Key Takeaways
Less than 1% of nurses face disciplinary action each year, with most cases involving issues related to professional conduct, scope of practice, or documentation errors.
State boards handle complaints, investigations, and penalties, which can include probation, fines, license suspension, or revocation.
It's essential to familiarize yourself with your state's nurse practice act, maintain accurate documentation, and adhere to reporting rules.
Nurses are trained to always be mindful of safety and professional ethics. They are the most trusted profession in the country, with 81% of Americans rating their honesty and ethics as very high or high. This guide to nursing disciplinary action explains what happens after a professional lapse.
Almost all nursing misconduct is addressed through nursing disciplinary action from the state board of nursing or civil lawsuits. This is why the RaDonda Vaught case, which resulted in felony convictions from a fatal medication mistake, drew national attention from nurses and nursing organizations. Many nurses protested and even quit after she was found guilty and sentenced to three years of probation with her nursing license revoked, alarmed at the criminalization of medical mistakes.
What Is Nursing Disciplinary Action?
According to the National Council of State Boards of Nursing (NCSBN), nursing disciplinary action "affects the nurse's licensure status and ability to practice nursing." Because state boards are in charge of licensing, they are also responsible for investigating complaints. While nursing mistakes or misconduct may lead to other consequences, such as employer reprimands, terminations, civil suits, or criminal charges, nurse disciplinary action directly affects a nurse's license.
In addition to suspending or revoking a nursing license, state boards of nursing may issue fines or warnings and possibly require a nurse to complete professional education as part of their nursing disciplinary action.
How Common Are Nursing Disciplinary Actions?
In 2021, there were 18,145 adverse actions against nursing licenses, according to the National Practitioner Data Bank (NPDB), affecting 140,859 nurses, 93,998 licensed practical nurses, and 9,002 nurse practitioners.
According to the NCSBN, this represents less than 1% of all nursing licenses.
What Is the Nursing Disciplinary Process?
Nursing disciplinary action consists of six separate phases.
Filing a Complaint
Initial Review
Investigation
Board Proceedings
Board Actions
Reporting and Enforcement
What Are the Most Common Reasons for Nursing Disciplinary Action?
Complaints fall into the following categories:
Failing to follow nursing practice
Substance misuse
Sexual misconduct (such as engaging in sexual relationships with patients)
Boundary violations (such as soliciting or accepting monetary or valuable gifts)
Abuse of patients (either physically or verbally)
Fraud
Positive criminal background checks
According to the CNA and NSO Nurse Professional Liability Exposure Claim Report, published in 2020, the most common allegations are the following:
Professional conduct (32.5% of all primary allegations)
Scope of practice violation (24.8%)
Documentation errors or omissions account (9.7%)
Treatment and care failures (9.3%)
Abuse of patients (8.8%)
Medication administration (6.2%)
Drug diversion or substance misuse made up 42.3% of all professional conduct alleged violations, and failure to maintain standards accounted for 58.9% of all scope of practice violations allegations.
The best defense is to know and follow your states nurse practice act and discuss questions with a supervisor. For example, while accepting valuable presents or money from a current or past patient is against nurse practice acts, most nurses dont want to hurt a patients feelings if they're offered a small personal gift of little financial value. Knowing exactly where to draw the line can help you respond.
What Are the Most Common Forms of Nursing Disciplinary Action?
Nursing disciplinary action may include:
Reprimand
Probation (The nurse may continue to practice, but any further validated complaints will result in more serious nursing disciplinary action.)
Limited or restricted practice (The nurse may continue to practice but under restrictions, such as not being able to access controlled substances.)
Suspended practice (loss of license for a specific period)
License revocation (complete loss of license)
Fines
Mandatory remedial education
Nurses may and often do get a lawyer during nursing disciplinary action, especially if the potential action includes a suspended or revoked license.
Frequently Asked Questions About Nursing Disciplinary Action
According to the CNA and NSO Nurse Professional Liability Exposure Claim Report, the most common reason for allegations is professional conduct violation (32.5% of all primary allegations) followed by scope of practice violation (24.8%).
Documentation errors or omissions account for another 9.7% and treatment and care failures for 9.3%.
Source List
- Kelman B, et al. (2022). Why nurses are raging and quitting after the RaDonda Vaught verdict.
https://khn.org/news/article/nurses-react-radonda-vaught-verdict-conviction/
- NCSBN board action. (n.d.).
https://www.ncsbn.org/nursing-regulation/discipline/board-action.page
- NPDB analysis tool. (n.d.).
- Nurse profesionial liability exposure claim report. (2020).
- Nurses retain top ethics rating in U.S. but below 2020 high.
https://news.gallup.com/poll/467804/nurses-retain-top-honest-ethical-profession.aspx
- Nursing Workforce Fact Sheet.
https://www.aacnnursing.org/news-data/fact-sheets/nursing-workforce-fact-sheet
- Registered Nurses Job Outlook
https://www.bls.gov/ooh/healthcare/registered-nurses.htm#tab-6
