What if My Employer Accuses Me of Negligence?

Nursing is a stressful, high-stakes job. Patients trust you with their lives. Employers often over-schedule nurses in under-resourced departments, despite how much their institutional reputation hinges on their nurses being able to provide quality care. You may be accused of negligence in the workplace if a patient suffers while under your care, or a supervisor observes or suspects that you are not providing an adequate level of care.

Nursing boards take accusations of negligence very seriously. Nurses are expected to follow doctors’ orders and employer policies to ensure that each patient’s care meets a certain standard. However, if your employer accuses you of negligence rather than the patient or their family, your state nursing board’s disciplinary process remains the same. The board members must remain unbiased in their assessment of the situation, then analyze the facts and circumstances to determine if disciplinary action is necessary, no matter who filed the complaint against you.

Employers may be large hospital networks or small private medical practices, but they are comprised of people. People can make mistakes and hold grudges. The person at your workplace who files the complaint may hold you to an impossibly high standard that they don’t hold other nurses to. You just might not get along, and they decide to fire shots at your career: accusations of nursing negligence, even if they’re false or overstated, can have a detrimental impact on your career.

You worked incredibly hard to build your nursing career, and accusations of negligence can immediately impact your ability to work. State nursing boards do not presume your innocence, and you should not represent yourself if you are facing, or expect to face, board proceedings. The LLF National Law Firm advocates for nurses nationwide. Our experienced Professional License Defense Team represents nurses facing potential disciplinary action, and we can represent you even if you have a complex case. Call us at 888-535-3686 or fill out our online intake form to tell us about your case.

What Constitutes Negligence in Nursing?

Negligence in nursing occurs when nurses fall short of the expected standard of care defined by their employer or the state nursing board, and that failure to meet the expectation results in the patient suffering.

What separates negligence from malpractice in nursing is that negligence is usually unintentional. You did not intend to harm the patient, but the patient still suffered due to inexperience, carelessness, rushed care, or lack of oversight. Negligence can also stem from systemic problems in your workplace, like fatigue from over-scheduling nurses and chronic short-staffing. Poor training and inadequate resources for your department, or the entire workplace, also contribute to negligence.

In the legal sense, there are four elements that establish whether nursing negligence took place:

1. Duty: As a nurse, you have a professional obligation to safely care for your patients.

2. Breach of Duty: The patient did not receive adequate care per the care standards your employer or nursing board holds you to.

3. Cause: This breach of duty contributed to the patient’s suffering or directly caused them harm.

4. Harm: The patient suffered an adverse outcome.

Negligence in nursing includes the following:

• Medication errors, such as administering the incorrect dosage or medication intended for a different patient

• Failure to notice an infection, internal bleeding, or signs of a stroke

• Patient has bedsores, did not receive food, soiled themselves, and other signs of their basic needs going unmet

• Does not escalate care if the patient’s status worsens

• Failure to follow up on abnormal vitals or lab results

• Dismissing or ignoring a patient’s complaints

• Vague or missing discharge and follow-up care instructions

• Does not explain to the patient how to use their medication, medical device, or other items that are part of their care plan

While this list is not exhaustive, these are common types of neglect in healthcare settings that cause patients, their families, or your employer to file a complaint. Neglect generally falls under medication errors, failure to notice or respond to changes in the patient’s status, and communication and patient education failures.

Your employer’s policies will outline the standard of care you are held to. Your state’s Nurse Practice Act and nursing board regulations may also provide additional statutory language for what constitutes neglect.

Even if your employer accuses you of negligence, you may not necessarily be in violation of any of these frameworks. The LLF National Law Firm’s Professional License Defense Team tailors your defense to your situation and the expectations for both your employer and your state’s nursing board.

State Nurse Practice Acts and Other Guidelines

Every state has a Nurse Practice Act and a nursing board. This type of law is generally referred to as a Nurse Practice Act, but your state may call it a different name, like Nursing Statutes or Standards of Nursing Practice.

While systems like the National Nurse Licensure Compact aim to make U.S. nursing licenses more portable than they historically have been, you are generally held to the standards of the state-level Nurse Practice Act where the negligence accusation took place. Travel nurses and nurses who regularly practice across state lines need to be particularly mindful of this. Depending on the rules of the state nursing board in which you received your original nursing license, you may face administrative inquiries from this board.

Your state’s Nurse Practice Act may have detailed statutory language for what constitutes neglect, or leave this standard up to your employer. Since your employer files the complaint in this case, any violations of their policies would be outlined. Depending on where you live and practice, the complaint may be kept confidential if it doesn’t escalate, or it may become public knowledge even if it gets dismissed. If you change jobs or relocate and they ask for your disciplinary history, you may need to include this complaint.

Board sanctions and possible legal violations aside, accusations of negligence may violate the code of conduct for any nursing societies and professional organizations you belong to. These organizations may suspend your membership while you are under investigation or sanctions.

Notable State Nursing Regulations on Negligence

Colorado

Colorado nurses are subject to discipline if they neglect patients. The scope is broad for negligence, but generally must meet the four elements of neglect previously described.

Texas

Texas nurses employed in long-term care facilities are subject to self-reporting requirements if another nurse is negligent. Other staff of these facilities are required to report incidents of neglect to the state Health and Human Services within two hours if severe bodily injury occurred, 24 hours if not.

How Nurses Can Prepare for Board Actions

If you are accused of negligence by your employer, it is a serious matter that can have both immediate and far-reaching impacts on your nursing career.

This is a sobering realization. However, there are steps you can take right now to increase your chances of achieving a more favorable outcome with the nursing board. Here’s what you should do once you receive a letter from the board:

• Arrange representation as early as possible. Most state nursing boards will notify you in writing if your employer filed a complaint against you. A complaint doesn’t automatically mean you will face sanctions: it could get dismissed. But you do not want to delay arranging representation once you receive this letter, as even false accusations can quickly create problems in your professional life. Contact the LLF National Law Firm right away so we can prepare your response and advocate for you through every step of the disciplinary process. The earlier you arrange representation, the more likely you are to successfully get the complaint dismissed or a lesser sanction if an investigation proceeds and then escalates.

• Thoroughly examine your employer policies, state Nurse Practice Act, and board regulations. Since your employer filed the complaint, you likely violated at least one or two of their policies. Are these policies fairly enforced among all staff? Have you typically had compliance issues at the employer level? Any disciplinary history with your employer will factor into the nursing board’s evaluation of the complaint. Additionally, check your nursing board’s standards and state Nurse Practice Act for any language concerning negligence. This can clarify the angle needed for your defense.

• Gather as much proof as possible that your employer does not enable nurses to provide care to the standard. More often than not,negligence is unintentional. A simple oversight or honest mistake can result in negligence. Employers may hold individual nurses accountable for their own systemic problems: Do they adequately staff the facility and provide the resources necessary to do their jobs? Was appropriate training and supervision available for tasks you had difficulty with? Gather evidence of chronic problems in your workplace, like short-staffing, inadequate resources, poor communication, and technology failures, among other shortfalls that prove you did not intentionally cause harm. If you were terminated from your employer, gathering proof can be difficult if you no longer have access to those records.

• If personal factors are more to blame for the accusation of negligence, elaborate on these personal dynamics. More often than not,negligence is unintentional. A simple oversight or honest mistake can result in negligence. Talk to other nurses about the person who filed the complaint: do they regularly treat you differently than your co-workers and hold you to a different standard, or are they equally hard on everybody? Can you find proof of the animosity this person has had towards you in the past? If you’re having personal problems that make it difficult to focus, like grieving a loved one or your own health issues, it can, unfortunately, affect the quality of care your patients receive. Honestly discuss these circumstances to explain why you currently seem prone to mistakes. The LLF National Law Firm can devise your defense to the nuances of your situation to help prove that you did not intend to neglect a patient.

• Stay calm and professional. It is reasonable to be angry and afraid right now. Emotions are running high because your career is on the line, and tensions may also increase at your workplace. Despite the stressful circumstances, it’s crucial to remain calm and professional in your interactions with the nursing board and your employer while you have an active case. 

How the Professional License Defense Team Will Strive to Protect Your Nursing Career

Neglect can have a myriad of causes that were not your fault, but still cause reputational harm in both the short and long term. Sanctions may be severe, or you may only face a minor reprimand if you cannot get the complaint dismissed. Regardless of the severity of the accusations against you, you do not want to represent yourself. Nursing boards do not presume your innocence as a court of law does.

Here’s how the LLF National Law Firm’s Professional License Defense Team will advocate for you before any state nursing board:

• Initial Complaint: The state nursing board will notify you if your employer filed a complaint against you. Depending on state laws and how your specific nursing board handles complaints and enforcement, you may receive several details about the complaint, including the person responsible for filing it. Regardless of how much information you receive, you should contact the LLF National Law Firm right away. There is a chance the board will dismiss the complaint, but arranging a defense in advance improves your chances of a better outcome if an investigation opens.

• Nursing Board Correspondence: In most states, you must respond to board correspondence within 15-30 days. Regardless of the complaint’s nature and status, you risk further sanctions if you ignore the complaint letter. If you are unsure how to respond to the board, the Professional License Defense Team can help with an effective written appeal. Depending on the nature and severity of the negligence accusation, the board may dismiss the complaint after your response. They may also dismiss the complaint after an investigation concludes that no legal violations occurred.

• Stipulated Agreements: If the complaint escalates to an investigation, and the complaint is not dismissed afterwards, you will have a more complex case. Complex, unprofessional conduct cases like this can lead to disciplinary hearings, where the Professional License Defense Team can negotiate a stipulated agreement. Stipulated agreements are the professional licensing board equivalent of out-of-court settlements, where we will negotiate the terms of your agreement and how to proceed with your nursing license intact. Stipulated agreements may include probation or temporary suspension with remedial education, rehabilitative treatment, counseling, or other remedies, depending on the nature of the case. This is a form of lesser sanctions than what the board originally had in mind.

• Adjudication: Most disciplinary proceedings for nurses remain at the board level and do not make it to a courtroom. However, if there are legal violations, such as violations of state and federal privacy laws or severe Nurse Practice Act violations, you will face a formal hearing before an administrative law judge. We can represent you at this hearing and negotiate for lesser charges.

The LLF National Law Firm’s Professional License Defense Team provides comprehensive representation at every step of the disciplinary process, from written responses to the initial complaint to adjudication if your case cannot be resolved at the board level.

Employment in healthcare can come with the same interpersonal squabbles as any corporate office, except that people’s lives and well-being are involved. Individual nurses may be held accountable for their employers’ systemic failures. Even if the complaint filed against you has no merit, you still must contend with the state nursing board to defend your professional future and integrity.

The LLF National Law Firm is ready to advocate for our nation’s hard-working nurses and achieve the best outcome possible if your employer accuses you of negligence. Call us today at 888-535-3686 or reach out via our online contact form.