Many nurses are concerned about professional negligence lawsuits, but disciplinary action imposed by state boards of nursing can have a major impact on a nurse's practice, as well.
Disciplinary action can result in consequences such as being unable to practice nursing for an extended period of time or obtain licensure in another state, and loss of membership in professional associations. I reviewed several board of nursing websites so I could share with you the following real life examples of determinations these boards have made.
Examples of disciplinary actions
- An RN failed to check two patient identifiers and scan the patient's ID band before administering medications. As a result, nine pills, including Norco, were administered to the wrong patient and without a physician's order. Disciplinary action included completing the board of nursing course, "Understanding Board Orders," a course on state nursing jurisprudence and ethics, and a course on medication administration.
- A school nurse had difficulty remembering names of students to whom she administered daily medications and struggled with calculating carbohydrates and insulin dosage for diabetic students. She allowed the students to calculate the dosage. Because of her own anxiety and alcohol abuse, she also failed to notify parents/guardians when medications were low or a student was injured. Disciplinary action included voluntary surrender of her license, which was recorded as an indefinite suspension. The license could be reinstated, but only after an administrative proceeding to consider her renewal application.
- An RN submitted timecards to her staffing agency for work she did not do at a healthcare facility -- the total cost of which was $40,510.44. Disciplinary action included her license being indefinitely suspended for a minimum of seven years, a fine of $1,000, and assessed costs for the investigation into the matter.
- An RN employed at a nursing home documented that she changed a joint replacement surgical patient's wound dressing when she had not. Disciplinary action included a reprimand. In addition, she had to complete three hours of education on proper patient documentation and pay $325.00 in costs.
- An RN was found guilty of state benefits fraud. Disciplinary action was a one-year suspension of her license.
- An RN continued to practice nursing for one year after her license expired. As part of the disciplinary actions taken, the nurse received a warning and was required to pay a $500 civil penalty.
- A certified registered nurse anesthetist engaged in unprofessional conduct (as defined in board rules) by possessing, obtaining, furnishing, or administering drugs to any person, including himself, except as legally directed. Disciplinary action included a reprimand, a fine, license suspension for 12 months, and a 58-month probationary status of license due to the drug-related misconduct to which he stipulated.
- An RN was more than 30 days delinquent in paying child support. Disciplinary action included license suspension.
Each decision by the respective board was based on the specific facts and circumstances of the case before it.
How to avoid ending up on this list
You can avoid being placed on a board of nursing disciplinary action list by:
Knowing and following your state nurse practice act and its rules.
Conducting yourself as a professional at all times, since a nurse practice act's "unprofessional conduct" provision and rules extend beyond the provision of nursing care.
Practice in accordance with standards of practice.
Keep current in your area of nursing practice.
Conform your practice with applicable legal and ethical mandates of the profession.
Remember when a license is suspended, you must petition the board for reinstatement of license and the petition is subject to an administrative hearing or agreed order to reinstate the license. You also may need to petition the board to end probationary status or some other limiting condition on your practice, unless the board's order allows for an "automatic" ending. Patient injury is not a prerequisite to a violation of the nurse practice act. Rather, it is the violation itself that serves as the basis for a disciplinary proceeding. If a discipline is imposed by the board, however slight, the discipline is reported to the National Practitioner Data Bank. Always seek legal representation by a nurse attorney or attorney in any board proceeding. For more information on board of nursing decisions generally, go to ncsbn.org/discipline. Also, read my other blogs on boards of nursing and their authority, including "What authority does a board of nursing possess?" and "What to expect when your nursing license is suspended".
Take these courses to learn more about protecting patients and yourself:
National Patient Safety Goals - Nursing (1 contact hr) This course covers the 2019 National Patient Safety Goals for nursing staff in the hospital setting. 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 shows how ethics functions within nursing and on a hospital-wide, interdisciplinary ethics committee. The course explains the elements of ethical decision-making as they apply both to the care of patients and to ethics committees. The course concludes with a look at the ethical challenges involved in physician-assisted suicide, organ transplantation, and genetic testing. Protect Yourself: Know Your Nurse Practice Act (1 contact hr) Nurses have an obligation to keep abreast of current issues related to the regulation of the practice of nursing not only in their respective states but also across the nation. Nurses have a duty to patients to practice in a safe, competent, and responsible manner. This requires nurse licensees to practice in conformity with their state statutes and regulations. This course outlines information about nurse practice acts and how they affect nursing practice.