You know the time, effort, and expense you invested in your nursing education and license. You also know the substantial financial and other rewards of your nursing practice. Patient neglect allegations in a state nursing board disciplinary proceeding threaten your nursing license, employment, and career. State nursing board disciplinary proceedings are complex and serious matters. You need highly qualified administrative defense attorney representation. Retain the Lento Law Firm's premier Professional License Defense Team now by calling 888.535.3686 or completing this contact form. Let us help you preserve and protect your nursing job, career, reputation, and rewards.
The Nature of Patient Neglect
Your nursing education will have provided substantial instruction in recognizing and avoiding patient neglect. Patient neglect generally involves a nurse's failure to provide or arrange for necessary patient care when owing an obligation to do so, knowing of the need for care, and being able to do so. If your nursing employment puts you in the care of a certain patient or resident, you have the means and skills to provide that care, you know of the patient's need for that care or should know, and yet you fail or refuse to provide or arrange for that care when you could do so, injuring, distressing, or discomfiting the patient or exposing the patient to risk of injury, you have likely committed patient neglect. If you face state nursing board disciplinary charges of this nature, get our help. Patient neglect can be a serious disciplinary charge.
Relationship of Patient Neglect to Patient Abuse
Some state nursing laws, rules, and regulations separate patient neglect from patient abuse. The Tennessee Board of Nursing's administrative rules are an example, separately defining unprofessional conduct to include abandonment or neglect on the one hand and intentional attempts to cause physical or mental injury (abuse) on the other hand. Other state nursing laws, rules, and regulations refer to patient neglect and patient abuse together. Michigan's public health code is an example, providing that an “employee of a nursing home shall not physically, mentally, or emotionally abuse, mistreat, or harmfully neglect a patient.” Other state nursing practice acts mention only patient neglect or mention only patient abuse while presumably intending or implying reference to both abuse and neglect. State nursing board disciplinary officials may even consider the two terms to be equivalent and may substitute one term for the other.
Yet despite the confusion or carelessness in the use of the two terms, in the strictest sense, patient neglect differs from patient abuse. Patient neglect generally implies a deliberate, reckless, or negligent failure to care for a patient, while patient abuse generally implies a deliberate or reckless affirmative act againsta patient or the patient's interests. A classic case of patient neglect might be leaving a patient in a soiled bed long enough that the patient develops sores and infections, while a classic case of patient abuse might involve berating and striking a patient for no reason other than to demean and injure.
Nursing Patient Neglect Examples
Nursing patient neglect can come in several forms. The form of patient neglect may matter to state nursing board disciplinary authorities. Some forms of patient neglect may approach outright deliberate cruelty, which states nursing board officials would discipline with severe sanctions up to license revocation. Other forms of patient neglect may be at the other end of the spectrum of reprehensibility, appearing more like ordinary carelessness, simple error, or even inability to attend to nursing duties due to circumstances beyond the accused nurse's control. Examples of patient neglect include:
- neglecting to turn a patient in bed, bathe a patient, or change a resident's clothes or bedding as conditions require, resulting in sores, lesions, infections, or other injurious or discomfiting conditions;
- failing to provide sufficient nutrition or hydration, causing patient distress, increasing patient health risks, or leading to deficiencies and injury;
- ignoring clear, legitimate, expressed patient complaints, concerns, or calls for help, or complaints, concerns, and calls of family members or others on an uncommunicative patient's behalf;
- identifying clear and substantial needs for patient nursing care but failing to address those needs or arrange for other nurses to do so;
- identifying clear patient conditions requiring substantial or critical physician or other medical care but failing to report and document those needs and confirm their address;
- failing to administer correct medication dosages or other therapeutic regimens as ordered and scheduled under circumstances where the failure leaves an obvious patient nursing care need;
- failing to adequately monitor, record, and respond to patient vital signs or related observations of need for medical care, and not checking monitoring equipment for proper operation;
- emotional neglect in the form of ignoring patient alarm for extended periods when knowing that an appropriate response could minimize patient suffering;
- inadequate supervision of patients, especially those prone to wander, fall, or otherwise self-injure;
- failing to promptly report patient injuries, illness, or disease progression to the patient's physician or other medical care provider when knowing that the failure could cause additional suffering or injury;
- abandoning a patient for an extended period without proper care or arranging nursing care by others, including leaving them in a location remote from their care room without arranging for their return; and
- leaving an immobile patient in their room for extended periods without assisting with mobility.
Signs of Patient Neglect
The signs of patient neglect can be important. Patient or family member complaints that a nurse has neglected the patient are one thing, while clear signs and symptoms are another thing. Patient and family member complaints of neglect may be deluded, exaggerated, retaliatory, manipulative, or spiteful. Defense of baseless complaints may be easy or at least possible and probable. But if signs and symptoms of neglect are apparent, then defense of neglect complaints can be more difficult and problematic, although not necessarily impossible. The point is that physical signs, symptoms, records, photographs, video, or other evidence of patient neglect increases the likelihood of discipline. Be sure to retain us to defend disciplinary charges of patient neglect where such signs are present. Signs of patient neglect can include:
- sores, lesions, rashes, and infections;
- readily preventable patient falls and injuries;
- badly soiled clothing and bedding;
- spoiled food and drink;
- molds and mildew on patient furnishings and utensils;
- loss of weight, malnutrition, and severe dehydration;
- poor patient hygiene;
- severe patient anxiety and unabated alarm;
- continuous patient restraint or isolation;
- absent or incomplete records of critical patient vital signs;
- unanswered emergency or critical calls or requests for care; and
- non-functioning monitors or other patient equipment.
Who Reports Patient Neglect
Anyone can (and should) report patient neglect. Some individuals, though, have duties to report patient neglect. Those individuals may include nurses, physicians, and other licensed medical care and healthcare providers. If one of your patient's shows signs of patient neglect, you can expect the attending physician or nursing supervisor to raise the issue and report the issue to disciplinary authorities if not promptly and responsibly corrected and avoided in the future. Facility directors and managers may also have a duty to report patient neglect to protect patients while holding incompetent or unfit nurses accountable to disciplinary authorities.
Beyond mandated reporters, patients themselves may report their own neglect to disciplinary authorities. So may their family members. A National Library of Medicine study of hospital patient neglect found that patients and family members report patient neglect more often than healthcare staff members report patient neglect. State nursing boards publicize to patients, their family members, and the public that complaint hotlines and online forms are readily available. State nursing boards want lay members of the public outside of the healthcare professions to report nursing failures for prompt correction, to protect patients, and to maintain public trust in the nursing profession. Public watchdogs, including media and advocacy organizations can also highlight and report patient neglect. State nursing board disciplinary officials will respond to media or other stories of patient neglect. Beware reports, accounts, speculation, gossip, or rumors that you committed or are committing patient neglect. Retain us to help you address those concerns and avoid or defend disciplinary charges.
How Patient Neglect Allegations Arise
You've just seen who may report patient neglect. But that discussion doesn't tell the full story on how patient neglect allegations actually arise. Nursing care can be complex and demanding. Patients and their family members may feel that a hospital or care facility is not meeting the patient's needs and may even be neglecting the patient. But that doesn't necessarily mean that they will promptly report the situation to state nursing board disciplinary authorities. They may instead appreciate the challenges of providing for the patient's consistent and effective care. They may not do anything other than notify the nursing supervisor or facility managers, or directors that they feel that neglect may be present.
It can thus take more, for neglect allegations to reach state nursing board disciplinary authorities. Patients and family members must generally feel that no one is listening to their concerns and that they must reach out to state nursing board authorities to get the relief they feel they deserve. The National Library of Medicine study referred to above found that the poor quality of the relationship between the nurse or other care provider and the patient is a frequent cause of patient neglect complaints. Serious patient illness or injury from neglect is the other common way that neglect complaints will reach state nursing board disciplinary authorities.
Avoiding Patient Neglect Disciplinary Complaints
As just suggested, you may be able to take proactive steps to avoid or head off a patient neglect complaint to state nursing board disciplinary authorities. Of course, the best way to avoid a complaint is to avoid patient neglect. But if you find yourself in a situation where you know that patient neglect has occurred, you may still be able to avoid or head off an actual disciplinary complaint. Your key is to act swiftly and surely to address patient or family member concerns over neglect before they rise to the level of a disciplinary complaint.
Let us help you do so. You may be in a situation where your supervisor or facility is not supporting you, instead putting you in a position where you are unable to avoid patient neglect or unable to address neglect concerns. The National Library of Medicine study referred to above found that patient neglect frequently arises out of organizational factors like high workloads and related staff burnout. Do not let your facility or colleagues make you the scapegoat for their own individual or systemic failures. Patient neglect can be, and often is, the result of poor systems and management rather than poor individual nursing. Let us help you avoid becoming the scapegoat for the failures of your facility or colleagues.
Nursing Board Authority to Discipline
Do not doubt your state nursing board's authority to discipline your nursing license. State nursing practice acts not only grant state nursing boards authority to license nurses. Those acts also grant state nursing boards the authority and responsibility to discipline licensees, up to suspending or revoking the license. Public protection involves more than ensuring a nurse has the education, training, fitness, and character for competent nursing care before issuing a license. Public protection also involves removing a nursing license when the nurse shows that the nurse is not providing safe, competent, and effective nursing care.
The Georgia Nurse Practice Act is an example, creating the Georgia Board of Nursing and authorizing it to promulgate rules and standards with which nurses must comply to retain their license. Georgia Board of Nursing rules also define what constitutes unprofessional conduct for purposes of imposing discipline. The Washington Nurse Practice Act is another example, authorizing the Washington State Board of Nursing to discipline nurses under the state's Uniform Disciplinary Act for licensed health professionals, right up to suspending or revoking their license for rule or standards violations. If you face disciplinary charges for patient neglect, let us help you defend and defeat those charges. Take the charges seriously. Your state nursing board has the authority to suspend or revoke your license.
Patient Neglect as a Ground for Discipline
State nursing practice acts routinely include patient neglect under their express grounds for imposing discipline. While most or all such nursing practice acts would have a catch-all provision covering patient neglect if not expressly mentioned, like prohibitions against unprofessional conduct, incompetence, and malpractice, the acts generally make specific mention of neglect. The administrative rules of the Indiana State Board of Nursing, adopted under the authority of the Indiana Nurse Practice Act, are an example, expressly authorizing discipline for registered or licensed practical nurses on the grounds of “[a]bandoning or knowingly neglecting patients/clients requiring nursing care.” You should expect your state nursing practice act to have a similar provision. Patient neglect is clearly a ground for discipline.
Nursing Board Sanctions for Patient Neglect
Nursing boards generally have broad discretion to impose a full range of license sanctions all the way up to license suspension and revocation. Section 4723.28 of Ohio's Nurse Practice Act is an example, authorizing a wide range of sanctions, including license denial, revocation, suspension, or restriction, as well as reprimand and fine. That discretion gives our attorneys the opportunity to argue for lesser sanctions or even for only remedial relief in the event that your state nursing board finds you responsible for the alleged patient neglect. We may, for instance, convince your state nursing board disciplinary officials to only impose nursing education, training, monitoring, supervision, or probation in lieu of harsh sanctions like suspension or revocation. Remedial relief may preserve your employment and reputation. But don't minimize the risk of a license suspension. Patient neglect charges can be especially serious if the involved patient or patients have suffered injury due to the neglect.
The License Impact of a Patient Neglect Finding
Be aware of the collateral impacts of license discipline. License suspension, of course, terminates your nursing practice. It may also terminate your nursing employment unless your employer has non-nursing duties you can perform. Any discipline, even a reprimand, could result in employment termination. It could also result in your inability to find another nursing job. You could also lose your nursing licenses in other states and the ability to gain a new license in another state. State nursing boards generally enter nurse discipline in the national Nursys database to alert other state nursing boards. Loss of employment could cause cascading losses of housing, transportation, healthcare insurance, family relationships, and even child custody in a separation or divorce. Beware of the broad and deep potential impacts of license discipline on patient neglect. Let us help you defend the charges.
Defenses to Patient Neglect Charges
As serious as patient neglect charges are, their defense may well be possible, depending on your matter's specific facts and circumstances. We can help you assert your available defenses in a strategic, sensitive, and effective manner. You've seen above, for instance, that patient neglect may be due more to systemic and management issues than an individual nurse's failures. We may be able to show that your facility assigned you impossible duties, failed to supply necessary aid and equipment, and ignored your requests for support and concerns over resulting patient neglect. We may, in other words, be able to show that your facility is scapegoating you for its own failures. Alternatively, we may be able to show that you were not responsible for the patient who suffered neglect, that the patient or facility misidentified you, or that the responsible nurse wrongly blamed you. We may even be able to show that no neglect occurred and that any decline in the patient's condition was due instead to the natural and unavoidable course of disease. You may have these and other defenses. Let us help you prove them.
Protective Procedures Against Neglect Findings
With our help, you will have a full and fair opportunity to contest your state nursing board disciplinary charges. State nursing practice acts offer protective procedures. They must do so as a matter of constitutional due process rights. The administrative rules of the Tennessee Board of Nursing are an example, offering extensive protective procedures regarding fair notice of the charges, a full hearing with the right to subpoena and call exonerating witnesses and cross-examine incriminating witnesses and other rights expressly drawn from the state's Administrative Procedure Act. Your state nursing practice act and state nursing board administrative rules will have similar protective procedures.
Invoking Protective Procedures
The above protective procedures are not generally self-executing. Your state nursing board's officials will not invoke them for you. You must generally instead answer the disciplinary charges, request a hearing, prepare for the hearing, and attend the hearing with your evidence. We can help you do so. If you do not invoke protective procedures and otherwise respond to your patient neglect disciplinary charges, your state nursing board's disciplinary officials may default you and impose a default sanction of license suspension.
The Role of a License Defense Attorney
You can see from the above discussion that our highly qualified administrative license defense attorneys play a key role in ensuring that you have the best opportunity to avoid sanctions, retain your license, and maintain your employment. Do not retain unqualified local criminal defense counsel. Administrative license proceedings differ from court proceedings. Unqualified counsel may be worse than no counsel when no counsel is itself a hazardous choice. Let us help you defend and defeat your patient neglect disciplinary charges.
Premier License Defense Available
If you face patient neglect allegations in a state nursing board license discipline proceeding, your best move is to retain the Lento Law Firm's premier Professional License Defense Team to defend those allegations for your best possible disciplinary outcome. Our highly qualified attorneys have helped hundreds of nurses and other professionals successfully defend patient neglect and other misconduct charges. Call 888.535.3686 or complete this contact form now. Preserve and protect your nursing job and career.
