Whether you're a registered nurse, a licensed practical nurse, or an advanced practice registered nurse such as a nurse practitioner or nurse anesthetist, you've worked hard to get to where you are today. You have likely endured years of schooling, many hours of training, and a lot of time studying for and taking your licensing exam (or exams), not to mention keeping up with your state's continuing education requirements. That's why when you learn that you've been accused of misconduct and are under investigation by your state's board of nursing, you need to contact the Lento Law Firm Professional License Defense Team as soon as possible.
Our experienced professional license defense attorneys understand how important your nursing license is to you, and they know how to defend you and protect your rights through what can be a long, stressful investigation and disciplinary process. Call us today at 888.535.3686 or use our contact form to set up a confidential consultation to learn more about how the Lento Law Firm Professional License Defense Team can help you.
The Disciplinary Process
While the procedures will vary somewhat from state to state, generally speaking, once a complaint has been made against you – which can come from anybody but tends to come from co-workers (including supervisors) or from patients and their families – the state board of nursing will first determine whether the complaint relates to something the board regulates. Fee disputes or personality clashes typically aren't things that are regulated, for example. However, if the complaint is about a nursing work-related issue, the board will assign it to an investigator, who will be responsible for looking into the complaint and gathering evidence about the issue.
If the investigator finds support for the claim, the board may come to you with a proposed resolution, essentially, a settlement where you admit to certain facts and agree to accept a certain penalty. If you don't agree to settle the matter, it will normally proceed to some kind of hearing. Penalties can vary widely and can range from essentially verbal warnings to written reprimands, probation periods that include education and reporting requirements, and may include scope-of-practice restrictions, license suspensions, and license terminations. And if you are disciplined in one state and licensed in others, that discipline is likely to be reported to and reflected in your other state registrations as well – meaning that if you are suspended in one state, you may be suspended everywhere you're licensed.
You can learn more about the typical disciplinary process here. But what's important to take away from all of this is that your chances of a favorable outcome are, in most cases, significantly better if you have retained an experienced professional licensed defense attorney. The Lento Law Firm Professional License Defense Team can help youunderstand the charges made against you, protect and advise you during the investigation process, conduct their own investigation where doing so is appropriate, and defend you during any disciplinary hearing.
Reasons Nurses Lose Their Licenses
Generally speaking, nurses will lose their licenses when they fail to provide an acceptable standard of care to one or more patients, and as a result, they place those patients in danger. The question is typically not whether the patient was actually harmed because of the nurse's actions; it is whether the patient was at risk of being harmed.
This means that a nurse can be sanctioned even in a situation where no patient was ever harmed by the nurse's actions. It's important to understand this because it means a complaint can be made against you even in situations where no specific patient was involved. If the complaint claims that you deviated from the proper standard of care, that is typically enough to move forward with the disciplinary process.
Here are some of the main reasons nurses find themselves facing discipline that, in the worst case, can mean losing their nursing licenses:
Substance Abuse
Whether it's illegal or legal drugs or alcohol, a nurse who practices while they appear to be impaired can find themselves the subject of a disciplinary investigation and proceeding. This can happen even by accident – a nurse is taking a prescribed or over-the-counter medication and has an unexpected adverse reaction to it.
But of course, it can also happen because a nurse has used or abused alcohol or drugs. We don't need to tell you that nursing can be an extremely high-stress profession, and when you add a stressful workplace to the other challenges that life tends to throw at all of us, it's not unusual for anyone (nurse or otherwise) to turn to alcohol or drugs as a release. But when it becomes a habit, or when the nurse is appearing for work while under the influence of drugs or alcohol, patients can be placed at risk.
If there is a number-one reason for nurse discipline, it is very likely misconduct that relates to drug or alcohol dependency or use. An analysis of one state's disciplinary proceedings for nurses between 2015 and 2017 revealed that more than 80 percent of the cases handled by the board of nursing involved alcohol or drugs, with the actual percentage possibly higher than that because some of the accused nurses voluntarily handed in their licenses rather than face board discipline.
Nurses found to have been working while under the influence of drugs or alcohol can face a number of sanctions, including restrictions on their practice – so they do not have access to certain drugs or only work a certain number of hours or shifts – as well as suspension of their licenses pending treatment for alcohol or drug abuse, or outright revocation of their licenses.
In many cases, nurses accused of drug- or alcohol-related misconduct may be offered an option to avoid disciplinary proceedings in return for participating in what is often called an “intervention program” or an “alternative to discipline” program. These may seem attractive at first glance, but it's important to note that most of them (a) require the nurse to stop working for an extended period of time and (b) expect very strict compliance with intensive and long-term education and therapy programs.
If you're offered one of these alternative programs, it can be enormously helpful to discuss it in advance with an experienced attorney from the Lento Law Firm Professional License Defense Team who can help you determine whether it really is your best option given the facts of your particular situation. And if you've been accused of alcohol- or drug-related misconduct, you need the strong defense that our license defense attorneys can provide.
Drug Diversion
Many nurses have day-to-day access to both prescription and non-prescription drugs and are expected to properly administer them to patients as directed by doctors and others authorized to prescribe. Most offices and care facilities that keep an inventory of these kinds of drugs also keep close control over who has access and what drugs are removed from stock and by who. Nevertheless, it is still possible for medical professionals, including nurses, to divert drugs that are intended for a specific patient to their own use (or for the use of a friend or even to sell).
When drug diversion happens, a number of people can be put at risk, beginning with the patient for whom the drug was prescribed. While the patient may be able to “get by” without one of their prescribed doses or with a reduced quantity of the prescribed drug, the fact remains that when a patient doesn't receive the medications they were prescribed, their care may be compromised.
Also put at risk is anyone who takes the diverted drugs without a prescription, whether it's the nurse who diverted them, the friend they diverted them for, or the person they sold the drugs to. While the focus of nursing board disciplinary proceedings is on patient care, when a nurse diverts drugs for any reason, it is grounds for serious disciplinary sanctions. It can also result in the nurse being reported to local law enforcement authorities, which can lead to a criminal investigation and charges.
The possibility of having to face both criminal charges and disciplinary proceedings means that a nurse accused of drug diversion needs the help of an experienced professional license defense attorney who also understands criminal law and procedure. The Lento Law Firm Professional License Defense Team can help in these situations. Contact us to learn more.
Theft
While drug diversion is, of course, also theft, there are other types of theft that can cause a nurse to be investigated and disciplined. For example:
- Theft from patients. Stealing money, jewelry, credit cards, or other items from patients strikes at the heart of the kind of trusting relationship that is at the heart of proper patient care. That said, because nurses have such frequent contact with patients, they are also often falsely accused when a patient's belongings go missing.
- Theft from employers. It might seem inconsequential to take home a roll of partially used tape, other office supplies, medical supplies such as masks and gloves, or other small inventory items, but the fact remains it's still theft. And while it may be something that “everybody does,” it can also be the basis for a disciplinary complaint, particularly if there are other care issues that support making a complaint. Another situation that can arise is when a co-worker or supervisor who you're having a personality dispute with decides they want to get back at you by filing a disciplinary complaint against you and use this sort of “petty theft” as an excuse. Of course, theft can be large-scale as well. It's not unheard of for equipment to go missing or for entire cases of supplies to disappear from stock rooms. These are more serious situations that can also result in criminal charges.
Theft allegations, particularly those against patients, are ones that strike at the heart of the bond of trust that should exist between a patient and their healthcare professional. For this reason, allegations that a nurse has stolen from a patient are taken particularly seriously. If you've been accused of doing so, you need help from one of the experienced attorneys from the Lento Law Firm Professional License Defense Team.
Fraud
Fraud is yet another type of theft and involves making claims that will result in undeserved payments being received by the nurse or by the nurse's employer.
There are several types of fraud allegations that nurses may face. One is fraud against their employer, which can happen when a nurse falsely records their time (claiming they worked hours or shifts they did not, for example) or asks to be reimbursed for work-related expenses they didn't incur.
A nurse can also be accused of defrauding a patient or an insurance company. For example, the nurse could claim that a patient received treatment they did not. Because the vast majority of patients are covered by insurance, this defrauds both the patient and their insurer because both are then responsible for paying for treatment that was not actually provided. This can often happen in home-care settings, where nurses are largely unsupervised on a day-to-day basis, and patients may be less diligent about reviewing bills. In some cases, however, a fraud claim against a nurse can happen when a patient doesn't understand what they've been billed for and mistakenly assumes that they didn't receive treatment that, in fact, was properly given.
Nurses who have the authority to write prescriptions have been accused of writing false ones for treatment, medication, or medical equipment that was not necessary. In these situations, the company selling the treatment, medication, or equipment has benefited, and the nurse typically benefits by way of a referral payment (or “kickback”) from the company for writing the fraudulent prescription. The insurer (or government, when Medicare or Medicaid is involved) suffers as a result of paying for unnecessary procedures or equipment.
Nurses accused of fraud by their board of nursing may also face criminal charges. If you find yourself facing fraud allegations – whether disciplinary, criminal, or both – contact the Lento Law Firm Professional License Defense Team for help.
Criminal Acts
Nurses are typically required to report any misdemeanor or felony convictions (or “no-contest” pleas) to their state nursing board when they apply for or renew their license. Depending on the state, they may also have an ongoing obligation to report criminal charges, convictions, or no-contest pleas to the nursing board in between renewals. These reporting requirements typically also apply in cases where a nurse is arrested for driving while intoxicated or under the influence, even if that charge is later reduced. Boards may or may not take action against the nurse, depending on the type of crime involved.
There are certain crimes that will result in a nurse losing their license almost without question. For example, any crime that results in the defendant having to register as a sex offender will typically result in the loss of the person's nursing license. Similarly, crimes of violence such as manslaughter, murder, elder abuse, child abuse, and others can vary from state to state.
This is why it's vitally important for you to discuss your situation with an experienced professional license defense attorney if you are charged with or convicted of any crime. The Lento Law Firm Professional License Defense Team understands the complexities of protecting yourself in a criminal case and having to defend your professional license as well. Many of our license defense attorneys also have criminal defense experience and know how to protect your rights when you're fighting both criminal and disciplinary charges.
Failing to Report Out-of-State License Discipline
Many nurses are licensed in more than one state, and a common requirement of any nursing license is that the nurse report when they've been disciplined by any of the other state nursing boards with which they're licensed. With the Nurse Licensure Compact (NLC) covering more than 40 states, it's relatively easy for a nurse who has earned a license in one NLC state to register for and secure a license in another NLC state.
While this makes it much more convenient for a nurse to live in one state and work in another, it also means that the nurse must pay close attention to the licensing requirements for each state in which they are currently licensed. Most states will require nurses to report out-of-state discipline so that the board of nursing can consider whether to also impose sanctions on the nurse based on the out-of-state misconduct.
There is a system in place called NURSYS that will report misconduct sanctions imposed by one NLC state to a nurse's employer in another state if the employer uses NURSYS and has included the nurse among those whose license status it is tracking. However, NURSYS does not take the place of state licensing regulations that require the licensed nurse to report out-of-state discipline to the local board of nursing. And it's not at all unusual to see a nurse disciplined by one state board to be disciplined by another state nursing board for failing to report the discipline imposed by the first state. This is on top of the nurse being disciplined by the second state for misconduct found by the first state if the misconduct in the first state is also prohibited by the second state.
If you hold a nursing license in more than one state and learn that a misconduct complaint has been filed against you in one of those states, contact the Lento Law Firm Professional License Defense Team as soon as possible. In addition to defending you against the misconduct allegations, our experienced attorneys will also make sure you meet the reporting requirements imposed by all of the other states where you hold a license.
Failing to Properly Document Patient Care
Record-keeping is a vital part of health care. Whether it's in an office or a hospital setting, it's important to record vital signs, test results, diagnoses, treatment protocols, medication given, and other information about each patient so that it's clear what has been done in the past, and so that the information can be used to help care for the patient in the future.
When a nurse fails to record information relating to a patient's care properly, it can put the patient at risk. Neglecting to document that a patient had received prescribed medication, for example, could result in the patient receiving a double dose. This can easily happen when shifts change in a care facility, and the incoming nurse is relying on the documentation left by the departing nurse.
Because documenting patient care is so critical, nurses who fail to do it properly are frequently reported to state boards of nursing. Indeed, most states make it mandatory for one licensed professional to learn that another licensed professional, such as a nurse, has violated the standard of care for a patient. This means that when that standard is violated, such as by failing to document the treatment the patient received, the professionals working with the nurse who is responsible for the mistake may be required by law to report the nurse.
Not all documentation violation accusations are valid, however. Particularly when multiple healthcare professionals have access to the same patient records, and a number of people can be responsible for making mistakes. That's why if you've been accused of failing to document the care given to a patient properly, you need a strong defense. The Lento Law Firm Professional License Defense Team is ready to help you protect your nursing license and your future in situations where you've been accused of improperly documenting patient care.
Boundary Violations
It can be difficult to draw the line between providing compassionate, competent care for a patient and becoming so close to the patient that it becomes possible to take advantage of them. Patients may be grateful for the care that a nurse is being paid to provide and may offer the nurse gifts or other favors as a way of expressing their gratitude. This can be a problem when the gifts are substantial. In addition to violating workplace policies, it can be viewed as taking advantage of the patient – particularly where there may be questions about the patient's mental state.
Many nurses who accept gifts from patients find themselves accused of misconduct, particularly if the gifts are substantial. Depending on the situation, the nurse may be accused of taking advantage of the nurse-patient relationship to improperly influence the patient to provide the gift.
If a patient is insisting on giving you a gift of any value whatsoever, bring the situation to the attention of your supervisor. Accepting it could be a trap that could wind up with you facing disciplinary sanctions. If you have been accused of improperly accepting a gift from a patient, the Lento Law Firm Professional License Defense Team is ready to help you defend yourself, your nursing license, and your future.
Sexual Misconduct
A nurse can face serious sanctions if they're found to have committed sexual misconduct, especially when it involves a patient. Where a patient is concerned, there is essentially no such thing as consensual sex when it comes to nurse-patient relationships. This is why if you've been accused of sexual misconduct involving a patient, you need the help of an experienced professional license defense attorney as quickly as possible.
Sexual misconduct can also take place between colleagues. In cases where the misconduct rises to the level of sexual assault, the matter is likely to be referred to law enforcement. In that kind of situation, a nurse accused of committing criminal sexual misconduct against a fellow employee can also be disciplined by their board of nursing based on the criminal charge.
Because many sexual misconduct cases are referred to local law enforcement if you are a nurse accused of sexual misconduct – whether with a patient or with another employee – you are also likely to need the help of a criminal attorney. The Lento Law Firm Professional License Defense Team includes attorneys with both professional license defense experience and criminal law experience. They are ready to help you defend yourself against both types of allegations, keeping in mind that even if you're not charged with a sexual assault crime, you can still face serious discipline from your board of nursing.
Failing to Provide the Appropriate Level of Care
Many nurses are disciplined for failing to provide patients with the appropriate level of care, which can also be referred to as a breach of duty, negligence, nursing malpractice, or by other terms. This is a broad category that can include a range of misconduct, depending on the circumstances. Some examples include:
- Providing a patient with the wrong medication, or wrong dosages, or at the wrong times
- Failing to monitor a patient as required based on the patient's condition
- Making mistakes when conducting routine procedures, especially if the patient is harmed as a result
- Failing to properly document patient care (discussed in more detail above)
- Abandoning a patient: a common example is if a nurse leaves their shift early and fails to make sure another nurse is caring for a patient in their place.
- Not getting a patient's “informed consent” for treatment or failing to make sure that the patient (or their proxy) has provided informed consent.
- If the nurse is supervising other nurses or student nurses and fails to do so properly, the nurse can be responsible if mistakes are made by the supervised students or nurses.
Everybody makes mistakes, and many disciplinary proceedings based on the failure to provide the appropriate level of care are the result of the nurse making one or more mistakes that either did or could affect the care given to one or more patients. In many cases, disciplinary sanctions will involve the nurse receiving additional training in specified areas and possibly being restricted from certain types of work until they have completed the required training.
The consequences can be more severe if the nurse has repeatedly failed to meet the required standard of care, even after being disciplined and retrained. In those cases, depending on the underlying allegation, the discipline could rise to the level of suspension or revocation of the nurse's license.
If you have been accused of failing to provide a patient with adequate care, you need the help of an experienced professional license defense attorney to protect your rights and gather information that can be used in your defense. The Lento Law Firm Professional License Defense Team understands how complicated these kinds of disciplinary charges can be to prove and will work with you to deliver as strong and effective a defense as possible.
Contact the Lento Law Firm Professional License Defense Team if Your Nursing License is in Jeopardy
It can be frightening and stressful to learn that a misconduct complaint has been brought against you, one that could result in your suspension or even the revocation of your nursing license. That's when you need the help of one of the experienced attorneys from the Lento Law Firm Professional License Defense Team. We've helped healthcare professionals all across the country, including nurses, protect their licenses, their livelihoods, and their futures when they face the board of nursing investigations and disciplinary proceedings.
And when your disciplinary matter threatens to result in a criminal charge, our attorneys are ready and able to fight for your rights and defend you in those types of proceedings as well.
Call us today at 888.535.3686 or contact us online to schedule a confidential consultation to learn how the Lento Law Firm can help defend your rights and protect your nursing license. You've worked hard to earn your license; let us help you keep it!
