Nurses study and work for many years to be able to practice in their profession. While licensure as a nurse is a difficult hurdle to clear, that hurdle is there for a good reason. Depending upon the level of nursing, nurses often exercise a great degree of professional judgment when making decisions for their patients. The nursing profession is thus bound by a strict code of professional conduct, and any deviations from that code — whether real or imagined — can put a nurse’s license to practice at risk. Suspension or revocation of a nursing license can seriously compromise a nurse’s ability to earn a livelihood. If you are a nurse facing professional disciplinary action, a Richmond Board of Nursing attorney can help you fight for your reputation. 

The Virginia Board of Nursing 

The nursing profession in Virginia is overseen by the Virginia Board of Nursing, which is within the Virginia Department of Health Professions (DPH). It is comprised of a 14-member board, a 5-member massage therapist board, and various supporting staff. It licenses and regulates the following professionals: 

• Advanced certified nurse aides
• Certified nurse aids
• Clinical nurse specialists
• Licensed massage therapists
• Licensed nurse practitioners
• Licensed practical nurses
• Registered medication aides
• Registered nurses

The laws governing nursing in Virginia are found in Chapter 30, Title 54.1 of the Code of Virginia, which are accompanied by an extensive set of nursing regulations governing licensure, practice, and continuing education. 

The Complaint, Investigation, and Adjudication Process

Anyone may file a complaint against a nurse, including patients, ex-patients, and other members of the healthcare profession. Once the Board of Nursing receives a complaint, it initiates the investigation and disciplinary process. The nurse against whom the complaint is made is referred to as the “respondent.” 

This quasi-judicial process generally proceeds as follows: 

• Investigation: The DHP’s Enforcement Division investigates complaints about nurses by interviewing relevant parties and obtaining necessary evidence. It then submits this information as a formal report to the board. 
• Probable cause determination: The board reviews the Enforcement Division’s report to determine whether there is probable cause to charge the respondent with a violation of a nursing law or regulation. If it determines that no probable cause exists, the process concludes. If it determines that probable cause exists, it issues notice to the respondent and schedules an informal conference. 
• Advisory letters: If the board has concerns about the nurse’s practice but chooses not to institute formal disciplinary actions, it may send the nurse an advisory letter. This letter generally will outline the board’s concerns and offer suggestions to the nurse as to how to improve their practice. 
• Informal conference: The informal conference is a meeting between a special conference committee and the respondent. At the conference, the board outlines the allegations against the respondent and gives the respondent an opportunity to present arguments in their defense. If the committee determines that there is sufficient evidence of a violation, it may (1) place the respondent on probation, (2) reprimand the respondent, or (3) impose a monetary penalty. If the committee determines that the violation merits suspension or revocation of the nurse’s license, it must refer the matter to a formal hearing by the full board. 
• Formal hearing: The formal hearing is conducted by a hearing officer, a panel of the board, or the whole board. It is similar to a courtroom proceeding in that the parties may examine witnesses and present evidence. At the conclusion of the hearing, the decision of the board is announced. 
• Judicial review: If the respondent is dissatisfied with the outcome of the formal hearing, they may appeal the board’s decision to a circuit court of appeals, up to and including the Supreme Court of Virginia. 

At any time during the disciplinary process, the board and the respondent may “settle” the matter by agreeing to a consent order or entering into a confidential consent agreement. Consent orders contain the board’s findings of fact, conclusions of law, and recommended sanction, which the respondent agrees to accept. Confidential consent agreements are used in cases where the respondent has engaged in minor, unintentional conduct and are not considered disciplinary actions. 

A Richmond Board of Nursing attorney can provide effective representation at any stage of the adjudication process. 

How the Board Decides to Issue Sanctions

Disciplinary actions against nurses are decided on a case-by-case basis in light of the totality of the circumstances. However, to minimize inconsistent outcomes and maintain impartiality, the board evaluates allegations against nurses according to a point system known as the Sanctioning Reference Points (SRP) system. The system is used for almost all of the most common allegations against nurses, including: 

• Inability to safely practice 
• Violations of patient care standards 
• Fraud, both against patients and against the Board of Nursing 
• Physical abuse of patients, including sexual abuse and inappropriate relationships 
• Verbal abuse of patients
• Theft or misappropriation of patient property 
• Neglect and abandonment of patients

To calculate the respondent’s SRP score, the board first assigns a score based on the type of case at issue. For example, a case involving the inability to safely practice may be assigned a score of 40. The board then assigns additional points based on the unique circumstances of the case, such as whether the respondent has ever been disciplined previously, whether a patient was injured, or whether the conduct was intentional. Those two scores are then added together to arrive at the respondent’s SRP score. While the board has discretion in deciding the appropriate sanction to issue in any given case, the higher the respondent’s SRP score, the more severe the sanction typically will be. 

Protect Your Career With Help From a Richmond Board of Nursing Attorney

Allegations of professional misconduct are serious business, no matter how meritless they appear on the surface. Probation, suspension, or revocation of your nursing license can prohibit you from practicing and cause severe financial burdens. For the best chances of maintaining your license and professional reputation, please consider speaking to a Richmond Board of Nursing attorney at Pierce / Jewett by calling 804-502-2320 or using our online contact form.