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RN's Credibility Questioned by State Court


In past blogs, I have written about the importance of your integrity and credibility when testifying in court. Credibility is also essential during board of nursing (BON) proceedings. In the following case, a nurse's veracity was the focus of a state supreme court decision and decisions in three prior proceedings.

Facts of the case

During a night shift, a staff nurse at a nursing home and a certified nursing assistant (CNA) needed to turn a patient living with obesity. The protocol for turning the patient required that the nurse direct the CNA on where to stand, indicate how the turn would take place, and run a 1-2-3 count so the two of them were in sync when turning the patient. The RN didn't follow this protocol, and as they turned the patient, she cried out. The patient asked why the RN was being so rough and complained to nursing home administrators. The RN was subsequently suspended and then terminated. He also was reported to the state agency that protects long-term care residents. The agency investigated the report, held a hearing, and placed the RN on the state's Adult Abuse Registry. The RN's appeal was dismissed. A complaint was filed with the state board of nursing, alleging that the RN had violated board regulations, including:

  • Failing to conform to legal and accepted standards of the nursing profession
  • Failing to take appropriate action to safeguard a patient from incompetent, unethical, or illegal care practice

An evidentiary hearing was held in which the RN, the CNA, and an investigator from the state's division of professional regulation testified, and documents and photographs were submitted. The hearing officer held that the RN violated the regulations. Her report recommended a reprimand, probation of his RN license for two years, and the completion of nine continuing education (CE) hours. The board of nursing voted to amend the recommendations of the hearing officer. It held that there was insufficient evidence that the patient suffered physical injuries, so two of the alleged violations couldn't be supported. The board issued a written order reducing the RN's discipline to a letter of reprimand for failing to competently turn the patient and requiring the completion of nine CE hours. The RN filed an administrative review case in state court.

State courts weigh in

After reviewing briefs by the parties, the court upheld the board's decision, saying there was substantial evidence to support its decision. The RN was not denied due process, nor did the board abuse its discretion. The RN appealed this decision to the state supreme court. His main argument was that there was no substantial evidence that his conduct was unprofessional. The supreme court upheld the state court's decision and noted inconsistencies in the RN's defense during the many judicial proceedings. For example, during the board's proceedings, the hearing officer found the CNA's testimony -- which didn't align with the RN's testimony -- more credible. In addition, the court found the RN's contention that the BON acted arbitrarily and capriciously in making its decision wasn't supported by the facts.

Talking points

Although it's within an individual's rights to argue legal or other principles in a court case or a professional licensure action, that defense must be based in facts and the assertions must be credible. In these proceedings, the RN raised whatever issues he thought would be advantageous for him without carefully evaluating what he asserted and having evidence to support those assertions. Not only did this approach not fare well for him, it also damaged his credibility. The case also illustrates some basic legal principles surrounding BON decisions and their review. Unless a board decision is arbitrary, capricious, or discriminatory -- or the board exceeds its authority, courts of review generally don't overturn those decisions. Even so, challenging a board decision is an important right you possess. But it can be an uphill battle, especially if the facts are not on your side, as was the case here. If you face a disciplinary proceeding by your BON, be certain to retain a nurse attorney or attorney who is experienced in representing nurses. Your attorney will be an invaluable asset to you if you find yourself in a legal battle. Start a conversation with your fellow nurses about this topic. Start by downloading the social networking app.