Common Disciplinary Categories Reviewed by Boards of Nursing
Complaints to nursing boards can come from a number of sources. Patients, coworkers, members of the public, or employers tin call the board of nursing, put complaints in writing, or complete a board of nursing Spider web site complaint class. Licensees may too self-report when required past law to do and so. Additionally, a lath may be notified by other nursing boards, other agencies, or law enforcement of action taken against a nurse. Mostly, the complaint is kept confidential, as is the identity of the complainant. The information obtained in the investigation may besides exist kept confidential, even from the subject of the investigation.
 | Effigy. Illustration by Janet Hamlin. |
Upon receipt of a complaint, the nursing board will confirm that the nurse is licensed in that country or jurisdiction and that the complaint is governed by the laws and regulations of that state. If the complaint lies outside the parameters of the nursing board'southward purview, the complainant will exist notified that the matter won't be addressed by the board. The complaint may be forwarded to other agencies under whose jurisdiction the matter does fall, or the case may be closed. If the thing is institute to be inside the lath's jurisdiction, and the complaint is such that, were the allegations truthful, they would constitute a violation of nursing rules and regulations, a formal investigation will ensue. The nurse is notified that an investigation is beingness undertaken; at that time, she or he should immediately seek the communication of counsel. Failure to answer to a nursing board enquiry can result in a default judgment of disciplinary action, including permanent revocation of one'due south license.
INVESTIGATION
Nursing boards take complaints very seriously and may be required by law to investigate each complaint received. Because the mission of the licensing board is to protect the public, an investigation may be required to ensure that the licensee is competent and upstanding and provides safe care. Investigations are conducted in a number of manners. Some nursing boards use lath-appointed investigators to acquit interviews of the licensee who is the subject of the complaint. Some boards require nurses to complete questionnaires, called interrogatories, to provide the necessary data. Nursing boards may also conduct informal settlement conferences or formal hearings to determine whether the nurse has violated laws and regulations that govern nursing practice in the country. Still other states issue an club to evidence cause, which is a courtroom social club requiring nurses to appear at a certain time and date and show why the board shouldn't accept disciplinary action. This is an adversarial process, and nurses shouldn't answer questions, make statements, or announced at proceedings without counsel present.
The purpose of the investigation is fact-finding. The investigator collects data, interviews parties, reviews records, and assembles evidence related to the events and circumstances surrounding the complaint. The investigator and so compiles a report that details the elements of the allegations against the nurse and the facts as determined by the investigation. Relevant evidence and documents are so forwarded to the prosecutor or nursing board-designated personnel. Skillful consultants may review the materials and may be used as testifying witnesses by the prosecutor. Investigations will include a review of adverse employment actions, other administrative agency determinations, criminal proceedings, and out-of-land disciplinary actions.
The licensee will be notified either that the investigation didn't result in information suggesting that violations occurred or that charges are warranted. If the nursing board finds that there isn't sufficient evidence to support adverse actions, the thing volition be closed. How long nursing boards keep the investigative materials and whether or non they expunge the complaint from the nurse'south record varies. (State-specific information tin be plant on the National Council of Country Boards of Nursing [NCSBN] Web site: http://www.ncsbn.org/boards.htm.) If the board thinks disciplinary action is indicated, the nurse may take one of several options: a consent agreement, settlement, or stipulation; attendance at an breezy settlement conference; or a formal hearing. Regardless of whether they result from a consent agreement, informal settlement conference, or formal hearing, disciplinary actions may and then exist published on the Cyberspace, posted on the nursing lath'south Web site, printed in the lath's next newsletter, or reported to other agencies, including information banks and the NCSBN. Nigh disciplinary actions go a permanent part of the nurse'south record and are considered public information.
Consent agreement. A consent understanding or stipulation is a negotiated settlement in which the board of nursing and the nurse concord to a penalisation. The nurse may or may not be required to admit wrongdoing to enter into the agreement. In states in which the licensee does have to acknowledge wrongdoing, it will be incommunicable to later deny the allegations or appeal the facts of the charges once the agreement has been signed. Signing a consent understanding may also waive one's right to a afterwards hearing or entreatment.
Once the understanding is signed, it's submitted to the board for approval, along with all investigative materials. The licensee may or may non exist present when the understanding is presented. If the nurse is present when the agreement is submitted to the lath, she or he may be required to take an adjuration and answer questions lath members pose. If the nurse isn't required to exist present, notification will be sent as to whether or not the agreement was accepted. If the agreement is accepted, it will be followed by a formal final club accepting the terms. (A terminal order is a written society issued past the lath that contains the findings of fact and conclusions of law in the example.) If the agreement isn't accepted, the prosecutor and the nurse will be notified and the matter may keep to an informal settlement conference or a formal hearing.
Informal settlement conference. Although less formal than an actual hearing, informal settlement conferences are notwithstanding official proceedings. Because statements made at an breezy settlement briefing can be harmful to the nurse in a subsequent formal hearing, nurses shouldn't attend informal settlement conferences without an attorney.
Generally, the prosecutor volition begin by offer an agreement that contains the findings from the investigation and the prosecutor'south recommendations regarding the discipline for the infraction. If the nurse agrees to the proposed order, the agreement is signed by both parties and sent to the board for approval. The board may approve the proposed order as is, suggest modifications, or reject it entirely. If the lath approves the proposed order without changes, it becomes a terminal order. If the board rejects the proposed club or suggests modifications, the nurse may still be able to proceed to a formal hearing.
If the nurse doesn't concord with the proposed order, the conference provides the nurse with an opportunity to reply to the allegations and dispute the testify or proposed disciplinary action and to provide additional information for the board'due south consideration. The committee or hearing officer will generally make a determination at the end of the conference. If the nurse disagrees with the recommendations, the board may crave the nurse to submit proposed revisions for consideration or permit the nurse to proceed directly to a formal hearing. There may be time limits for requesting the hearing, and the right to do so may be waived if the borderline is missed.
Formal hearing. Formal hearings are similar to civil trials. The board of nursing must prove the allegations in the complaint, simply the standard of proof required to do so volition differ past state. Even though the standard isn't every bit rigorous every bit in a criminal prosecution (beyond a reasonable doubt), the board may need to show by a preponderance of the show (more likely than not) or by clear and disarming evidence that the assertions are truthful. The hearing takes place in a courtroom-like setting in forepart of an administrative police force approximate (ALJ), hearing officeholder, a board of nursing member, a hearing panel consisting of several nursing board members, or the entire board of nursing, depending on the land.
A courtroom reporter records the entire proceeding and a transcript is made. The prosecutor makes statements; examines witnesses, including experts; and presents show. The defense may catechize the prosecution's witnesses. After resting her or his example, the defence may besides present evidence and the defense witnesses may exist cantankerous-examined past the prosecutor. When both sides have rested their cases, the hearing will be concluded.
Decisions are mostly non handed down at the decision of the hearing. The transcript of the proceedings is made available to both sides, along with the opportunity to right any errors. In some states the parties take a certain period of fourth dimension to suggest an order. In other states the ALJ or hearing panel will render a decision and make a recommendation to the nursing board. Attorneys for both sides may exist permitted to file exceptions (statements of disagreement) regarding the findings, which the lath may take into consideration. The board considers the ALJ or hearing panel recommendation and issues a concluding guild. The process can be a lengthy i and take months or even years to fully resolve.
CAUSES OF DISCIPLINARY Activity
The lath of nursing may have disciplinary action against any nurse who'south idea to be in violation of nursing laws or who's thought to pose a danger to the public. Many complaints can autumn into a category of "professional misconduct" or "unprofessional conduct" every bit well as unsafe practice or illegal or unethical behavior. These terms are divers by the individual states, and nurses are brash to know the definitions in each country in which they're licensed or in which they practice.
Professional misconduct or unprofessional conduct. Professional misconduct is a broad term that encompasses many areas in both clinical and nonclinical arenas. Anything that falls outside the premises of what the lath of nursing considers acceptable may exist deemed professional misconduct or unprofessional conduct. Charges of professional misconduct tin can be brought against a nurse for such things equally
* dishonesty or fraud in obtaining or renewing a license.
* practicing outside one'due south authorized scope or delegating to an unlicensed person activities that may merely exist performed by licensed professionals.
* failure to adequately monitor and supervise those to whom care has been delegated.
* practicing negligently, incompetently, or while impaired.
* failure to practise within minimally adequate standards of safety practise.
* habitual drug or booze use or chemical dependency.
* criminal convictions or failure to notify the board of nursing of the same.
* disciplinary action imposed by another licensing board.
* violations of public wellness police.
* failure to abide by a state'due south mandatory reporting obligations.
* failure to abide by consent agreement provisions or weather condition of probation or practicing while one'south license is suspended or expired.
* failure to notify the lath of nursing of address or name changes within the required fourth dimension frame.
* moral grapheme lapses.
* falsifying medical or business records.
* inadequate or improper documentation.
* failure to cooperate in a board of nursing investigation.
* privacy violations.
* advertisement or soliciting business in violation of state rules.
* refusing to intendance for patients on the basis of race, religion, or other nonclinical reasons.
* patient abandonment, neglect, or corruption.
* sexual misconduct or boundary violations with patients or inappropriate involvement with patients or their finances.
* failure to article of clothing an identification badge with one'southward proper noun and status prominently displayed.
* failure to abide by infection control practices.
* failure to protect clients from unsafe practices or conditions, calumniating acts, or fail.
* appropriating for personal use medication, supplies, equipment, or personal items of the patient or employer, or borrowing coin, materials, or property from patients.
* fiscal improprieties or failure to file accurate and timely tax returns.
* failure to pay spousal or child support or pupil loans.
* driving under the influence.
Many professional person misconduct allegations aren't directly related to the nurse'south clinical practise just may still effect in an investigation and disciplinary action on one's license. In Weber 5. State Board of Nursing (1992),i the Colorado Board of Nursing charged nurse Sherry Weber with failing to furnish medical records in a timely manner to iv of her patients, guilty pleas in two felony check charges, and procuring her nursing license by fraud, deceit, misrepresentation, misleading omission, or material misstatements of fact, in that she had denied that she'd pled guilty to the felonies when renewing her RN license. The board imposed a one-year suspension of her license, to be followed by two years of probation.
Weber unsuccessfully appealed the nursing board decision by arguing that she was disciplined for carry that didn't involve the practice of nursing. Specifically, she argued that the state's definition of nursing didn't include the handling of medical records. She argued that, therefore, even if she had failed to handle her patients' medical records properly, that failure didn't violate mostly accepted standards of nursing exercise.
The court noted that an expert had testified at the hearing that the failure to properly maintain patient medical records brutal below mostly accepted standards of nursing practise. The ALJ had concluded from this testimony that the handling of records constituted "an integral function of the profession of nursing" and "an essential element of appropriate patient care." This part of the ALJ's conclusion was upheld.1
Weber also argued that the guilty pleas were deferred judgments that never resulted in convictions. In one case she had completed the deferred judgment period, her guilty pleas were withdrawn. The pleas, therefore, didn't legally exist at the time the board brought charges against her. The court agreed with her that the board had been incorrect on the law for this portion of the ALJ's decision. Nonetheless, the court too held that, "[i]n professional disciplinary proceedings, a licensing board is allowed to consider the underlying acquit giving rise to the criminal charges in the context of other disciplinary rules." The example was then sent back to the board of nursing for a new hearing on the penalty.1
Substance corruption or damage. Between 8% and 12% of nurses accept substance abuse disorders, and such disorders may impair their do.2 This proportion is comparable to that in the full general population; government statistics put the percentage of the population ages 12 or older with substance dependence or abuse at 8.7%.iii Compared with that in the general population, prescription medication utilize is higher among nurses, but marijuana and cocaine use is lower.two Because vulnerable patients may be harmed by impaired providers, nursing boards will respond to complaints regarding substance use, fifty-fifty if such substances are legal.
Many states offer an alternative-to-discipline program for nurses if patients haven't been harmed. Such programs may be referred to as peer help, professional aid, diversion, or intervention projects. Although the verbal style in which they operate is specific to the state and the program, they typically operate with a mission to protect the public and rehabilitate the nurse. Although participation in the programme is voluntary, the alternative may be actual disciplinary activity on one'southward license or reporting to a data depository financial institution. A growing number of boards of nursing are adopting alternative-to-discipline programs considering they protect the public while providing for early on intervention and monitoring.4
Nurses in these programs may exist required to sign written agreements and temporarily surrender whatever or all of their licenses to the nursing lath. They volition exist evaluated by an habit eye approved by the board, and then participate in treatment and ongoing monitoring. This may be at the nurse'due south expense. Once the lath-approved monitor deems the nurse gear up to return to practice, the board may return the nurse'south license while imposing practise restrictions, probationary terms, random drug testing, individual and grouping counseling, and continuing monitoring and treatment. Deviations from the prescribed treatment plan, violations of probationary terms, or a return to substance use may disqualify the nurse from the program and result in disciplinary action. The programs may be lengthy, requiring monitoring for months or even years. Chemical dependency or mental illness programs are more often than not confidential, but nurses may be required to propose their employers and any prescribing providers of their participation in these programs.
Even in the absence of dumb practice, exposure to illegal substances tin result in disciplinary activeness. In Ferguson five. Delaware Bd. of Nursing (2009),5 nurse Marilyn Ferguson was issued a letter of reprimand by the board after she tested positive for marijuana. Although she presented good testimony that the test had been unreliable and that passive inhalation could produce a positive effect, the board nonetheless held that she had violated professional conduct rules. On appeal, the court held that the board had ignored skilful testimony and that its decision wasn't supported by substantial show. Information technology reversed the board's decision and sent the instance back for reconsideration.
Criminal convictions. Nursing boards may take disciplinary action confronting a licensee on the footing of criminal convictions. "Conviction," as divers past the lath, may include plea arrangements or deferred adjudication, and the board may refuse to upshot a license to an bidder with any criminal history, including such arrangements. In Bethea-Tumani 5. Agency of Professional and Occupational Diplomacy (2010),half-dozen Pennsylvania's board of nursing had denied Glecina Bethea-Tumani'southward application for licensure every bit an RN based upon misdemeanor convictions for insurance fraud and conspiracy. Bethea-Tumani was granted a hearing, and the board institute that she had failed to produce "satisfactory testify that she is of good moral grapheme, tin can practice nursing with reasonable skill, honesty, and safety to patients, and is able to meet the requirements of the profession." When a license was still refused, Bethea-Tumani filed an appeal. On appeal, the lath contended that the convictions demonstrated a pattern of bad judgment and chosen into question her moral character and power to practice nursing. Because the convictions straight related to honesty, and because they had occurred within a year of the application for licensure, the board had substantial prove to support the decision to decline a license. Additionally, the law specifically authorized the board to reject to issue a license to an applicant when the applicant has pled guilty to a felony or crime of moral turpitude. The courtroom agreed and upheld the lath'southward decision.
Reciprocal discipline. Disciplinary action in one country creates grounds for other states to have activity against a licensee, regardless of whether that license is agile or lapsed. Nurses may need to defend themselves in every state in which they've always been licensed if they're charged with misconduct in whatever one of them. In Lankheim five. Bd. of Registration (2011),7 nurse Penelope Lankheim was dismissed from a Florida graduate nursing plan after failing a course. In 2003, she was subsequently charged by the Florida Section of Health with falsely representing to a medico that she was withal enrolled in the program so he would human activity every bit her preceptor. While seeing patients under his supervision, she prescribed treatment plans and medications and disclosed confidential information on some of the patients.
An ALJ determined that Lankheim had violated the rules of professional conduct by "making fraudulent representations relating to the exercise of nursing ([as evidenced by] misrepresenting herself as a current nursing graduate student); by practicing as an unlicensed advanced registered nurse practitioner; and by violating rules governing patient confidentiality."vii The Florida Board of Nursing agreed to impose the ALJ's recommended penalties, which included a reprimand, probation, and a fine. Nurse Lankheim, however, offered to voluntarily relinquish her license. Every bit Florida law specifically states in the Board of Medicine Voluntary Relinquishment class, which contains clarifying linguistic communication (http://bit.ly/RTWoYP),
"If a licensee wishes to voluntarily relinquish a license, merely the licensee or the license is currently under[horizontal ellipsis] [investigation with pending disciplinary action][horizontal ellipsis] then the licensee may relinquish the license only with the approving of the Lath. If the voluntary relinquishment is accepted past the Lath at the fourth dimension an investigation is underway, or is anticipated, or when a disciplinary activeness is in progress, then the credence of the voluntary relinquishment of the license shall be considered disciplinary activeness confronting the license[horizontal ellipsis] and shall be reported as such past the Board. In addition, the licensee will be required to cease practise immediately upon signing the voluntary relinquishment and agrees to never reapply for licensure in Florida again."
The board made information technology clear to Lankheim that relinquishment would be considered discipline and issued a final lodge indicating that this had been explained to her. Lankheim had held a Massachusetts nursing license since 1987. Massachusetts concluded that the facts underlying her relinquishment in Florida (the unauthorized practice of nursing, deceiving a dr., and violating patient confidentiality) constituted violations of Massachusetts nursing law and moral graphic symbol requirements, therefore warranting sanctions in Massachusetts. In 2005, the Massachusetts Board of Nursing issued an guild to show cause addressing why, in light of her discipline in Florida, her Massachusetts license should not be disciplined. The Massachusetts board and then issued a determination suspending her Massachusetts license for five years.
Lankheim appealed the Massachusetts board's decision, arguing that for a number of reasons, the final guild of the Florida Board of Nursing didn't constitute discipline that could serve every bit the basis of reciprocal discipline in Massachusetts7:
* The Florida lath's decision included no findings of fact.
* Lankheim hadn't understood that the voluntary relinquishment of her license in Florida would found subject.
* She hadn't admitted whatsoever wrongdoing.
* She hadn't agreed not to competition the allegations against her.
The court held that the first three arguments were not supported past the evidence. As for the fourth argument, the courtroom held that when she had agreed to relinquish her license voluntarily and permanently in lieu of other sanctions, she effectively agreed not to contest the allegations confronting her. Because she had been gratuitous to challenge the evidence before the Florida board and chose not to exercise so, she could not now do then in Massachusetts. The Massachusetts board's decision to append her license for 5 years was upheld.
POTENTIAL DISCIPLINARY OUTCOMES
Nursing board decisions to take disciplinary action make up one's mind one's ability to do or concur oneself out as a nurse. Specific actions that a lath of nursing tin can take vary by country. The matter may be closed without sanction, or disciplinary action can be taken. If the matter is not closed without sanctions, punishments tin have a number of forms and may exist imposed in combination. Examples include
* reprimand or censure-reprimand and censure are similar in that they're official records indicating that a licensee has been disciplined. They may, in themselves, not compromise one'southward ability to practice only may be imposed along with other penalties.
* commendation-the board of nursing imposes a fine or society of abatement in lieu of making a formal allegation.
* cease and desist guild-an lodge to stop a detail activity or else face further penalization.
* warning-this tin be accompanied by stipulations or specific requirements.
* mandated standing education.
* fine or civil punishment.
* remediation-an endeavor to correct practice and promote safety; it may define terms for the license to be reinstated in good standing.
* referral to an alternative-to-subject area program.
* community service.
* probation-during probation, the nurse may or may not be permitted to practise. If the nurse is permitted to remain in practice during the menstruation of probation, information technology is with terms and atmospheric condition or restrictions.
* practise restrictions, monitoring, or supervision.
* break-a menses of time in which a nurse may not practice or hold herself or himself out as a nurse. The break may be bodily or stayed. During actual suspension, the license is surrendered to the board and the licensee may non exercise or hold herself or himself out every bit a nurse during that time. During a stayed suspension, the nurse may be permitted to work with probationary terms. Suspensions may exist partially actual and partially stayed, and may be for a definite or indefinite menstruum of time.
* emergency or summary suspension-an emergency suspension occurs when the nursing board determines that there is an imminent threat to public safety in assuasive the nurse to continue in practise.
* give up or relinquishment-a voluntary returning of one's license to the board of nursing afterwards which the nurse may no longer do or concord herself or himself out equally a nurse. Surrender and relinquishment are viewed equally the equivalent of revocation. There may or may not be the opportunity to petition for reinstatement at a later engagement.
* revocation-an indefinite or permanent separation from do in which the nurse may no longer practice or agree herself or himself out equally a nurse. States differ, merely there may be a waiting period during which the nurse may not petition for reconsideration or restoration. The mandatory waiting flow may be as long as seven years from the date of revocation.
COLLATERAL IMPLICATIONS
Even if one's license has been restored to adept status, the fact that there was disciplinary action tin can create other barriers to practise. When a nurse has been disciplined, the board of nursing may report that discipline to other agencies or government. The board may consider disciplinary action to exist public information and post the infraction and penalty on the Internet. Other regulatory agencies may follow those postings and take action.
The state health section, the Role of the Medicaid Inspector General, or the attorney general's office may be brash that disciplinary activity was taken against a nurse by the board, or discover the action through interagency communications. Such bodies may then have activity as well. The Function of the Medicaid Inspector General, for example, may identify the nurse on its disqualified- or excluded-provider list. Once on the listing, the nurse may not work for any employer in that state that receives Medicaid reimbursement for nursing services. Similarly, the federal regime may exclude the nurse from participation in the Medicare plan. Although nigh nurses aren't direct billers to these programs, they may even so be disqualified from working for employers who do receive Medicaid or Medicare reimbursement. Consequently, the nurse may be unable to secure employment, even if the license has been restored to expert standing with the nursing board. Placement on a disqualified-provider listing may also make information technology hard to obtain licensure and employment in another country.
Action taken against a health care professional'southward license is reported to federal data banks, the National Practitioner Information Bank (NPDB) and the Healthcare Integrity and Protection Data Banking company (HIPDB). According to the U.S. Department of Health and Man Services (DHHS),8 the NPDB
"is intended to ameliorate the quality of wellness care by encouraging State licensing boards, hospitals, professional societies, and other health care organizations to identify and discipline those who engage in unprofessional beliefs; to report medical malpractice payments; and to restrict the ability of incompetent physicians, dentists, and other health care practitioners to move from State to State without disclosure or discovery of previous medical malpractice payment and adverse action history."
The DHHS describes the purpose of the HIPDB this style: "to combat fraud and abuse in health insurance and health care commitment."eight
Information banking concern listings can compromise clinical privileges, professional society membership, participation in Medicare and Medicaid, collaborative practise agreements, and employability.
Obtaining licensure in another field may also be difficult if a nursing license has been disciplined. Cosmetologists, barbers, architects, real estate agents, and workers in many other not-health care fields require licenses to practice, and such licenses may not be issued if a nursing license was revoked, surrendered, or suspended.
CHALLENGING NURSING Board DECISIONS
Nurses take property interests in their professional person licenses because it's the license that permits them to earn a living. The Constitution prohibits states from depriving citizens of their property rights without due procedure. For nurses defendant of professional misconduct, this means that they take the right to notice of the charges and the opportunity to be heard in their own defense force. Nurses who have had adverse license determinations, therefore, may entreatment those decisions. This may exist done internally-by petitioning for a rehearing or review of the matter past the board-or it may entail requesting judicial review-going to court. Both actions may exist restricted by a fourth dimension limitation, after which an entreatment may not be possible. Similarly, an appeal may not be possible if the nurse has signed a consent agreement that waives appeal rights.
The state's administrative process act will outline the specific requirements, fourth dimension frames, and procedure for highly-seasoned nursing board decisions. The process tin can be lengthy, simply it may be possible to obtain a temporary injunction confronting the lath while the affair is awaiting. In such cases, the subject field is stayed, assuasive the nurse to go along practicing until a court renders a decision. Successful appeals crave an understanding of what is required to perfect the appeal, likewise as noesis of administrative and procedural requirements in the state.
Although the explicit standards for appealing a licensing board determination are state specific, the courts are ordinarily reluctant to overturn a board of nursing determination. At that place may be narrow grounds upon which they will do so. The deference granted to nursing board decisions is based upon a legislative intent and supposition that professional regulation is performed past those agencies with expertise in the profession beingness regulated. Courts, therefore, are hesitant to substitute their judgment for that of the board. The courtroom considers the testify and all reasonable inferences from the show in the light most favorable to the nursing board'southward findings. If the court thinks that the board could accept reasonably made its findings and reached its result, the courtroom will affirm its decision.
The reasons a court will hear an appeal of a nursing lath's determination are outlined by individual state statutes (referred to equally a standard of review), but in that location are several common reasons a courtroom will contrary a nursing board or send the matter back to the board (remand) for a new proceeding:
* The lath'southward decision was in violation of the land'south constitution.
* The lath exceeded its authority.
* The lath made an error of law.
* The lath'southward decision was not supported past substantial evidence.
* The board's decision was arbitrary and capricious.
* The board's determination was an abuse of discretion.
In all steps, from the filing of a complaint through final resolution and appeal, nurses obtain more favorable outcomes when represented by attorneys with specific expertise in authoritative law and nursing-licensure defense.
It'south important to notation that the emotional and psychological effects of beingness investigated by the nursing board are considerable. For near nurses, their license and identity equally nurses are at the core of their cocky-image, and when the latter is threatened it tin can be very destabilizing. Nursing is non just what we do; for many of united states of america information technology is who nosotros are. Part iii will discuss licensure-protection strategies and suggest deportment nurses can take to maintain their licenses in adept standing.
REFERENCES
Source: https://www.nursingcenter.com/ce_articleprint?an=00000446-201211000-00026
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