Being Truthful on a Nursing Employment Application

This video examines why a nurse should be completely truthful on new employment applications and the potential Board of Nursing consequences that may arise if they are found to have submitted an application with deceitful information.

Tennessee Board of Nursing Complaint Process

Below is a discussion of the Tennessee Board of Nursing Complaint Process.  When an individual feels they must report a problem with a nurse licensed by the Tennessee Board of Nursing (“Board”) they can file a complaint with the Health Related Boards, Office of Investigation. Issues not within Board Authority includes fees and/or billing disputes for amounts charged for services, overcharges, etc.

Filing the complaint

The complainant’s identity will remain confidential and cannot be disclosed. Patients, peers, family members, facilities, pharmacists, law enforcement and anonymous people can file a complaint.

Similarly, all the practitioner’s complaint information remains confidential. However information against a practitioner will no longer remain confidential if complaints lead to formal discipline by the professional licensure board.

All complaints are reviewed by a licensed clinical consultant in good standing with the relevant licensure board. The consultant will have a consultation with a staff attorney assigned by the Department of Health on behalf of the relevant health related board.

Based on the provided allegations, both the reviewers then conduct a paper review to determine if there is any potential violation of a statute and/or rules about your profession. The file is forwarded to a field investigator if a potential violation is identified for collection of witness statements and documents proving or disapproving the allegations. This investigation file is then returned to the Nashville Central Office for the review team to analyze the statements and documents to determine if and which rules and/or statutes are violated.

Investigation copy

It is not possible to get copies of the complaint or investigation findings as both of them contain confidential information which cannot be disclosed. You will receive a written notification of the outcome once the investigation findings are returned to the Office and a review is organized. If required, you will be guided on how to improve your practice. However if the investigation reveals findings requiring the filing of formal charges against you, you will be sent a written notice and provided with an opportunity for hearing.

As complaint information and the complainant’s and practitioner against whom the complaint was filed are confidential by statute, your office staff or designee cannot call to get a status update. The staff processing these confidential documents are trained at using the strictest measures to help ensure confidentiality is maintained. Thus only the practitioner is given information related to the complaint and complaint status to maintain strict adherence to the confidentiality requirements.

About talking to an investigator, being the named practitioner, you will be asked to participate in an interview if the review team requests an investigation. This interview is to give you the opportunity to give an explanation about your decisions, actions and behaviors related to the matter under investigation.

The issues under investigation ranges from malpractice and/or negligence in treating patients to impairment, drug diversions, situational behaviors, abuse and neglect, prescribing or supervisory responsibilities.

Decision making

The matter is a part of a legal process once the Allegations Report is filed with the state. Both the assigned attorney with the Department of Health and Board’s Consultant will ascertain whether the investigation’s collected evidence like medical records, witness statements and business records support a finding of one or more statutory or rule violations.

You will be notified in writing if no violation is found. However if violations are found, its nature, severity and position of the board in disciplining and/or similar violations is considered to determine if an informal letter of correction is issued by the Board’s Consultant or if the file will be referred to the legal office to consider formal disciplinary charges.

Results

Written notification in the form of a letter signed by the Office of Investigations staff member or a letter of correction, letter of concern or letter of warning signed by the Board’s Consultant will be issued to you if the complaint filed against you closes without violations and/or violations which do not rise to the level of formal disciplinary action. You will receive communication from the attorney assigned to your file if your complaint file is referred to the legal office.

If you are disciplined, the discipline will remain on your licensure record, which is a publicly available document. This is because formal disciplinary action which can only be taken by your licensure board after notice and a hearing opportunity, indefinitely remains part of your disciplinary history and your licensure record.

Appealing decisions

The statute lets you make an appeal of formal disciplinary actions within a fixed time span, based on statutory mandates. As informal letters of correction, letter of concern and/or letter of warning are not considered discipline and are not considered part of the licensure file are not matters subjected to appeal.

Ohio Board of Nursing Criminal Convictions

Ohio Board of Nursing Criminal ConvictionsFor those planning to become a nurse in Ohio, at present, there are altogether eleven offenses which form automatic bars to your obtaining a nursing license. These offenses apply to those people who have entered a pre-licensure nursing education program after June 1, 2003.

Thus, the Ohio Board of Nursing (“Board”) cannot issue a nursing license to individuals that have pleaded guilty to, have been convicted of or has a judicial finding of guilt associated with any one of the offenses listed below:

  • Murder, felonious assault, kidnapping, aggravated murder, aggravated robbery, sexual battery, rape, gross sexual imposition, aggravated arson, voluntary manslaughter or any other crime which is rather similar to these crimes in other states.

In addition to all this, there is a chance that the Board will propose to deny any applications which are made, will venture to place restrictions on any license which is granted for any convictions, will deny any judicial findings of guilt, will deny any judicial findings of guilt inthe applicant which had resulted from a plea of no contest, will deny a plea of guilty to and even deny any judicial findings of eligibility because the applicant had intervened in lieu of conviction in any of the following cases:

  • Any crime committed involving gross moral turpitude or immorality, any type of felony which may not be an absolute bar, any violation of misdemeanor drug laws and any form of misdemeanor in the course of practice.

With regard to all these types of offenses, the Board finds it difficult to advise or even give any definite answer about the effects the applicant’s criminal history will have on the applicant’s ability and chances of obtaining a nursing license in Ohio State.

Moreover the Board cannot make determinations or adjudications till an application has been filed as they don’t have the authority to do this. In case the applicant does have a criminal history, the first thing that the Board does is to conduct a complete investigation.

While doing so, the Board considers various factors which include, but is not limited to:

  • If the applicant has made a restitution, if the applicant has completed probation and has been rehabilitated, the age of the applicant while performing the offense, the total number of offenses the applicant had performed and its patterns and the facts and circumstances which surround the offense.

It should be known that though there is a chance that the Board may grant the applicant a license even though the applicant has a criminal offense history, due to the state laws, the applicant may not be able to, or be permitted to work in certain settings because of her/his criminal history.

This especially applies to those settings which require checking of criminal records before employing the applicant and where there is a chance of the Board imposing absolute or discretionary bars for employment in some patient care settings like in places where there are facilities or settings which involve taking care of older adults, children or disabled adults.

In addition to this, the Board does not have the authority to answer questions about one’s eligibility for attending nursing school or for participating in clinical instruction. As all the nursing programs differ in their enrollment criteria, it is recommended that any and all applicants first contact the nursing program to find out if they are actually eligible to enroll to the program.

Contact Chelle Law regarding questions associated with Ohio Board of Nursing Criminal Convictions.

Massachusetts Board of Nursing Substance Abuse Program

Massachusetts Board of Nursing Substance Abuse ProgramThe Massachusetts Board of Nursing (“Board”) Substance Abuse Rehabilitation Program (“SARP”) is a program which helps nurses with alcohol or other drug problems to return to practice while protecting the public’s safety, health and welfare. The SARP is five years in length and was created as a voluntary alternative to disciplinary action taken against nurses with drug and alcohol problems.

Consent Agreement for SARP Participation (“CASP”)

All SARP participants have to sign a legally-binding document which outlines the nurse’s individual recovery plan requirements. The requirements include toxicology screening, formal therapy, attending self-help groups, employment stipulations, regular assessment of the participant’s recovery progress and the use of prescribed and over-the-counter medications. Not complying with the CASP terms may lead to a termination from SARP and a referral to the Board for the right action.

Confidentiality

All files related to the nurse’s SARP participation are maintained confidentially. Though SARP participation is confidential, communication with SARP and the therapist, nurse employers, licenses and other related people is necessary.

SARP FAQ

When can nurses start participating in SARP?

Their participation starts on the date both the applicant and the Board’s designated staff sign the applicant’s CASP.

When can a nurse resume nursing?

The SARP participants approval to practice is based on the evaluation made on the participant’s ability at safe practice.

What is the Substance Abuse Rehabilitation Evaluation Committee (“SAREC”) role?

Board appointed SAREC members are volunteers who have to evaluate the SARP participants about CASP compliance. They give recommendations to the Board for making changes to the SARP participants’’ CASP based on board-approved SARP Policies.

Do SARP participants need prior approval to accept a nursing position?

Yes. Nurses need an SARP Coordinator’s approval to all their prospective nursing positions to accept a nursing position.

Can nurses enroll in SARP without any complaint against the nurse’s practice?

Yes, nurses can enroll without a complaint. They are immediately referred to a designated provider for a SARP assessment and are encouraged to start attending self-help groups to learn about substance abuse and dependence. Alcoholic Anonymous (AA) and Narcotic Anonymous (NA) are great sources of guidance, assistance and encouragement to learn how to maintain sobriety.

How much is it to participate in SARP?

SARP participants have to pay for 15 individual therapy sessions and drug toxicology screens.

What should participants do if they fall ill and cannot follow the terms of their Consent Agreement for SARP Participation (CASP)?

The SARP Coordinator has to be notified immediately.

Do SARP Participants’ nursing license status remain current online?

Yes, when the nurse remains in SARP, their license status remains current but with contract restrictions on the Board’s license verification website ‘check-a-license’.

What are the prescribed or over-the-counter medications permitted for SARP participants?

Their treatment provider may prescribe medications for treating particular illnesses. All participants’ medications have to be reviewed by the Medical Review Officer (MRO) and the SARP Coordinator.

What happens to the nurse’s nursing license on completing SARP?

The nurse will be able to practice without restrictions after 5 years of participation.

California Board of Nursing Diversion Program

California Board of Nursing Diversion ProgramThe California Board of Registered Nursing (“Board”) provides a Diversion Program (“Program”) that is a confidential, but voluntary program for registered nurses where their substance use disorder or mental illness impairs their practice. The Programs goal is to protect the public with the early identification of impaired registered nurses and by providing these nurses access to the required treatment services and intervention programs. The public is protected with the careful monitoring of the nurse, and if required, may even suspend the nurse of practice.

What are the services provided by the California Board of Nursing Diversion Program?

For the public:

  • Help in preparing to talk with registered nurses about any apparent problem
  • Private consultations with the concerned employers, public, family members,co-workers, consumers of nursing care and friends
  • Protects the public with an immediate intervention, which is an effective option to a longer disciplinary process
  • Ensure the nurse participant a secure and smooth transition to nursing practice by consulting the employers

For the Program’s Registered Nurses

  • Private consultations while thinking about joining the program
  • Examination and referral to discuss the right treatment or detoxification
  • Create a rehabilitation plan for mental illnesses or substance use disorders
  • Random tests of body fluids
  • Holding talks with employers to assure the nurse participant a smooth and secure transition back to nursing practice
  • Supporting, guiding and encouraging the registered nurse to recover as an effective substitute to taking any disciplinary action and ensuring the registered nurse can resume nursing practice

Registered nurses are not immune from mental illnesses or diseases of substance use disorder. The stresses of working in health care environment and the increased opportunity and access to controlled substances make all health care professionals, including registered nurses susceptible to substance abuse problems.

There are many registered nurses with substance use disorders who can find the assistance and support they require to stay clean and sober without any involvement from the BRN. Though mental illness is not so prevalent, it can affect a registered nurse’s ability at practicing safely. For example, any untreated major depression problem seriously effects any person.

Unfortunately, most of the people who suffer from these mental illnesses or substance use disorder deny they have a problem. In fact, most of the time, they are the last to recognize they have a problem, and admit that they need help. Any mental illness or substance use problem which is left untreated eventually jeopardizes the patient’s safety and health, and even threaten the afflicted person’s life. The Diversion Program also provides a good substitute to the traditional disciplinary procedure.

Eligibility

Eligible registered nurses are those who are:

  • Suffering from mental illness or abuse alcohol or drugs so much that it affects their nursing practice
  • Licensed and residing in California
  • Ready to undergo appropriate psychiatric or medical evaluations and voluntarily enter the program

The ineligible nurses are those who have:

  • Sold drugs
  • Harmed patients or caused death
  • Been disciplined for substance abuse or mental illness by the board
  • Been terminated after joining this program or any other diversion program for non-compliance

Getting into the Program

Nurses can enter the program in one of two methods:

  • Board-Referral where the Board refers registered nurses to the Diversion Program because of a complaint indicating the RN is impaired because of mental illness or substance use disorder. In case a nurse decides not to enter the program, the complaint is transferred to the Enforcement Program for possible disciplinary actions after investigation.
  • Self-Referral– Registered nurses seeking assistance can directly contact the program

Confidentiality

The staff of the Diversion Program are available for private consultations about possible referrals to the program. The law protects the confidentiality of the participants. So when a nurse enters the program, all information collected to help in developing a rehabilitation plan and any other related recorded information is kept confidential.

The Diversion Program records are destroyed when a nurse successfully completes it. In case a nurse does not successfully complete the program, any original complaint is investigated by the Board’s Enforcement Program.

Florida Board of Nursing Intervention Project

Florida Board of Nursing Intervention ProgramFlorida Board of Nursing Intervention Project for Nurses

The Florida Board of Nursing Intervention Project for Nurses (“IPN”) is designed to maintain public health and safety through a program which closely monitors nurses who are unsafe to practice because of drugs and alcohol usage and/or some psychological, psychiatric and physical conditions. The goals of the program are:

  • Give an opportunity to retain nurses in the nursing profession
  • To give affected nurses a program to be rehabilitated in a non-punitive, therapeutic and confidential process.
  • To provide a confidential consultations for Nurse Managers and cost effective alternative to the traditional disciplinary process.
  • To have the nurse immediately withdraw from practice till the IPN is assured that he/she can safely return to nursing practice.
  • To provide for an early intervention and thus reduce the time between the nurse acknowledging the problem and hi/her entering a recovery program.
  • To create a statewide resource network for referring nurses to the appropriate services.

Impairment

Impairment is that condition which manifests from the use of mind/mood altering substances, distorted thought processes existing in the psychologically impaired or physical conditions which prevent the nurses from practicing safe patient care.

It is characterized by the nurse’s inability at carrying out their professional duties and responsibilities in reasonable manner which is consistent with nursing standards. This guide however focuses only on impairment created by chemical dependency.

Problems related with chemical dependency cannot be resolved without any effective intervention or treatment. Co-workers tend to feel helpless and frustrated while staff morale deteriorates while the chemically impaired nurse is more impaired.

With the progress of chemical dependency, the potential for compromising patient care increases. Consequently, decision making, cognitive functioning, judgment, reaction time and the capacity to handle stress all get increasingly affected.

  1. Who can make a report to the Intervention Project for Nurses (IPN)?

Anyone who suspects a nurse’s impaired ability at providing safe nursing care can report the nurse to IPN or/and the Department of Health (“DOH”). According to Florida’s Mandatory Reporting Law, licensed nurses have to report any suspected practice impairment to IPN and/or DOH.

  1. Does participating in the IPN protect a nurse’s license from disciplining by Florida Board of Nursing?

The inability to practice safe nursing due to alcohol, drugs, chemicals, some mental condition or possessing or distributing controlled drugs for reasons other than legitimate purposes violates the Nurse Practice Act and can result in the Florida Board of Nursing taking disciplinary action against a nurse’s license.

If nurses reported only to IPN agree to participate in IPN and successfully complete it, the file is closed and held in confidence without taking any disciplinary action. If the nurses reported only to IPN do not agree to participate and do not successfully complete IPN, information in IPN’s possession is forwarded to the DOH which may lead to disciplinary action if deemed appropriate. Sometimes, the nurse is reported to both IPN and DOH wherein the disciplinary process is started and may lead to disciplinary action.

  1. Can nurses participating in the IPN still practice nursing?

Initially during the evaluation phase and any resulting treatment, the nurse may have to refrain from nursing practice and resume practice only after receiving authorization by IPN. This approval is based on recommendations from approved treatment providers in consultation with IPN staff. Generally, practice limitations are needed during the early phase of return to practice.

  1. Why should nurses choose to participate in IPN?

The staff at IPN can help the nurse receive the right treatment and provide continuing care and support. IPN participation is an alternative to disciplinary action by the Florida Board of Nursing for nurses who have violated the Nurse Practice Act.

An IPN representative will be present for nurses who are already involved in the DOH disciplinary process. It is when the nurse’s case is heard before the Florida Board of Nursing, that IPN will confirm that the nurse is engaged in the recovery process.

  1. Will nurses get evaluated and treated by IPN?

While IPN does not evaluate and treat the nurse, it does provide referrals to board-approved psychiatrist, addictionists and/or other treatment professionals who are located through the State of Florida. All referrals are made to providers who are located geographically closest to the nurse’s place of residence.

  1. What are the IPN participation costs/fees?

Unlike some other professional alternatives to discipline programs, IPN does not charge any participation fees. The nurse only has to pay for all required evaluation and treatment costs. Nurses who have to submit to random drug testing have to pay for all laboratory tests which are performed.

New Jersey Board of Nursing Continuing Education Requirements

New Jersey Board of Nursing Continuing Education New Jersey Board of Nursing Continuing Education Requirements

30 hours of CE credits during the two-year period preceding renewal is needed to maintain licensure. Thus, if you plan to renew a license in January 2015, you should complete 30 hours of CE credits between December 2013 and January 31, 2015.

Retirement and inactive nursing license

If you retire, but plan to maintain an active nursing license, it’s important that you complete all the required continuing education (“CE”) credits. However, if you plan to not return to nursing practice, you can always place your license in inactive status. There is no need of completing CE courses with an inactive license but you will have to go through the entire reactivation process to return to an active license status.

You need to complete all the required CE credits to maintain an active nursing license in New Jersey, even if you do not practice nursing here. You can place your license in an inactive status if you don’t practice here wherein you need not complete CE courses. However you will have to go through the entire reactivation process to return to active license status.

If your license was inactive for five or more years, and you want to reactivate your license you need to provide proof of completing both a nursing refresher course with a clinical component and the National Council Licensure Examination (“NCLEX”).

Online continuing education courses

A credential agency which is accredited by the National Commission for Certifying Agencies or provided by entities certified by the International Association for Continuing Education Training (“IACET”) approves all continuing education courses related to nursing. For more information on the types of courses the Board accepts, visit N.J.A.C on the Board’s website under the Laws and Regulations link.

It’s not necessary to personally attend CE classes. You can obtain and complete your credits by successfully completing online courses. Just remember to download and retain all completion certificates.

Continuing education courses completed through your employer will be accepted by the Board if the courses carry credit-hour designations. This means a credit hour for each 60 minutes of attendance where the employer provides you with a successful completion certificate. Once you receive your CE certificates, it is recommended by the Board that you retain them for a minimum of five years.

Additional CE credits

If required, the Board may request copies of your continuing education certificates for various reasons. They may need it for a random CE audit or while performing a disciplinary investigation. However if you do not satisfy your CE requirements, the Board may impose sanctions by public order.

In case you complete more CE credits than required during the renewal period, you can carry over a maximum of 15 additional continuing education credits into the next renewal period.

Georgia Board of Nursing Mandatory Reporting

Georgia Board of Nursing Mandatory ReportingGeorgia Board of Nursing Mandatory Reporting

On July 1, 2014 the Georgia Board of Nursing announced the implementation of mandatory reporting. The following incidents are required to be reported:

  • Furnishing a fraud license to work as an advanced practice registered nurse, a registered nurse or even a licensed practical nurse.
  • Working as a registered nurse, an advanced practice registered nurse or a licensed practical nurse without having a valid or current license.
  • Working as a licensed practical nurse, a registered nurse or an advanced practice registered nurse when their license has been revoked, surrendered, suspended or lapsed for failing to review.
  • Working as a licensed practical nurse, a registered nurse or an advanced practice registered nurse through a an illegally or fraudulently obtained, issued or signed diploma, record or license.
  • Using cards, signs, titles, words, figures, abbreviations or devices to prove that such people are registered nurses, licensed practical nurse or an advanced practice registered nurse unless the person is recognized or licensed by the Georgia Board of Nursing to practice under the Nurse Practice Act’s provisions.
  • Willfully helping or abetting people violating the Nurse Practice Act.
  • Previously or currently displaying the inability at working as a registered nurse, licensed undergraduate nurse, an advanced practice registered nurse or a licensed practical nurse with reasonably skill and safety because of the influence and use of narcotics, drugs, alcohol or chemicals.
  • Having been convicted of crimes related to moral turpitude, any felony or crimes violating federal or state law in relation to controlled substances or dangerous drugs in the states’ courts, any other state, territory or country or in US courts including, but not limited to pleas of nolo contendere entered to the charge.

What need not be reported?

  • Not accepting an assignment
  • No call-no show
  • Not completing a resignation notice or sudden termination
  • Acting rude or having non-threatening verbal interactions with staff or patient
  • Falsifying employment application except when the falsification is related to the licensure status
  • Momentarily and unintentionally nodding or falling asleep, unless it’s a pattern of behavior or leads to patient risk or neglect.
  • Protected information related to the nurse’s mental or physical condition which was obtained while providing care to the nurse
  • Not following agency policy unless there’s a violation of Nursing Practice Act
  • System issues which includes, but is not limited to:
  • Staffing or work hour issues
  • Old policy procedures which do not reflect the present evidence based practice
  • Malfunctioned equipment
  • Communication barriers with the physician or nurse
  • Wrong assignment practices

Who has to make reports?

Any nurse which includes nursing colleagues, nurse administrators, nurse supervisors and other nurses have to report the name of any licensed practical nurse, registered nurse or advanced practice registered nurse if there is reasonable proof that the nurse has violated any grounds for discipline provided in the Nurse Practice Act.

Do employers have to report?

Any and all employers of licensed, advanced practice registered or registered nurses have to report the name of any nurse who had resigned or whose employment was terminated to avoid termination for any reasons found in the Nurse Practice Act.

Do other regulatory bodies have to report?

State agencies licensing, registering or certifying hospitals, home health agencies, nursing homes or other health care facilities, or who surveys one of these facilities or agencies have to report to the Board if the agency has proof that the nurse had violated any of the Nurse Practice Act provisions.

California Board of Nursing Enforcement Program

California Board of Nursing Enforcement Program

CA Board of Nursing Enforcement ProgramThe main responsibility of licensing and regulating registered nurses in California is handled by the Board of Registered Nursing (“BRN”). It’s responsibilities stem from the Nursing Practice Act composed of California statutes which give BRN the authority perform functions like investigate complaints and to take disciplinary action against registered nurses. It is the Board’s Enforcement Program which handles these investigation and disciplinary functions. The Board of Registered Nursing’s Enforcement Program work at identifying the registered nurses who have engaged in unsafe activities which may put the public at risk.

The program’s responsibilities are divided into four main categories:

  1. Placing complaints
  2. Investigation
  3. Legal action
  4. Probation monitoring

The BRN not only takes disciplinary action against a nurse’s license, but is also responsible for denying a license to individuals who make potentially unsafe practitioners. In case of denied applications, the applicant can appeal the denial following the same disciplinary actions.

Placing Complaints: Information alleging a registered nurse or applicant has violated the Nursing Practice Act through activities or behavior deemed inconsistent with professional responsibiites is called a complaint. Any person believing an unlicensed person is providing nursing care illegally or a registered nurse is acting in an unprofessional or unsafe manner should file a complaint as soon as possible. The two most common complaints are:

  • Chemical Dependency– This is where the complainant believes the nurse abuses alcohol or other drugs.
  • Patient Care– This is when the complainant believes the registered nurse uses unsafe or inappropriate actions like failure to provide care, patient abuse or committing serious medication errors.

The Complaint Process

Once the BRN receives information or a complaint, a written notification is sent to the complaint within 10 days’ time. This information is reviewed to decide if the RN is eligible for BRN’s Diversion Program, if the BRN requires additional information or if the complaint should be forwarded to another agency with jurisdiction. Generally complaints are confidential and not publicly recorded during its investigation. However if accusations are filed, it is a matter of public record wherein the BRN will disclose the specific charges when requested. Imposed disciplinary action however becomes a permanent part of the nurse’s record, which is subjected to public disclosure.

Investigation: In case more information is required, it is gathered and then the complaint is forwarded to the Department of Consumer Affairs, Division of Investigations (DOI) for a thorough investigation. Sworn peace officers, DOI investigators conduct interviews, submit reports, gather evidence and refer cases determined of a crime to the District Attorney’s Office.

On completing an investigation, the investigator submits a written report of all findings to the BRN for review. The case is closed and the complainant is notified if no violation is substantiated.

Legal action: In case investigations prove that the nurse had committed a minor violation where the violation does not warrant any formal disciplinary action, the case is handled informally through the BRN Citation and Fine system. According to this system, the Executive Officer has the authority to issue fines and citations for minor violations of the Nursing Practice Act. If require, the nurse can also contest the citation and fine through an informal or formal appeal procedure.

Disciplinary Action: In case investigations reveal that the nurse had violated the Nursing Practice Act where the violation warrants formal disciplinary action, the case is sent to the Attorney General’s Office for review. With sufficient evidence, an accusation or legal document listing the charges is made and sent to the nurse. The nurse then has a chance to dispute the charges at an administrative hearing which closely resembles a court trial. Sometimes, the BRN may negotiate a stipulated agreement to have the case resolves in lieu of a hearing. According to the agreement, the nurse admits to the specific charges and agrees to the proposed disciplinary action. The Administrative Law Judge writes a proposed decision after the hearing which is sent to the nine-member Board for consideration. These members then decide on disciplinary matters to either adapt, change or reject the proposed decision.

In case the complainant is found guilty of violating the Nursing Practice Act, then the final decision may be to:

  • Have the license revoked or suspended
  • Place the nurse’s licenses on probation
  • Accept the surrender of license as revoking, suspending and voluntary surrendering of the license prohibits the nurse from practicing.
  • Cite and fine

Probation Monitoring: Nurses on probation have to comply with the specific probation conditions. Compliance of conditions is monitored by a BRN probation monitor and the license is restored without restrictions if the nurse successfully meets the probation conditions.

Texas Board of Nursing Investigation

Texas Board of Nursing InvestigationWhile the Texas Board of Nursing (“Board”) receives more than 16,000 complaints a year, not all of them lead to the Board taking any investigation or disciplinary action because many complaints the Board receives contains insufficient information about the nurse, are considered to be ‘minor incidents’, are not in the Board’s jurisdiction or sometimes are issues which even if proven, do not violate the Nursing Practice Act. The complainant’s identity is always kept confidential.

Investigation Procedure:
During a Texas Board of Nursing Investigation the Board usually notifies the nurse about the investigation and allegations. Nurses are also given a chance to respond to the allegation and show some compliance with the Nursing Practice Act (“NPA”).  Collecting relevant evidence and contacting witnesses is part of the investigation. While most of the investigations are conducted over the mail and phone, at times, on-site investigations are also conducted.  On collecting relevant evidence, the investigative team reviews all the evidence to find out and determine if any violation of the NPA has occurred. It is based on this review that some cases are closed.

Depending on the type of closure decided and the Board’s retention policies, the complaint and all related evidence may be immediately expunged from the nurse’s file or retained for a specific period. In case the case was closed and its file retained, it will be reopened if the Board receives additional information, complaints or evidence before expunging the file.  In case the evidence proves that a sanction has to be produced against the nurse to protect the public, it requires an Order of the Board which includes both the sanction and other requirements placed on the nurse to retain his/her license.  Some possible sanctions are a fine, a warning, remedial education, probation, suspension, reprimand and revocation. While most Board Orders are public information and permanent designations in the nurse’s licensure records, successfully completed deferred disciplinary orders are an exception.

Based on the circumstances of the complaint, an investigation is generally completed between five (5) to twelve (12) months. Various factors beyond the Board staff’s and the nurse under investigation’s control affect the complaint’s resolution time. Despite this, the case resolution time is ardently monitored and all internal processes are reviewed routinely, and improved to ensure all the complaints are resolved as quickly as possible.  While both the nurse being investigated and the complainant are periodically notified of the status of all investigations, unless instructed otherwise, all complainants are also notified of the investigation’s final outcomes.

Informal Settlement:
An informal settlement starts with the nurse being offered proposed agreed orders with the investigative findings, sanction, law conclusions and the stipulated requirements ensuring the nurse is safe to practice.  Nurses agreeing with the proposed agreed order’s contents sign and return it to the Board’s office before a notary. These agreed orders are then placed for review and ratification by the Board every month. While most of the Board’s reviewed agreed orders are accepted and ratified, the Board may finally modify or reject orders they disagree.

Nurses who don’t agree with their proposed orders can submit specific written suggested revisions to the proposed order for the Board to consider. If these submitted revisions are accepted, new proposed and agreed orders with the accepted revisions are sent.  Sometimes, at the Board’s discretion, nurses are invited to attend informal settlement conferences held a month or more in advance, at the Board’s Austin, Texas offices. The Executive Director or his/her designee conducts informal conferences which are attended by one of the Board’s attorneys, the Director of Enforcement, the assigned investigator and other Board staff.  The nurse and Board staff dialogue about the possible violations, evidence and acceptable settlement during each conference. Nurses are then informed about the panel’s recommended case disposition at the end of most of the conferences.  If the panel determines that there is a need of taking action to protect the public, then new proposed agreed orders are mailed to the nurses. Like other proposed agreed orders, the nurses can sign their orders before a notary and return it, or they may submit some suggested written revisions to be made to the proposed orders for the Board’s consideration.

It is when the orders are ratified that they become final Board orders and its terms are termed effective. Each final Board order’s copy is sent to the nurse and the last employer while complainants are also notified of the outcome. Generally, the Board’s disciplinary action is public information, and is a permanent part of the licensure record. The disciplinary action is printed on the Board’s quarterly newsletter and also reported to the National Practitioner Data Bank and National Council of State Boards of Nursing.

Formal Settlement Process:
If the Board and nurses cannot reach agreements for an informal settlement or if the Board cannot contact the nurses during investigation the Board files formal charges wherein the nurses have to file written answers to the charges. In case the required answers for formal charges are not filed, the case may lead to the revocation of the licenses by default.  In case answers are filed to the formal charges, negotiations towards agreed settlements are continued while formal public disciplinary hearings before the Administrative Law Judge (“ALJ“) is scheduled. Cases which do not reach agreed settlements proceed to hearings where the Board staff presents evidence while the nurses present their side of the case.  The ALJ submits a proposal for decision (“PFD”) after each hearing to the board where each PFD contains the Judge’s findings of fact and law conclusions. The Board then reviews and acts on each PFD by either imposing the appropriate penalties or by closing the case without any action.