Certified Nurse Anesthetists (CNAs) are nurses licensed to provide anesthesia. In Wyoming, the licensing authority for CNAs is the Wyoming State Board of Nursing (WSBN). Pursuant to the Wyoming Administrative Procedures Act, Title 33, Chapter 21 — also known as the Wyoming Nurse Practice Act — the WSBN has the legal authority to take disciplinary action against CNAs and/or refuse to renew, relicense, or reinstate CNA licenses. The Board also electronically publishes a list of nurses, identified by name and license number, who have incurred disciplinary sanctions. Call the Lento Law Firm's Professional License Defense Team at 888-535-3686 to discuss your options, which may include an appeal of your case, if your professional license is in jeopardy.
Low Bar for Complaints Puts Licensees at Risk
The Wyoming State Board of Nursing encourages complaint filing, and the bar for filing complaints is low. Complaints need only be submitted to the Board using the form provided; contain the name, address, and signature of the person making the complaint; and contain allegations that a nurse violated the Wyoming Nurse Practice Act (NPA) and/or Board rules and regulations. The complainant doesn't bear any expenses or need to engage legal counsel. Unfortunately for nurse anesthetists who work hard to earn and maintain their CNA licenses in good standing, it takes little effort for a complainant to jeopardize a CNA's professional license, livelihood, and reputation. Any person, organization, or agency may file a complaint, and there are no time limits on filing. Wyoming employers and Wyoming licensees and certificate holders are required to report possible violations of the Nurse Practice Act and the Board's rules. Board staff may also initiate complaints. Complaints are subject to a Public Record Act request, even when they don't result in disciplinary action.
Nurse Licensure Compact Impacts Ability to Practice in Other States
Pursuant to Article 2 of the Nurse Practice Act, Wyoming is part of the Nurse Licensure Compact (NLC), which is an effort to unify nursing standards across the United States. CNAs who are licensed in one NLC-compliant state can practice in other NLC-compliant states without obtaining additional licenses. However, when you lose your license to practice nursing in Wyoming, you also lose your ability to practice in other NLC-compliant states. Even if you want to practice in a state that isn't part of the NLC, your nursing record in one state can follow you to another.
Grounds for Sanctions Against Nurse Anesthetists Practicing in Wyoming
According to the NPA and Board Rules, the reasons the Wyoming State Board of Nursing (WSBN) may take disciplinary action against a CNA include:
- Violating any provision of the Nurse Practice Act or the Board's Rules
- Intentionally failing to report a violation of the Nurse Practice Act or the Board's Rules
- Violating a previous Board order
- A Court order to withhold, suspend, or otherwise restrict a license issued by the Board
- Practicing fraud or deceit when procuring a license to practice nursing; filing/reporting any health care information; signing a report/record as a licensed or certified individual; representing authority to practice; and/or submitting any information to the Board
- A felony or misdemeanor related to the practice of nursing
- Engaging in any act inconsistent with reasonable standards of nursing practice
- Unfitness or incompetency to practice nursing with reasonable skill and safety
- Failing to submit to a competency examination following a proper request
- Unauthorized possession or use of controlled substances
- License denial, revocation, suspension, or discipline in another jurisdiction
- Practicing beyond the scope of licensure
- Being impaired with the intent of practicing nursing or nurse assisting due to disability (physical or mental), nursing incompetence, substance dependency, or substance abuse
- Being under the influence of drugs, alcohol, or other chemicals or substances with the intent of practicing nursing or nurse assisting
- Abusing a client or member of a vulnerable population, including physical, verbal, mental, emotional, financial, or sexual abuse
- Engaging in “sexual misconduct,” which includes sexual contact while the patient is under the CNA's care, or offering medical services in exchange for sexual gratification
- Neglecting a client who belongs to a vulnerable population, including failing to provide necessary goods, services, care, or attention, including insufficient observation; inadequate assessment and/or intervention; inappropriate delegation of care; or accepting assignments that are not within the CNA's competency or scope of practice.
- Abandoning a client, where “abandonment” means terminating a client relationship, with or without the client's knowledge, without arranging for appropriate continuation of care
- Distributing, selling, or using without authorization illegally possessed or manufactured controlled or illicit drugs
- Diverting drugs or medications to oneself or others
- Interfering with a client's plan of care
- Performing unsafe client care
- Violating client boundaries, including but not limited to sexual boundaries or entering into financial transactions with clients
- Misappropriating client property
- Misappropriating property belonging to a hospital, medical clinic, or facility providing care to a client
- Violating a client's privacy or confidentiality in any form, including by written, verbal, or technological means
- Failing to appropriately supervise anyone working under the CNA's direction
- Improperly delegating a nursing task
- Aiding another licensed nurse in practicing beyond the scope of the nurse's license or experience
- Prescribing, dispensing, administering, or distributing drugs or medications in an unsafe manner or without adequate instructions to patients according to the acceptable and prevailing standards
- Prescribing, dispensing, administering, or distributing drugs or medications for other than therapeutic or prophylactic purposes
- Prescribing or dispensing drugs or medications to individuals who are not within the nurse's role and population focus
State Board of Nursing Disciplinary Process
The procedure for reviewing, investigating, and resolving a complaint against a Wyoming Certified Nurse Anesthetist can take months and span multiple phases. Pursuant to the Nurse Practice Act, the State Board of Nursing cannot suspend or revoke a nurse anesthetist's license without affording them due process of law, which includes proper notice of the allegations and any hearing(s).
Initial Review of the Complaint
Once the WSBN receives a complaint against a CNA, the Board conducts an initial review to determine whether the Board has jurisdiction and the complaint contains an allegation that the CNA has violated the Nurse Practice Act and/or Board rules and regulations. If both factors are present, the Board opens an investigation. The complaint is a public record subject to a Public Record Act request.
Board Staff Investigation
The Board staff investigates complaints on the Investigative Committee's (IC) behalf. The IC will be comprised of at least one Board member or the Executive Director. When the Board begins an investigation into the allegations in the complaint, the CNA must receive a copy of the complaint, so they have an opportunity to respond to the allegations. In cases where the physical condition, mental condition, or competence of the CNA is in question, the IC may ask the CNA to submit to one or more evaluations, which may include psychological, psychiatric, substance abuse, and fitness for duty or competency. Such evaluations will be conducted by a provider selected or approved by the IC and at the sole expense of the CNA. Failure to submit to such evaluations could lead to disciplinary action such as license suspension or revocation. The IC may recommend dismissal of the complaint, issuance of a Notice of Warning, approval of a settlement agreement, or disciplinary action (including license suspension or revocation).
Disciplinary Committee Review and Recommendation
If the IC recommends disciplinary action, the Disciplinary Committee (DC) will review the file, investigate the complaint, and make recommendations to the Board for disciplinary action. In a typical investigation, the DC file review may take two weeks. The DC may recommend any of the following:
- Dismissal of the complaint
- Issuance of a Notice of Warning (NOW)
- Letter of Reprimand (LOR)
- Restricted or Conditional License/Certificate (Conditional)
- Suspension
- Revocation
LORs, Conditional Licenses, and Suspension or Revocation of the license are considered disciplinary on a license or certificate. While the WSBN doesn't consider a Dismissal or a NOW to be disciplinary action, the Board must still approve the DC's recommendation.
The DC will be comprised of no more than two Board members selected by the Executive Director. Attendance at the DC meeting(s) may include the WSBN Executive Director, the Board's Prosecuting Attorney, and Board staff responsible for investigating complaints.
Notice to Licensee of Disciplinary Recommendation
If the DC recommends discipline, the Board will send the CNA a Notice of Intent to notify them of the recommendation. The Notice of Intent must include a brief description of the facts or conduct that warrant the disciplinary recommendation and a citation to the relevant provisions in the NPA and/or Board's Rules, and give the CNA fifteen days from the date of mailing to request either a Settlement or a Hearing. The CNA may also request an informal conference with the IC to provide any additional information or to resolve the complaint without a Hearing.
Board Action and Processing of Disciplinary Committee Recommendation
The Board will either approve or deny the DC recommendation. In matters where the DC recommends discipline, the Board will consider the recommendation by a Settlement Agreement or Contested Case Hearing (Hearing). The IC will initiate formal proceedings for disciplinary action by serving a Petition for a Hearing. Within twenty days of the date of the mailing of the Petition, the CNA may respond by filing an admission or a denial of the allegations in the Petition. In matters where the DC doesn't recommend discipline (i.e., the NOW or the dismissal), the Board will consider the recommendation by consent agenda.
Regardless of who petitions for a Hearing, the Board must serve the CNA a Notice of Hearing that includes, among other things, the nature of the Petition, the facts upon which the Petition is based, and citations to the applicable provisions of the NPA and/or Board Rules the CNA allegedly violated. If the CNA fails to answer the allegations in the Petition within twenty days of the date of mailing and fails to appear at the Hearing, the Board may enter an order of default judgment against the CNA based on the allegations in the Petition.
In the event of a Contested Case Hearing, the IC must prove by clear and convincing evidence that the CNA violated the Nurse Practice Act, Board Rules, or both.
Once the Board issues an order or approves the NOW or dismissal, the investigation is closed. The Board's written decision is a public record and, therefore, available for inspection and dissemination in accordance with federal and state laws.
Appealing an Unfavorable Ruling
Appeals from decisions of the Board are entitled to judicial review. To initiate an appeal, the CNA must file a Notice of Appeal with the District Court in the county where the CNA resides.
Nationwide Professional License Defense
The CNA is entitled to representation throughout the disciplinary process. Given how easy it is to file complaints against nurses and the low threshold for sanctioning them, it's wise to mount a vigorous defense. The Lento Law Firm Team has experience defending nurses throughout the United States and is committed to pursuing all legal avenues to protect your reputation and livelihood. Our Professional License Defense attorneys can suggest and execute strategies to protect your due process rights, respond to allegations, negotiate settlement agreements, and prepare you for any hearings or informal meetings. If you're already subject to a Board order or court order for disciplinary action, we can represent you in appeals, which may require further interaction with the WSBN. Call the Lento Law Firm at 888-535-3686 or contact us online to learn how we will fight for your professional nursing license.
