A Certified Registered Nurse Anesthetist (CRNA) takes away the pain of patients who would otherwise be in immense agony. Their critical role in administering anesthesia is vital to the healthcare industry's function, and CRNAs undergo rigorous training before entering the workforce.
Unfortunately, countless CRNAs face the loss of their hard-earned licenses due to perceived wrongdoing, misunderstandings, and other unfortunate circumstances.
Despite their qualifications, CRNAs are not immune from stress, office politics, judgment errors, and other circumstances that can lead to license-related sanctions. Whether you have made an error or been unfairly targeted for discipline, you must do everything possible to defend your license, reputation, and career as a CRNA.
The Lento Law Firm's Professional License Defense Team has helped many CRNAs overcome the threat of serious license-related sanctions. Call us today at 888-535-3686 or submit your details online, and we will contact you.
Who Oversees CRNA Licensing Issues in Washington?
As an advanced practice registered nurse (APRN), every CRNA understands how to administer anesthesia safely on a patient-by-patient basis. They must understand each patient's unique biological profile, monitor them as they undergo anesthesia, and ensure their safety while in their care. This is a great responsibility, and CRNAs do not operate without oversight.
The Washington State Board of Nursing oversees nurses who work in the state, including CRNAs. More specifically, the Nursing Care Quality Assurance Commission (NCQAC) is tasked with:
- Protecting the public from unsafe or unprofessional conduct by nurses
- Investing reports that nursing-related laws have been violated
- Investigating reports that a nurse is unfit to practice for any reason (even if the nurse has not broken any laws)
- Disciplining any nurses (including CRNAs) whose conduct reaches the sanctionable threshold
The NCQAC has a great responsibility to protect the public. However, it has just as important a responsibility to ensure that CRNAs are not unjustly disciplined based on faulty or misguided reports of wrongdoing or unfitness.
What Actions Can the Washington State Board of Nursing Take Against a CRNA's License?
The National Council of State Boards of Nursing (NCSBN) lists several types of disciplinary action that CRNAs in Washington may face, which include:
- Public reprimand: The CRNA may receive a formal reprimand, which may affect their reputation and employment opportunities. While a formal reprimand is preferable to more severe discipline (like license suspension), it is best to avoid any formal sanction when possible.
- Monitoring, remediation, and other conditional sanctions: A CRNA may be allowed to resume working under conditional terms. These terms may include a period of monitoring their practice or mandatory remediation.
- Limiting the scope of the CRNA's practice: A CRNA may face the limitation of their hours or activities as a condition of discipline.
- Suspension: The temporary revocation of a CRNA's license can be professionally devastating. Also referred to as “separation from practice,” a suspension must be avoided.
- Loss of license: The revocation of a CRNA's license may be the most severe sanction outside of legal penalties.
The nature of allegations against you, proof of wrongdoing (or lack thereof), the makeup of the disciplinary board, and other factors may determine the sanctions you could face. In any case, the most effective buffer against potentially life-changing disciplinary sanctions is a capable defense.
This Washington State Board of Nursing Does Not Always Make the Fair or Correct Decision
Unfortunately, attorneys know that disciplinary panels often get it wrong. Despite knowing that a CRNA's livelihood and reputation are at stake, a disciplinary panel may:
- Fail to investigate the circumstances that have prompted the disciplinary process adequately
- Allow a biased member to oversee a CRNA's disciplinary case
- Misinterpret the context of a CRNA's actions
- Take hasty action that compromises the CRNA's reputation and livelihood
- Misinterpret evidence and witness statements in ruling on the disciplinary matter
Disciplinary panels are merely groups of fallible humans. Your defense must be as effective as possible, as this is the most certain way to protect your reputation and career.
How the Nuse Licensure Compact Is Relevant to CRNAs Facing Discipline in Washington
In April 2023, Washington became the 40th state to join the Nurse Licensure Compact (NLC). This compact allows nurses with valid multistate licenses (MSL) to work in Washington without having to undergo additional training or licensing.
Washington's participation in the NLC enhances the value of your Washington-based CRNA license, as that license now enables you to work in other states should you choose to. This elevated value of your license also means that the disciplinary process becomes even more high stakes, as you now have more to lose.
How the Nursys Database Could Affect You
The Nursys database is a condition of states' participation in the NLC. This unified network:
- Provides a single repository for information about nurses operating in NLC-compliant states
- Contains up-to-date information about the status of a nurse's license
- Documents disciplinary proceedings and outcomes
The Nursys database is easily accessible by current and prospective authorities, as well as other parties who may influence your career. Because Washington participates in this database, the outcome of your disciplinary proceedings could have a nationwide reach.
Why CRNAs Practicing in Washington Could Face Discipline
The NCSBN highlights several types of conduct that can lead to disciplinary proceedings for CRNAs in Washington, including:
- Practice-related issues, like using unsafe equipment
- Drug-related concerns
- Boundary violations, such as unnecessarily invading patients' personal space
- Sexual misconduct
- Abuse
- Fraud
- Positive criminal background checks
Virtually anyone can file a complaint against a CRNA for virtually any reason. Whatever the reason you are facing potential discipline, an effective defense is imperative.
How Authorities in Washington Adjudicate CRNA Licensure Issues
The NCQAC follows a complaint flowchart in adjudicating allegations of wrongdoing or unfitness levied against CRNAs in Washington. Any complaint against you will likely lead to:
Early Remediation
Upon receiving a complaint against you, an NCQAC Case Management Team will review the complaint within 21 days of receipt (p.13). Some CRNAs are eligible for early remediation of the complaint, which may be appropriate when:
- The CRNA has no prior history of discipline
- The alleged infraction is relatively minor
- All parties (including the CRNA's employer) agree to the action plan, which may involve remedial education and certain other measures
Remediation can be a favorable outcome in some nurse license discipline cases. However, you should not agree to a remediation plan without first consulting an attorney from the Lento Law Firm Professional License Defense Team.
Every form of discipline has consequences. Before agreeing to any formal sanction, you must fully consider those consequences.
Investigation
If the complaint is not resolved through early remediation, the NCQAC will conduct further investigation of the complaint. The Commission will assign an investigator to your complaint, and they will:
- Inform the complainant of the investigation
- Inform you of the investigation (in writing), though this is up to the investigator's discretion
- Seek evidence that a violation by a CRNA has occurred
If the investigator finds no evidence that a violation has happened, the case will return to the Case Management Team. At that point, the Case Management Team may seek further evidence of a violation (with the investigator's assistance) or close the complaint.
If the investigator finds evidence that suggests a possible violation, they must write the CRNA a letter explaining the allegations. The CRNA will then be allowed to address the allegations and any related evidence. You should always have an attorney advise you before providing any formal statements to the NCQAC.
The investigator overseeing your case has 170 days to find evidence of a violation. Your attorney will monitor the investigation and ensure adherence to this deadline.
A Panel Reviews the Investigator's Findings
Upon concluding their investigation, the investigator will provide the report to the NCQAC. A panel assigned to review the report will then:
- Find evidence for further disciplinary action: If the panel determines there is sufficient evidence to proceed further with administrative action, it will transfer the case to the Legal Services Office for either a Statement of Charges or Stipulation to Informal Discipline.
- Determine whether the nurse poses an immediate threat to the public: If the panel believes the CRNA is an immediate danger, it will summarily suspend their license.
- Find evidence of a substance use disorder: In this case, the CRNA may be referred to an alternative discipline program to address any substance use issues they are struggling with.
- Find no evidence of responsibility by the nurse: In this case, the panel will close the case, which is the best case for a CRNA.
If you hire the Law Firm Professional License Defense Team, we expect you are seeking a finding of no responsibility. However, every CRNA's disciplinary circumstances are unique. We will fight for the best possible outcome for your case, whatever that may be.
Formal or Informal Decision by the Panel
The Washington State Nurses Association explains that the NCQAC can either resolve your case with formal or informal discipline (or can close the case altogether). The differences between formal and informal discipline include:
- Formal discipline includes a Statement of Charges: This statement will detail any alleged misconduct the panel believes the CRNA has committed.
- Informal discipline produces a Stipulation to Informal Discipline: In this case, the CRNA accepts the panel's recommended discipline but does not admit any wrongdoing.
Depending on your circumstances, one or both of these options may be viable. The proposed disciplinary action of the panel, their proposal of formal or informal charges, and your own actions that led to the disciplinary process will all be relevant to your decision.
Settlement or Formal Hearing
Once the CRNA receives the disciplinary panel's proposed charges or actions, they have the right to request a hearing. You can have your lawyer lead this process, and you'll have the opportunity to:
- Present evidence supporting your defense
- Present witnesses and elicit their testimony through questioning
- Make a verbal case in your defense
You can also request a settlement conference, whether or not you request a formal hearing. NCQAC staff would meet with you and your lawyer in pursuit of an agreement all parties find acceptable.
If your case does not settle and proceeds to a formal hearing, the Assistant Attorney General will try your case. A health law judge from the Office of Professional Standards will referee the hearing, while the disciplinary panel of NCQAC members will make the ruling.
Why Should I Hire a Professional License Defense Lawyer?
As you can tell, the process of adjudicating allegations of CRNA misconduct is complex and high stakes. You may hire an attorney from the Lento Law Firm Professional License Defense Team because:
- You are not familiar with the disciplinary process
- Our firm has resolved many CRNA disciplinary cases in Washington
- You may have other concerns in your life that detract from your ability to mount an effective defense
- Your attorney from our team will be single-mindedly focused on resolving your disciplinary case successfully
Your license is at stake. At the very least, you should have a set of experienced eyes lending advice about your defense. We will do that and much more.
What a CRNA License Defense Attorney from the Lento Law Firm Will Do for You
Our team will take a personal investment in your career and defense, and we will:
- Investigate the circumstances leading to your disciplinary process
- Obtain evidence and witness testimony
- Accompany you through investigation proceedings, hearings, and all other steps of your case
- Advise you throughout the disciplinary process
- Take any necessary legal measures to clear your name
Each instance of CRNA discipline is unique, so we will provide the representation you need.
Our Professional License Defense Team Knows Medical Providers Throughout Washington
The Lento Law Firm has represented nurses throughout Seattle, and we are familiar with:
- UW Medical Center - Montlake (Seattle)
- Seattle Children's Hospital (Seattle)
- Swedish Medical Center - First Hill Campus (Seattle)
- MultiCare Tacoma General Hospital (Tacoma)
- Virginia Mason Medical Center (Seattle)
- Providence Sacred Heart Medical Center (Spokane)
- Providence Regional Medical Center Everett - Colby Campus (Everett)
- EvergreenHealth Medical Center (Kirkland)
Whether you have worked at these or other medical providers in Washington, let the Lento Law Firm lead your defense.
Call the Lento Law Firm Professional License Defense Team Today
Time is of the essence in CRNA license defense issues. Our team will begin building your defense and seeking a resolution as soon as you hire us.
Call the Lento Law Firm Professional Defense Team today at 888-535-3686 or submit your details online, and we will contact you.
