AVOIDING LIABILITY BLOG

WHAT CONDUCT BY A NURSE LICENSEE WOULD ALLOW THE BOARD OF NURSING TO TAKE DISCIPLINARY ACTION AGAINST A NURSE?

This bulletin discusses some of the grounds upon which a board can take disciplinary action

against a nurse if they are proven.

The nurse practice act and/or its rules will include the basis upon which a board of nursing can

take disciplinary action against a nurse licensee. In the act itself, the section may be titled

“Disciplinary Grounds” or “Violations of the Act” or something similar. Keep in mind that

because each state has the authority to pass its own act and rules, disciplinary grounds may

vary somewhat from state to state, so it is important that you read your own act and rules as

well as applicable acts and rules if you are licensed in more than one state.

One ground that is often included as a basis for discipline of a nurse licensee is if the nurse is

convicted of some kind of crime under the laws of any United States jurisdiction. The

conviction can be by a jury verdict, by a plea of guilty, or by a finding of guilt, as examples.

Some states may include only felony convictions (a serious crime such as murder, forgery, or

diversion of controlled substances) while others also include a misdemeanor conviction, which

is a lesser crime, such as battery or a traffic violation. Still others, like Illinois, include any

misdemeanor conviction that requires dishonesty as an essential element or that is directly

related to the practice of the profession. (1)

A second basis for discipline of the nurse licensee is if the individual uses chemical substances,

such as alcohol or narcotics, which could impair the individual’s ability to practice with

reasonable skill, judgment or safety. Because chemical use and abuse is a major problem, some

states have established non-disciplinary treatment programs for nurse licensees who are

eligible for the program. As an example, if the nurse enters into the treatment program,

surrenders his or her license during the treatment, and successfully completes its requirements,

including aftercare, no discipline is taken against the nurse and no public record of the

treatment takes place. (2)

If a nurse licensee engages in conduct that is determined to be unethical, unprofessional, or

dishonorable, and such conduct could deceive, defraud or harm the public as defined in the act

or its rules, disciplinary action can be taken against the individual. Often, this allegation is

included with other violations of the act. Examples of reported disciplines that includes such

conduct are falsifying or knowingly making incorrect entries in the patient record or related

documents, failing to document and maintain accurate records, diverting controlled substances

2

from the employer, and misappropriating property, equipment, materials, drugs or money from

an employer or patient. (3)

Crossing professional boundaries with a patient, whether sexual or otherwise, is another

common ground for which the board of nursing can take action. Examples include dating a

patient, harassing a patient in some way, keeping secrets with a patient, witnessing legal

documents for the patient, and excessive self-disclosure. (4)

If a nurse licensee’s clinical practice is not “up to par”—that is, not meeting standards of

practice—the nurse can be disciplined as well. Because patient safety is always at issue when

clinical difficulties exist in a nurse’s practice, he or she can be disciplined. If the nurse is

experiencing mental or physical problems that make it problematic for the nurse to function

with safety and skill, discipline can be imposed as well.

It is important to remember that a patient does not need to be injured for a discipline to be

imposed against a nurse when his or her clinical practice is under question. Rather, it is the risk

to the patient, potential or real, that is the basis of any discipline that might be imposed by the

board of nursing.

Maintaining patient confidentiality and privacy is essential for the nurse-patient relationship,

both ethically and legally. A breach by the nurse licensee, except as may be required by law

(e.g., a court order requiring the nurse to speak about a particular patient), is an often included

basis for discipline by the state board of nursing.

If a nurse is licensed in several states and a state board of nursing in one of those states takes

disciplinary action against the nurse, the other state boards of nursing can also take disciplinary

action against the nurse when the other boards have similar grounds for discipline. You may ask

how another board of nursing would find out about a discipline in another state.

Disciplinary actions by state boards of nursing are shared with other boards of nursing across

state lines through various means, one being the National Council of State Boards of Nursing’s

Disciplinary Data Bank established in 1981.

The National Healthcare Integrity and Practitioner Data Bank is another entity that stores

disciplinary actions against health care providers, including nurses. State boards have access to

this information as do employers. Employers check the Data Bank to determine if a licensee

has been disciplined and do so for new applicants and for current nurse employees (the latter

check is on a regular basis).

3

Additionally, many nurse practice acts and/or rules require a nurse licensee to self-report to

any board of nursing where licensed a discipline by a board of nursing in another state. If not

reported, the nurse can face discipline for this violation as well.

The examples listed are but a few of the bases upon which a disciplinary action by a state board

of nursing can occur. Check out your nurse practice act and rules for what types of violations

can result in a disciplinary action against you. You might be surprised at some of the categories.

However, surprise at receiving a notice of a possible action being taken against you is no fun.

Know what your state board of nursing requires of you. It will hold you accountable and

responsible when any violations of those expectations takes place.

FOOTNOTES

1. Illinois Nurse Practice Act, 225 ILCS 65/70 (b) 3 (2007).

2. Examples of state boards of nursing taking this approach with a chemically impaired

nurse include Ohio, Indiana, Rhode Island, and Illinois.

3. Pennsylvania State Board of Nursing Newsletter (August 2009). Disciplinary Actions.

Available at www.dos.state.pa.us . Accessed Marc h 18, 2012.

4. National Council of State Boards of Nursing. Professional Boundaries: A Nurse’s Guide

To The Importance Of Professional Boundaries. Available on the Council’s website at

www.ncsbn.org . Accessed January 4, 2012.

 

THIS BULLETIN IS FOR EDUCATIONAL PURPOSES ONLY AND IS NOT TO BE TAKEN AS SPECIFIC LEGAL OR ANY OTHER ADVICE BY THE READER. IF LEGAL OR OTHER ADVICE IS NEEDED, THE READER IS ENCOURAGED TO SEEK SUCH ADVICE FROM A COMPETENT PROFESSIONAL.
REFERENCES

 

ABOUT THE AUTHOR

Nancy Brent: Nursing

Nancy Brent: Nursing

Nancy J. Brent, RN, MS, JD, a nurse attorney in private law practice in Wilmette, IL, represents nurses and other health care providers before the state agency that regulates health professionals. Brent graduated from Loyola University of Chicago School of Law in 1981. Her experience prior to opening her private practice included a year of insurance defense for a major insurance company and establishing a law firm with two other attorneys. After three years of doing defense work at the firm, Brent decided to establish a private practice in 1986. Brent has published extensively and has lectured across the country in the area of law and nursing practice. She is a member of several legal and nursing professional associations, including the American Nurses Association, Sigma Theta Tau International Honor Society of Nursing, the Illinois State Bar Association, and The American Association of Nurse Attorneys (TAANA).

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