ATrain Education

 

Continuing Education for Health Professionals

FL: Laws and Rules of Nursing

Module 5

The Disciplinary Process

 

Basically, the nurse may be disciplined for any violation of the Nurse Practice Act, for any violation of Chapter 456, Florida Statutes, for violation of any Rule of the Board of Nursing (Chapter 64B9, F.A.C.), for violation of any law applicable to nurses or nursing, or for violation of any final order of the Board of Nursing or Department of Health. The most ambiguous of these tends to be actions of the nurse which fail to meet “minimal standards of acceptable and prevailing nursing practice” (sometimes called “falling below the standard of nursing practice” or “substandard performance”), as stated in Section 464.018, Florida Statutes.

George F. Indest III
Nursing Law Manual, 2008

 

Each state has a method for investigating and disciplining its nurses. The Florida State legislature grants the Florida Board of Nursing the authority to hear and decide cases against nurses who have been accused of violating their state practice act. Laws related to the various ground for discipline include:

  • Chapter 456, Florida Statutes (applies to all licensed health professionals)
  • Chapter 464, Florida Statutes (Florida Nurse Practice Act)
  • Chapter 64B9, Florida Administrative Code (Rules adopted by the Board of Nursing)

The Florida Nurse Practice Act describes disciplinary actions that can be levied against a licensed nurse in Florida. It outlines specific acts that constitute grounds for denial of a license or disciplinary action. A wide variety of criminal acts such as bribery, fraudulent practices, indecent exposure, assault, battery, child abuse, and domestic violence, among other transgressions, can be grounds for denial of license or other disciplinary action by the board.

 

Legal Representation

Most nurses work from a place of service and goodwill. They think if they just explain what they have done the issue will be resolved. This is a risky assumption. Any nurse formally charged with a violation of practice should seek legal representation before making any statement to anyone in defense of self.

 

Denial of a License or Disciplinary Action

According to section 464.018 of the Florida Statutes, the following acts constitute grounds for denial of a license or disciplinary action:

  • Procuring, attempting to procure, or renewing a license to practice nursing by bribery, by knowing misrepresentations, or through an error of the department or the board.
  • Having a license to practice nursing revoked, suspended, or otherwise acted against, including the denial of licensure, by the licensing authority of another state, territory, or country.
  • Being convicted or found guilty of, or entering a plea of nolo contendere to, regardless of adjudication, a crime in any jurisdiction which directly relates to the practice of nursing or to the ability to practice nursing.

In addition, being found guilty, regardless of adjudication, of any of the following offenses:

  • A forcible felony
  • A violation relating to:
    • theft, robbery, and related crimes
    • fraudulent practices
    • lewdness and indecent exposure
    • assault, battery, and culpable negligence
    • child abuse, abandonment, and neglect

Other actions that can result in a disciplinary action include:

  • Having been found guilty of domestic violence.
  • Making or filing a false report or record.
  • False, misleading, or deceptive advertising.
  • Unprofessional conduct.
  • Engaging or attempting to engage in the possession, sale, or distribution of controlled substances.
  • Being unable to practice nursing with reasonable skill and safety to patients by reason of illness or use of alcohol, drugs, narcotics, or chemicals or any other type of material or as a result of any mental or physical condition.
  • Failing to report to the department any person who the licensee knows is in violation of this part or of the rules of the department or the board.
  • Knowingly violating any provision of this part.
  • Failing to report to the department any licensee who the nurse knows has violated the grounds for disciplinary action set out in the law.
  • Failing to meet minimal standards of acceptable and prevailing nursing practice, including engaging in acts for which the licensee is not qualified by training or experience.

The section on disciplinary actions against licensed nurses can be read here.

The following video, produced by the National Council of State Boards of Nursing describes the complaint process, from investigation to resolution.

 

Video—Nursing Complaint Process (9:59)

Source: NCSBN Disciplinary Resources Committee, 2010.
https://www.ncsbn.org/426.htm
https://www.youtube.com/watch?v=fzEwtCxaTmI&feature=youtu.be

 

Denial, suspension, or revocation of certification can be taken by the board against a certified nursing assistant as well for any violation of Chapter 456 or any of the rules adopted by the nursing board. The regulations related to disciplinary actions against a certified nursing assistant are described in Chapter 464, Part II (464.204) of the Florida Statutes.

The section on disciplinary actions against certified nursing assistants can be read here.

An Alternative to Discipline

Licensed nurses may be subject to a complaint if their behavior or practice is affected by the use of drugs, alcohol, or other chemicals or by a physical or mental condition or if they are in violation of nursing or nursing-related laws or rules (NCSBN, 2013a). The American Nurses Association estimates that in the United States 6% to 8% of nurses are impaired by drugs or alcohol while at work; yet, only about one-third of one percent of all actively licensed nurses are sanctioned each year for their conduct (NCSBN, 2011).

The Florida Intervention Project for Nurses (IPN)—is a statewide program established in 1983 as an alternative to discipline. It was the first diversion program for nurses in the United States. IPN is not part of the board of nursing and a nurse can complete the IPN program without ever having notified the board. In fact, about 80% of complaints to the IPN program come from individuals and employers, while only about 20% are referred by the board of nursing (Personal communication, 2013).

The goal of the IPN program is to ensure public health and safety by providing close monitoring of nurses who are unsafe to practice due to impairment as a result of misuse or abuse of alcohol or drugs, or both, or due to a mental or physical condition that could affect the licensee’s ability to practice with skill and safety (IPN, 2013).

A nurse entering the IPN program goes through an organized process involving intake, intervention, evaluation, treatment, and monitoring. If the licensee refuses to participate or fails to progress, a report is made to the Department of Health, which begins a process involving an investigation that can lead to disciplinary action (Smith, 2013).

Educating employers about the IPN diversion program is a primary goal of the IPN program. According to Vicki Fitzpatrick, clinical director and nurse support group liaison at IPN, many employers see substance abuse as a “moral failing” rather than a progressive brain disease that can be effectively treated. IPN works to dispel this perception. The ultimate goal is recovery from substance abuse and retention of the nurse in the profession.

Florida’s mandatory reporting law requires licensed nurses to report anyone who engages in acts that constitute grounds for denial of a license. However, if you suspect a colleague of engaging in an activity that constitutes grounds for denial of license and that colleague is actively participating in a board-approved program for the treatment of a physical or mental condition, you are only required to report the person to an impaired professional’s consultant (Smith, 2013).

 

Video—Substance Use Disorder in Nursing (12:35)

Source: NCSBN, 2013.
https://www.ncsbn.org/333.htm
https://www.youtube.com/watch?v=p8Rhs5h6QIc&feature=youtu.be

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