What are common board of nursing disciplinary actions? What are the options for a board to discipline a nurse? Now, before I get started, this is a topic that’s very state specific. Every state has its own spectrum of disciplinary actions. So, my talk today is going to be general, meaning, it may be different in the state that you’re in, but this is kind of the normal structure of what kind of disciplinary action is for board. There are usually three options for non-disciplinary actions, and I think I should just go through those first. Obviously, if a complaint is filed, a case can be dismissed, and it could be dismissed for several reasons.
Usually, the two most common reasons for dismissal are, one, the board doesn’t have jurisdiction over the complaint and then two, the conduct alleged in the complaint is not a violation of the nurse practice act. And then the other way of dismissing the case is obviously after an investigation if they believe there are no grounds to discipline the nurse in any way, it can be dismissed. Most boards will then have a non-disciplinary option. I know here in Arizona; it’s called a letter of concern. It could be a reprimand, advisory letter, it goes by different names, but I’ll just call it a letter of concern. It’s simply a letter that goes in your file of the board which just states there is a concern about the incident, but it’s not considered formal disciplinary action and wouldn’t be reported to any databases, nurses, national practitioner database.
It would just be kind of on file with the board. And if the nurse were to get in trouble in the future, then they would look back at the letter of concern and then decide of whether they need to take additional action. Some boards also offer an administrative penalty, which would be considered non-disciplinary. If a nurse files for the renewal late or they don’t provide the necessary fee, some boards will just give fine normally or admit a straight penalty. Most of the time, that’s not considered disciplinary action. The last option would be a non-disciplinary agreement for continuing education. Now, not every state requires continuing education for nurses. It’s not an option in every state, but many states offer non-disciplinary continuing education where they’d have to take a course in documentation, nursing ethics, assessments, something like that. Other blogs of interest include:
Those are all the non-disciplinary options. What we’re here for are the common disciplinary options, and I’ll kind of go through those. Most states have what’s usually called a decree of center or letter of reprimand, something like that. It’s a formal document that states the nurse did violate the state law in some way, but it doesn’t rise to the level where the nurse is put on probation. It’s like a formal slap on the wrist. It is reported to the database and nurses and the nurse would have to report it in the future. If on any kind of employment application, it stated, have you ever been formally disciplined by a board? They’d have to answer “yes”, but in many cases, it’s a decent outcome. I guess the two choices were probation or decree of center. Clearly, decree of center is the better route to go.
Another disciplinary option is disciplinary order for continuing education. There’s a non-disciplinary potential and then a disciplinary potential. They would just depend upon the facts of the situation. I mean, the order would be the same. They must do a certain amount of continuing education where they could get in trouble. But in this case, maybe the clinical problem rose to the level that the board felt they needed to put it on the record. And so, a disciplinary order for continuing education is another option. A civil penalty is used in many states and that’s just like a fine, usually, somewhere between $500 to $2,000. The difference between what led up to a complaint that ended up in a decree center and a civil penalty is maybe the civil penalty route was a little more concerning to the board, but that’s another option as well. Now, anything after that, for the most part, would be probationary.
If a nurse, let’s just take for instance, a nurse who had substance abuse problems and she had several DUIs, and the board felt it was necessary to put her on probation. A normal probation would include, well, for substance abuse, random drug testing, AA participation, and some level of monitoring at work, maybe you can’t pass narcotics for a period, maybe they’ll make the nurse do counseling. They could add continuing education to a consent agreement as well. Probation can last from usually a year all the way up to three years or more. And then after the probationary period is over with, and the nurses fulfilled all of the obligations of the probation, then they’re no longer on probation, their licenses unencumbered, and they can work freely without any requirements.
The levels after that are bad. One would be a suspension. A nurse can be suspended in several ways. If they were on a consent agreement and they violated the terms of the agreement. Most boards have the option to suspend the nurse’s license. If there’s a bad incident, the board can take what’s called a summary suspension where the board will take emergency action to suspend a nurse’s license. Those are kind of two ways the board can suspend a license. And then, finally, revocation is the worst-case scenario for a nurse. That is discipline. If, once again, they violate the terms of a current consent agreement, many boards have an automatic option where the nurse’s license is revoked. Once again, if there’s heinous incident, it could lead to a quick revocation as well.
It’s not common for a nurse’s license to be revoked. I mean, it’s less than a fraction of 1% of nurses how their license is revoked. It must be very difficult and concerning conduct to get to that level. But it is always an option. I guess there’s one more. A nurse can voluntarily surrender their license. That is considered a disciplinary action. I have nurses sometimes, and maybe they’re toward the end of their careers, they’re not interested in going on probation or fulfilling the terms of whatever the offer consent agreement is. And they can just give up their license. It’s called surrender. Therefore, they no longer have their license. Normally, there would be a period fixed to it, of when they could reapply if they wanted to. But a voluntary surrender is considered a disciplinary action as well.
Those are the common reasons for a board of nursing. I guess the common reasons for disciplinary action from the board of nursing. There’s a wide spectrum of things they can do. I mean, I get asked like, what’s your win rate, or what are your outcomes? I mean, it’s impossible to answer as an attorney who represents nurses. Getting a nurse on probation and not getting their license revoked can be a huge win versus getting somebody dismissed versus a decree of center could be a huge one as well. It just depends upon the conduct. And most boards will have a range. I mean, I can just see a case and kind of understand, alright, this is where it’s going to fall within. But if you’re looking for an attorney and you ask that question, it’s very difficult to answer because every situation is unique.
And so, one outcome could be an enormous one for one person and a terrible outcome for another. It just depends upon the situation.
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