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?
Take these courses about nursing practice:
- Protect Yourself: Know Your Nurse Practice Act (0.5 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, 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.
- HIPAA and Confidentiality (1 contact hr) The federal Health Insurance Portability and Accountability Act was implemented in 1996 and has been revised since then. HIPAA can refer to guidelines that protect your ability to maintain your health insurance as you move from job to job or place to place ("portability"). HIPAA can also refer to efforts to simplify the administration of health insurance. These efforts include the creation of national standards for diagnostic terms, insurance forms and provider identification. Perhaps the most common use of the term for healthcare professionals, however, involves protecting the confidentiality and privacy of healthcare information. In this module, you will learn about parts of HIPAA, especially as they concern nursing and other health professionals and the protection of healthcare information. Because you play a key role in the production of healthcare information, you play a key role in its protection.
