A reader submitted a question about forgetting to report a misdemeanor conviction for a fight she was involved in with a neighbor to her board of nursing when she renewed her license.
The board offered her a reprimand as discipline and a fine of $500. The reader wonders what effect this will have on her nursing practice if she accepts the offer.
Generally, the types of discipline that can be imposed by a board of nursing include an administrative warning letter, reprimand, probation, suspension and revocation.
In addition, a board may require the nurse to pay a fine, as in the reader’s case, mandate the nurse to take a continuing education course or seminar on professionalism or nursing ethics, or place a limitation on certain aspects of the nurse’s practice.
A reprimand, sometimes called a censure, is less serious than other disciplines, and is because of some type of improper conduct by the nurse. Most often, no limitation of the nurse’s practice occurs. Nonetheless, it is still a discipline.
Except for an administrative warning letter, all other disciplines are public disciplines, available on the board’s website or included in its newsletter. In addition, federal law requires any discipline imposed by a board of nursing be reported to the National Practitioner Data Bank.
The National Council of State Boards of Nursing’s Nursy database also lists state disciplinary actions against nurse licensees in member states, including Arizona, Texas, Utah and Wisconsin. This database is available to the public.
Ramifications of a professional discipline
Regardless of the type of professional discipline, you need to ensure you never receive one. It is difficult and costly to challenge a board decision, as I wrote in my blog, “Is challenging a board of nursing an uphill battle?”
Challenging a board of nursing decision is difficult, and its ramifications are numerous.
The most obvious consequence of a discipline is its direct effect on continuing your nursing practice. In today’s world, employers seek employees with an active and unencumbered license. In most instances, any disciplinary action results in a non-hire.
As a result, keeping your current job after a discipline has been imposed, or finding a new position, is difficult at best.
A second consequence of a professional disciplinary action is a loss of any specialty certifications you may hold. As you know, you must meet certain requirements to obtain your certification.
If the certification body evaluates the discipline imposed as compromising any of those requirements, the result can be a loss of your certificate.
Your professional liability insurer also may see any discipline by a board of nursing as a breach of its contract of insurance with you.
Although some nurses do practice without professional liability insurance, this is a huge risk if you are sued for an injury to or death of a patient. Your personal assets become the basis for any financial payments to the patient or patient’s family as a result of a verdict against you.
And then there is the damage to your reputation. Your good name — and good practice — is worth its weight in gold. When lost because of a professional licensure discipline, it is difficult to re-establish.
You can read more about the ramifications of a professional disciplinary action against you in Jon E. Porter and Taralynn R. Mackay’s 2012 article, “The Collateral Damage to Nursing Licenses Caused by Nursing Board Disciplinary Actions.”
Reprimand recommendations for nurse readers
Despite the consequences of a professional disciplinary action, it is most likely in the reader’s best interest to accept the offer by her board of nursing.
If she refuses, the board can then take steps to initiate an administrative hearing against her. Administrative hearings are costly, lengthy and the outcome uncertain.
In either case, it is clear that if you are faced with such a decision, it is best to consult with a nurse attorney or attorney to carefully evaluate how to proceed.
Your attorney can advise you, based on your specific situation, of the potential ramifications of accepting the offer or, in the alternative, of proceeding to an administrative hearing.
It will be important for you to be honest with your attorney concerning the conduct that resulted in the board’s offer. The attorney is your advocate, so nothing should be kept secret.
If you accept the board’s offer, it will be in written form, and it is essential that your attorney review the agreed order or letter of discipline carefully before you sign it so you are as protected as you can be in the circumstance.
If you have been faced with accepting a reprimand by a board of nursing, how did you handle it? What was most helpful to you?
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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, especially when their nursing practice crosses state borders. Because the practice of nursing is a right granted by a state to protect those who need nursing care, 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.
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Nurses have an obligation to keep abreast of issues surrounding the regulation of the practice of nursing. The practice of nursing is a right granted by a state to protect those who need nursing care, and nurses have a duty to patients to practice in a safe, competent, and responsible manner. This course outlines information specific to the Florida Nurse Practice Act and the Florida Administrative Code.
Correct HIPPA to HIPAA
Thank you. We have fixed the typo.
The following statement appears in the article:
“Although some nurses do practice without professional liability insurance, this is a huge risk if you are sued for an injury to or death of a patient. Your personal assets become the basis for any financial payments to the patient or patient’s family as a result of a verdict against you.”
This is a wildly misleading statement.
Almost all nurses are covered by their employer’s professional liability insurance. Since the employer has vicarious liability for an employee’s negligence while acting in the course of her employment under the doctrine of respondeat superior, the employer and the nurse are in the same boat and the employer and its insurance will defend the nurse. In my years of malpractice litigation experience I never saw an employer fail to defend a nurse nor try to shift liability to the nurse. And payments made on the nurse’s behalf were made by the employer’s carrier if the nurse did not have a policy, and even then, the settlements were often shared between the carriers (remember the employer liability?).
The statement should have referred to practicing without a separate, individual liability policy. The majority of nurses who I’ve had as defendants in malpractice litigation did NOT have individual policies. And no, of course, their personal assets were NOT the basis for payments made.
Nurses are often consulted outside of the practice organization. We are nurses 24/7, if my neighbor requests aspirin and I provide it resulting in an allergic reaction or the worst, anaphylactic shock, could I be held legally accountable? The Nurse Practice Act and Code of Ethics applies 24/7.
Keep license protection insurance nurses, the example above says nothing of a nurse who is fired or quit getting a bon complaint in retaliation for telling others how bad the experience was . To fight for your license by a corrupt board (AZ) who is working with the hospital, you will need the funds and then some.
The majority of board cases have nothing to do with nursing at all !
I was put on probation after attending a school in 2010 for the 30 unit option. After 8 years I am contacted on the phone by a woman that gave 2 different names from a personal phone (not the state phone number) asking me questions. I didn’t answer. After 11 months this woman, Helen, who called from a state government number this time, calls again introducing herself as the woman I spoke with 11 months earlier, saying she sent me a letter for us to meet. I told her nope we would not be meeting without legal representation and to send the letter certified as a professional should. I then retained an attorney who, from what the findings say, did not do what he told me he was doing with my case.
After the hearing I was put on probation. There is no reason for me to be Punished, Broadcasted and Humiliated by the BVNPT for going to school. There have been many cases like this and the nurses were not treated like trash. It took me over 1 year to come to terms with being a NOBODY!!! I finally looked at the findings and found holes that my attorney at the time could have stopped all of this. But, he didn’t take the time out to care. I have a Deaf daughter and a daughter that was headed to college and her dreams are gone. Nurses need to make a STAND and stop being scared and timid when it comes to the Board of Nursing. Those are just people that sit there and paint you like a threat to society. How do they live their lives? Are they perfect? I also have a very disparaging recording that happened after my probation hearing that I will let loose to the Public. It’s legal, I can’t help it if they recorded the meeting but forgot to press the END meeting button. California is a state looking to squeeze money out of nurses by using investigations and charging the nurses thousands.
Sounds about right. Uncaring and punitive.