What Happens When a Nurse Is Reported to the Board? | Nursing Board

First, this will be a general overview of any nursing board investigation. It’s not going to be state-specific. Every board does things differently, but the general process is mostly the same amongst all the boards. I’ll give a brief overview of how the process generally works and then some things to think about from the nurse’s perspective. As far as the first step, someone will file a complaint. That’s one way an investigation initiates. Anyone of a patient, colleague, or employer can initiate. Many states have criminal reporting requirements.

In some states, if a nurse receives criminal charges, they must report them to their board. And others, if the nurse gets convicted of a crime, then it’s reported. Some states must report it immediately. Other states only until renewal. So, you need to look and see what the criminal reporting requirements are. And then there are also self-reports for substance abuse issues, nurses dealing with alcoholism, drug abuse, and mental health issues. And most states have a confidential monitoring program that can assist the nurse in getting over whatever issues they have. Let’s say someone files a complaint and the nurse self-reports.

Complaints and Nursing Board Jurisdiction

Whatever reason initiates the investigation, the first hurdle is, does the board have jurisdiction over what the complaint is about? There are certain things the board can and cannot investigate. And so, the first analysis from the board is, do we have jurisdiction over this nurse?

Most of the time, the answer is yes. Very rarely, it is no. Let’s say you were successful in overcoming the hurdle. What will happen is the board will then notice the nurse and let them know a party filed a complaint. And either they will send a questionnaire that needs to be filled out and sent back in, or they may say, sit tight, and we’ll contact you when we’re ready to move forward. In the investigation, some boards will investigate every single complaint. Others are better at triaging complaints and then getting rid of them before a full investigation occurs. In this scenario, let’s say a full investigation will occur here. So, in the response, the board will want a written statement from the nurse at some point. This is tricky. 

Beware of Too Much Information When Responding to Complaints

I find most nurses want to overshare. They want to put down ten pages of explanation and grievances sometimes with the employer or coworkers. I don’t think this is beneficial to the nurse at all. For a couple of reasons, you don’t want to give anything to a board if they don’t have it. It means you don’t want to admit to things the board has no idea happened. Or some nurses inadvertently admit to doing things they think are completely fine. But when you look closer at the statutes. Which laws dictate what the board can and can’t do, and what are the violations? It may be a violation of the statute, and they didn’t even realize it.

I think less is more as far as a written response. And then one kind of problem that we have is that the boards always want a response quickly. Still, we don’t always have access to the documents, or we seldom have access to the full documents until after they want the written response.

What Level of Scrutiny Should a Nurse in a Complaint Expect?

We often say we will supplement with a more substantive statement once we have access to the file at the board. It could be medical records, employment files, disciplinary history, or illegal stuff. We can usually get ourselves, so we don’t need to wait for the board to do that. Alright, so you’ve sent in the response short and sweet. At that point, the board sends out subpoenas and a request for documents to the employer for your employment file. And then if medical records are involved, those as well. The boards want to see our employment file to see how much or if you’ve had disciplinary action, corrective action, verbal coaching, or counseling. Usually, if there’s a complaint, the board wants to see if you’ve had any other incidents or problems with that specific thing.

For instance, if the complaint is that the nurse falsified the record, maybe they forgot to take vitals or something, and then they just put them in. And then it’s shown that they just fudged the numbers, weren’t in the room, and took the vitals. They want to see, alright, has this nurse done that in the past? So, they will usually subpoena the employment file from your current employer. But, I should say that in reverse, they’ll subpoena the employment file from wherever this happened. Still, if a complaint is filed, you’ve been fired. They will also want to subpoena your current employment file. To see if, once again, anything reoccurred, that’s how the complaint works.

Key Points During an Interview With an Investigator

After the board has all the documents back, sometimes subpoenas can take a long time. I’m talking like six months to a year sometimes. At some point, the board will usually abandon going for a subpoena. This is if whoever is completely unresponsive. And then, usually, at that point, the nurse will come in for an interview with the investigator. An investigator with the board will get assigned to your case. They’ll be the one that’s the point person, setting the subpoenas, talking to witnesses, and the complainant who filed the complaint. And then the nurse as well. The interview is the best opportunity for the nurse to provide context. I think it’s probably beyond the board meeting that is the most important step in the process. And so, having the nurse prepared to one, anticipate the questions they’re going to ask. 

And then two, knowing how to answer the questions is important. So, understanding once again, most people overshare, especially when speaking, they ramble on. It’s, once again, better to answer the question directly, stop, and then let the investigator follow up with more questions. Just talking for 10 minutes straight is not effective in any media.

What Impact Might a Complaint Have on a Nurse’s License and Practice?

After a completed interview, the investigator will usually draft a report. Then they’ll go over that report with either peers or the director of whatever state board you’re in. And then they’ll recommend some options to the board. Or some executive directors will have the power to dismiss a case or give a non-disciplinary outcome. In most states, it’s called a letter of concern. If they think disciplinary action is necessary or want the board to look at it. At some point, the nurse will attend the board meeting agenda. Most states meet monthly or every two months and then review every complaint. And then, the nurse can have the opportunity to address the board. If they have an attorney, the attorney can address the board. The board can ask questions to the nurse. 

Then ultimately, they will vote right in front of the nurse. This is what we’re going to do. And then, depending upon what the outcome of the board meeting was, the nurse always has appeal rights. If they’re unhappy with the outcome, they can always appeal and move forward to a hearing in most states. It’s in front of what’s called an administrative law judge. It’s a well, supposedly impartial kind of judge outside the board system. So, that’s what happens when filing a complaint against a nurse with the state board. Once again, this is just a general outline of what happens and what to expect.

Other Blogs of Interest

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• Nursing: What Does It Mean When a Nurse Is Suspended?
• Which is the Most Frequent Reason for Revocation of a Nurse’s License?

Nursing Reports: What Happens When a Nurse is Reported?

What happens when a nurse gets reported? First, I’m not going to talk about what happens when a nurse gets reported to a nursing board. I will talk about all the places to report a nurse. And then, there are some things to consider regarding handling those situations. Now, first, this is not going to be state-specific. I’m giving general information that a nurse could use in almost any state. Rules can vary from state to state, but this will be a general discussion of what happens when it gets reported.

Places or Agencies Nurses Can Be Reported to

First, where are the places/agencies to report a nurse? Well, let’s talk about that. First, you can report a nurse to the employer. A patient could complain about a nurse’s conduct. A nurse reported to the employer, and then the employer would do an investigation. Nurses can be reported to a board if there’s an alleged violation of the nurse’s practice act in the state. A patient, a colleague, an employer, or the police can all report nurses to the board of nursing. You can report a nurse to the police. And this usually comes from the employer. There are times when there is some alleged criminal conduct on the part of a nurse, and it may, or at least the employer may, feel it necessary to contact the police.

Let’s take, for instance, a nurse caught diverting fentanyl, something like that, which is serious. They would then contact the police and say, we believe the nurse was diverting fentanyl, which violates the law. And then they would investigate as well.

Adult Protective Services

Another frequent place to report a nurse would be the branch of adult protective services. Suppose there is an allegation of patient abuse, and the patient is an adult. In that case, the adult protective services could do an investigation. The department of child services or child protective services is another place. If your patient was a child and there was alleged abuse, the child protective services in that state could also initiate an investigation.

And to give an example, I had a nurse who left a heating pad on an infant child, which caused a burn. And then, obviously, she didn’t mean to. There was no intent to hurt the child, but there was a negative outcome. Then child protective services came in and did an investigation. Those are the main places. So, employer, board, police, adult protective services, and child protective services. Those are the main places where you can report a nurse.

What Can a Nurse Do if a Patient Reports Them Over an Incident?

What can you do once reported to any of those? Well, it would depend upon the organization what you should do. If a patient complains, the employer approaches you and asks you what happened. Then there are no problems talking to them about what happened. Now, I guess it would depend upon the severity of the nurse’s actions. I’ve had a couple of previous blogs that went through what happens for an employer investigation.

And sometimes it doesn’t make sense to say anything, but if it’s a minor disagreement. I mean, some patients/family members will never be satisfied with the care provided. And so, in a situation like that, if the nurse didn’t do anything wrong. Then certainly feel free to discuss that. If the nurse screwed up somehow, it might make sense to be quiet about it and not give a statement.

If the police are involved, you must find an attorney first. I understand that some people believe they can talk their way out of things. Don’t do that. Suppose any police department contacted you or even the Attorney General’s office in your state. In that case, a criminal investigation is underway, and they will talk to you and pretend like you’re a friend. They’ll say, why don’t you tell me what went on here? And then they’re going to use all those things against you. Do not say anything if you have any contact from the Attorney General’s office, a police department, a detective, or an officer. Call a criminal defense attorney wherever you live and have them represent you.

Hire a Board Defense Attorney

Not spending the money on that is extraordinarily done. That’s what you need to do. If you’ve had an adult protective services complaint, a child protective services complaint, or whatever the name of it is in your state. It might make sense to involve an attorney who has done administrative hearings. I find the investigators and many of those specific departments almost always find abuse. So, talking to an attorney who handles those things in your state would make sense. 

Now, as far as the board goes, it depends upon the complaint. Sometimes, there are just terrible complaints, like there’s no basis or fact for them. The board will likely dismiss them quickly or dismiss them after a brief investigation. Is an attorney necessary for that? Probably not, but there are certainly instances where an attorney with experience with the board of nursing could assist you. I would contact them before you respond to the board at all. There are plenty of great nursing board attorneys throughout the country. It would help if you found somebody with experience with your state’s board.

Record Tracking for Topnotch Board Defense Attorney

One way of finding that would be going through old agendas. Almost every state requires open records. And so, there must be a post regarding any board meeting from a governmental agency. And they do that through the minutes, which basically summarize what happened during a board meeting. Then the agenda, which is what we’re going to discuss during the meeting. Most states will post if someone is represented by counsel and the minutes and then who that is. It’s not a bad idea to look in the old minutes in your state to see the attorneys representing most of the nurses. And then that’s usually a good indication that they at least have experience. I can’t say if they’re good or not, but at least they have experience handling the board.

So, that’s what happens if there’s a nurse reported to a bunch of different agencies. It would help if you always were careful about what you’re saying to anyone. They can use your words against you. And it makes sense to involve a professional with experience handling matters across all those areas.

How Do I Report an Arizona Nurse for Unprofessional Behavior?

Suppose someone would like to report or file a complaint against nurses licensed in Arizona. In that case, they must determine if the alleged conduct is reportable. Here is a link to the Board’s website where an individual can file a complaint: Submit a Complaint.

The Arizona Board of Nursing will not investigate the following behaviors:

• Rudeness to peers
• Co-worker disputes
• Personality conflicts
• Absenteeism
• Tardiness
• Labor-management disputes such as work schedules/wages/wrongful termination
• Resignation without notice whereby an unaccepted patient assignment.

Conduct that can be reported:

• Information that a nurse or certificate holder may be mentally or physically unable to practice nursing or perform nursing-related duties safely
• Conducts involving practicing beyond the scope of practice of the license or certificate. Examples include knowingly giving a medication not authorized by a treating provider, obtaining laboratory or other tests not authorized by a treating provider, and unauthorized adjusting of dosage.
• Conduct that leads to the dismissal for unsafe nursing practice or conduct or other unprofessional conduct
• Conduct that appears to be a contributing factor to high risk/harm to a patient and requires medical intervention
• Actual or suspected drug diversion
• Conduct that appears to be a contributing factor to the death of a patient
• Conduct involving the misuse of alcohol or other chemical substances to the extent that nursing practice may be impaired or may be detrimentally impacted
• A pattern of failure to account for medications; failing to account for wastage of control drugs
• Falsification of medical or treatment records
• A pattern of inappropriate judgment or nursing skill
• Failing to assess or intervene on behalf of the patient(s)
• Conduct involving sexual contact with a patient, patient family member, or other dual relationships
• Conduct involving physical/verbal patient abuse
• Practicing nursing without a valid nursing license
• Conduct involving misappropriation, theft, or exploitation of a patient
• Violation of a disciplinary sanction imposed on the nurse’s license by the board
• Conduct that deceives, defrauds or harms the public.

What Happens When a Nurse Is Reported to the Board?

What happens if a patient reports a nurse’s incident to their state board? First, this will be a general overview of any nursing board investigation. It’s not going to be state-specific. Every board does things differently, but the general process is mostly the same amongst all the boards. I’ll give a brief overview of how the process generally works and then some things to think about from the nurse’s perspective. As far as the first step, someone will file a complaint. That’s one way of initiating an investigation which could be a patient, a colleague, or your employer. Many states have criminal reporting requirements for an incident. Such as medication administration errors and patient safety concerns.

In some states, if a nurse is charged with a crime by other health care providers or a patient, they must report it to their board. And in others, if the nurse gets convicted of a crime, it’s reported. Some states must report it immediately, and other states only until renewal. So, you need to look and see what the criminal reporting requirements are over an incident. And then, there are also self-reports for substance abuse issues, nurses dealing with alcoholism, drug abuse, and mental health issues. And most states have a confidential monitoring program that can assist nurses in getting over whatever issues they have. 

Complaints and Nursing Board Jurisdiction

Someone files a complaint over an incident and the nurse self-reports. Whatever initiated the investigation, the first hurdle is, does the board have jurisdiction over what the complaint is about? There are certain things the board can and cannot investigate. And so, board’s initial analysis, do we have jurisdiction over this nurse due to an incident?

Most of the time, the answer is yes. Very rarely, it is no. Let’s overcome the hurdle. What will happen is the board will then notice the nurse and let them know there’s a filed complaint over an incident. And either they will send a questionnaire that needs to be filled out and sent back in. They may say, sit tight, and we’ll contact you when we’re ready to move forward. In the investigation, some boards will investigate every single complaint. Others are better at triaging complaints and then getting rid of them before a full investigation occurs. Let’s say a full investigation of an incident will occur here in this scenario. So, in the response, the board will want a written statement from the nurse at some point. This is tricky. 

Beware of Too Much Information When Responding to Complaints

I find most nurses want to overshare and provide full disclosure in an incident report. They want to put down ten pages of explanation and grievances sometimes with the employer or co-workers. I don’t think this is beneficial to nurses at all. For a couple of reasons, one, you don’t want to give anything to a board if they don’t have it. It means you don’t want to admit to things the board has no idea will happen. Or some nurses inadvertently admit to doing things they think are completely fine. When reporting errors to a committee or the board of nursing over an incident regarding patient safety, I advise nurses to provide just the information needed and not overshare. Nurses must review their lengthy explanations and not include grievances over co-workers or employers.

When you look closely at the statute, the laws dictate what the board can and can’t do. And then what the violations are, it may be a violation of the statute, and they didn’t even realize it. I think less is more as far as a written response. And then one kind of problem that we have is that the boards always want a response quickly. Still, we don’t always have access to the documents, or we seldom have access to the full documents until after they want the written response.

What Level of Scrutiny Should a Nurse in a Complaint Expect?

We often say we will supplement with a more substantive statement once we have access to the file at the board. It could be medical records, employment files, disciplinary history, or criminal stuff. We can usually get ourselves, so we don’t need to wait for the board to do that.

Alright, so you’ve sent in the response short and sweet. At that point, the board usually sends out subpoenas, which is a request for documents to the employer for your employment file. And then if medical records are involved, those as well. The boards want to see our employment file to see how much, or if you’ve had disciplinary action and corrective action, verbal coaching, counseling, anything like that. Usually, if there’s a complaint, the board wants to see if you’ve had any other incidents or problems with that specific thing.

For instance, if the complaint is that the nurse falsified the record. Maybe they forgot to take vitals or something and just put them in. And then it’s shown that they just fudged the numbers, weren’t in the room, and took the vitals. They want to see, alright, has this nurse done that in the past? So, they will usually subpoena the employment file from your current employer. I should say that in reverse, they’ll subpoena the employment file from wherever this happened. Still, if there’s a filed complaint, you’ve been fired from that job, they will also want to subpoena your current employment file. To see if anything kind of reoccurred, that’s like what the complaint is about.

Why Is the Interview With the Investigator Crucial?

After the board has all the documents back, sometimes subpoenas can take a long time. I’m talking like six months to a year sometimes. At some point, the board will usually abandon going for a subpoena if whoever is just completely unresponsive. And then, usually, at that point, the nurse will come in for an interview with the investigator. There’ll be an assigned investigator with the board. They’ll be the one that’s the point person, setting the subpoenas, talking to witnesses, talking to the complainant who filed the complaint, and then the nurse as well.

The interview is the best opportunity for the nurse to provide context. In my opinion, it’s probably beyond the board meeting that is the most important step in the process. And so, having the nurse prepare, anticipate the questions they’re going to ask, and then two know how to answer them is important. So, understanding once again, most people overshare, especially when speaking. They just kind of ramble on. It’s again better to answer the question directly, stop, and then let the investigator follow up with more questions. Some nurses just found it difficult to stop talking, and they might share too much information. Just talking for 10 minutes straight is not effective in any media. 

What Impact Might a Complaint Have on a Nurse’s License and Practice?

After the completed interview, the investigator will usually draft a report. Then they’ll go over that report with either peers or the director of whatever state board you’re in. And then they’ll recommend some options to the board. Or some executive directors will have the power to dismiss a case or give a non-disciplinary outcome. In most states, it’s called a letter of concern. If they think disciplinary action is necessary, or if they want the board to look at it, at some point, the nurse will get placed on the agenda at the board meeting.

Most states either meet monthly or every two months, and then they review every single complaint. And then, the nurse can have the opportunity to address the board. If they have an attorney, the attorney can address the board. The board can ask questions to the nurse. Then ultimately, they will vote right in front of the nurse. This is what we’re going to do. And then, depending upon what the outcome of the board meeting was, the nurse always has appeal rights.

If they’re unhappy with the outcome, they can always appeal and move forward to a hearing. In most states, it’s in front of an administrative law judge. It’s a well, supposedly impartial kind of judge outside the board system. So, that’s what happens when filing a complaint against a nurse practitioner with the state board. Once again, this is just a general outline of what happens and what to expect.