What Happens When a Nurse is Reported? | Nursing Reports

What happens when a nurse is reported?  First, I’m not just going to talk about what happens when a nurse is reported to a nursing board. I will talk about all the places a nurse can be reported. 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, and obviously, rules can vary from state to state, but this will just be kind of a general discussion of what happens when you’re reported.

Places or agencies nurses can be reported to

First, where are the places/agencies a nurse can be reported? Well, let’s talk about that. 

Nurses Can Be Reported To The Employer and The Nursing Board

First, nurses can be reported to the employer. A patient could complain about a nurse’s conduct. They could be reported to the employer and then the employer would do an investigation. Obviously, 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. Nurses can be reported to the police. And this usually comes from the employer. There are times when there is some alleged criminal conduct on part of a nurse and it may, or at least the employer may feel necessary to contact the police.

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

Other Branches Nurses Can Be Reported To

Another frequent place nurses could be reported would be the branch of adult protective services, and whatever state you’re in, if there is an allegation of patient abuse and the patient is an adult, then the adult protective services could investigate. 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 just to kind of 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, and then child protective services came in and investigated. Those are the main places. So, employer, board, police, adult protective services, and child protective services. Those are the main places where nurses can be reported.

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

What can you do if you’ve been reported to any of those? Well, it would depend upon the organization what you should do. If a patient complains and 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 there are times when 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 just 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. If you are contacted by any police department or even the Attorney General’s office in your state, there is a criminal investigation underway, and they’re going to talk to you and pretend like they’re your friend and just 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 Criminal 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 types of things in your state would make sense. 

Now, as far as the board goes, once again, kind of depends upon the complaint. Sometimes, there are just completely terrible complaints, meaning terrible like there’s no basis and fact for them. The board will likely dismiss them quickly or after a brief investigation, dismiss them. 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. You need to find somebody with experience with your state’s board.

How To Find An Attorney

One way of finding that would be going through old agendas. Almost every state requires open records. And so, any kind of board meeting from a governmental agency must be posted. They do that through the minutes, which summarize what happened during a board meeting. And then the agenda, which is, this is what we’re going to discuss during the meeting. Most of the 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 a nurse is reported to various agencies. You always need to be careful about what you’re saying to anyone. Your words can be used against you. And it makes sense to involve a professional with experience handling matters across all those areas.

Other Blogs of Interest

• Easiest Way For a Nurse to be Suspected of Diverting Narcotics
• What Does it Mean When a Nurse is Suspended?
• Which is the Most Frequent Reason for Revocation of a Nurse’s License?
• How a Nurse Should Handle an Employer Investigation

How Do I Report an Arizona Nurse For Unprofessional Behavior?

If someone would like to report or file a complaint against nurses licensed in Arizona, they must first 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 following behaviors will not be investigated by the Arizona Board of Nursing:

• Rudeness to peers
• Co-worker disputes
• Personality conflicts
• Absenteeism
• Tardiness
• Labor-management disputes such as work schedules/wages/wrongful termination
• Resignation without notice whereby a patient assignment has not been accepted.

Below is a list of conduct that can be reported:

• Information that a nurse or certificate holder may be mentally or physically unable to safely practice nursing or perform nursing-related duties
• 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, 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 kind of 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 just kind of 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. It could be a patient, a colleague, or your employer. Many states have criminal reporting requirements over an incident, such as medication administration errors, and patient safety concerns, among others.

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 is convicted of a crime, then it’s reported. Some states, they 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 as well. And most states have a confidential monitoring program that can assist nurses in getting over whatever issues they have. 

Complaints and Nursing Board Jurisdiction

Let’s just say someone files a complaint over an incident, and the nurse self-reports. Whatever reason the investigation is initiated, 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, kind of the first analysis from the board is, 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 just say that hurdle is overcome. What will happen is the board will then notice the nurse and let them know a complaint has been filed over an incident. And either they will send a questionnaire that needs to be filled out and sent back in, or they may say, just sit tight, and we’ll contact you when we’re ready to move forward. In the investigation, some boards will kind of 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 coworkers. 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, meaning, you don’t want to admit to things that the board has no idea will happen, or some nurses inadvertently admit to doing things that they think are completely fine. When reporting errors to a committee or to 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 any grievances over coworkers or employers.

When you look closer at the statutes, which are the laws that 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, but we don’t always have access to the documents, or I guess, we rarely have access to the full documents until after they want the written response.

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

Many times, we’ll just 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, which 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 then they just put them in. And then it’s shown that they just fudged the numbers, they weren’t in the room, and they 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 not only your current employer but, I guess I should say that in reverse, they’ll subpoena the employment file from wherever this happened, but usually if a complaint is filed, you’ve been fired from that job, they’re also going to want to subpoena your current employment file as well. Just to see if once again, if anything is kind of reoccurred, that’s like what the complaint is about.

When Will The Nurse Be Called For An Interview?

After the board has all the documents back, sometimes subpoenas can take a very long time. I’m talking like six months to a year sometimes. I mean, at some point, the board will usually just 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. An investigator with the board will be assigned to your case, and they’ll be the one that’s kind of 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. I think, 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 they’re speaking. They just kind of ramble on. It’s once 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 interview is completed, 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 generally recommend some options to the board, or some executive directors will have the power to either 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 just want the board to look at it, at some point, the nurse will get placed on the agenda at the board meeting. Most states meet monthly or every two months, and then they just 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 kind of the process of what happens when a complaint is filed against a nurse practitioner with the state board. Once again, this is just a general kind of outline of what happens and what to expect.