Agency nursing is a difficult job, both physically and emotionally. As an agency nurse in Virginia, you likely face long hours, physical demands, and difficult and stressful situations daily. While your work is incredibly important, it is often thankless. Patients and their families don't always appreciate the care and attention you put into your job day in and day out. When dedicating so much of your time and energy to others, it is painful to learn allegations have been made against you that can threaten your agency nursing license.
Disciplinary action against your nursing license must be taken seriously. Even if the infraction seems like no big deal, there is too much at stake not to take immediate action. The Lento Law Firm's Professional License Defense Team has helped numerous Virginia agency nurses battling disciplinary action. You cannot afford to go through this process without professional assistance. With the Lento Law Firm on your side, we walk you through every step of the process and thoroughly prepare you for the journey ahead. Don't wait to call our Team at 888-535-3686 or contact us online.
Virginia Agency Nurse Regulatory Body
The Virginia Department of Health Professions and its Board of Nursing are the regulatory bodies overseeing nurses and their licenses. The Board of Nursing regulates a wide variety of nurses and health aids, including those agency nurses working as registered nurses (RNs), licensed practical nurses (LPNs), advanced practice registered nurses, nurse anesthetists, nurse midwives, advanced certified nurse aides, and clinical nurse specialists. The Board also controls the prescriptive authority for nurse practitioners. The Virginia Board of Nursing comprises 14 members and support staff for administrative, licensing, discipline, and education purposes.
Virginia Agency Nurse Laws and Regulations
Various laws and regulations govern nurses in the Commonwealth of Virginia; the main ones under which disciplinary action may be taken against an agency nurse include the Virginia Nurse Practice Act and the Medical Practice Act. There are also specific laws related solely to certified nurse aides. Additionally, Virginia has a variety of laws governing medical professionals' prescription and handling of drugs.
The Board of Nursing also publishes guidance documents that outline standards of care, protocols, and more. Nurses must abide by these guidance documents to avoid disciplinary action.
Virginia Agency Nurse License Disciplinary Actions
While every case is different, all cases involving potential violations of nursing laws and regulations will begin with a complaint and some level of investigation. If matters are pursued past the initial investigation, they will follow some version of this trajectory:
Complaint
Complaints are filed through the Department of Health Professions Enforcement Division. This Division receives and investigates thousands of complaints each year; of course, not all are found and result in any form of disciplinary action. The Enforcement Division is the first to accept any complaints from Virginia healthcare professionals, including nurses who may have violated Virginia's nursing laws, regulations, or standards of care.
Anyone can file a complaint against a healthcare professional. A complaint can be filed in a few ways; the easiest and most common method is through the Online Complaint Form. The complaint form can be printed, mailed, emailed, or faxed to the Enforcement Division. Alternatively, the Division does accept verbal complaints by phone.
The Enforcement Division does allow anonymous complaints, but they state they cannot guarantee anonymity throughout the disciplinary process. The Division of Enforcement will share the complaint with the nurse subject to it; the Division will not make any effort to redact any identifying information and must provide the complaint in its original unedited state to the nurse.
When a complaint is filed, it will immediately be recorded in the Department of Health Professions tracking system. A Complaint Intake Analyst will assess the complaint to determine if it warrants further investigation. During this assessment, the analyst will decide if additional information is needed; if so, an initial investigation will begin. This is not a true investigation but just a preliminary step used to decide whether further investigation is warranted.
The Complaint Intake Analyst can take the opinion that further investigation is not warranted and recommend this to the Board of Nursing, who will review it. The Board of Nursing then has the authority to concur and have the matter dropped or return the case to the Enforcement Division for further investigation.
You must immediately retain legal counsel as soon as you become aware that a complaint has been filed against you. The Lento Law Firm Professional License Defense Team has been involved in countless Board of Nursing cases, and we cannot stress enough the importance of having your attorney present from the start. You cannot guarantee that anyone other than your Lento Law Firm attorney is on your side or will fight for you during the disciplinary process.
Investigation
If the Enforcement Division determines there is merit to the complaint, an investigation will be opened and assigned an investigator. Cases are prioritized based on which require the most immediate attention; those cases are the ones the Enforcement Division believes possess a real or potential danger to public health or safety. There are four priority levels to which a case can be assigned:
- Priority A: Where an individual may have committed an act or is highly likely to commit an act that constitutes significant and substantial danger to health or safety, and such conduct could cause substantial harm and warrants summary suspension or license restriction.
- Priority B: Where an individual may have committed a harmful act to another person but does not pose an imminent threat to public safety.
- Priority C: Where an individual may have committed an act that could be harmful or considered substandard.
- Priority D: Where an individual has committed an act that does not harm the patient but may result in the loss of property, mislead a patient, or cause inconvenience.
The Enforcement Division has the authority to change the priority level of a case at any time new information is received.
During this time, investigators will collect evidence, including relevant documents, and interview those with knowledge or information about the allegations. The investigator will review their findings and draft a written report to be submitted to the Board of Nursing.
After a preliminary investigation, cases with allegations of unlicensed nursing activity will be sent to the Commonwealth of Virginia's Attorney General's Office for consideration of prosecuting the unlicensed nurse in a criminal matter. These cases will not be sent to the Board of Nursing.
Board of Nursing Review
The Enforcement Division's written investigation report will be sent to the Board of Nursing when completed. This will be the first time the Board of Nursing has become involved in the disciplinary process. The Board of Nursing will review the investigative report and determine if there is probable cause to continue pursuing the case. If probable cause is not found, both the complainant and the nurse in question will receive notification that the case will not be pursued further.
If the Board of Nursing is going to pursue the complaint, it will assess whether it is appropriate to immediately suspend the nurse's license as a summary suspension. This determination will be made if the Board of Nursing believes the nurse's conduct represents a substantial danger to public health or safety. To take action to suspend a nurse's license, they must either assemble a quorum or meet by telephone conference to vote on the matter. While the summary suspension does not require a formal hearing before issuance, the Board of Nursing must schedule a formal hearing.
The Board of Nursing has an obligation to immediately suspend the license of a nurse who has been convicted of a felony, has had their license revoked or suspended in another jurisdiction which has not been reinstated, has been den declared legally incompetent, or pays for their licensure with a dishonored check. Under rare circumstances, the court, as opposed to the Board of Nursing, will have the authority to suspend a nursing license; this particular occurrence would be for non-payment of child support.
Consent Orders
A nurse may enter a consent order with the Board of Nursing before an informal conference or formal hearing has been conducted. Entering into a consent order will generally require the nurse to admit guilt; you never want to admit guilt to the Board of Nursing without first consulting your Lento Law Firm attorney, who will help you weigh the pros and cons of pursuing a consent order.
Informal Conference
Informal conferences provide a mediation-type environment and opportunity to resolve the matter without the trial-like procedures and formalities accompanying a formal hearing. A committee from the Board of Nursing will conduct the informal conference, which will be open to the public. Through the informal conference, the nurse can share their side of the story and refute the evidence presented in the investigative report.
During the informal conference, the Board of Nursing may offer the agency nurse the option to enter a consent order, accept a reprimand, issue monetary penalties, impose terms and conditions on a license, exonerate the agency nurse of all charges, modify a previous disciplinary order, reinstate the agency nurse's license, or refer the matter to the full Board of Nursing for a formal hearing.
You are legally entitled to be represented by your Lento Law Firm attorney at the informal conference and should exercise that right. It might seem like the Board of Nursing is trying to work with you, and of course, you want a quick resolution, but you cannot afford to have your rights infringed upon or be taken advantage of if you do not have legal counsel there to defend you.
Formal Hearing
Under Virginia law, the purpose of a formal hearing is to take evidence regarding the allegations against the agency nurse through an adversarial, trial-like process. This process is an administrative proceeding and is significantly more formal and structured than the informal conference.
Even before the formal hearing starts, your Lento Law Firm attorney will file preliminary motions and prepare to fight for you in front of the Board of Nursing. Like at trial, there will be opening statements, testimony, direct and cross-examination of witnesses, evidence presentation, and more. Just as you would never represent yourself in court, under no circumstance should you represent yourself in the formal hearing.
Determinations
The Board of Nursing can take many possible actions. Some of these actions, as discussed above, are less formal and kept private; other determinations may become publicly available. The Board of Nursing may choose from any one or more of these options:
Case Closure
The Board of Nursing will close a case if there is insufficient evidence of violating a nursing law or regulation.
Consent Agreement
A consent agreement is a private between the Board of Nursing and the nurse; it is used instead of a public discipline in situations where there is little or no injury to a patient or the public and little likelihood of repetition by the practitioner
Consent Order
As discussed above, a consent order settles a case before the Board of Nursing pursues an informal or formal hearing with the agency nurse. The consent order will be a formal document containing a finding of fact, a conclusion or law, sanctions, and a waiver of rights to further proceedings (like a typical legal settlement). Consent orders are part of the public record and, therefore, have a greater impact on the agency nurse's career.
Reprimand
The Board of Nursing can choose to reprimand the nurse if they have committed a violation. The reprimand will have no impact on their practice ability. This option can only be pursued after the Board of Nursing has conducted either an informal conference, a formal hearing, or both. Both informal conferences and formal hearings are open to the public, and the decision will become part of the public record.
Monetary Penalty
The Board of Nursing can demand a monetary penalty; the penalty goes into the State Literary Fund. Monetary penalties can only be ordered after the Board of Nursing has conducted either an informal conference, a formal hearing, or both. Informal conferences and formal hearings are open to the public, and the decision will become part of the public record.
Impose Terms and Conditions
The Board of Nursing can impose different corrective actions for the agency nurse to take to continue practicing and maintain their Virginia nursing license. These corrective actions could include requiring the agency nurse to take supplemental education in certain areas or putting the agency nurse on probation with set terms to be completed before resuming normal practice. Imposing terms and conditions on a nursing license is a common way for the Board of Nursing to address violations surrounding physical or mental health or substance abuse. The Board of Nursing might require the agency nurse to participate in the Health Practitioner's Monitoring Program in these cases.
Like a few options above, the Board of Nursing can only pursue imposing terms and conditions on a license after conducting either an informal conference, a formal hearing, or both. Both informal conferences and formal hearings are open to the public, and the decision will become part of the public record.
Limited Practice Privileges
When the Board of Nursing orders limited practice privileges, it will suspend or revoke some privileges and responsibilities agency nurses have under their unrestricted license. For example, suppose the agency nurse's violation was related to substance abuse or misallocating restricted substances (morphine, oxycodone, etc.). In that case, they may lose the privileges of accessing, handling, or distributing these medications. As with many disciplinary actions, the Board of Nursing may only take this action after an information conference or formal hearing. The disciplinary action will be publicly available.
Suspension or Revocation
For severe violations, an agency nurse may face license suspension or revocation. This action can only be taken following a public informal conference or formal hearing and will be in the public record.
Dismissal
Unlike case closure, a dismissal will occur at a public informal conference or a formal hearing. Dismissal is reserved for cases where the agency nurse is acquitted or if insufficient evidence of a violation has been put forward during the proceedings.
After the Board of Nursing makes any of the above decisions, it will communicate those findings to the agency nurse and the person who filed the complaint.
Appeal
Once an order has been issued during an informal conference, it will become final 33 days after it is mailed to the agency nurse. During this 33-day window, the agency nurse can fight that order by requesting a formal hearing. Your Lento Law Firm attorney will do this on your behalf if you want to pursue this option.
Orders issued after a formal hearing also have a 33-day appeal window. If you want to appeal this order, your Lento Law Firm attorney will file an appeal with the circuit court in the relevant jurisdiction.
If you have not retained an attorney during the informal conference or the formal hearing, the Lento Law Firm can still help. You should never feel that all hope is lost. While it is never the best decision to enter disciplinary proceedings without a lawyer, the Lento Law Firm frequently enters cases during the appeals stage and has great success.
Burden of Proof
The burden of proof lies with the Commonwealth of Virginia; this means that the Board of Nursing must establish clear and convincing evidence that the nurse violated relevant nursing laws and regulations to take disciplinary action against them.
The burden of proof shifts to the agency nurse when they are requesting their license be reinstated. In these cases, the agency nurse has the burden of proof to establish evidence that they meet the eligibility requirements and are safe and competent to resume nursing practice.
Allegations That Can Lead to Actions Against Your Agency Nursing License
Many actions can threaten an agency nurse's license. Whether the actions are purely administrative or ultimately cause harm to a patient, all of the actions will be investigated. While there is a whole laundry list of actions that can threaten your agency nursing license, a few common actions include:
- Falsifying order
- Documentation errors
- Insurance fraud
- Abuse or theft of controlled substances
- Unprofessional conduct
- Inappropriate relationships with a patient
- Theft or misappropriation of patient property
- Criminal conviction
Consequences of Disciplinary Action Against Your Agency Nursing License
As you can imagine, the consequences of disciplinary action against your Virginia agency nursing license can be life-altering. Losing your license means losing your livelihood, damaging your reputation, and potentially impacting your personal relationships. Likely, you have people in your life who are counting on you, and you cannot afford to have the allegations against you derail your life.
Disciplinary action against you will lead to immediate consequences. When disciplinary action is taken against your agency nursing license, you will be added to the Nursys, a national licensure and disciplinary database for nurses. This database, and others, provides employers and the public access to licensure information on nurses throughout the country. This means that disciplinary action taken against you in Virginia will have a ripple effect on your potential employment in all other states.
Areas We Serve in Virginia
The Lento Law Firm serves agency nurses all over Virginia. We have worked with nurses from some of the largest healthcare systems in the Commonwealth, including Inova Healthcare Services, Inova Health System, Sentara Hospitals, Valley Health, Children's Health System, and more.
Why You Need the Lento Law Firm Professional License Defense Team
You cannot afford to lose your Virginia agency nursing license, and the Lento Law Firm's Professional License Defense Team can make all the difference in the success or failure of your case. When you retain our Team, we walk you through all aspects of the disciplinary process, assist you in gathering evidence, and advocate for you throughout the negotiation, informal conference, hearing, and appeals process. We work to create open, non-hostile communication between you and the Board of Nursing to ensure we minimize or eliminate any action against your license. No matter the allegation against your license, our Team is here to support you. Let us help you by calling 888-535-3686 or contact us online today.
