reporting to nursing board

What Happens When a Nurse Is Reported to the Board? | Nursing Board

First, this will be a general overview of any nursing board investigation. It’s not going to be state-specific. Every board does things differently, but the general process is mostly the same among all the boards. I’ll give a brief overview of how the process generally works and then some things to consider from the nurse’s perspective. As far as the first step, someone will file a complaint. That’s one way an investigation initiates. Anyone of a patient, colleague, or employer can begin. Many states have criminal reporting requirements.

In some states, if a nurse receives criminal charges, they must report them to their board. And others, if the nurse gets convicted of a crime, then it’s reported. Some states must report it immediately. Other states only until renewal. So, you need to look and see what the criminal reporting requirements are. And then there are also self-reports for substance abuse issues, nurses dealing with alcoholism, drug abuse, and mental health issues. And most states have a confidential monitoring program that can assist the nurse in getting over whatever issues they have. Let’s say someone files a complaint, and the nurse self-reports.

Complaints and Nursing Board Jurisdiction

Whatever reason initiates the investigation, the first hurdle is whether the board has jurisdiction over the complaint. There are certain things the board can and cannot investigate. And so, the first analysis from the board is, do we have jurisdiction over this nurse?

Most of the time, the answer is yes. Very rarely, it is no. Let’s say you were successful in overcoming the hurdle. What will happen is the board will then notice the nurse and let them know a party filed a complaint. And either they will send a questionnaire that needs to be filled out and sent back in, or they may say, sit tight, and we’ll contact you when we’re ready to move forward. In the investigation, some boards will investigate every single complaint. Others are better at triaging complaints and then getting rid of them before a full investigation occurs. In this scenario, let’s say a full investigation will occur here. So, in the response, the board will want a written statement from the nurse at some point. This is tricky. 

Who Can Report a Nurse to the Board?

Anyone can report a nurse to the nursing board if they have concerns about the nurse’s conduct, performance, or competence. While certain individuals, such as fellow healthcare professionals, certificate holders, and healthcare institutions, are often required by law to report issues, other individuals, including patients and their families, may also file a complaint. The primary goal of nursing boards is to ensure patient safety and uphold professional standards within the nursing field. By reporting concerns, individuals play a crucial role in maintaining the quality of care and fostering a safe healthcare environment for all.

For nurses facing disciplinary actions or licensure issues, Chelle Law is a trusted partner in providing representation before the Arizona Board of Nursing .

Reasons People Report a Nurse to the Board

Reasons to report a nurse to the board may include but are not limited to falsifying medical records, demonstrating a pattern of poor judgment or inadequate nursing skills, failing to properly assess or intervene on behalf of patients, engaging in inappropriate sexual contact or dual relationships with patients or their family members, substance abuse, or any form of patient abuse or neglect. Reporting such concerns helps maintain the nursing profession’s high standards and ensures patients’ safety and well-being. It is crucial for individuals to report any observed misconduct to uphold the integrity of the healthcare system and protect vulnerable individuals from harm.

Beware of Too Much Information When Responding to Complaints

I find most nurses want to overshare. They want to put down ten pages of explanation and grievances sometimes with the employer or coworkers. I don’t think this is beneficial to the nurse at all. For a couple of reasons, you don’t want to give anything to a board if they don’t have it. It means you don’t want to admit to things the board has no idea happened. Or some nurses inadvertently admit to doing things they think are completely fine. But when you look closer at the statutes. Which laws dictate what the board can and can’t do, and what are the violations? It may be a violation of the statute, and they didn’t even realize it.

I think less is more as far as a written response. And then one kind of problem that we have is that the boards always want a response quickly. Still, we don’t always have access to the documents, or we seldom have access to the full documents until after they want the written response.

What Level of Scrutiny Should a Nurse in a Complaint Expect?

We often say we will supplement with a more substantive statement once we have access to the file at the board. It could be medical records, employment files, disciplinary history, or illegal stuff. We can usually get ourselves, so we don’t need to wait for the board to do that. Alright, so you’ve sent in the response short and sweet. At that point, the board sends out subpoenas and a request for documents to the employer for your employment file. And then if medical records are involved, those as well. The boards want to see our employment file to see how much or if you’ve had disciplinary action, corrective action, verbal coaching, or counseling. Usually, if there’s a complaint, the board wants to see if you’ve had any other incidents or problems with that specific thing.

For instance, if the complaint is that the nurse falsified the record, maybe they forgot to take vitals or something, and then they just put them in. And then it’s shown that they just fudged the numbers, weren’t in the room, and took the vitals. They want to see, alright, has this nurse done that in the past? So, they will usually subpoena the employment file from your current employer. But, I should say that in reverse, they’ll subpoena the employment file from wherever this happened. Still, if a complaint is filed, you’ve been fired. They will also want to subpoena your current employment file. To see if, once again, anything reoccurred, that’s how the complaint works.

Key Points During an Interview With an Investigator

After the board has all the documents back, sometimes subpoenas can take a long time. I’m talking like six months to a year sometimes. At some point, the board will usually abandon going for a subpoena. This is if whoever is completely unresponsive. And then, usually, at that point, the nurse will come in for an interview with the investigator. An investigator with the board will get assigned to your case. They’ll be the one that’s the point person, setting the subpoenas, talking to witnesses, and the complainant who filed the complaint. And then the nurse as well. The interview is the best opportunity for the nurse to provide context. I think it’s probably beyond the board meeting that is the most important step in the process. And so, having the nurse prepared to one, anticipate the questions they’re going to ask. 

And then two, knowing how to answer the questions is important. So, understanding once again, most people overshare, especially when speaking, they ramble on. It’s, once again, better to answer the question directly, stop, and then let the investigator follow up with more questions. Just talking for 10 minutes straight is not effective in any media.

What Impact Might a Complaint Have on a Nurse’s License and Practice?

After a completed interview, the investigator will usually draft a report. Then they’ll go over that report with either peers or the director of whatever state board you’re in. And then they’ll recommend some options to the board. Or some executive directors will have the power to dismiss a case or give a non-disciplinary outcome. In most states, it’s called a letter of concern. If they think disciplinary action is necessary or want the board to look at it. At some point, the nurse will attend the board meeting agenda. Most states meet monthly or every two months and then review every complaint. And then, the nurse can have the opportunity to address the board. If they have an attorney, the attorney can address the board. The board can ask questions to the nurse. 

Then ultimately, they will vote right in front of the nurse. This is what we’re going to do. And then, depending upon what the outcome of the board meeting was, the nurse always has appeal rights. If they’re unhappy with the outcome, they can always appeal and move forward to a hearing in most states. It’s in front of what’s called an administrative law judge. It’s a well, supposedly impartial kind of judge outside the board system. So, that’s what happens when filing a complaint against a nurse with the state board. Once again, this is just a general outline of what happens and what to expect.

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• Nursing: What Does It Mean When a Nurse Is Suspended?
• Which is the Most Frequent Reason for Revocation of a Nurse’s License?

Nursing Reports: What Happens When a Nurse is Reported?

What happens when a nurse gets reported? First, I’m not going to talk about what happens when a nurse gets reported to a nursing board. I will talk about all the places to report a nurse. And then, there are some things to consider regarding handling those situations. Now, first, this is not going to be state-specific. I’m giving general information that a nurse could use in almost any state. Rules can vary from state to state, but this will be a general discussion of what happens when it gets reported.

Places or Agencies Nurses Can Be Reported to

First, where are the places/agencies to report a nurse? Well, let’s talk about that. First, you can report a nurse to the employer. A patient could complain about a nurse’s conduct. A nurse reported to the employer , and then the employer would do an investigation. Nurses can be reported to a board if there’s an alleged violation of the nurse’s practice act in the state. A patient, a colleague, an employer, or the police can all report nurses to the board of nursing. You can report a nurse to the police. And this usually comes from the employer. There are times when there is some alleged criminal conduct on the part of a nurse, and it may, or at least the employer may, feel it necessary to contact the police.

Let’s take, for instance, a nurse caught diverting fentanyl, something like that, which is serious. They would then contact the police and say, we believe the nurse was diverting fentanyl, which violates the law. And then they would investigate as well.

Adult Protective Services

Another frequent place to report a nurse would be the branch of adult protective services. Suppose there is an allegation of patient abuse, and the patient is an adult. In that case, the adult protective services could do an investigation. The department of child services or child protective services is another place. If your patient was a child and there was alleged abuse, the child protective services in that state could also initiate an investigation.

And to give an example, I had a nurse who left a heating pad on an infant child, which caused a burn. And then, obviously, she didn’t mean to. There was no intent to hurt the child, but there was a negative outcome. Then child protective services came in and did an investigation. Those are the main places. So, employer, board, police, adult protective services, and child protective services. Those are the main places where you can report a nurse.

What Can a Nurse Do if a Patient Reports Them Over an Incident?

What can you do once reported to any of those? Well, it would depend upon the organization what you should do. If a patient complains, the employer approaches you and asks you what happened. Then there are no problems talking to them about what happened. Now, I guess it would depend upon the severity of the nurse’s actions. I’ve had a couple of previous blogs that went through what happens for an employer investigation.

And sometimes it doesn’t make sense to say anything, but if it’s a minor disagreement. I mean, some patients/family members will never be satisfied with the care provided. And so, in a situation like that, if the nurse didn’t do anything wrong. Then certainly feel free to discuss that. If the nurse screwed up somehow, it might make sense to be quiet about it and not give a statement.

If the police are involved, you must find an attorney first. I understand that some people believe they can talk their way out of things. Don’t do that. Suppose any police department contacted you or even the Attorney General’s office in your state. In that case, a criminal investigation is underway, and they will talk to you and pretend like you’re a friend. They’ll say, why don’t you tell me what went on here? And then they’re going to use all those things against you. Do not say anything if you have any contact from the Attorney General’s office, a police department, a detective, or an officer. Call a criminal defense attorney wherever you live and have them represent you.

Hire a Board Defense Attorney

Not spending the money on that is extraordinarily done. That’s what you need to do. If you’ve had an adult protective services complaint, a child protective services complaint, or whatever the name of it is in your state. It might make sense to involve an attorney who has done administrative hearings. I find the investigators and many of those specific departments almost always find abuse. So, talking to an attorney who handles those things in your state would make sense. 

Now, as far as the board goes, it depends upon the complaint. Sometimes, there are just terrible complaints, like there’s no basis or fact for them. The board will likely dismiss them quickly or dismiss them after a brief investigation. Is an attorney necessary for that? Probably not, but there are certainly instances where an attorney with experience with the board of nursing could assist you. I would contact them before you respond to the board at all. There are plenty of great nursing board attorneys throughout the country. It would help if you found somebody with experience with your state’s board.

Record Tracking for Topnotch Board Defense Attorney

One way of finding that would be going through old agendas. Almost every state requires open records. And so, there must be a post regarding any board meeting from a governmental agency. And they do that through the minutes, which basically summarize what happened during a board meeting. Then the agenda, which is what we’re going to discuss during the meeting. Most states will post if someone is represented by counsel and the minutes and then who that is. It’s not a bad idea to look in the old minutes in your state to see the attorneys representing most of the nurses. And then that’s usually a good indication that they at least have experience. I can’t say if they’re good or not, but at least they have experience handling the board.

So, that’s what happens if there’s a nurse reported to a bunch of different agencies. It would help if you always were careful about what you’re saying to anyone. They can use your words against you. And it makes sense to involve a professional with experience handling matters across all those areas.

How Do I Report an Arizona Nurse for Unprofessional Behavior?

Suppose someone would like to report or file a complaint against nurses licensed in Arizona. In that case, they must determine if the alleged conduct is reportable. Here is a link to the Board’s website where an individual can file a complaint: Submit a Complaint.

The Arizona Board of Nursing will not investigate the following behaviors:

• Rudeness to peers
• Co-worker disputes
• Personality conflicts
• Absenteeism
• Labor-management disputes such as work schedules/wages/wrongful termination
• Resignation without notice whereby an unaccepted patient assignment.

Conduct that can be reported:

• Information that a nurse or certificate holder may be mentally or physically unable to practice nursing or perform nursing-related duties safely
• Conducts involving practicing beyond the scope of practice of the license or certificate. Examples include knowingly giving a medication not authorized by a treating provider, obtaining laboratory or other tests not authorized by a treating provider, and unauthorized adjusting of dosage.
• Conduct that leads to the dismissal for unsafe nursing practice or conduct or other unprofessional conduct
• Conduct that appears to be a contributing factor to high risk/harm to a patient and requires medical intervention
• Actual or suspected drug diversion
• Conduct that appears to be a contributing factor to the death of a patient
• Conduct involving the misuse of alcohol or other chemical substances to the extent that nursing practice may be impaired or may be detrimentally impacted
• A pattern of failure to account for medications; failing to account for wastage of control drugs
• Falsification of medical or treatment records
• A pattern of inappropriate judgment or nursing skill
• Failing to assess or intervene on behalf of the patient(s)
• Conduct involving sexual contact with a patient, patient family member, or other dual relationships
• Conduct involving physical/verbal patient abuse
• Practicing nursing without a valid nursing license
• Conduct involving misappropriation, theft, or exploitation of a patient
• Violation of a disciplinary sanction imposed on the nurse’s license by the board
• Conduct that deceives, defrauds or harms the public.

What Happens When a Nurse Is Reported to the Board?

What happens if a patient reports a nurse’s incident to their state board? First, this will be a general overview of any nursing board investigation. It’s not going to be state-specific. Every board does things differently, but the general process is mostly the same amongst all the boards. I’ll give a brief overview of how the process generally works and then some things to think about from the nurse’s perspective. As far as the first step, someone will file a complaint. That’s one way of initiating an investigation which could be a patient, a colleague, or your employer. Many states have criminal reporting requirements for an incident. Such as medication administration errors and patient safety concerns.

In some states, if a nurse is charged with a crime by other health care providers or a patient, they must report it to their board. And in others, if the nurse gets convicted of a crime, it’s reported. Some states must report it immediately, and other states only until renewal. So, you need to look and see what the criminal reporting requirements are over an incident. And then, there are also self-reports for substance abuse issues, nurses dealing with alcoholism, drug abuse, and mental health issues. And most states have a confidential monitoring program that can assist nurses in getting over whatever issues they have. 

Someone files a complaint over an incident and the nurse self-reports. Whatever initiated the investigation, the first hurdle is, does the board have jurisdiction over what the complaint is about? There are certain things the board can and cannot investigate. And so, board’s initial analysis, do we have jurisdiction over this nurse due to an incident?

Most of the time, the answer is yes. Very rarely, it is no. Let’s overcome the hurdle. What will happen is the board will then notice the nurse and let them know there’s a filed complaint over an incident. And either they will send a questionnaire that needs to be filled out and sent back in. They may say, sit tight, and we’ll contact you when we’re ready to move forward. In the investigation, some boards will investigate every single complaint. Others are better at triaging complaints and then getting rid of them before a full investigation occurs. Let’s say a full investigation of an incident will occur here in this scenario. So, in the response, the board will want a written statement from the nurse at some point. This is tricky. 

I find most nurses want to overshare and provide full disclosure in an incident report. They want to put down ten pages of explanation and grievances sometimes with the employer or co-workers. I don’t think this is beneficial to nurses at all. For a couple of reasons, one, you don’t want to give anything to a board if they don’t have it. It means you don’t want to admit to things the board has no idea will happen. Or some nurses inadvertently admit to doing things they think are completely fine. When reporting errors to a committee or the board of nursing over an incident regarding patient safety, I advise nurses to provide just the information needed and not overshare. Nurses must review their lengthy explanations and not include grievances over co-workers or employers.

When you look closely at the statute, the laws dictate what the board can and can’t do. And then what the violations are, it may be a violation of the statute, and they didn’t even realize it. I think less is more as far as a written response. And then one kind of problem that we have is that the boards always want a response quickly. Still, we don’t always have access to the documents, or we seldom have access to the full documents until after they want the written response.

We often say we will supplement with a more substantive statement once we have access to the file at the board. It could be medical records, employment files, disciplinary history, or criminal stuff. We can usually get ourselves, so we don’t need to wait for the board to do that.

Alright, so you’ve sent in the response short and sweet. At that point, the board usually sends out subpoenas, which is a request for documents to the employer for your employment file. And then if medical records are involved, those as well. The boards want to see our employment file to see how much, or if you’ve had disciplinary action and corrective action, verbal coaching, counseling, anything like that. Usually, if there’s a complaint, the board wants to see if you’ve had any other incidents or problems with that specific thing.

For instance, if the complaint is that the nurse falsified the record. Maybe they forgot to take vitals or something and just put them in. And then it’s shown that they just fudged the numbers, weren’t in the room, and took the vitals. They want to see, alright, has this nurse done that in the past? So, they will usually subpoena the employment file from your current employer. I should say that in reverse, they’ll subpoena the employment file from wherever this happened. Still, if there’s a filed complaint, you’ve been fired from that job, they will also want to subpoena your current employment file. To see if anything kind of reoccurred, that’s like what the complaint is about.

Why Is the Interview With the Investigator Crucial?

After the board has all the documents back, sometimes subpoenas can take a long time. I’m talking like six months to a year sometimes. At some point, the board will usually abandon going for a subpoena if whoever is just completely unresponsive. And then, usually, at that point, the nurse will come in for an interview with the investigator. There’ll be an assigned investigator with the board. They’ll be the one that’s the point person, setting the subpoenas, talking to witnesses, talking to the complainant who filed the complaint, and then the nurse as well.

The interview is the best opportunity for the nurse to provide context. In my opinion, it’s probably beyond the board meeting that is the most important step in the process. And so, having the nurse prepare, anticipate the questions they’re going to ask, and then two know how to answer them is important. So, understanding once again, most people overshare, especially when speaking. They just kind of ramble on. It’s again better to answer the question directly, stop, and then let the investigator follow up with more questions. Some nurses just found it difficult to stop talking, and they might share too much information. Just talking for 10 minutes straight is not effective in any media. 

After the completed interview, the investigator will usually draft a report. Then they’ll go over that report with either peers or the director of whatever state board you’re in. And then they’ll recommend some options to the board. Or some executive directors will have the power to dismiss a case or give a non-disciplinary outcome. In most states, it’s called a letter of concern. If they think disciplinary action is necessary, or if they want the board to look at it, at some point, the nurse will get placed on the agenda at the board meeting.

Most states either meet monthly or every two months, and then they review every single complaint. And then, the nurse can have the opportunity to address the board. If they have an attorney, the attorney can address the board. The board can ask questions to the nurse. Then ultimately, they will vote right in front of the nurse. This is what we’re going to do. And then, depending upon what the outcome of the board meeting was, the nurse always has appeal rights.

If they’re unhappy with the outcome, they can always appeal and move forward to a hearing. In most states, it’s in front of an administrative law judge. It’s a well, supposedly impartial kind of judge outside the board system. So, that’s what happens when filing a complaint against a nurse practitioner with the state board. Once again, this is just a general outline of what happens and what to expect.

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How to file a complaint, what to include in your complaint.

• Who committed the actions you are reporting?
• Who was the victim(s)?
• Who discovered the incident/behavior?
• Who else was involved?
• What happened?
• What equipment was involved?
• Where :
• Where did the incident/behavior occur?
• Where were the witnesses (if any) during the incident?
• When did the incident/behavior occur?
• When were supervisors/authorities notified?
• How was the incident committed?
• How was the incident/behavior discovered?
• How much property or money was taken?
• Complaints : Complaints may be filed in writing (using our  online complaint form ) or by US mail.  Anonymous complaints are accepted, but are more difficult to investigate.  Approximately 50–60 percent of complaints come from nursing employers.  The remainder come from state agencies, other professionals, coworkers, or patients and their families.
• Investigations : Investigations into complaints are performed by OSBN staff investigators.  Investigators first validate whether the complaint falls into the OSBN's jurisdiction and if there is concern about the nurse’s practice or conduct.  The investigation may include interviews with the complainant(s), coworkers or employer; and a review of patient records, the nurse’s personnel record, police reports, or court records.
• Stipulated agreement —The nurse signs a document acknowledging the facts of the incident, violations of law and OSBN rules, the proposed disciplinary action and any terms and conditions to be imposed.  The agreement goes to the Board for consideration and potential adoption and a Final Order is issued.  Most disciplinary cases (75 percent) are resolved by stipulated agreement.
• Notice —If agreement is not reached, a "Notice" document is sent to the nurse.  The Notice is a public document and may be requested by the complainant or the public.  It is essentially a statement of charges against the nurse.  The Notice contains a timeframe within which a hearing can be requested, and specifies the level of sanction that has been proposed.  The nurse is entitled to a hearing and is granted every opportunity to exercise that right.  If the nurse does not request a hearing within the allotted timeframe, the case goes to the Board for a decision by default.  If the nurse has a hearing and does not agree with the Board’s final decision, she/he can appeal to the Oregon Court of Appeals.  If there is disagreement with the Court’s decision, the nurse can appeal further to the Oregon Supreme Court.
• Reprimand —A formal notice to the nurse that OSBN standards have been violated. The nursing license is not "encumbered."
• Civil Penalty —A fine of up to $5,000.
• Probation —An imposition of restrictions or conditions under which a nurse must practice, including the type of employment setting or job role.   Information about monitored practice .
• Suspension —A period of time during which a nurse may not practice nursing.
• Revocation —A removal of a license or certification for an unspecified period of time, perhaps permanently.
• Voluntary Surrender —An action on the part of the nurse to give up her/his license or certificate instead of facing potential suspension or revocation.
• Denial of Licensure —An action by the Board not to issue a license or certificate.

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Nursing Disciplinary Action Explained

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• Nursing Disciplinary Action
• Nursing Disciplinary Process
• Reasons for Disciplinary Action
• Types of Disciplinary Action

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Nurses are trained to always be mindful of safety and professional ethics. They are one of the most trusted professions in the country because of their high standards. This guide to nursing disciplinary action explains what happens after a professional lapse.

Almost all nursing misconduct is addressed through nursing disciplinary action from the state board of nursing or civil lawsuits. This is why the RaDonda Vaught case , which resulted in criminal charges from a medical mistake, drew national attention from nurses and nursing organizations. Many nurses protested and even quit after she was found guilty, alarmed at the criminalization of medical mistakes.

What Is Nursing Disciplinary Action?

According to the National Council of State Boards of Nursing (NCSBN), nursing disciplinary action “affects the nurse’s licensure status and ability to practice nursing.” Because state boards are in charge of licensing, they are also responsible for investigating complaints. While nursing mistakes or misconduct may lead to other consequences, such as employer reprimands, terminations, civil suits, or criminal charges, nurse disciplinary action directly affects a nurse’s license.

In addition to suspending or revoking a nursing license, state boards of nursing may issue fines or warnings and possibly require a nurse to complete professional education as part of their nursing disciplinary action.

How Common Are Nursing Disciplinary Actions?

In 2021, there were 18,145 adverse actions against nursing licenses, according to the National Practitioner Data Bank (NPDB), affecting 140,859 nurses, 93,998 licensed practical nurses, and 9,002 nurse practitioners.

According to the NCSBN, this represents less than 1% of all nursing licenses.

What Is the Nursing Disciplinary Process?

Nursing disciplinary action consists of six separate phases.

Filing a Complaint

Any person with knowledge of a violation of the state’s nurse practice act, unethical behavior, or behavior that either endangers a patient or represents a potential danger to patients can file a complaint with the state board of nursing.

Other healthcare professionals are mandatory reporters, meaning they must report violations. If they do not, that is grounds for a complaint against their license. Nurses may also report themselves. (One of the reasons many nurses protested the ReDonda Vaught trial and verdict is that they feared it would have an effect on self-reporting or reporting colleagues.)

Criminal convictions also trigger a review.

Initial Review

During the review, the state board of nursing first decides if the complaint falls under nursing disciplinary actions, that is, if it violates the nurse practice act for that state. This does not yet determine if the complaint is valid, just whether the board of nursing has jurisdiction.

Investigation

The investigation process depends on the nature and seriousness of the complaint. It may involve interviews with the nurse, patients, and witnesses; asking for a written response; and reviews of documentation and other evidence. Investigations may take several months depending on the case.

Board Proceedings

After the investigation, the board of nursing may decide to close the case if the complaint was found to be not valid. It may also proceed by holding a settlement conference or hearing. It may also result in filing formal charges or assigning the nurse to an alternative-to-discipline program.

Board Actions

Nurse disciplinary actions include fines, reprimands, or remedial action (such as completing mandatory education). It also includes restriction of a license where a nurse can continue practicing but under specific conditions, suspension of a license where a nurse can continue practicing after a set period of time, or the permanent loss of a license.

Reporting and Enforcement

The state board of nursing must report the results of any nursing disciplinary action to Nursys, the national database of nursing licenses and license status, and to the NPDB. The NPDB tracks data about licensing actions and malpractice suits for all healthcare professionals.

What Are the Most Common Reasons for Nursing Disciplinary Action?

Complaints fall into the following categories:

• Failing to follow nursing practice
• Substance misuse
• Sexual misconduct (such as engaging in sexual relationships with patients)
• Boundary violations (such as soliciting or accepting monetary or valuable gifts)
• Abuse of patients (either physically or verbally)
• Positive criminal background checks

According to the CNA and NSO Nurse Professional Liability Exposure Claim Report, published in 2020, the most common allegations are the following:

• Professional conduct (32.5% of all primary allegations)
• Scope of practice violation (24.8%)
• Documentation errors or omissions account (9.7%)
• Treatment and care failures (9.3%)
• Abuse of patients (8.8%)
• Medication administration (6.2%)

Drug diversion or substance misuse made up 42.3% of all professional conduct alleged violations, and failure to maintain standards accounted for 58.9% of all scope of practice violations allegations.

The best defense is to know and follow your states nurse practice act and discuss questions with a supervisor. For example, while accepting valuable presents or money from a current or past patient is against nurse practice acts, most nurses dont want to hurt a patients feelings if they’re offered a small personal gift of little financial value. Knowing exactly where to draw the line can help you respond.

What Are the Most Common Forms of Nursing Disciplinary Action?

Nursing disciplinary action may include:

• Probation (The nurse may continue to practice, but any further validated complaints will result in more serious nursing disciplinary action.)
• Limited or restricted practice (The nurse may continue to practice but under restrictions, such as not being able to access controlled substances.)
• Suspended practice (loss of license for a specific period)
• License revocation (complete loss of license)
• Mandatory remedial education

Nurses may and often do get a lawyer during nursing disciplinary action, especially if the potential action includes a suspended or revoked license.

Frequently Asked Questions About Nursing Disciplinary Action

What is the most common reason that nurses are disciplined by the state board of nursing.

According to the CNA and NSO Nurse Professional Liability Exposure Claim Report, the most common reason for allegations is professional conduct violation (32.5% of all primary allegations) followed by scope of practice violation (24.8%).

Documentation errors or omissions account for another 9.7% and treatment and care failures for 9.3%.

How common is it for nurses to have their license revoked or suspended?

Nursing disciplinary action that includes license suspension or revocation is rare. According to the NCSBN, each year less than 1% of nurses have any adverse action taken against their licenses. According to the NPDB, there were 18,145 adverse actions against nursing licenses in 2021, while there are more than 3.8 registered nurses alone.

What can nurses do if they receive disciplinary action?

Nurses can get legal counsel at any stage of nursing disciplinary action, from the initial complaint through the board’s actions. Some law firms specialize in medical disciplinary actions.

Nurses can also appeal nursing disciplinary actions and, depending on the specific action, may later appeal for restoration of a revoked license.

What are nursing fines or civil penalties?

Nursing disciplinary action can include fines or civil penalties. Fines or civil penalties apply to several violations, but they are common in cases where a nurse committed fraud or otherwise gained financially from their violation.

Nurses must also pay for any remedial requirements (such as mandatory education) or substance misuse treatment.

Source List

• Kelman B, et al. (2022). Why nurses are raging and quitting after the RaDonda Vaught verdict. https://khn.org/news/article/nurses-react-radonda-vaught-verdict-conviction/
• NCSBN board action. (n.d.). https://www.ncsbn.org/673.htm
• NPDB analysis tool. (n.d.). https://www.npdb.hrsa.gov/analysistool/
• Nurse profesionial liability exposure claim report. (2020). https://www.nso.com/
• Saad L. (2022). Military brass, judges among professions at new image lows. https://news.gallup.com/poll/388649/military-brass-judges-among-professions-new-image-lows.aspx
• Nursing fact sheet. (2019). https://www.aacnnursing.org/News-Information/Fact-Sheets/Nursing-Fact-Sheet

Page last reviewed April 24, 2022

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What Nurses Should Know About License Investigations

• 40% of Complaints are “Impairment”
• Moral Injury on Top of Burnout

The Process of Defending a Nursing License

In a recent nationwide survey of 30,000 nurses, the American Nurses Association (ANA) found that 32% said they were unprepared to care for a Covid 19 patient (Williams, 2021).  The pandemic has filled hospitals to capacity and stretched overworked nursing staff to the breaking point. Nurses are taking on more patients, and these patients are sicker than before the pandemic.  This situation leaves nurses at risk for license complaints and the possibility of losing not only their job, but their professional credentials. According to the laws in some states, a nurse must ensure he or she is competent to care for a patient before accepting an assignment (Williams, 2021). The pandemic and its effect on hospitals and staffing may be putting nurses in compromising positions and leaving them with ethical and moral dilemmas more than ever.

40% of Complaints Against a Nurse’s Credentials is “Impairment”

 Jennifer Flynn, Risk Manager for Nurses Service Organization, says the incidence of nursing license surrender has increased to 4.8% in the most recent 2020 data. That number is up from 3.2% from the previous report .

Barbara Holtry, spokesman for the Oregon State Board of Nursing (OSBN), says there has not been an increase in complaints against nurses’ licenses in Oregon since the start of the pandemic. However, the most common reason for a complaint against a nurse’s credentials is “impairment,” according to Holtry. Confidentiality of records kept by any Board of Nursing as well as relative newness of the pandemic may mean that there is a lag in statistics about how the pandemic affects the nursing profession. And, while substance abuse has long been a troubling issue for nurses, the pandemic may be exacerbating the problem. Complaints against a nurse’s license involve substance abuse about 40% of the time Flynn says. NSO recognizes nurses’ unique situations when it comes to substance abuse. When stress, patient load, and access to medications combine, the situation can quickly become combustible. Additionally, pandemic-related stress may lead some nurses to experience new-onset drug or alcohol abuse problems (Williams, 2021).

Nurses Are Dealing With Moral Injury on Top of Burnout

Matt Caliza, Nurse Practice Consultant with the Oregon Nurses Association (ONA), says Covid 19 has pushed nurses beyond burnout.   He says the pandemic has forced nurses into a state of moral injury. Calzia says the most recent Covid surge has hit nurses particularly hard and caused an increase in anxiety. Substandard care is one reason a nurse could be subject to board investigation. Nurses are asked to care for patients that are sicker than ever before, and according to Caliza, the ONA’s position is that a nurse should not accept a patient unless he or she possesses the knowledge, competency, skills and abilities to care for the patient. With each surge of the pandemic patients’ acuity has also surged. Hospitals, particularly ICUs, are filled beyond capacity, causing sicker people to flood floor beds. A nurse who refuses to care for a particular patient because he or she doesn’t feel adequately prepared is likely to face backlash from unit managers, charge nurses, or coworkers. This may make accepting care for patients when the nurse may not have the competency, skills, or ability to care for them may feel like the only choice. It is important for clinicians to remember that employers cannot threaten an employee’s professional license; they can only file a report with the state board.  Sometimes an RN may be forced to choose between their employer and their license, says Calzia.  The increasing complexity of patient care may put nurses in the position of needing to defend their license in front of their respective state nursing board.

 A nurse could face a myriad of consequences when patient care is called into question. A family may file a civil lawsuit. Family members, employers or coworkers may also file a complaint with the state’s board of nursing. The practitioner who loses a civil lawsuit can continue to practice after paying the damages, whereas a complaint filed with a state board of nursing could end a career. The nurse has the opportunity to defend his or her license in front of the Board and be represented by counsel.  Still, Flynn says nurses don’t always take a complaint filed with a nursing board seriously.  Forty-five percent of cases are closed with no board action. In 55% of cases , the Board takes some sort of action against a nurse’s license. 

The first step when OSBN receives a complaint is to evaluate it to ensure the Board has jurisdiction over the situation. 

• If the complaint violates the Nurse Practice Act and there is enough information to follow up, a case is opened and assigned to an investigator. 
• The investigator will conduct interviews with the complainant, the licensee, employer and coworkers. The investigator will also review pertinent documents, including patient records, HR records, or police reports. 
• The investigator will then present a case report to the board for review and possible disciplinary action. 
• Types of sanctions the Board could take range from a fine of up to $5,000., to suspension of a license, to revocation of licensure.

The pandemic has put a strain on hospitals and nursing staff like nothing in recent memory. Sicker patients with complex care needs may challenge a nurse’s skills as well as their emotions. Among the risks brought about by the pandemic is the risk of being accused of substandard care. Nurses may also be at greater risk for addiction-related, in part to increased stress.  These factors can put nurses at risk of a Board of Nursing investigation and possible loss of their professional license. Nurses should be prepared to handle a board investigation.

Calzia, M. (2021, November 18). Nurse Practice Consultant, Oregon Nurses Association. (E. Cole, Interviewer)

Holtry, B. (2021, December 3). Oregon State Board of Nursing Media Contact. (E. Cole, Interviewer)

Relias Media. (2021). Nursing license complaints must be taken seriously, avoided if possible. Unknown: Relias Media. Retrieved from www.reliasmedia.com/articles/148574-nursing-license-complaints-must-be-taken-seriously-avoided-if-possible.

Williams, H. E. (2021). Covid-19 related nursing license complaints: Considerations for LNCs. The Journal of Legal Nurse Consulting, 32(2), 12-17. doi:2470-6248

Ellen Cole, MSN-RN is a Medical Surgical nurse and freelance writer who lives in Portland Oregen. Ms. Cole started working as a CNA in 2003 and has worked in a variety of nursing specialties along the way. She brings that varied experience into her writing, as she writes on a variety of topics from health and wellness to patient care to nursing career issues. Her work can be read at her website: ELLEN COLE - Scriveners Sojourn

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Current Address

Why is it so important to change my name or address with the Board within ten (10) days?

it is your responsibility as a nurse to keep the Board informed regarding your contact information. In the event that the Board investigates allegations against you and is not able to correspond with you, your case may proceed. In such cases, formal charges may be filed and the Board may seek a default revocation of your license(s).

Back to Topics

I am under investigation

If allegations have been made against me, and an investigation is opened, do I have to tell my employer and can I continue to work?

Since investigations are confidential, there are no provisions in the Nursing Practice Act or Board Rules requiring you to tell your employer about any pending investigation. It is a matter of personal choice as to whether or not you choose to tell your employer. You are afforded all due process rights and you can continue to work until the Board issues an Order affecting your employment and takes final action on your license(s).

If I am being investigated, can I see the records and documents that the BON has gathered in my case?

not subject to disclosure. You can make a written request to the investigator assigned to your case, and the investigator will provide you with an estimate for the costs of the records as soon as they are available. In most cases, records can be made available to you either as paper copies or imaged onto a disc; however, since some records may have restrictions governing their release, you may be offered an appointment to review the records at the Board's office.

If I am under investigation, how can I prove to the Board that I didn't do anything wrong?

Providing the investigator with all information requested in a prompt fashion is most helpful and you can also submit any additional information that you want the Board to consider. This assists the Board in conducting a fair and impartial investigation into the allegations against you.

If, while in the disciplinary phase, I no longer wish to practice nursing, can I surrender my license(s)?

Yes, the Nursing Practice Act (NPA) provides for the voluntary surrender of a license. You cannot apply for reinstatement until at least one (1) year has lapsed from the date of surrender and your reinstatement will be considered based upon the NPA and Rules in effect at that time. Please note that a voluntary surrender is considered an official Board discipline and/or sanction.

Confidentiality

If I make a complaint against a nurse, will my identity be kept confidential?

All complaint information submitted to the Texas Board of Nursing (BON or Board) is kept confidential throughout the entire process of the investigation. Even if the nurse is disciplined publicly, the source of the complaint remains confidential.

How are the patients' identities protected during investigations?

The Board is authorized to have access to protected patient information because of its health oversight activities and every effort is made to protect the identity of patients during the entire process of the investigation. If and when records must be filed publicly, all confidential information is deleted.

If allegations have been made against me, how long will the investigation take?

An investigation typically takes six (6) to twelve (12) months to complete, depending on the circumstances. The complainant and the nurse being investigated are notified periodically of the status of the investigation. Reasons for delays in completing the investigation are numerous and factors creating these delays are often not within the control of the investigator, the Board, or the nurse under investigation. Each complaint is resolved as soon as possible.

If I receive disciplinary action against my license, why does it have to be published in the Board's Newsletter?

Disciplinary Board orders are public information and the NPA requires that the Board inform the public about the disciplinary actions it takes. The Board is a public entity, and as such is subject to open record laws. Cases in which formal charges have been filed also become public information at the time of the filing and continue to be public information throughout the remainder of the disciplinary process. See Section 301.158 and 301.463 (c).

Responsibility

If I am a licensee and see another nurse or a student nurse do something wrong, must I report it to the Board?

Section 301.402(b) of the Nursing Practice Act requires you to report the conduct either to the Board, to the facility's peer review committee, or to the nursing educational program if the occurrence involved a student. Reports to the Board must be submitted in writing and signed. Failing to submit a required report is a violation of the Act.

Substance Issues

What is the Board's policy on Drug Screening for Nurses under Board Order?

Please read the Board's Instructions for Urine Drug Screen Collection for detailed information.

How do I meet my reporting requirement when I suspect a nurse’s practice is impaired?

When a nurse accepts an assignment, the nurse must have the education, experience and knowledge to deliver safe patient care, and the emotional and physical ability to carry out the assignment safely [ 22 TAC §217.11 (1)(T)]. There are a number of factors that may impair a nurse’s practice. Life events may impact a nurse’s emotional ability to accept an assignment and factors such as fatigue or physical injuries can impact a nurse’s physical ability to accept an assignment. Some circumstances may impact the nurse’s ability to self-assess fitness to practice including substance use disorders, mental health condition or diminished mental capacity. 

Conduct subject to reporting includes a suspicion “that the nurse’s practice is impaired by chemical dependency or drug or alcohol abuse” [ Tex. Occ. Code, Sec. 301.401 (1)(B)]. A nurse is required to report when the nurse suspects that another nurse has engaged in conduct subject to reporting [ Tex. Occ. Code, Sec. 301.402 (b)(1)].

The reporting requirements for nurses, employers and others are addressed in the Nursing Practice Act (Texas Occupations Code, Chapter 301, et. seq.). There are three pathways that a report related to an impaired nurse’s practice may potentially take.

• A report to the Board of Nursing (Board) is required if the nurse is impaired or suspected of being impaired by chemical dependency or diminished mental capacity and there is a belief that the nurse in question committed a practice violation [ Tex. Occ. Code, Sec. 301.410 (b)].
• A report may be made to a nursing peer review committee (please see Tex. Occ. Code, Chapter 303) instead of to the Board [ Tex. Occ. Code, Sec. 301.402 (e)(1)].
• A report may be made to the Texas Peer Assistance Program for Nurses (TPAPN) instead of to the Board or to a nursing peer review committee if the nurse has not committed a practice violation [ Tex. Occ. Code, Sec. 301.410 (a)].

If a person is required to report and is unsure whether there is a practice violation, the report may be made to both the BON and to TPAPN.

For information on filing a complaint to the Board, please click on the link below: Discipline & Complaints – How to File a Complaint: http://www.bon.texas.gov/discipline_and_complaints_policies_and_guidelines_filecomplaint.asp

For information on filing a complaint (referral) to TPAPN, please click on the link below: https://cdn.ymaws.com/www.texasnurses.org/resource/resmgr/tpapn/tpapn-referral-form2018_-_fi.pdf

What is TPAPN and what do they do?

Texas Peer Assistance Program for Nurses (TPAPN) was established for nurses to help nurses. It helps RNs and LVNs get through the difficulties of substance abuse and/or mental health condition(s) – and get back to work. For more information regarding TPAPN, please see their website.

For more information on these and other topics, use the search field at the top right corner of the page. Should you have further questions or are in need of clarification, please feel free to contact the Board.

Workplace and Employment — General Information

What is the BON Proposed Nursing Work Hours Position Statement?

BON Proposed Nursing Work Hours Position Statement. The Texas Board of Nursing's (BON) Nursing Practice Advisory Committee (NPAC) initiated an online survey ...

Florida Board of Nursing

File a Complaint

You may learn more about the Complaint process and submit the appropriate complaint forms by visiting our online Enforcement website .

Continuing Education

Discipline and Complaints

Nurse discipline in washington state.

The Nursing Care Quality Assurance Commission (NCQAC) works to protect the public by investigating reports of violations of nursing laws, and by taking disciplinary action when it finds sufficient evidence of unprofessional conduct. The Nursing Commission responds to findings of unprofessional conduct through remedial training, practice restrictions, or rehabilitation to address violations. In some instances, suspension or revocation is necessary to protect the public.

The Nursing Commission also investigates reports that a nurse may be unable to practice with reasonable skill and safety because of a mental or physical condition. File a complaint about a:

• licensed practical nurse (LPN), registered nurse (RN), advanced registered nurse practitioner (ARNP), or nurse technician
• nursing education program, nursing assistant training program, or nursing education faculty  
• physician or physician assistant (Medical Commission)
• other health professions (including nursing assistant)

Check the  complaint process flowchart  if you have a complaint filed against you, or if you have filed a complaint. Learn what will happen, your options, and the basic timelines of a case.

If a complaint involves substance use disorder, the nurse may be referred to  Washington Health Professional Services , the commission-approved substance use disorder monitoring program.

If a complaint meets the requirements for the Early Remediation Program, the nurse may be referred to that program, which addresses standard of practice cases with little to no harm. See procedure  A34 (PDF)  for more information.

Check Provider Credential Search  to see if specific nurses have disciplinary action against licenses. The  Public Disclosure law , requires DOH to make these documents available to the public. Documents are available for 75 years, and cannot be removed unless a court orders DOH to remove them. Only formal charging documents, and final orders and stipulations are available. The  complaint process flowchart  outlines the process.

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How Do I File a Complaint?

Online: DCA BreEZe Online Services

Mail: You may complete a Complaint Form and mail to:

Board of Registered Nursing Attn: Complaint Intake PO Box 944210 Sacramento, CA 94244-2100 Fax: (916) 574-7693

Email: [email protected]

In filing your complaint, the information you provide will determine the action the Board will take. The most effective complaints are those that contain firsthand, verifiable information. Therefore, please provide a statement, in your own words, which describes the nature of your complaint. Please include as many specific details as possible, including dates and times, as well as any documentary evidence related to your complaint. The emphasis should be on providing necessary factual information. While anonymous complaints will be reviewed, they may be impossible to pursue unless they document evidence of the allegations made.

Please visit The Complaint Process page for helpful information regarding the complaint process.

805 Reporting - Health Facility Reporting Requirement for Nurse Practitioners

• Health Facility Reporting Form (805 Report) PDF

Are you an employer who wants to know if an 805 report has been filed on a Nurse Practitioner? Click here to submit your request.

• Frequently Asked Questions
• What is an 805 report? An 805 report is the mechanism in which peer review bodies, most commonly found in hospitals, are required to report specific information regarding licensees to the Board of Registered Nursing.
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• A peer review body denies or rejects a licensee’s applications for staff privileges or membership for a medical disciplinary cause or reason;
• A licensee’s staff privileges, membership, or employment are revoked for a medical disciplinary cause or reason;
• Restrictions are imposed, or voluntarily accepted, on staff privileges, membership, or employment for a total of 30 days or more within any 12 month period for medical disciplinary reasons;
• If the resignation, leave of absence, withdrawal or abandonment of application or for renewal of privileges occurs after receiving notice of a pending investigation initiated for a medical disciplinary cause or reason;
• A summary suspension of staff privileges, membership, or employment is imposed for a period in excess of 14 days.
• The effective date of the action to deny or reject an application for staff privileges or membership;
• The effective date of the action to revoke staff privileges, membership, or employment;
• The effective date of the action to impose restrictions on staff privileges, membership, or employment for a total of 30 days or more within any 12 month period;
• The Imposition of a summary suspension of staff privileges, membership, or employment for a period in excess of 14 days;
• The licentiate resigns, takes a leave of absence, withdraws or abandons the application for privileges or the application to renew privileges after receiving notice of a pending investigation.
• What is "medical disciplinary cause or reason"? "Medical disciplinary cause or reason" as defined in 805(a)(6) means that aspect of a licentiate's competence or professional conduct that is reasonably likely to be detrimental to patient safety or to the delivery of patient care.
• A health care facility or clinic licensed under Division 2 of the Health and Safety Code or a facility certified to participate in the federal Medicare Program as an ambulatory surgical center.
• A health care service plan licensed under Chapter 2.2 of Division 2 of the Health and Safety Code or a disability insurer that contracts with licentiates.
• A medical or podiatric professional society having as members at least 25% of the eligible licentiates in the area in which it functions, which is not organized for profit and which has been determined to be exempt from taxes.
• A committee organized by any entity consisting of or employing more than 25 licentiates of the same class that functions for the purpose of reviewing the quality of care provided by members or employees.
• The chief of staff of a medical or professional staff;
• Other chief executive officer;
• Medical director, or administrator of any peer review body; or
• Chief executive officer or administrator of any licensed health care facility or clinic.
• Name of licensee
• License number; and
• Description of the facts and circumstances of the medical disciplinary cause or reason and any other relevant information deemed appropriate by the reporter.
• Are 805 reports confidential? 805 reports are not public documents available to consumers; however, copies may be requested by certain health care facilities licensed pursuant to California Health and Safety Code 1200-1209 for credentialing purposes. This does not cause the 805 report to become public record.
• Is 805 information posted to the nurses profile? Only if the 805 report indicates hospital disciplinary action that resulted in the termination or revocation of a licensees' staff privileges based on medical disciplinary cause or reason. The licensee’s profile will display "Hospital Discipline" as secondary status. Further details if the report results in a Disciplinary Action.
• What are the penalties for failing to file an 805 report? Failure to report may result in a $50,000 fine per violation. Intentional or willful failure to report may result in a $100,000 fine per violation.
• What if the licensee disagrees with the 805 report? Pursuant to Business and Professions Code Sections 800 and 805(f), a licensee may submit "additional exculpatory or explanatory statements" to supplement the 805 report. This addendum will be disseminated with the 805 report to any eligible requesting party.
• What is the 805.01 reporting form? An 805.01 report is a mechanism in which peer review bodies are required to report a final decision or recommendation of certain actions being taken against a licensee after an investigation.
• If an 805.01 report was previously filed, is an 805 report still necessary? Yes. An 805 report is still required once the recommendations are made final by the reporting entity. The main objective of the 805.01 is to allow the Board to expedite the investigation process.
• Are 805.01 reports confidential? 805.01 reports are not disseminated and not posted on a licensee’s profile.

More information on reporting requirements for 805.01 and 805 reports can be found in the California Business and Professions Code ( ARTICLE 11. Professional Reporting 800 - 809.9 ).

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• Nursing Practice Challenges

Do You Have to Report DUI to the Board of Nursing?

As a nurse, it is crucial to understand the regulations and reporting requirements set forth by the Board of Nursing in your state. This not only ensures compliance with the law but also protects your professional license. Reporting a DUI to the Board of Nursing is typically mandatory, and failure to do so can result in severe repercussions.

When you are required to report

The specific reporting requirements vary by state, so it is essential to consult your state’s Board of Nursing for accurate information. However, in general, you are usually required to report a DUI to the Board of Nursing within a specified timeframe, often within 30 days of the conviction or plea.

Potential consequences of not reporting

Failing to report a DUI to the Board of Nursing can result in serious consequences, including but not limited to:

• License suspension or revocation: The Board may suspend or revoke your nursing license if they discover that you failed to report a DUI.
• Fines and penalties: You may face fines and other penalties for violating reporting requirements.
• Professional reputation: Not reporting a DUI can damage your professional reputation within the nursing community, potentially affecting job prospects and advancement opportunities.

How It Affects Your License

• Temporary license suspension: Upon reporting a DUI to the Board of Nursing, they may temporarily suspend your nursing license pending an investigation. This is to ensure patient safety and to assess your fitness to practice as a nurse.
• Probation or monitoring programs: In some cases, the Board may place you on probation or require you to participate in monitoring programs as part of the disciplinary action. This can involve regular drug tests , mandatory counseling, or other conditions to monitor your rehabilitation and ensure patient safety.
• License revocation: In more serious cases or if you have a history of DUI convictions, the Board may decide to revoke your nursing license. This is a severe consequence that can significantly impact your career and ability to work as a nurse.

Protecting Your Rights after a DUI

A lawyer experienced in both DUI defense and nursing board matters can help protect your rights, guide you through the legal process, and advocate for the best possible outcome.

How to choose the right representation

When choosing a lawyer, consider their expertise in both DUI defense and nursing board matters. Look for someone who understands the unique challenges and implications that a DUI can have on your nursing career. Additionally, seek recommendations, read reviews, and schedule consultations to find the right representation for your specific situation.

What to Do If You’re Facing This Situation

• Contact a lawyer: Seek legal representation from an attorney who specializes in DUI defense and nursing board matters. They can guide you through the legal process and help protect your rights.
• Report the DUI to the Board of Nursing: Familiarize yourself with the reporting requirements in your state and promptly report the DUI within the specified timeframe.
• Cooperate with the investigation: If the Board of Nursing initiates an investigation, cooperate fully and provide any requested information or documentation.

Long-term strategies and considerations

• Rehabilitation: If you are facing disciplinary action or probation, actively engage in rehabilitation programs, counseling, or treatment to demonstrate your commitment to recovery and patient safety.
• Continuing education: Consider participating in additional educational programs or courses to enhance your knowledge and skills as a nurse. This can demonstrate your dedication to professional growth and improvement.
• Professional support: Seek support from colleagues, mentors, or support groups within the nursing community. They can provide guidance, advice, and encouragement during this challenging time.

Q: Can reporting a DUI to the Board of Nursing affect my ability to find employment as a nurse?

A: Yes, reporting a DUI to the Board of Nursing can potentially affect your ability to find employment as a nurse. Employers often conduct background checks and may consider a DUI conviction when making hiring decisions.

Q: Is it possible to expunge a DUI conviction from my record?

A: Expungement laws vary by state, but in many cases, DUI convictions cannot be expunged from your record. It is important to consult with a lawyer familiar with the laws in your state to understand your options.

Q: Will a DUI conviction prevent me from becoming a nurse?

A: A DUI conviction does not automatically prevent you from becoming a nurse, but it can raise concerns during the licensing process. Each state’s Board of Nursing evaluates applicants on a case-by-case basis, considering factors such as the severity of the offense and evidence of rehabilitation.

Q: Can I still work as a nurse while my DUI case is pending?

A: Whether you can continue working as a nurse while your DUI case is pending depends on the policies of your employer and state nursing board. It is crucial to consult with both your employer and legal representation to understand your options and any restrictions.

Q: Are there any specific reporting requirements for nurses who hold multiple state licenses?

A: Nurses with multiple state licenses are generally required to report a DUI to all the Boards of Nursing where they are licensed. It is essential to familiarize yourself with the reporting requirements in each state and comply accordingly.

Q: Does a DUI conviction affect my ability to renew my nursing license?

A: A DUI conviction can impact the renewal of your nursing license, as the Board of Nursing may request information about any recent convictions or arrests. It is crucial to comply with reporting requirements and provide accurate information during the renewal process.

Q: Will my nursing license be permanently revoked if I report a DUI?

A: The permanent revocation of a nursing license due to a DUI conviction would depend on various factors, including the severity of the offense , your disciplinary history, and evidence of rehabilitation. Each case is evaluated individually by the Board of Nursing.

Q: How can I rebuild my nursing career after a DUI conviction?

A: Rebuilding your nursing career after a DUI conviction involves taking steps to demonstrate your commitment to rehabilitation and patient safety. This can include completing rehabilitation programs, engaging in continuing education, seeking mentorship, and maintaining a positive professional reputation.

Q: Can I appeal a disciplinary action taken by the Board of Nursing related to a DUI?

A: In most cases, you have the right to appeal a disciplinary action taken by the Board of Nursing. It is crucial to consult with legal representation experienced in nursing board matters to understand the appeals process and determine the best course of action.

Q: How long does a DUI conviction typically stay on my record?

A: The length of time a DUI conviction stays on your record varies by state. In general, it can remain on your criminal record for several years, potentially affecting background checks conducted by employers and licensing authorities.

Olivia Williams

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What Are Texas Nurses Required to Report?

Nurses licensed by the Texas Board of Nursing (BON) are required to report certain conduct. Failure to report when it is required could lead to disciplinary action by the BON, which may include a warning, fines, reprimand, remedial education, suspension, probation, or license revocation.

The Nursing Practice Act (NPA) defines what conduct nurses must report. Under the NPA a nurse “shall” report to the Board “if the nurse has reasonable cause to suspect that:

• another nurse has engaged in conduct subject to reporting; or
• the ability of a nursing student to perform the services of the nursing profession would be, or would reasonably be expected to be, impaired by chemical dependency.”

NPA §301.402(b) . The NPA defines what “conduct subject to reporting” means. It means conduct by a nurse that:

• Violates the NPA or a board rule and contributed to the death or serious injury of a patient.
• Constitutes abuse, exploitation, fraud, or a violation of professional boundaries.
• Indicates that the nurse lacks knowledge, skill, judgment, or conscientiousness to such an extent that the nurse’s continued practice of nursing could reasonably be expected to pose a risk of harm to a patient—regardless of whether the conduct consists of a single incident or a pattern of behavior.
• Causes a person to suspect that the nurse’s practice is impaired by chemical dependency, drug, or alcohol abuse.

NPA §301.401(1) . If you are a Texas nurse and you witness another nurse engaging in the above conduct or their conduct causes you to question their ability to safety provide patient care, you have a duty to report it to the Board.

How Must Texas Nurses Report to the Board?

The NPA prescribes the manner by which nurses must report. Depending on the circumstances, a nurse could report directly to the Board, to a nursing peer review committee (NPRC), or to the Texas Peer Assistance Program for Nurses (TPAPN). NPA §301.402(e) .

Employers of eight or more nurses are required to establish a NPRC. A nurse working for an employer required to have a NPRC may choose to report to the NPRC or directly to the BON. NPRC’s are also subject to reporting requirements under NPA §301.403 and employers of nurses under NPA §301.405 . Reports must be in writing, signed, and include the identity of the nurse and any additional information required by the Board. NPA §301.402(d) .

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Self Reporting for Nurses Fired for Misconduct

• April 21, 2015
• Nursing License Defense

Should a Nurse Self Report Potential Misconduct?

Get your side of the story to the board.

It is generally best to self report as opposed to waiting for the board to receive a third party notification about your alleged misconduct. Assuming you have an adequate defense or some information in your favor, this will allow you to assert your position to the board.

Self Reporting May Minimize Punishment

I have often found that self reporting diminishes the board’s punishment. If the board can see that you are being honest and straightforward about a disagreement that happened at work, and that your story is just as believable as your employer’s, the chances are that they will be able to work out some kind of agreement that minimizes the effect on your unencumbered nursing license .

Self Reporting for Serious Offenses

If a nurse is terminated for justified reasons – such as being caught with illegal narcotics at work – I will usually still recommend self reporting. In this type of situation, you should probably self report immediately and explain what you are doing to fix the problem . For the example above, you could check yourself into a rehab center and make plans to consult with a addictologist. Self reporting will allow you to let the board know immediately that you are addressing the problem you have had at work.

You are going to have to fight these issues before the board of nursing at some point, so being proactive about clearing up the issue can work in your favor.  Each nurse’s situation is different, however, so it is best to work with an experienced nursing attorney who can advise you based on the specific facts of your case.

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Health Care’s Rebuke of Reckless Reporting

The health care community stands together to express grave concerns about the recent Bloomberg article, " The Miseducation of America’s Nurse Practitioners ." The authors failed to write a balanced story by cherry picking negative information and failing to report the enormous contributions nurse practitioners (NPs) make to patient care and across the health care system.

The authors have omitted the fact that NPs have consistently risen to meet our nation's health care challenges. This includes risking their lives with other health care professionals to treat patients during the pandemic despite a limited supply of personal protective equipment (PPE); setting up mobile clinics or going door to door in disadvantaged communities to provide care; being among the first clinicians to treat patients with opioid use disorder in hundreds of rural counties; and providing care in rural counties, after other clinicians left and hospitals closed, to ensure continued access.

Unfortunately, these types of hit pieces can be written about any profession, but distinctly have no place in our nation’s health care system. This type of journalism not only disparages an honorable profession at a time in which our country is struggling to build our nation’s workforce, but also frightens patients from seeking needed care.

The following points were either provided by AANP or could have been found by the authors if they were seeking to provide readers with any type of balanced article:

• The authors only included one study, which they appeared to discredit by saying it included international NPs. In fact, the authors were provided more than  50 studies  that definitively demonstrate that NPs in the United States provide high-quality primary, acute and specialty health care services across the lifespan and in diverse settings.
• The National Academies of Science, Engineering and Medicine’s report on the future of nursing found that: “Such restrictions limit access to care generally and to the high-quality care offered by APRNs. Those supporting these restrictions maintain that nonphysician providers are less likely to provide high-quality care because they are required to receive less training and clinical experience. However, evidence does not show that scope-of-practice restrictions improve quality of care (Perloff et al., 2019; Yang et al., 2020). Rather, these regulations restrict competition and can contribute to higher health care costs (Adams and Markowitz, 2018; Perloff et al., 2019).” (National Academies of Sciences, Engineering, and Medicine. 2021.  The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity .)
• The American Enterprise Institute wrote: “Can NPs provide health care of comparable quality to that provided by primary care physicians? Our studies showed that beneficiaries who received their primary care from NPs consistently received significantly higher-quality care than physicians’ patients in several respects. While beneficiaries treated by physicians received slightly better services in a few realms, the differences were marginal. These results held when vulnerable populations of Medicare beneficiaries were analyzed separately and compared to those cared for by physicians, aligning with the findings of many other studies conducted over the past four decades.” (American Enterprise Institute. 2018.  Nurse Practitioners: A Solution to America’s Primary Care Crisis .)
• The Brookings Institution wrote: “Opponents contend that quality of care may suffer under the direction of a nonphysician practitioner, citing the shorter length of training and clinical experience required. Their argument is that restrictions are necessary to protect public health. However, academic literature finds no evidence of harm to patients associated with less-restrictive Scope of Practice (SOP) laws. When no harm is present, the restrictions serve only to generate artificial barriers to care that ultimately provide physicians with protection from competition, prevent the attainment of system-wide efficiencies, and constrain overall provider capacity.” (The Hamilton Project. Brookings. 2018.  Improving Efficiency in the Health-Care System: Removing Anticompetitive Barriers for Advanced Practice Registered Nurses and Physician Assistants .)
• The National Academies of Science, Engineering and Medicine’s nursing home report found that: “Numerous reviews have identified key outcomes resulting from APRN provided care in nursing homes, including improved management of chronic illnesses, improved functional and health status, improved quality of life, reduced or equivalent mortality and hospital admissions, improved self-care, reduced emergency department use and transfers, lower costs, increased time spent with residents, and increased resident, family, and staff satisfaction.” (National Academies of Sciences, Engineering, and Medicine. 2022.  The National Imperative to Improve Nursing Home Quality: Honoring Our Commitment to Residents, Families, and Staff .)
• NPs typically complete at least six years of formal nursing education and pass national board certification prior to getting licensed and entering practice. NPs enter their graduate degree programs as registered nurses having already completed formal undergraduate Bachelor of Nursing programs, which include clinical rotations. During graduate school, NPs complete academic coursework and additional clinical rotations that prepare them to independently diagnose, manage patient care and prescribe medications and other treatments.
• NP programs are nationally accredited and the national accreditation bodies are held accountable to the U.S. Department of Education (DOE). NPs complete hands-on, supervised patient care clinical rotations that are embedded in their graduate programs and must adhere to accreditation standards. NP students must demonstrate they have integrated this prior knowledge and skill — and do not progress, or graduate, simply based on hours spent in rotation. NPs are required to pass national certification board exams and retain board certification throughout their careers.
• The authors mistake confidence for competence. It’s not unusual for some professionals in any discipline to lack confidence after graduation. For example, a recent survey by the American Academy of Pediatrics found that only 42% of pediatric residents who graduated in 2022 felt prepared for primary care practice, a significant decline from 69% in 2015.
• Citing a fringe medical group as a source, which frequently encourages the disparagement of other health care professions and engages in fear mongering in effort to restrain trade by reducing perceived competition, is reckless.
• In a Medicare Payment Advisory Commission (MedPAC) focus group, patients cited a variety of reasons for choosing an NP or physician associate (PA) as their regular primary care provider, including switching from a physician to an NP or PA as their primary care provider when their physician retired, choosing to see an NP in their practice when they had communication issues with their physician or generally preferring NPs and/or PAs to physicians.
• NPs provide a substantial portion of the high-quality, cost-effective care that communities nationwide require. According to MedPAC, APRNs and PAs comprise approximately one-third of our primary care workforce, and up to half in rural areas. NPs are essential to providing equitable access to care for all communities, including a substantial portion of health care in rural areas and areas of lower socioeconomic and health status.

Generalizations, sensationalism and cherry-picking should not be used by news sources to disparage NPs or other professions that are caring for patients and their families throughout the nation. Taking only individual negative outcomes or perceptions and then generalizing them to an entire profession that cares for patients in over a billion patient visits per year is irresponsible and dangerous. We stand together in rebuking this type of fear mongering by these reporters, Bloomberg News or any group seeking to advance an agenda with these despicable tactics.

American Association of Nurse Practitioners American Academy of Emergency Nurse Practitioners American Academy of Nursing American Academy of Nurse Practitioners Certification Board American Association of Colleges of Nursing American College of Nurse-Midwives American Nurses Association American Psychiatric Nurse Association Commission on Collegiate Nursing Education Convenient Care Association Emergency Nurses Association Gerontological Advanced Practice Nurses Association National Association of Clinical Nurse Specialists National Association of Neonatal Nurses National Association of Neonatal Nurses-Advanced Practice National Association of Nurse Practitioners in Women’s Health National Association of Pediatric Nurse Practitioners National Certification Corporation National Organization of Nurse Practitioner Faculties Advanced Practice Nurses of New Jersey Alaska APRN Alliance Alaska Nurse Practitioner Association Arizona Nurse Practitioner Council Arkansas Nurse Practitioner Association Association of Nurse Practitioners in Business Association of Oklahoma Nurse Practitioners Astera Cancer Care California Association for Nurse Practitioners Coalition of Advanced Practices Nurses of Indiana Connecticut Advanced Practice Registered Nurse Society Delaware Coalition of Nurse Practitioners Florida Association of Neonatal Nurse Practitioners Florida Association of Nurse Practitioners Florida Chapter of Gerontological Advanced Practice Nurses Association Florida Coalition of Advanced Practice Nurses Florida Nurse Practitioners Network Hart & Arndt Family Health PC Illinois Society for Advanced Practice Nursing Jamaica Association of Nurse Practitioners Kentucky Association of Nurse Practitioners and Nurse-Midwives Maine NP Association Maryland Academy of Advanced Practice Clinicians Massachusetts Coalition of Nurse Practitioners Michigan Council of Nurse Practitioners Minnesota Nurse Practitioners Mississippi Association of Nurse Practitioners Missouri APRN Full Practice Authority New Hampshire Nurse Practitioner Association New Jersey Palliative Care Advanced Practice Nurse Consortium New Mexico Nurse Practitioner Council Northern New Jersey Hospice and Palliative Nurse Association North Alabama Nurse Practitioner Association North Texas Nurse Practitioners NP’s of Lee County Nurse Practitioner Alliance of Alabama Nurse Practitioner Alliance of Rhode Island Nurse Practitioner Association New York State Nurse Practitioner Association of Long Island Nurse Practitioner Association of Maryland Nurse Practitioner Council of Miami-Dade Inc. Nurse Practitioners of Idaho Nurse Practitioners of New York Nurse Practitioners of Oregon Ohio Association of Advanced Practice Nurses Oasis Health Partners Oregon Nurses Association Patients First Medical Clinic Pennsylvania Coalition of Nurse Practitioners Robert Wood Johnson University Hospital Society of Psychiatric Advanced Practice Nurses South Florida Council of Advanced Practice Nurses Tampa Bay Advanced Practice Nurses Council Tennessee Nurse Practitioner Association Texas Nurse Practitioners United Advance Registered Nurses Utah Nurse Practitioners Association Vermont Nurse Practitioner Association Virginia Council of Nurse Practitioners West Virginia Nurses Association

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News you can trust — By Montanans, for Montanans

Start your day with the latest in-depth, independent reporting from across our state delivered directly to your inbox.

Montana Free Press

Montana's independent nonprofit news source.

Education leaders take stock of changes to school quality requirements

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One year ago, the Office of Public Instruction debuted a new system and a revised set of regulations designed to ensure that Montana’s more than 800 public schools meet a state-mandated threshold of educational quality. Now state and local education leaders are taking stock of those accreditation changes and identifying areas for ongoing improvement, a conversation that will continue to shape how Montana holds its K-12 schools accountable to state laws and the students they serve. TK

Under the new accreditation rules, OPI reported this month that 3% of Montana schools were ranked as “deficient” during the 2023-24 school year due to ongoing deviations from state quality requirements. One year prior, under the old rules, that total was 31%. But School Administrators of Montana Executive Director Rob Watson cautioned against comparing the latest accreditation results to past school years, since the system is now operating on a “totally new scoring system.”

“It’s really probably not accurate to compare your old score versus your new score because it’s like apples and oranges,” Watson told Montana Free Press in an interview. 

Accreditation has served for decades as one of the key ways Montana holds its public schools accountable to the educational assurances laid out in state law and the Montana Constitution. Every year, school administrators report to OPI on a series of metrics including staffing levels and qualifications, student test scores and implementation of local policies. Such metrics help determine whether schools have enough licensed teachers to cover classroom needs, whether class sizes meet state standards, and whether students are showing proficiency in core subjects like reading and math. 

Any deviation from state requirements is logged and tracked over time and, if not addressed, results in a deficiency rating for the school. Such dings in state reports can threaten a school’s reputation, necessitate corrective action and, if left unaddressed, result in the possible loss of a school’s accredited status. 

State and local education leaders have characterized the state’s former accreditation process as largely a series of check-boxes. But as of last July, new reporting requirements call for districts to submit a host of narrative documentation — comprehensive needs assessments, strategic action plans, generic profiles of school graduates — as further evidence of their work educating students and engaging with parents. 

The Board of Public Education approved the changes in March 2023 after a lengthy and at-times contentious review by OPI of Montana’s accreditation rules, collectively known as Chapter 55. OPI put the new regulations into effect ahead of the 2023-24 school year. In numerous public statements this year, State Superintendent Elsie Arntzen has described the changes as providing improved accountability and transparency.

“The new process emphasizes more meaningful outcomes of school accreditation through the inclusion of a more robust and comprehensive view [of] how our schools serve our students,” OPI spokesperson Brian O’Leary told MTFP via email. “The changes to Chapter 55 focused on increased transparency and local accountability that verifies accreditation standards for school quality have been met.”

O’Leary added that the marked drop in schools rated as deficient this year is a direct result of the addition of new components to the accreditation process. Prior to 2023-24, schools employing one or more unlicensed teachers in their classrooms — an increasingly widespread occurrence statewide resulting from Montana’s ongoing teacher shortage — automatically earned them a deficiency status. Now such staffing considerations are just part of an expanded range of reporting requirements.

Board of Public Ed formally adopts new school quality rules

Rule changes approved by the Montana Board of Public Education Friday add new financial literacy and civics requirements for graduation, expand family and community engagement in career and college readiness, and preserve ratios for school counselors and librarians.

Laurie Barron, superintendent of the Flathead Valley’s Evergreen School District, said the documentation schools were required to submit this year wasn’t necessarily new for many districts. Evergreen, for example, has had a strategic action plan for more than a decade and regularly compiles its own needs assessment. The challenge, Barron told MTFP, was in matching those documents with OPI’s reporting system, and doing so on a tight deadline while also complying with a host of other legal and regulatory changes implemented by state lawmakers and education officials over the past year.

“There were so many new things last year that all came at one time from the Office of Public Instruction, from the Legislature, and schools are expected to implement those with fidelity and high quality,” Barron said. “I’m not sure that someone not in a school understood all the pressures from all the different areas coming on schools at one time.”

In recent deliberations with the Board of Public Education, several district superintendents expressed similar concern with the amount of documentation required by the new accreditation process and the amount of time it took local administrators to complete this spring. East Helena Schools Superintendent Dan Rispens cited several examples, including incompatibilities between the district’s existing planning and needs documents and what OPI required, which in some cases meant he had to “almost start from scratch.”

“There were so many new things last year that all came at one time from the Office of Public Instruction, from the Legislature, and schools are expected to implement those with fidelity and high quality. I’m not sure that someone not in a school understood all the pressures from all the different areas coming on schools at one time.” Laurie Barron, superintendent of the Flathead Valley’s Evergreen School District

“The no-save feature, which I’m sure you’ve heard a lot about, was frustrating for some people,” Shelby Public Schools Superintendent Elliott Crump told the board, referencing administrators’ inability to save partial information entered into OPI’s accreditation portal. “There was a district that went through the process, computer went down, internet went down, they lost everything, they had to start over again.”

Crump also noted that the deadline for districts to complete their accreditation reporting this year — Good Friday — may “not have been the best choice,” as some districts recognize the date as a school holiday. Crump described the overall process as feeling like “busy work” for administrators that is “taking us away from what I believe we should be doing, working with students and providing them the best quality education we can.”

“I’ve been a superintendent in Montana for 14 years,” Crump said. “I spent less time in the classroom this past year than I ever have. I spent time filling out paperwork for accreditation that did not improve the education for my kids.”

Watson acknowledged that the new accreditation process is intensive and takes time to complete. But he also said it’s a more qualitative and comprehensive approach. While ensuring a school has enough licensed teachers to meet student needs is an important factor, Watson said, it’s “not the whole measure of school quality.”

“With this more comprehensive approach, it’s an opportunity for us to show all the other things that we’re doing that we feel reflect a quality education,” Watson continued. “We haven’t lost anything from the old standards, but we’ve actually changed the way that schools are evaluated in the state.”

In response to feedback from administrators, OPI agreed last week to allow districts to submit amendments to their accreditation status if they believe their score was impacted by errors or technical glitches this year. Writing on behalf of the agency, O’Leary told MTFP that challenges are likely to arise any time a state agency implements changes to a process “that has been in place since the 1970s.” Though she argued that Evergreen did much of the required work not for OPI or accreditation but for the good of the district, Barron said she believes accountability is important and recognizes that change can come with growing pains.

“It doesn’t matter how good it is, it’s still going to be challenging in the first run,” Barron said. “It was just so fast and there were so many different components and different focus on things that perhaps had not been as strong a focus in the past, even if they should have been.”

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Alex Sakariassen is a 2008 graduate of the University of Montana's School of Journalism, where he worked for four years at the Montana Kaimin student newspaper and cut his journalistic teeth as a paid news intern for the Choteau Acantha for two summers. After obtaining his bachelor's degree in journalism and history, Sakariassen spent nearly 10 years covering environmental issues and state and federal politics for the alternative newsweekly Missoula Independent. He transitioned into freelance journalism following the Indy's abrupt shuttering in September 2018, writing in-depth features, breaking... More by Alex Sakariassen

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Letter: RI needs Nursing Home Workforce Standards board

My name is Sherman Pines and I am writing to express my disappointment in Gov. Dan McKee’s recent veto of the Nursing Home Workforce Standards Board Bill (WSB). This bill was a commonsense way to tackle the extreme issues that exist in our state’s nursing homes including chronic short staffing, low wages and high turnover. 

As a former nursing home resident, I unfortunately know these problems all too well. In 2021, I spent one month in Kingston Center in West Kingston for rehab during the height of the pandemic. I witnessed firsthand the terrible reality of short staffing. There were only two CNAs for an average of 30 residents. Once, I had to wait an hour to get a glass of water, another time, when I needed assistance to use the restroom, it took over an hour for someone to come. What was even more disturbing was that I could hear residents screaming out in the middle of the night because they needed help … but there wasn’t enough staff there to help them. The staffing situation got so bad, nursing home workers were flown in from Texas and Alabama. Even though this was during the pandemic, the situation has barely improved.

Finally, I thought this bill would help make the change we desperately need. The WSB would help CNAs by raising wages, improving training and giving them a seat on the board along with representatives from government, industry and Medicaid community groups. It would use data and collaboration to create a long-term plan and was voted on overwhelmingly by the General Assembly. Because Rhode Island’s 2021 nursing home staffing law was never enforced; the WSB is our best hope to make sure no one has to go through what I went through.

For these reasons and more, I can’t understand why Gov. McKee would veto this important piece of legislation. In the last few years, he has done nothing to help nursing home residents and instead issued six executive orders suspending the staffing law. Enough is enough. Nursing home workers, residents and family members have been through too much and we need relief. We need the General Assembly to override this veto and let the WSB become law. 

Sherman Pines, Newport resident, CEO of Newport Healthcare Advocate