to an investigation often involves the nature and quality of your responses more so than the actual facts of the matter. Things are what they are. Investigators are reasonably likely to discover those things, with or without your help. But if your responses are incomplete, inaccurate, inconsistent, careless, and misleading, then the investigator may recommend disciplinary charges against you for obstructing the investigation or failing to cooperate. You may face those charges even if you did nothing else wrong. We can help ensure that your responses are accurate, complete, and truthful. We can also make a reliable record of your responses so that you do not face false charges of obstruction.
Other things that you can do right in an investigation include immediately preserving all potential evidence that is arguably material to the complaint's allegations, including electronically stored information. Set everything aside in a secure location for our inspection and for us to share with the investigator in the proper manner. You can also reserve discussing the complaint's allegations with others unless we have advised you to do so. No need to spread rumors, increase undue attention to your delicate matter, or make contradictory or speculative statements.
What Might I Do Wrong in an Investigation?
The worst thing that you could do wrong in an investigation would be to destroy, conceal, or withhold material evidence. Obstructing a state nursing board investigation in such a deliberate and nefarious manner would likely lead to prompt license suspension or revocation when discovered and proven. Deliberate destruction of material evidence can be a difficult disciplinary charge to defend. Don't make a cover up worse than the underlying wrong.
Also, avoid gossiping and conjecturing about the complaint's allegations among colleagues or, especially on social media. Your investigator may ask your colleagues if you have admitted any of the alleged wrongs and may check your social media for such admissions. Others may misremember or misconstrue your conversation as if you admitted the complaint's allegations, even when you did not do so. Better not to talk than to talk too freely, needlessly, and carelessly.
What Does the State Board Do With Investigation Results?
Your investigator is likely to prepare an investigation report summarizing the evidence that the investigator discovered relating to the allegations of wrongdoing. The investigation report may recommend any of the following alternative courses:
- dismissal of the complaint and closure of the file;
- issuing formal disciplinary charges for service on you;
- leaving the file open for further potential developments or information.
If the investigator recommends disciplinary charges and the state nursing board authorizes those charges, we can help you answer and defend the charges following your state nursing board's administrative procedures.
Premier License Defense Attorneys Available
If you learn that your state nursing board has begun a license investigation against you, promptly retain the Lento Law Firm's premier Professional License Defense Team for the representation you need to respond to the investigation. We have helped hundreds of nurses and other professionals nationwide defend all kinds of state licensing board disciplinary charges. Call 888.535.3686 or complete this contact form now for our skilled and experienced defense attorney representation.
