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Falsification in Nursing: It's a Legal Line You Should Not Cross

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Falsification of credentials on business cards raises red flags

A reader asked about a nurse colleague who had business cards made that falsely indicated the nurse colleague had a BSN degree when she did not, nor was she enrolled in a baccalaureate nursing education program. Moreover, according to the reader, the nurse's immediate supervisor knows the nurse does not have a BSN, but has not required her to correct the fabrication. The reader was concerned about where to go with this information. 

The nurse certainly could try to report her concerns to the CNO, who should appropriately intervene in the situation. Or the nurse could report the situation to her state board of nursing, which would investigate the matter and determine if disciplinary proceedings should be initiated. The bottom line is that the reader is describing an example of falsification, which is the willful perversion of facts and includes such behavior as lying, distorting and paltering.

There's no shortage of penalties for falsification

When anyone falsifies information about themselves, it is a serious matter, as it is obviously misleading, deceptive and reflects on your trustworthiness. But it is extremely serious when a nurse does this. 

State boards of nursing can initiate professional disciplinary proceedings against a nurse when falsification occurs, including in cases when unprofessional conduct is likely to deceive, defraud or harm the public; using false, deceptive or fraudulent statements in any record in connection with a nurse's practice; practicing beyond the scope of one's practice; and violating state or federal laws, rules and regulations governing controlled substances. In most states, disciplinary actions include a reprimand, censure, probation, suspension or revocation of the nurse's license.

"When anyone falsifies information about themselves, it is a serious matter, as it is obviously misleading, deceptive and reflects on your trustworthiness. But it is extremely serious when a nurse does this."

Unfortunately, falsification of documents in nursing is not a new phenomenon. A 2012 article in the Journal of Nursing Regulation by Latrina Gibbs McClenton, discusses two cases of falsification of licensure applications by two separate candidates applying for RN licensure in Mississippi. McClenton identifies falsification in such instances as a result of "deception or omission" and includes failure to disclose a criminal history, listing or claiming an educational degree that the applicant does not possess, and using personal information taken from another to apply for licensure. 

Falsification by nurses also occurs in other situations. The Texas Board of Nursing, in its publication "Behavior Involving Lying and Falsification," gives examples such when an individual pretends to be a nurse or when a nurse licensee may represent that he or she has a "broader scope of practice" than is actually authorized by his or her license. These individuals are viewed by the board as nurse imposters. 

Perhaps the most troubling instances of falsification by nurses is when they occur in relation to patient care. I discussed one such circumstance in Brent's Law on Sept. 17, 2012, when a hospice nurse practitioner misdated her visits. Although the nurse practitioner's rationale was that she didn't remember the dates and probably "just signed the wrong day," it is difficult to accept her lack of memory of the visits when she then adds that she probably used the wrong dates. If there is no memory of the visits, no date would have been accurate, and the issue of falsification is raised as the real culprit.

"Falsification by nurses is not only unethical, it shatters legal parameters. Initially, criminal charges on the state or federal level may be brought against the nurse."

Other examples of nurse falsification with patient care matters include inaccurate entries; medications and treatments documented as being given when they are not; covering up bad outcomes; and staff simply documenting in charts "en masse," not knowing for sure whether what is being recorded is accurate ("Falsified Patient Records Are Untold Story of California Nursing Home Care," California Advocates For Nursing Home Reform). 
 

Falsification by nurses is not only unethical, it shatters legal parameters. Initially, criminal charges on the state or federal level may be brought against the nurse. These charges include fraud (see "Five Years In Prison For Miami VA Nurse Who Falsified Patient's Record" at: ), falsifying business records, criminal possession of a controlled substance, practicing nursing without a license, and petit larceny. 

If your falsification involves a felony conviction relating to a controlled substance or a misdemeanor conviction relating to healthcare fraud, you may be excluded from working in any Medicare or Medicaid facility by the Office of Inspector General of the U.S. Department of Health and Human Services. And boards of nursing report disciplinary actions against nurses to the National Practitioner Data Bank. The data bank is used by organizations to determine licensing, credentialing, privileging or employment decisions. 

Falsification can end your career or even land you in jail. Two words sum whether you should be accepting of falsification by other nurses or practice it yourself: Not ever.

Courses Related to 'Maintaining Ethical and Legal Standards as a Nurse'

60207: Texas Nursing Jurisprudence and Ethics (2 contact hrs)

The goal of this continuing education module is to provide Texas nurse licensees, and those who are interested in being licensed in Texas, with an introduction to the Texas Nursing Practice Act and Rules. In addition, ethical principles and six grounds for discipline of nurses will be discussed.

CE548: Protect Yourself (1.00 contact hr)

This module will enhance nurses' knowledge of nurse practice acts and how they define professional practice and nurses' rights and responsibilities as practitioners. It includes information on provisions included in most nurse practice acts and types of violations included and the rights afforded the nurse licensee in most nurse practice acts.

EDITOR'S NOTE:

Nancy Brent's posts are designed for educational purposes only and are not to be taken as specific legal or other advice. Individuals who need advice on a specific incident or work situation should contact a nurse attorney or attorney in their state. Visit The American Association of Nurse Attorneys website to search its attorney referral database by state.