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Case Shows Board's Power to Discipline Nurses

Judge gavel

Readers have submitted many questions about nursing boards' decisions concerning the discipline of nurses for violations of their state nurse practice act and/or their rules.

In the following case (Holmes v. Louisiana State Board of Nursing, 156 So. 3d 183 (2014)), an RN learned the hard way about her board's decision-making authority. Mary Ann Holmes obtained her license as an RN in Louisiana in 2010. She landed a job at a nearby medical center. Unfortunately, Holmes did not get along with her co-workers and many refused to work with her. She allegedly yelled at co-workers, was generally rude and behaved in an "insubordinate manner," according to court documents. This behavior continued even though she was counseled about it. Many patient complaints also were lodged against Holmes. Patients said they "felt insecure" about her care. One day, Holmes allegedly yelled at a unit secretary, shook her, plopped her down in her chair and pushed the chair across the nurse's station. ("Disruptive Behavior: License Revocation Upheld", Legal Eagle Eye Newsletter for the Nursing Profession, September 2014, 5) Holmes was terminated and her behavior reported to the Louisiana Board of Nursing after she allegedly became physically assaultive with the secretary. She was sent a notice of the allegations and was informed that if the allegations were true, her license could be disciplined, which could include a revocation of her license. An investigation was conducted. Holmes retained an attorney and requested a formal hearing before the board concerning the allegations. After the evidence was presented by both sides, the board deliberated in closed session. The board accepted the proposed findings of fact and law submitted by the prosecuting attorney and ordered that Holmes' license be revoked. Holmes' attorney filed a petition for judicial review of the board's order in the district court. The district court affirmed the board's decision. Holmes filed for an appeal of that decision.

Appeals court rules

The appeals court reviewed the applicable law and Holmes' allegations of why the board order should not be affirmed. Her arguments, among others, included that her rights were violated under the Louisiana and federal constitutions; that the board accepted the findings and conclusions of the prosecuting attorney without deliberation; and that her due process rights and rights to a fair hearing before an impartial tribunal were violated, according to court documents. The court held Holmes' arguments were without merit. In doing so, it underscored the importance of the board's obligations to protect the public and ensure nurses practice safely and competently. The court clearly stated the evidence presented supported the board's conclusion that Holmes was "unfit or incompetent and failed to utilize appropriate judgment." Moreover, the court concluded, no constitutional or statutory provisions were violated, the board's decision was not arbitrary, capricious or an abuse of discretion. It upheld the judgment of the district court. A board of nursing has many options when it decides to discipline you. Other possibilities include placing the nurse on probation or suspending the license for a period of time. Revocation, of course, is the most serious alternative. This case clearly illustrates a board of nursing's power and authority to discipline you as a nurse licensee. As long as the board does so within its statutory authority and provides you with all the protections afforded to you, the decision will be upheld by the judicial system. The case also speaks to the importance of retaining a nurse attorney or attorney to represent you in a professional disciplinary proceeding. The attorney here represented his client well as he attempted to legally challenge the decision of the board. Given the court's ruling to uphold the board's decision, do you have any thoughts about the board's order to revoke Holmes' license?  

Courses Related to 'Ethics and behavior'

WEB296: Nurse Bullying: Stereotype or Reality? What Can We Do About It? (1 contact hr) October is Bullying Prevention Month. Have you ever felt bullied in the workplace? How has the "nurses eat their young" idiom survived through nursing history? In the past few years, interesting research has emerged ranging from workplace aggression to incivility to nurse bullying. Knowledge is power. Become equipped to professionally challenge bullying in the workplace and empowered to demonstrate good examples of nursing leadership in our profession! 60097: Everyday Ethics for Nurses (7.3 contact hrs) This course provides an overview of bioethics as it applies to healthcare and nursing in the U.S. It begins by describing the historical events and forces that brought the bioethics movement into being and explains the concepts, theories and principles that are its underpinnings. It also shows how ethics functions within nursing, as well as on a hospitalwide, interdisciplinary ethics committee.