Defending Nurse Licenses

NSBN Complaint

What you should do after you receive a notice of complaint or investigation from the Nevada State Board

One of the most difficult moments in your career might come when you receive a “Notice of Complaint/Investigation” from the Nevada State Board of Nursing. It’s a devastating moment. You lose sleep. You can’t eat. Your nerves are shot. You’re paralyzed with fear and apprehension.

Am I overexaggerating the reactions of nurses with whom I’ve met after they receive this kind of letter? Not at all. If anything, I can’t adequately put into words the untold feelings of worry and distress nurses share with me after receiving this type of letter. And while I can’t erase the emotional toll such a letter can take on you, I can help you come to grips with what it means and how to approach the situation.

You’re Not Alone

Oftentimes, after the initial reaction of fear or distress, you’ll feel it’s “me versus the Board” and you are all alone. You can’t talk to co-workers about it. You can’t talk to the administrators. No one else outside the practice of nursing fully understands what you’re going through; it’s not like you want to go around sharing it. You are at a loss as to who to turn to, and there’s no one around of whom you can seek competent advice.

The first thing you should know is that help is available. Although there aren’t many of us, there is a very small group of attorneys in Nevada who have dealt with these situations regularly, so we have a pretty good feel for how things are going to proceed in your case, and the likely outcomes.

One of the first things I try to tell nurses when they come in for their first consultation is that they are not going to lose their license. That’s always the biggest initial concern. While some situations will warrant revocation or suspension of their license, it’s not common, so I try to address the issue quickly in order to immediately reduce the level of anxiety. This evaluation (if I can give it) is always met with great relief.

You are entitled to legal representation at every phase of the the disciplinary process. Having someone by your side, looking out for your legal interests, giving you advice all along way, can go a long way to reducing your stress. It also creates a buffer between you, the Board, and the Board’s staff. You don’t have to talk to them, we’ll talk to them on your behalf. Besides reducing stress, there are also sound reasons for doing this.

Providing a Written Response to the Board

When you receive a Notice of Investigation/Complaint, you will see in the last paragraph that they are asking for a response in writing. In virtually every notice I have reviewed, the Board asks for a response within two weeks. How to respond to this notice is of great concern, and frankly, it should be of great concern.

Most nurses miss the penultimate (second to last) paragaph which states that you are being given the “opportunity” to respond. Because of the other scary language in that paragraph, this is often overlooked. Writing a letter back to the Board is not mandatory. It is something you can either do or not do. Most nurses miss that fact.

Should you write to the Board? Should you take this “opportunity” to respond? In most cases, I believe the answer is no, but it depends upon the circumstances. You have to understand the power of an administrative body in order to know how this decision affects you.

The United States Constitution separates the powers of government into three branches, which act as a “check and a balance” against one another: executive, legislative and judicial. It works well, but it’s inefficient (time consuming). You’ve heard of the term “gridlock” when talking about the U.S. Congress and passing laws? That’s what we are talking about; it takes alot of energy and effort to pass laws, which have to pass through two legislative bodies and avoid a presidential veto to become law.

Government cannot operate at every level with such inefficiencies, so they create administrative bodies, like the Board of Nursing, to administer the laws. Administrative agencies have a parts of all of the branches of government rolled into one entity: they partially have executive, legislative and judicial powers. Let’s focus on their executive and judical powers for a moment. They investigate and prosecute cases and sit as the trier of fact. It’s kind of like the police, the prosecutors and the judges working in the same office. This is an oversimplification, but you can see that checks and balances provided by separation of these powers is reduced when both prosecutors and judges work together in the same office.

Back to writing a responsive letter. When you write back a letter, anything you say can and will be used against you at a later time. In regular life, a citizen accused of a crime has the “right to remain silent, anything you say can and will be used against you.” You have that same right, and if you decide not to remain silent, you have given up a very important right. Most nurses don’t think of it in those terms, they think that if they “cooperate” by writing a letter, things will be “better” for them. However, I have seen nurses treated more harshly after writing such letters. I have seen nurses charged with more violations after writing letters. For these and other reasons, I almost always advise nurses not respond. After all, they will other opportunities to expain themselves.

Seeking Legal Advice: Sooner is Better

This next and final piece of advice is going to sound self-serving; see a lawyer as soon as possible. I’ve already stated that meeting with an attorney can reduce your anxiety almost immediately, and that we can give you some idea about your options. But other reasons exist as well.

When I started helping nurses, I had to decide whether I was going to charge for an initial consultation. After all, it takes alot of time to meet with a nurse the first time, and go through your options. In the words of Abraham Lincoln, “Time is a lawyer’s stock in trade.” In other words, we have nothing to trade with you but our time, so we have to use it carefully. I don’t fault those who charge for initial consultations.

In the years that I have offered my services to nurses, I have not charged for the initial consultation. I want you to know that my job, first and foremost, to help you in your difficult time. It’s not all about the money. I’d prefer you come to meet me, “kick the tires,” and see if we are a good fit and can work together to help you in your time of need. So far, this method has worked for me, and it works for the nurses who come to see me.

So here’s why I say, the sooner you seen attorney, the better. First, at least in my case, it’s not going to cost you anything to come and see me. So what have you got to lose? Second, the sooner you come in, the sooner your stress can go down when you find out you’ll probably survive this ordeal and be able to continue to practice nursing. Third, I usually work on a fixed flat fee, so the sooner you come see me, the more work I can do for you for the money you have to pay. Fourth, the sooner you have a buffer between you and the nursing board, the better. If this were a crime, would you want to continually talk to the police or to the prosecutor about your case and how you plan on defending yourself? Without an attorney, the investigators on staff at the Board will continue to call and try and talk to you. It’s hard to refuse them. That’s a lot of pressure. You get rid of all of that if you hire an attorney. Finally, I believe, based upon past experience, that you will have a better outcome. Having someone in your corner helping you make decisions how to proceed, I believe, is invaluable. You won’t ever have to wonder whether you made the best, most informed decisions. Of course, I can’t guarantee a better outcome, every case is different, and your results may vary.

When you get that letter of investigation/complaint, try not to panic. Consider your options. Don’t respond right away with your own written letter. Seek competent legal advice. Find out yout options. Once you have an understanding of the choices available to you, choose the best option that best fits your situation.