The U.S. healthcare staffing market is big business. In 2022, it was a $21 billion dollar industry and continues to show steady growth. Agency or “traveling” nurses are a new but rapidly evolving piece of that industry, and they're changing the way we look at healthcare.
Of course, with new solutions come new challenges, and that's certainly true with agency nurses. While this type of medical professional provides a crucial service – often filling in where nurses are needed the most – the nature of this “floating” employment can open the door to complaints of misconduct.
And because agency nurses aren't really “employees,” the dismissal process is often swift, leaving the nurse little chance to offer a defense and protect their good name.
But given how important nurses are to our healthcare system, it's crucial that all nurses have the resources they need to defend themselves against accusations of wrongdoing. Having an experienced Professional License Defense Team that understands the South Carolina disciplinary process can help you defend your license and protect your career.
And that's why you should call the Lento Law Firm today. Our Professional License Defense Team has years of experience navigating the disciplinary process, and we can help you achieve the best possible outcome. Our law firm has worked with nurses and other medical professionals across the country in similar situations, and we can help you, too. Contact the Lento Law Firm today at 888-535-3686, or tell us about your situation online.
How Are Nurses Regulated in South Carolina?
In the United States, regulatory authority over nurses is granted to the individual states and territories, referred to as Nursing Regulatory Bodies, or NRBs. Each NRB then enacts its own version of the Nurse Practice Act (NPA) to manage and regulate the nursing profession.
In South Carolina, this regulation is handled by the state's Board of Nursing (Board) in cooperation with the South Carolina Department of Labor, Licensing and Regulation (LLR). The Board oversees a variety of licensing concerns that range from verification of credentials to managing continuing education requirements and responding to complaints and licensing issues.
In the event that a complaint is made against a nurse, the Board will work with the LLR to investigate and resolve it, using the authority granted by the state's NPA and further defined within its Code of Laws. Most aspects of the investigation will be handled by the Board's Office of Investigations and Enforcement (OIE). This can include all types of allegations and can require a variety of investigation methods as well, such as record requests, witness interviews, depositions, and on-site examinations.
Who Is The NCSBN?
Because nurses are such a crucial part of quality patient care, the states joined together to create an additional layer of oversight and governing known as the National Council of State Boards of Nursing (NCSBN).
This not-for-profit organization enables states to collaborate on aspects like training, examinations, and licensing, and it ensures that all nurses work with a similar set of standards and expectations throughout all fifty states, plus Washington D.C., and four US territories.
What Types of Allegations Can Endanger a Nursing License?
Complaints against medical professionals can include a variety of actions and behaviors, and this is true for nurses as well. South Carolina has a long and detailed list of actions that could put your nursing career at risk, including:
- Allowing someone else to use your license
- Violating federal or state law with acts of moral turpitude
- Demonstrating behavior or conduct that suggests incompetence
- Providing nursing care while under the influence
- Failing to properly document patient records with the expected standard of care
- Practicing outside the scope of your license
- Practicing with a fraudulent license
- Abandoning a patient
- Excessive use or abuse of drugs and alcohol (note that this includes off-site, after-hours use as well as on the job)
- Patient abuse or neglect, including physical, verbal, and emotional mistreatment
- Theft and fraud, including physical property as well as electronic theft, such as falsifying records or billing insurance companies for services not rendered
- Failing to report incompetence, abuse, theft, or any other actions that could cause harm or jeopardy
- Unprofessional conduct
- Practicing with an expired, suspended, or revoked license
- Misrepresenting yourself as a physician
Also, keep in mind that patients aren't the only people who can make complaints. Allegations of this kind can be reported by almost anyone, and this includes your co-workers as well. South Carolina has mandatory reporting requirements that apply to all healthcare professionals, facilities, peers, organizations, and insurance companies.
That means anyone who has direct knowledge of the action or behavior in question can file a complaint.
Do Agency Nurses Face Unique Disciplinary Challenges?
The short answer is yes! Like staff nurses, agency nurses are held to the highest standards and are required to pass the same licensing and continuing education requirements. They are also subject to the same kind of allegations mentioned above.
But where staff nurses typically have the benefit of orientation and additional on-site training, agency nurses are often bridging a gap in more urgent situations — covering shifts that no one else wants, for example, or filling in because the facility has a staffing problem, a sudden surge in patients, or an ongoing nursing shortage.
Circumstances like this can put agency or “contract” nurses in stressful or even volatile situations, with little to no support or guidance. This opens the door to mistakes and miscommunication that can result in formal complaints.
In addition, agency nurses don't usually receive the same kind of facility “loyalty” that staff nurses might expect, meaning that it's often easier to just let the nurse go rather than investigate the claim. This “out the door before you even know about the complaint” can make it difficult to defend your standing as a qualified medical professional.
Other potential concerns agency nurses should be aware of include:
- Poor management and oversight in the facility
- Dangerously low staffing levels
- Lack of proper support and/or job screening procedures within your agency
- Internal conflicts and low employee morale within the facility
- Resentment or lack of cooperation from staff nurses or other personnel
Of course, you don't have to face these challenges alone. The Professional License Defense Team at the Lento Law Firm can help you protect your nursing license and defend your reputation when you need it.
What Happens If a Complaint Is Filed Against Me?
Ultimately, agency nurses will face the same complaint process and potential disciplinary actions as any staff nurse working in South Carolina. The main difference is that you may not be afforded the same initial considerations that a staff nurse would receive from the facility, as we mentioned above.
If an allegation is made against you, the facility may choose to simply dismiss you and report it to your contracting agency. Your agency may also choose to dismiss you in lieu of pursuing any investigation, and this can make it difficult to defend your reputation and license to practice.
In fact, by the time the Board gets involved (if they get involved), you may have already lost both your assignment and your agency contract. And this can be frustrating, to say the least.
Having an experienced Professional License Defense Team can help you defend your nursing license and protect your good name in the field. The Lento Law Firm Team has that experience, and we're ready to help when you need us most.
What Is the Disciplinary Process for Agency Nurses In South Carolina?
The LLR can receive complaints via mail, fax, or online. Once a complaint is received, it is passed onto the OIE for review.
If it is determined that the allegations as submitted would constitute a violation of the NPA, the case is assigned to an investigator. Within 30 (thirty) days of the assignment, the investigator will contact you to get your side of the story.
You do not have to participate, but it is strongly recommended that you do, as the complaint will be investigated with or without your involvement. You are allowed to consult with legal counsel during this time, and the Lento Law Firm can help you prepare a response to any allegations that may have been made.
As mentioned, the investigation can involve different methods and actions, including witness interviews and on-site inspections. The investigator can also issue subpoenas and request records as well. This process is usually completed within 180 days but can last longer if necessary.
Once the investigation is complete, the investigator will convene an Investigation Review Conference (IRC) with the chief investigator, the Board administrator, professional members of the Board, and the Board's legal counsel. Together, members of this conference will hear the evidence and decide how to proceed.
This conference will have one of four outcomes:
- More information is needed
- A recommendation that the LLR file a formal complaint
- A letter of caution should be issued to the licensee
- The matter should be dismissed
You should note that the participants in this conference do not have the final say in this matter. That resides with the Board, and it will hear recommendations resulting from the conference at its next scheduled meeting.
The Board can then decide to accept the recommendations or make a ruling on its own. Either way, the Board will choose one of three options:
Dismiss the complaint
If the complaint is dismissed, the investigator will send you a letter confirming this fact, and the complaint will be closed.
File a formal complaint
If a formal complaint is filed, the investigator will prepare formal charges, and you will be served with a formal summons.
Issue a non-disciplinary letter of caution
In this instance, it has essentially been determined that no statutory violation exists, and therefore, the complaint will be closed. However, certain actions or behaviors “raised some eyebrows,” and you should take care to avoid these actions and behaviors going forward.
Will A Complaint Affect My Multistate (Compact) Nursing License?
In addition to providing continuity for training and educational resources among nurses, the NCSBN also created the Nurse Licensure Compact. This is a multistate agreement that gives nurses the ability to move between member states and go wherever they're needed most without having to obtain new, stand-alone licenses for each state.
South Carolina is a member of this Compact, making it easy for agency nurses to travel between states as new employment opportunities arise.
If the complaint of misconduct is dismissed, there shouldn't be any cause for concern. But if disciplinary action is taken, then yes, that can affect your multistate license.
The reason is that multistate licenses rely on the credentialing process of the home state to satisfy the initial screening and verification process. In fact, it's the first requirement to obtain a multistate license - you must be in “good standing” in your home state. Disciplinary action would not meet that requirement.
You also can't be under any active disciplinary actions in other states; that's one of the requirements, too, so any formal actions taken against you could have a direct effect on your continued ability to practice in other states.
Should I Sign a Consent Agreement?
When a formal complaint is filed, nurses are sometimes given the option to sign a consent agreement as a way of avoiding a formal hearing and any potential disciplinary actions that might follow. This agreement is a legally binding contract between you and the Board, and it is not something to take lightly.
The agreement basically works like a plea deal: you agree to accept responsibility for the actions alleged in the complaint, and you agree to accept whatever disciplinary action the Board has deemed appropriate. In exchange, the Board will not pursue further action; you don't have to go through a formal hearing, and the process is essentially over.
And in some cases, that may be your best course of action. But there are downsides to consent agreements, too.
For starters, you are admitting to the charges, so you're waiving your right to a hearing. That makes it harder to appeal the decision if you change your mind down the road.
The consent agreement and any license restrictions or other disciplinary actions that result are also public records, and this is especially important for agency nurses.
After all, one of the benefits of agency nursing is the freedom to travel, and the multistate license is a key piece of that puzzle. A consent agreement triggers the same license requirements as disciplinary actions that result from a formal hearing, and both can affect your ability to continue practicing as a nurse.
The good news is that the Professional License Defense Team at the Lento Law Firm has experience defending nurses nationwide.
That means we can help you navigate these proceedings and negotiate the best possible outcome everywhere you practice.
What Happens If a Formal Complaint Is Filed?
In the event you refuse to sign a Consent Agreement (or if this option is not offered), you may be served with a summons notifying you of a formal hearing.
If this happens, it's important that you stay calm. Don't panic.
This hearing will be before the Board, and it will work very much like a regular court hearing. The State will present its case through an attorney representing the LLR, and then you will have the chance to present your side.
Once all evidence and testimony have been presented, the Board may choose to hold a vote, or they may defer voting pending further consideration. If the Board finds that your actions violated a statute or regulatory rule, they have the authority to impose sanctions.
This authority is broad — disciplinary actions can range from monetary fines to revocation of your nursing license. The severity of the disciplinary action will depend upon the specific allegations under consideration, and should the Board rule against you; you will have thirty (30) days to appeal to the Administrative Law Court.
That makes it all the more important that you present your best defense and demonstrate your commitment to your practice as a nurse.
Once again, you are allowed to have counsel present and acting on your behalf during this process. It is crucial that you don't try to navigate this process on your own and that your legal team understands the delicate nature of these proceedings. The Lento Law Firm has both the experience and knowledge of the law to help you present your best defense in these matters.
How Can I Verify My Nursing License Is in Good Standing?
Registered Nurses (RNs), Practical Nurses (PNs), and Vocational Nurses (VNs) in South Carolina can verify their credentials using an online database called Nursys. This database is managed by the NCSBN and its member boards and provides nationwide licensing verification, along with disciplinary actions and practice privileges.
Nursys can also supply status updates and license expiration alerts for nurses who sign up and can also forward your credentials to a member Board if you'd like to pursue practicing in another state.
What Does it Mean to Make My License “Legally Defensible?”
As an agency nurse, you are essentially a freelance provider… and that means you also have to be your own PR department. Providing clear communication, attention to detail, and expert-level skills can help ensure you always receive good feedback from your facilities.
And that improves your ability to get new assignments in the future.
This same kind of mindset can help you defend your license, too.
When you are called before the Board, you're not just explaining your side of the story; you're also demonstrating why you should be allowed to continue your practice as a nurse.
This is known as making your license “legally defensible,” and it can be a major asset to your defense.
Your “evidence” can include any special training you've received, educational programs you've taken, and the experience you bring to the table.
The American Nurses Association (ANA) offers online classes on a variety of focused topics, for example, designed to help nurses advance their skills and improve their ability to provide patient care.
Paying attention to the details – such as double-checking patient documentation, verifying instructions, and staying observant and attentive – can help, too.
What A Professional License Defense Team Can Do for You
We understand that this can be overwhelming. You've worked hard for your nursing license, and now it feels like it could just all be taken away. That's why now is the time to take action. In fact, the sooner, the better. The Professional License Defense Team at the Lento Law Firm can help you navigate every stage of the disciplinary process – even before a formal complaint has been filed – and prepare your best defense. This can include a variety of actions, such as:
- Analyzing your case and offering guidance on your best course of action
- Filing an initial response to the complaint
- Gathering evidence and witnesses to help support your defense
- Negotiating with the Board
- Negotiating with your contracting agency or facility
- Representing you in all interactions with the LLR, the Board, and the Administrative Law Court, if necessary
- Negotiating the best possible conditions for a consent order
- Defending you at a formal hearing
- Helping you show your commitment to your nursing practice
Having our team on your side will give you the peace of mind you need to make it through this process and keep your composure. We know it can be scary. We know it can feel overwhelming. That's why we're here.
What Areas Does the Lento Law Firm Serve?
As we mentioned earlier, our law firm has worked with nurses and other professionals all across the country. That means we can help you regardless of where you live and work. This includes South Carolina's largest cities, such as Charleston, Columbia, and Mount Pleasant, as well as its smaller towns and rural areas, like Georgetown, Lake City, and Beaufort.
It also means that our law firm can help you defend your multistate practice as well, and that can be essential for agency nurses who like to travel between states. Many nurses also offer telehealth services, and we can help you there too.
In fact, our Professional License Defense Team can help you protect your license, no matter where you work or where you live.
Contact The Lento Law Firm to Protect Your Nursing License
We know you want to do everything you can to protect your nursing license; our law firm will work just as hard to defend it. And that's important when your career and your future are on the line.
Having an attorney who understands the disciplinary process in South Carolina can be the catalyst you need to level the playing field and give you the best possible outcome.
Rest assured that the Board and the LLR will have all the resources they need to conduct their investigation and choose the best course of action. Shouldn't you have that same kind of support?
The bottom line is this: you don't have to face this process alone. You don't have to “wing it” or just “hope for the best.” Our Professional License Defense Team will give you the support and experience you need to present your best defense. Don't wait another day.
Contact the Lento Law Firm Team today at (888) 535-3686 or through our online form, and get the peace of mind you need.
