While some state BONs have complaint forms and others accept letters that detail the complaint, your complaint should always include the name of the party harmed; the date, time, shift, and place of the alleged disciplinary violation(s); an explanation of your relationship to the party harmed; and other details as required by the state or that you deem appropriate to the complaint. Many states will accept confidential complaints, but you should check with your state BON before submitting a complaint confidentially, to ensure that it will review and investigate such complaints.

You don’t need to provide evidence to compel investigation of a complaint. An investigator—who may or may not be a nurse—is sent to the site to gather as much information as possible about the incident. While additional evidence can be helpful, the complaining nurse can risk censure by using information generated during the care of a patient because patient records are considered the property of the health care entity or the patient. The nurse can and should make note of records that she believes address the concerns of the case, as the BON can obtain and review medical records, drug logs, personnel records, and incident reports, as well as take depositions or call in prospective witnesses for questioning.

Once the investigation is complete, the investigator recommends to the BON whether charges should be initiated. State BONs vary in their processes: in some states, the entire board considers the matter, while in others, the BONs have special committees to evaluate the charges. In addition, some BONs rely on an attorney to make the determination and the attorney then drafts the complaint for review and approval by the BON. Regardless, the BON has to approve the initiation of disciplinary action against a nurse.

You may be reluctant to report a colleague to your state BON, but nurses have a legal and ethical duty to report substandard care. Not only do most state nurse practice acts mandate that nurses report unsafe and incompetent care, but the Code of Ethics for Nurses with Interpretive Statements clearly addresses the nurse’s primary duty to patients, as well as the duty to preserve integrity and safety in practice.

The repercussions of not reporting instances of substandard care can be significant. State BONs can use failure to report to initiate action against nurses aware of deficient or incompetent nursing practice. Thus, in addition to the BON investigating the deficient practitioner, it will investigate any nurse who was aware of the deficient practice and did nothing to mitigate the actual or potential harm to patients. Failure to act to mitigate harm to a patient also may be incorporated into a malpractice claim.

Next month, Workplace Rights will discuss what to expect if you are the subject of a BON investigation.

Resources

For contact information on your BON, visit the National Council of State Boards of Nursing (NCSBN) Web site, www.ncsbn.org. To order a copy of the Code of Ethics, call (800) 637-0323 or go to www.nursesbooks.org.

Winifred Y. Carson is nurse practice counsel at the ANA.

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