Board Of Nursing Investigation Process Common Questions
My Nursing License is under investigation. What do I do? The first step in most disciplinary cases filed by the Board of Registered Nursing is an investigation, conducted either by a BRN investigator or by the Department of Consumer Affairs . These investigations can be triggered by a patient complaint, by a hospital administration report, or by an arrest and/or subsequent criminal conviction. If you receive word that you are being investigated, call an attorney right away. You should not attempt to deal with an investigator yourself.
How will I know if Im being investigated?The Board of Registered Nursing does not have to inform you if you are being investigated, and in fact sometimes the registered nurse whos being investigated is the last to know. Sometimes, the nurse will be given advance warning of an investigation by their supervisor or hospital administration More often, the nurse finds out about the investigation when theyre contacted directly by an investigator. The investigator will ask the nurse for employment records and may even request a meeting. Registered nurses are required to cooperate with investigators, but they do not have to sign releases or agree to a meeting. Dont take action without consulting an attorney first.
Leading California Nursing License Defense Attorneys
At Ray & Bishop, PLC, we know how important registered nurses are to healthcare in California. We represent hundreds of nurses each year against the Board of Registered Nursing and the Department of Consumer Affairs, and in every case, our clients rely on us to protect their license and protect their livelihood.
We call ourselves Californias best nursing license defense attorneys for a reason: our experience and our results. If you have an Accusation or a disciplinary action with the Board of Registered Nursing or a Deputy Attorney General, we can help. Our attorneys regularly appear before the Office of Administrative Hearings in Los Angeles, Sacramento, Oakland, and San Diego, to defend nurses against charges brought by BRN. No matter what stage of the disciplinary process you are in, we can help.
On this page, youll find helpful information that weve gathered from years of experience working to protect nurseswe hope some of it can help you achieve some peace of mind about your disciplinary case. However, the only case that matters is yours, and the information on this page is not a guarantee, warranty, or a prediction about your case outcome. If you have a disciplinary matter, call us right away.
Possible Disciplinary Action That Could Be Taken Against A Nurse
The types of action that are typically taken against a nurse as a result of professional misconduct include:
- Remedial education
- License suspension
- License revocation
If you are facing an allegation of professional misconduct, you have the right to defend yourself before your case gets to the point that your license has been revoked or suspended. For a free, no-risk review of your license defense for nurses case, contact the Law Offices of Anidjar & Levine today at .
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Managing Risk With Malpractice Insurance For Nps
According to the nations largest provider of nursing liability insurance, the Nurses Services Organization , an NPs specialty and work environment can affect their overall likelihood of being the target of legal action.
Over 80 percent of all claims occur within four specialties: primary care, family practice, behavioral health, and gerontology. Regarding work environment, over 65 percent of all claims occur in private physician practice, private NP practices, and aging services facilities hospitals and emergency departments see significantly lower claims.
Regardless of specialty or practice environment, NPs can take certain steps to reduce their risk and protect themselves from liability claims. Documentation of patient interactions is critical, as is strict adherence to ones scope of practice. NPs will need to know the laws of their state, know the policies of their employer, and, most importantly, know that they have comprehensive malpractice insurance coverage.
I have represented NPs who did not have enough insurance, or who were only covered by their employer, and who got in trouble with the board of nursing, and found themselves in a big heap of a mess, Klein says. If they had their own malpractice insurance, they wouldnt be in a heap of a mess. Yes, you need malpractice insurance. That is non-negotiable.
Matt Zbrog
Two How Much Does Nursing Malpractice Insurance Cost
Individual nursing malpractice insurance is generally inexpensive. The average cost is about $100 per year, but like other forms of insurance, your actual premium price will vary depending upon what underwriters view as risk factors. Nursing Malpractice Insurance Cost Varies by:
- How many years of experience you have
- Your level of education
- The state in which you work
- Your work setting
- How much time you spend on the job
Costs will also depend upon whether you choose a claims-made policy, or an occurrence-based policy , with the latter providing more extended coverage at a higher price.
- Loss of income for attending trials or depositions
- HIPAA violations
- Slander and libel
Notably, there are limits to what types of claims nurse malpractice insurance will cover. Exclusions include dishonest or criminal acts and sexual misconduct, including sexual harassment claims filed by patients and situations involving reckless disregard on the part of the nurse.
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Do You Work In A High
Nurses who are most vulnerable to these claims are those who work in high-risk areas of hospitals, including labor and delivery and the emergency department. It is also worth noting that complaints of negligence are far more likely to be filed against agency nurses, home health agency nurses, nursing home nurses, and independent duty nurses.
What Level Of Personal Risk Are You Comfortable With
While cost is always a consideration when deciding whether to purchase nursing malpractice insurance, most plans are relatively inexpensive, and worth the peace of mind that they provide. An even more relevant factor to consider is your personal level of risk for being the subject of a malpractice claim.
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Examples Of When This Would Be Necessary
Lets say you got sued by a patient for malpractice. Maybe you committed a med error by programing a pump incorrectly. The patients family sues you. You would need legal representation for this.
Lets say that med error also gets reported to your state board of nursing as well. The board decides to have a disciplinary hearing about you and your license. You would also need legal representation for this situation as well, ideally from lawyers experienced in dealing with departments of professional regulation. However, not all liability insurance for nurses has coverage for professional licensing defense.
While many of us think wed never get disciplined/were too careful to end up in front of a professional disciplinary committee, here are some of the most common reasons for complaints against nurses :
- Unprofessional conduct. This would be things like falsifying patient records, or documents. Essentially actions that can deceive or defraud the public would fall into this category.
- Criminal convictions. While not common, it is still possible. Most felonies and misdemeanors fall into this category.
- Unsafe practices. If you provide care that is reckless or below the accepted standard of care
- Inappropriate use of substances. You may find yourself working impaired, diverting drugs, or the subject of an investigation.
- Unethical practices include harassment, discrimination, inappropriate sexual relationships with patients, breeching confidentiality, and more.
Do I Really Need An Attorney To Protect My Nursing License
You always have the right to defend yourself against complaints to the BON, but for most nurses, it is highly inadvisable. Many nurses make the mistake of assuming the BON is there to protect them and is therefore on their side, and if they just explain the situation, the board will understand. That’s not how the BON operates. They don’t exist to protect you they exist to regulate your actions and to protect the public. Thus, if someone files a complaint against you, you need to assume that the burden of proof is on you.
Here’s why it’s best to have an attorney when your nursing license is challenged:
- The Board of Nursing understands the disciplinary process better than you do. This puts you at a disadvantage unless you have an attorney who also understands the process.
- The challenge to your nursing license is a legal matter. Your license constitutes a legal agreement with the state to abide by that state’s Nursing Practices Act, so violations constitute a legal breach. It falls under the category of administrative law, which is why a judge often presides at professional license hearings. In a legal situation, having a lawyer may be key to your success.
Bottom line: You are a nurse, not a lawyer. Since disciplinary actions over your license are a legal matter, you need a legal expert in your corner to improve your chances for a positive outcome.
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Q: Does Having Individual Professional Liability Coverage Help Nurses In Disciplinary Cases With Boards Of Nursing
A: Yes. They are the named insured. One of the biggest things that an individual policy provides a nurse that an employer policy does not is a defense against board investigations. That means for the price of the policy, you are getting an attorney to represent you. This is a major benefit. Disciplinary proceedings are costly, especially if the case goes to a hearing, and can drag on for a long period of time.
In the years that Ive been doing defense work in professional liability actions, I would say only half of the nurses Ive represented had their own liability policy. Others did not, so all costs as a result of the proceedings, including attorney fees, came out of their own pockets.
To Have Or Not To Have Malpractice/liability Insurance
Barbara Forshier, RN, BSN, JD
Editors Note: The Author is an Attorney for Nurses
Nurses frequently ask me whether or not they should have their own professional liability insurance. The answer is yes, you should carry your own insurance. You insure your home, your car, your health, why would you not insure your ability to practice your profession, your livelihood? Some nurses have heard that if you carry malpractice insurance you are more likely to be sued in a medical malpractice case. This is not true.
Now, you may ask, what about my employer, dont they cover me? The answer is yes and no. The employer covers you for negligence that happened while you were on the clock for them. However, the employer will be looking out first for their best interests, not yours. Your employer does NOT cover you if you are summoned to appear before the Minnesota Board of Nursing.
So, insure your right to practice your profession. Invest in insurance.
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Where To Get This Insurance
NSO was highly recommended by Lorie.
Full disclosure: They do partner with the American Association of Nurse Attorneys, an organization Lorie is a part of. Granted, they are a partner of many professional nursing organizations as well. However, she is a big proponent of this insurance policy because it carries a professional licensing defense.
If you have homeowners or car insurance, that company may also offer professional liability insurance policies. However, ensure that they also cover professional licensing defense before purchasing.
Lorie recommends searching online for your state + state department of insurance carriers for nursing malpractice. So, for example, New York State Department of Insurance carriers for nursing malpractice. Just make sure you get one that has a professional licensing defense included!
What Type Of Insurance Do Nurses Need
From hospitals and clinics to senior homes and community health centers, nurses play a hugely impactful role in promoting better health and providing necessary care. This includes conducting physical exams, counseling and education, and coordinating patient care.
The duties of the average registered nurse are many and varied, which can get even more complicated with over 100 different specializations. That inherently results in some amount of legal and financial risk. Thankfully, you have various forms of insurance to lean on, providing protection when you need it. What types of insurance do nurses need?
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If An Investigator From The Board Of Nursing Shows Up At My Home Or Work Am I Required To Answer Their Questions Or Let Them Look Around
Noand in fact, you should politely decline until your attorney is present. Generally speaking, your willingness to cooperate in an investigation will help your case because it shows good faithbut remember, investigators are looking for evidence that could be used against you, and they aren’t above putting you at a disadvantage or catching you off guard by showing up unannounced. You have the right to defer all questions to your attorney or to insist that your attorney be present at all interactions. If an investigator shows up unannounced, politely ask for their contact information and let them know your attorney will be in touch.
Registered Nursing License Denials
I have a criminal conviction in my background, can I still get an RN license?The answer is generally yes, but how long it will take to get a license and what restrictions the license might have will need to be worked out with the Board and their attorneys. We have helped hundreds of license applicants to disclose their convictions and discuss how to achieve a license in California.
I already have a license in another state, why was I denied in California?California is not bound by the decisions of other state licensing agencies, and the Board of Registered Nursing in California makes an independent decision about every applicant. In most cases, if a licensee is disciplined in one state, California will insist on equivalent discipline even if the incident is many years old. All licensing application questions should be directed to a qualified, experienced attorney.
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Disclaimer
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Other Areas Of Health Care Litigation
In addition to defending professional liability actions and False Claims Act lawsuits, our health care law attorneys are available to serve physicians and hospitals in other types of litigation, including:
- Disciplinary actions before professional licensing boards, such as the Texas Medical Association and the Texas Board of Nursing
- Defense of employment law claims against physicians groups, practice groups and hospitals
- Anti-trust lawsuits, Stark Law complaints and other anti-kickback claims
- Partnership disputes
Another Recent Prominent Case Of A Nurse With Criminal Charges
In our interview, Lorie mentions a few other cases involving nurses and criminal charges and I wanted to list them here.
Christann Gainey She was an LPN at a senior living facility. A patient fell and hit his head. He was supposed to have routine neuro assessments after the fall. Gainey documented that she completed the checks, but video surveillance showed that she was nowhere near the patient during the times she documented her neuro checks for him. CPR was not performed on him when he was found unresponsive in the hallway.
She was originally charged with neglect of a care-dependent person, involuntary manslaughter, and tampering with records. She plead guilty to neglect of a care-dependent person and tampering with records. She was sentenced to 6-months of house arrest and cannot seek reinstatement of her LPN license or work in a care facility/home during her 5-year supervision period.
This case hasnt made quite as many headlines, but that could be due to the fact that it didnt go to a jury trial as the Vaught case did.
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Nursing Malpractice Coverage Brings Peace Of Mind
Health care is a highly complex and ever-changing environment that can lend itself to high-risk, and life-threating, situations. Healthcare professionals, including nursing professionals, can make mistakes so having the appropriate malpractice coverage in place is crucial. While healthcare facilities must secure medical liability coverage for their organization and its employees there are benefits for nursing professionals having their own professional liability policy.
Georgia Reiner, a senior risk specialist with Nurses Service Organization , says there are a few key differences between employer-provided malpractice coverage and an individual professional liability insurance policy.
First is peace of mind.
If there were ever to be a conflict between a nurses best interests and their employers best interests, the employer provided coverage is intended to protect the employer first and foremost, and really only the nurse by extension, Reiner said. Whereas if the nurse has their own coverage, that can then afford them their own attorney, their own representation to defend them and their interests.
Second, when nursing professionals secure their own professional liability coverage they are adding an extra layer of protection, Reiner added.
There could be serious cover gaps in an employers policy. An employers policy could only provide coverage for a nurse for incidents that occur at work and coverage may not apply for State Board of Nursing investigations.
Seven What To Look For In A Nursing Malpractice Insurance Policy
If youve decided to move forward with individual nursing malpractice insurance, you want to make sure that the policy you choose is worth the premium you pay. Make sure that the policy you choose includes:
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Q: How Does Individual Insurance Coverage Differ For A Nurse Practitioner
A: Nurse practitioners are in an expanded role of practice. For example, in many states, they can diagnose, treat, and prescribe. So their role in patient care is much more involved than that of an RN. In some states, they have full independence in treating their patients. If you are a licensed NP, your liability insurance policy should specifically acknowledge that increased skill level so your policy will cover you for your full scope of practice if you are sued.