Nurses generally enjoy reasonable compensation for their nursing services. But nurses, like other professionals, may have the need for additional income over and above what their regular employment is able to provide. Moonlighting can be an attractive option for generating income and even building relationships, networks, and a business. But moonlighting also comes with disciplinary risks involving duties of loyalty, conflicts of interest, patient confidentiality, and trade secrets. If you face state nursing board disciplinary charges related to your moonlighting, retain the Lento Law Firm's premier Professional License Defense Team for your defense representation. Our skilled and experienced attorneys are available nationwide for your nursing license defense on moonlighting and other issues. Call 888.535.3686 or complete this contact form now for our attorneys' highly qualified representation.
What Is Moonlighting?
Moonlighting involves working a second job at night, on weekends, or on other off hours from your regular job, for additional income. Moonlighting is an odd way to describe a second job for additional income. The term comes from the fact that much moonlighting comes at night after work hours under the figurative, if not also the literal, moon's light. Others may call moonlighting a side job, side hustle, second gig, or similar slang terms, while the official nomenclature may be simply other remunerative work.
How Common Is Moonlighting?
You are not alone if you are moonlighting as a nurse. Moonlighting among nurses is relatively common. One National Library of Medicine study in another country found that between one quarter and nearly one half of nurses moonlight, depending on their public or private healthcare sector. Other healthcare professionals, including physicians, psychologists, and therapists, also moonlight in significant numbers, even during medical training and residency. Nurses may, though, find moonlighting especially attractive and available, given the prevalence of nurse staffing agencies. Nurses who have regular, permanent, full-time employment at a hospital, with a medical practice, or at a care facility may sign up with a nurse staffing agency for occasional assignments.
Why Do Nurses Moonlight?
Additional income is the primary reason for nurse moonlighting, like side hustles in other fields. Nurses at all stages of their careers may need or desire more income than their regular, full-time employment offers. Nurses just graduating from nursing school may have educational debt to retire. Nurses well into their careers may have homes to finance and childcare expenses to cover. Nurses in mid-career may have children to put through college and family vacations they want to take. Nurses nearing the end of their career may have retirement funds to supplement and adult children or minor grandchildren to bless with gifts. The reasons for pursuing additional income are many, often compelling and urgent, and sometimes frivolous or adventurous.
Moonlighting can also supply other benefits. Nurses who moonlight in their own startup businesses may be building equity, value, and opportunities that lead to their full-time self-employment. Nurses who moonlight at other facilities or with other medical groups may be learning new skills and practices, expanding their support network, and discovering more satisfying potential full-time jobs with better pay and benefits. Moonlighting can also freshen a nurse's outlook with new challenges, opportunities, and relationships, even if the nurse has no particular need for the additional income. Disciplinary officials generally understand and respect these reasons to moonlight. But no matter how compelling the reason, the same disciplinary rules and standards apply.
What Are the Moonlighting Risks?
Moonlighting can indeed carry significant license disciplinary risks. Those risks may not be obvious, but they can nonetheless be real and substantial. Give careful thought to your moonlighting to ensure that you appreciate the disciplinary risks and appropriately minimize those risks. Consider the following primary disciplinary risks of moonlighting, along with some related contractual and employment risks.
Conflicts of Interest as a Moonlighting Risk
A first risk of moonlighting is a conflict of interest between the duties you owe to your patients and employer in your full-time employment, with interests you have and duties you may owe in your side job. Conflicts of interest can be especially acute if your side job is working for a supplier of goods or services to your full-time employer. Your full-time employer may see your moonlighting as potentially favoring the supplier over your full-time employer, using the employer's inside knowledge. Conflicts of interest can be even more acute if you moonlight for a competitor of your full-time employer, where you might aid the competitor and harm your full-time employer through the diversion of patients or other acts. Beware conflicts of interest spurred by your moonlighting. Let us help you address conflict of interest allegations in disciplinary charges and dealings with your full-time employer.
Breach of the Duty of Loyalty as a Moonlighting Risk
A second risk of moonlighting is a breach of the duty of loyalty that you owe your full-time employer. A duty of loyalty requires that you treat your full-time employer's interests as your primary interest, valuing and respecting that your full-time employer deserves your full commitment. Breaches of the duty of loyalty can create disciplinary risk, where licensing officials may see your disloyalty as an indication of bad character and patient substandard care risk. When you take on moonlighting, you inevitably give some devotion and attention to your moonlight employer, potentially reducing the devotion and attention you give to your full-time employer and its patients, creating patient-harm risks. The duty of loyalty goes hand-in-hand with the duty to avoid conflicts of interest. Let us help you address allegations of a duty of loyalty breach.
Violation of Employer Trade Secrets as a Moonlighting Risk
A related risk is the duty you owe your employer not to steal its trade secrets or otherwise use or disclose its proprietary information. While these risks may not be a violation of explicit disciplinary standards, they may implicate the above duty of loyalty and conflict of interest disciplinary standards. A trade secret is any confidential information of value to your full-time employer, the disclosure of which could destroy that value. Unique hospital systems and practices, confidential patient contact information and lists, and confidential provider pricing and lists can be valuable trade secrets and proprietary information. Special computer software and unique designs of special tools or equipment can also be proprietary to your full-time employer. Trade secret theft is a big issue for employers, especially when it comes to expensive technology solutions that give an employer a leg up over the competition. Beware disclosures to your moonlight employer of trade secrets and proprietary information your full-time employer values.
Breach of Patient Confidentiality as a Moonlighting Risk
Violation of patient confidentiality is another moonlighting risk. When you take your nursing services to your moonlighting location, you work with a distinct community of healthcare professionals who have no business learning the medical information of your full-time employer's patients. Your inadvertent or purposeful disclosures of that confidential patient information in the course of your moonlighting work may breach patient confidentiality, for which state nursing board officials may pursue disciplinary charges. Loose lips sink ships. Beware any disclosure of patient information from your full-time nursing practice in your moonlighting situation. Let us help you defend patient confidentiality breach disciplinary charges.
Breach of Contract as a Moonlighting Risk
Violating your employment agreement with your hospital, medical group, or other full-time employer is a related contractual risk. You could get fired from your regular job for moonlighting. Healthcare providers often include non-compete clauses in their employment agreements with nurses and other healthcare professionals. Those clauses protect the providers from their own employees undermining their interests by working for a competitor during or immediately after their employment. While violating a non-compete clause may not be a direct disciplinary risk, and instead is primarily a matter between you and your employer, it could spur your employer to complain to disciplinary authorities of your conflicts of interest, trade-secret violations, patient confidentiality breaches, or other wrongs subject to discipline.
Why Moonlighting Can Be a Licensing Issue
You can see from the above discussion some of the grounds on which state nursing board officials may pursue your license discipline, including conflicts of interest, loyalty breaches, patient confidentiality breaches, and even trade secret disclosure or theft. You might reasonably think that your moonlighting is between you and your employer as solely a business matter. But disciplinary officials can take an interest in issues that arise from your moonlighting, too. And disagreements with your employer over your moonlighting may lead your employer, patients, or colleagues to report you to disciplinary authorities for investigation of charges. Moonlighting simply carries risks that it will adversely affect your nursing practice for your full-time employer. In a perfect world, you would work for only one employer, with your full attention and devotion. But the world isn't perfect. You needed or wanted to moonlight, surely for good reasons. Just be ready now to deal with the disciplinary charges. And let us help you do so, raising your best defense.
Nursing Board Authority to Discipline
Your state nursing board likely has clear authority to discipline you for the above issues relating to your moonlighting. State nursing practice acts and their implementing regulations routinely include conflicts of interest, patient confidentiality breaches, and even duty of loyalty violations among their grounds for license discipline. The Minnesota Nurse Practice Act is an example. Its Section 148.261 includes among the nearly two dozen disciplinary groundsviolations of the standards or ethics of the nursing profession, any unprofessional conduct, and any other acts that harm or endanger patients. Those and related provisions are plainly broad enough to reach conflicts of interest and loyalty breaches. Section 148.261 also expressly lists patient confidentiality breaches as grounds for discipline. Don't doubt your state nursing board's authority to discipline you for issues that arise out of your moonlighting.
Disclosure of Moonlighting Disciplinary Issues
How your state nursing board's disciplinary officials learn of your alleged nursing violations arising out of your moonlighting may affect the outcome of those issues. Disciplinary officials generally respond diligently to patient complaints about nursing care and nurse character, given the officials' duty to protect patients and the public. But disciplinary officials may credit your full-time employer's complaints even more, given your employer's greater knowledge of nursing rules and standards. If you get sideways with your full-time employer over your moonlighting, one of your employer's representatives or your colleagues at your full-time workplace may report your alleged misconduct. Nurses and other healthcare professionals often owe duties to report suspected disciplinary violations by other health professionals, as an important practice of self-policing. Let us help you promptly address any patient or employer concerns before they reach the level of a formal complaint to your state nursing board's disciplinary authorities.
Defenses to Moonlighting Disciplinary Issues
Just because you face a disciplinary charge over your moonlighting activities does not mean that you will incur a license sanction such as suspension or revocation. You may have a perfectly valid defense to the disciplinary charges that we can raise, document, and present, leading to the early dismissal of the charges before your matter reaches a formal hearing, or after presenting your defense evidence at that hearing.
Conflict of interest defenses may include that you had no competing interests, the dual interests instead aligned, or the involved parties were aware of your conflict of interest and waived it because it presented no significant risk of harm. Breach of loyalty defenses may include that you were fully loyal to your full-time employer and its patients, that you committed no loyalty breaches, and that your moonlighting, if anything, benefited your full-time employer and its patients rather than interfering with their better interests. We may also be able to show that you respected all patient confidentialities and committed no trade secret violations. Let us help you evaluate, present, and strategically advocate your defenses to achieve your goal of avoiding disciplinary sanctions.
Nursing Board Sanctions for Moonlighting Issues
Your state's nursing practice act will provide a range of disciplinary sanctions in the event that the nursing board finds that you violated one or more of its standards. Nursing practice acts routinely authorize sanctions progressing from warnings and private reprimands to remedial education or training, peer review and mentoring, public censure, probation with conditions or license restrictions, and fines and restitution, up to license suspension and revocation. The Texas Nurse Practice Act and its implementing regulations are an example. They refer for disciplinary grounds and sanctions to Texas Occupational Code Section 301.452. Drawing from that authority, the Texas Board of Nursing publishes a discipline matrix applying all of the above sanctions and more.
Mitigating Sanctions over Moonlighting Issues
While the breadth and potential severity of disciplinary sanctions may concern and even scare you, state nursing practice acts generally leave to the state nursing board the discretion to choose the sanction. That discretion enables us to advocate wisely and strategically for remedial measures over punitive sanctions, to preserve your license and employment. We may be able to make out a strong case in mitigation, reducing or even eliminating any sanction, even if your moonlighting did lead to standards or ethics violations. For instance, we may be able to show that no patient suffered or risked any harm from your alleged violations, that your employers suffered no damage, and even that your moonlighting benefited both employers and their patients. Alternatively, we may be able to show that you reasonably and innocently misunderstood your obligations and that you have had or will readily agree to have additional education and training in the relevant standards and ethical provisions. Our attorneys know what state nursing board officials are likely to accept in the way of compromise workouts that preserve your clean disciplinary record, license, and employment.
Board Procedures Over
If you already face formal disciplinary charges over your moonlighting issues, we can help you invoke the available procedures to protect your interests. You hold a constitutionally protected property and liberty interest in your nursing license and practice, against state nursing board action without due process. Due process guarantees that you receive fair notice of the charges and a fair opportunity to contest those charges in a hearing before an independent decision maker. Your state nursing practice act should recognize and reinforce those constitutional guarantees. The South Carolina Nurse Practice Act is an example, providing for a hearing at which the accused nurse may present exonerating and mitigating evidence, and an appeal from any adverse decision. The Act further references the state's administrative procedures act for other procedural protections.
The Attorney's Role in Nursing Board Procedures
We can invoke your state nursing board's protective procedures to your best advantage in defense of your disciplinary charges relating to moonlighting. We can evaluate the board's notice of charges, ensuring that the board adequately details and specifies the charges so that we can help you effectively defend. We may be able to arrange an early resolution conference at which to present your evidence and arguments for voluntary dismissal of the charges. If your matter proceeds on formal charges, we can invoke your right to a formal hearing, at which we can present your witnesses and other exonerating and mitigating documentation and evidence, while cross-examining adverse witnesses and challenging other incriminating evidence. If you have already lost your formal hearing, we can take the available appeals, whether to a higher agency panel or official, or straight to civil court, depending on your state's procedures. Our attorneys know the procedures and how to invoke them for your best defense.
Preserving Your Full-Time Employment
You retain our premier license defense attorneys primarily to represent you in your state nursing board license disciplinary proceeding. We may well be able to help you prevail in that proceeding, resulting in a dismissal of all charges and keeping your record clean. But we recognize that your employer may misconstrue notice of charges as if you in fact did some wrong, warranting your employment termination. Your interest isn't only in preserving your license. A license without a job may not mean that much, if you're not earning an income. Your goal in this matter likely includes preserving your current employment or other planned or prospective employment.
To achieve your full range of goals, our attorneys can help you communicate with your current employer. If your employer raises concerns over your disciplinary charge, we can communicate with your employer that we are aggressively and effectively defending you, expecting to preserve your nursing license. We can also communicate with your employer with reassuring updates on the status of your disciplinary proceeding, again with the goal of preserving your employment. If your employer has already terminated your employment over the disciplinary charges, we may be able to invoke your employer's grievance procedures seeking reinstatement, especially if we are able to win a dismissal of the disciplinary charges. Let us help you manage your employer relationship, even as we primarily focus on the disciplinary proceeding.
Your Stakes in the Disciplinary Proceeding
The above discussion about your employment is a good reminder that your stakes in the disciplinary proceeding are much broader than just keeping or losing your current nursing license. If you lose your license, you could lose other licenses you hold in other states and the ability to obtain reciprocal licenses in other states. You could also lose other healthcare licenses or certifications you hold. If you lose your license, you will lose your nursing employment. If you lose your employment, your personal and family finances may suffer greatly, leading to other severe collateral consequences. Beware all that you have at risk in your disciplinary proceeding. Let us help you manage, reduce, and eliminate those risks.
Premier Attorneys for Nursing License Defense
The Lento Law Firm's premier Professional License Defense Team is available to defend you against your state nursing board's unauthorized moonlighting disciplinary charges. Our attorneys are available nationwide. We have successfully defended hundreds of nurses and other professionals across the country on all kinds of license issues including issues related to moonlighting. Call 888.535.3686 or complete this contact form now for our premier license defense representation.
