The nursing profession has been regulated at the state level for more than a hundred years. Each state and territory in the US has its own Board of Nursing (BON) that establishes nursing requirements, determines what the educational, practical, and testing requirements are for each type of nurse, issues the appropriate nursing licenses, and, when necessary, disciplines nurses who violate the law or medical practice standards.
If you have a nursing license and have been notified that someone has filed a complaint against you with your state's Board of Nursing, you are facing a serious matter that can affect your life's work and your ability to make a living. The license that you need to practice your profession is at risk and will continue to be at risk until your BON resolves the complaint. While only a small percentage of complaints end up with a nurse's license being revoked, if you ignore a complaint or try to explain things to the BON on your own, you put yourself at much greater risk of more serious discipline than if you have the help of an experienced nursing license attorney.
Joseph D. Lento and the Lento Law Firm Professional License Defense team have years of experience helping nurses across the US, involved in Board of Nursing complaint investigations and hearings. They understand how important it is to fully investigate the complaint filed against you, how to interact and negotiate with your BON, and how to protect your rights if your complaint goes to a hearing.
Types of Nursing Misconduct Regulated by State Boards of Nursing
There are certain specific types of nursing misconduct that Boards of Nursing in all states and territories of the US regulate through the complaint process.
“Practice-related” complaints are ones that claim the nurse failed to follow the standard of nursing care that applies to a given treatment situation. This can include failures to note a patient's changes of condition; to treat patients in line with required or ordered practices; to keep an accurate record of how a patient has been treated; or to properly administer required drugs to a patient.
“Drug-related” complaints are ones that claim the nurse misappropriated patient medications, falsely claimed that drugs were given to patients, worked while impaired as a result of drug use, or tried to get drugs from a pharmacy by presenting a fake prescription.
“Boundary violation” complaints arise when a nurse misuses the relationship with a patient to attempt to gain a personal benefit, for example, by playing on a patient's sympathies in an attempt to get them to provide the nurse with money or other favors.
“Sexual misconduct” complaints are exactly what they sound like – when a nurse either sexually assaults a patient or when a boundary violation situation results in sexual contact with the patient.
“Abuse” complaints arise when a nurse physically strikes a patient or threatens to do so or when a nurse uses severe language against a patient to the point where the language amounts to a verbal assault.
“Fraud” complaints occur when a nurse falsely claims to have worked a certain number of hours, submits inaccurate billing records to patients or insurers, or says that the patient received care or treatments that the patient did not receive. A fraud complaint can also arise when a nurse overstates their background or experience.
“Positive Criminal Background Check” complaints may arise, depending on the jurisdiction, where the nurse fails to disclose past or present criminal charges or convictions. The types of criminal conduct that need to be reported are different depending on the state, but generally, if patients could be harmed as a result of the nurse's conduct that is connected in some way to the nurse's criminal background, it is a matter that Boards of Nursing will take very seriously.
The Board of Nursing complaint process is typically not for situations where a nurse and a patient don't get along or where the nurse refuses to provide the patient with treatment that is not appropriate given the patient's condition or the physician's orders in place at that time. It's also not appropriate for labor disputes, legitimate fee or billing disputes, or complaints made against hospitals, clinics, or care homes.
The Typical Complaint Process
There are a number of steps involved in the typical complaint process, starting when a complaint is filed against a nurse. Patients aren't the only ones who can file a complaint; it could come from a patient's family member, a colleague, a doctor, the nurse's employer, or from anyone else who believes the nurse violated the law or nursing regulations.
The Initial Review
The Board of Nursing will first examine the complaint to determine whether it is the type of complaint that the BON is responsible for. As noted above, not every complaint against a nurse is about something that the BON regulates.
The Investigation
Assuming the complaint is about a matter that the BON is responsible for, it will begin an investigation that could take months to complete and can be quite wide-ranging. The BON may interview the person who filed the complaint, the nurse against whom the complaint was filed, the nurse's colleagues and supervisors, and others. The BON may examine electronic files or other documents related to the complaint and may even make visits to the nurse's home, workplace, or patient's home, depending on the nature of the complaint.
Depending on what the BON discovers during the investigation process, it may elect to close the case or move forward with a formal charge against the nurse.
Formal Charges
If the BON decides to file formal charges against the nurse, there are several possible next steps.
There may be a settlement conference, during which the BON and the nurse (who has the right to be represented by counsel) meet to discuss the complaint, the formal charges, and possible ways to resolve the charges by way of an agreement.
If the settlement conference is not successful in resolving the matter, or if the nurse refuses to participate, the matter will go to an administrative hearing where the BON will present the charges to an administrative law judge, and the nurse and their representative will have an opportunity to defend. Both sides will typically introduce evidence and may call and question witnesses as part of the hearing process.
In some cases, the BON may agree to implement an “Alternative-to-Discipline” process that requires the nurse to enter some sort of rehabilitation or remediation program. This often occurs in cases where the nurse is accused of substance abuse. In other cases, the nurse will agree to a period of on-the-job monitoring as an alternative to having a public record of the BON's discipline against them.
Possible Outcomes
In cases where the BON rules against the nurse, there is typically a range of possible consequences depending on the severity of the charge. Some of these – such as a reprimand or censure, a fine, a restriction on the nurse's ability to practice certain types of nursing, or a suspension of the nurse's license – are public and will go on the nurse's record. Others, such as assignment to an alternative-to-discipline program or remediation training, may not be made public.
Appeals
In most states, decisions of the BON may be appealed in state court. An appellate court will not retry the BON hearing, however, it will only review the hearing process and BON decision for procedural and legal errors. As a result, it can be difficult to overturn a BON decision on appeal.
More Information
Joseph D. Lento and the Lento Law Firm Professional License Defense Team can help all types of nurses nationwide in situations where complaints have been filed against them with their Boards of Nursing (or the equivalent licensing body responsible for nursing licenses in a state).
- Licensed Practical Nurses
- Clinical Nurse Specialists
- Nurse Practitioners
- Nurse-Midwives
The Lento Law Firm Professional License Defense Team Can Help
Attorney Joseph D. Lento and the Lento Law Firm Professional License Defense Team have years of experience advising and representing all types of healthcare professionals nationwide, including nurses who are being investigated and charged as a result of formal complaints filed with their state Boards of Nursing. If you are a nurse who has had a complaint filed with your BON against you, don't wait – contact Joseph D. Lento and the Lento Law Firm Professional License Defense Team today. They can help you gather the information you need to defend against the complaint and can help you defend yourself in negotiations with your BON or during any formal hearing.
You can reach Attorney Joseph D. Lento and the Lento Law Firm Professional License Defense Team at 888.535.3686 or through their online contact form. Contact them today for a confidential consultation about your situation. They're here to listen and to help.
