Board of Nursing Disciplinary Action

Situation

The state board of nursing has received multiple complaints about

J.R., an RN who works in a long-term care facility. J.R. has signed off

on 3 controlled substances count sheets that have been determined to

be inaccurate. During an investigation it was discovered that several

members of the nursing staff knew about J.R.’s reported behavior, but

they did not report their observations to the unit administrator

because the administrator is J.R.’s aunt. After the investigation, the

board of nursing subpoenas J.R. to a meeting to discuss charges in

preparation for a disciplinary hearing.

Ethical/Legal Points for Consideration

Regulation of professional nursing practice is the right of each of the

50 states. Most have regulatory agencies charged with writing

regulations and rules to implement the state nurse practice act. The

regulations approved by these agencies carry the weight of law.

Failure to behave accordingly places a nurse at risk for disciplinary

action.

The RN who is charged with unprofessional behavior has been

charged with an offense and is entitled to the same legal rights as any

other person, including a fair and timely hearing, opportunity to

confront the accusers, right to be represented by an attorney, and

right to prepare a defense.

Possible disciplinary actions include temporary suspension of the

nursing license, revocation of the nursing license, mandatory

rehabilitation for substance use, and mandated supervision and

evaluation of practice. Sometimes the disciplinary action includes

fines and requires reeducation. The state board of nursing may report

the action to the state attorney general if evidence suggests that a

crime has been committed. The RN who is found guilty of

unprofessional practice must report this action on all future

applications for nursing positions.

All RNs should be familiar with their state’s nurse practice act and

regulations, and the composition and actions of the state board of

nursing. Nurses should pay attention to the regulation that lists

examples of actionable behavior and disciplinary actions sanctioned

by the state.

RNs have a legal and ethical obligation to report suspected illegal

behavior to their administrators and to continue reporting until the

situation is resolved. By failing to report, the RN may be charged as

an accessory to the act or aiding and abetting the behavior. This RN

may be charged with unprofessional behavior and risks losing his or

her nursing license. Shifting the obligation to someone else to report

or failure to continue reporting each incident does not satisfy this

duty.

Discussion Questions

1. How would you handle a situation in which retaliation for

reporting unprofessional behavior may occur?

2. What would you do if the nurse suspected of illegal behavior is

related to someone in the administrative hierarchy?