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Nurses are the backbone of the American healthcare system. They perform an incredibly wide array of functions in almost every healthcare setting and are often the healthcare workers with whom patients have the most contact. Given the trust that patients put in their nurses to exercise their professional judgment and to look out for their best interests, nurses are subject to a strict code of professional contact, and the nursing profession is highly regulated. Disagreements and misunderstandings between nurses and patients can lead to patient complaints, which can, in turn, lead to disciplinary actions that can threaten nurses’ license to practice. Virginia nurses who are facing threats to their nursing licenses should consider speaking with a Norfolk Board of Nursing license attorney

The Virginia Department of Health Professions

Nurses in Virginia fall under the regulatory authority of the Virginia Department of Health Professions (DPH), of which the Virginia Board of Nursing is a part. DPH also regulates doctors, optometrists, dentists, physical therapists, and veterinarians in Virginia. The Virginia Board of Nursing oversees the licensing and continued educational requirements of advanced certified nurse aides, certified nurse aides, clinical nurse specialists, licensed massage therapists, licensed nurse practitioners, licensed practical nurses, registered medication aides, and registered nurses. It enforces Virginia’s nursing laws and regulations, as well as proposes new regulations and amendments to existing regulations. 

The Sanctioning Reference Points System

The Board of Nursing uses a Sanctioning Reference Points (SRP) system to evaluate the severity of allegations against nurses and to guide its decisions with respect to sanctions. The purpose of the SRP system is to make sanctioning decisions more predictable and to reduce bias by adding an objective, empirical element to the otherwise subjective nursing disciplinary process.

Common Allegations Against Nurses 

The case types the SRP system covers vary by nursing specialty, but they generally cover the following allegations: 

  • Impairment due to alcohol, illegal substances, or prescription drugs
  • Violations of the Drug Control Act
  • Speaking to patients in a rude manner
  • Disclosing client information without permission or necessity 
  • Theft or diversion of drugs 
  • Diagnosis issues, including improper diagnosis, delayed diagnosis, and failure to diagnose 
  • Medication and prescription errors
  • Exceeding the scope of the nurse’s license 
  • Practicing without a valid nurse’s license
  • Inappropriate relationships and sexual abuse 
  • Abuse, abandonment, or neglect of a patient
  • Failure to provide assistance to patients in need 
  • Misappropriation of patient property
  • Performing unwarranted services 
  • Falsifying patient records
  • Improper billing and falsification of records (including licensure documents)
  • Improper advertising 
  • Failure to maintain the security of controlled substances 

While some of these allegations are more serious than others, any allegation of misconduct can seriously damage your professional reputation. If you have been accused of engaging in any of these behaviors, you should consider speaking to a Norfolk Board of Nursing license attorney. 

Calculating the SRP Score

To calculate a nurse’s SRP score, the board assigns a certain number of points based on the type of allegation involved. For example, an allegation of misappropriation of patient property carries a score of 30, while an allegation of an inappropriate relationship carries a score of 50. 

The board then considers other factors related to the respondent’s history and the circumstances of the case (known as the “offense and respondent” score), including: 

  • Whether their license has ever been suspended or revoked
  • Whether the nurse has had past difficulties 
  • Whether the patient suffered an injury
  • Whether the patient was particularly vulnerable 
  • Whether the nurse’s act was intentional 
  • Whether the nurse failed to initiate corrective action 

The case type score and the offense/respondent score are then added together to give the total SRP score. 

Possible Sanctions Against Nurses 

The Board of Nursing has wide latitude to impose sanctions on nurses. The sanctions the board can impose include: 

  • Monetary penalties
  • Reprimands
  • Probation 
  • Terms (e.g., continuing education, counseling, monitoring, etc.) 
  • Stayed suspension (suspension contingent on terms) 
  • Suspension of license
  • Revocation of license 

A nurse’s SRP score generally dictates the type of sanction he or she will be subjected to. For example, an SRP score of 51-85 in a fraud case carries a recommendation of a reprimand, while a score of 136 and up carries a recommendation of suspension or revocation. However, the board is not required to abide by the SRP’s recommendations if it feels that there are aggravating or mitigating circumstances in any particular case.

Department of Health Professions Adjudication Process 

In addition to the SRP system, the board also has a formal process in place to investigate complaints and adjudicate cases against nurses. These proceedings are quasi-judicial in nature, making them ideal for Norfolk Board of Nursing license attorneys

At the first stage of the adjudicatory process, the Enforcement Division of DHP conducts an inquiry into the allegations against the respondent and submits its findings to the board for a determination of probable cause. If the board finds that probable cause exists to charge the respondent with a violation, it will schedule an informal conference with the respondent. At any time after the probable cause determination, the respondent and the board may enter into voluntary consent agreements by which the respondent accepts the charges against them and agrees to whatever sanction the board deems appropriate. 

If the respondent and the board do not reach an agreement, the case proceeds to an informal conference in which the respondent is presented with all the evidence against them and given an opportunity to respond to it. Most cases are resolved at the informal conference stage. However, if the board determines that a license suspension or revocation is appropriate, it will refer the case to the full board for a formal hearing — a trial-like procedure in which witnesses are called and evidence is presented. If the board rules against the respondent at the formal hearing, they may appeal the board’s decision to a civil court of appeals. 

Safeguard Your Nursing License With Help From a Norfolk Board of Nursing License Attorney

Nurses who are facing disciplinary proceedings by the Virginia Board of Nursing are entitled to representation by an attorney. To maximize your chances of success in the disciplinary process, please contact a Norfolk Board of Nursing license attorney at Pierce / Jewett by calling 757-304-6655 or using our online contact form.