When we think of the BON taking disciplinary action against a nurse’s license, we generally think of standards of nursing practice issues. It is true that the board holds the nurse responsible and accountable for their actions when providing patient care. But there are other areas of concern that the Board has rules to cover.
There is a whole other area that the Board monitors beyond standards of practice. It is the area that would be considered unprofessional or misconduct. While I am focusing on the state of Texas, there are similarities in all states. It is significant to note that the Texas board rules state that “The purpose of these rules is to identify unprofessional or dishonorable behaviors of a nurse which the board believes are likely to deceive, defraud, or injure clients or the public.” This area covers topics and issues that might be or might not be directly related to patient care. For example, drug related misconduct, diversion, falsification of drug and controlled substance records are some behaviors of the nurse that the board would follow up with disciplinary action if indicated. These actions you can see are related to patient care.
Other areas that the board holds the nurse accountable for that can be found in the rules addressing unprofessional conduct or misconduct include such things as issues related to record keeping, documentation, threatening or violent behavior in the workplace, providing information that is false or untrue related to nursing practice, failing to follow policies and procedures at the place of employment, and leaving an assignment without following proper protocol.
Of special note are two areas that nurses always seem surprised to find in the rules: ‘Failure to repay a guaranteed student loan or failure to pay child support payments’. Nurses have stated that these issues fall outside of the practice of nursing. What they do not realize is that we are nurses 24 hours a day. We do not stop being nurses at the end of our shift/tour of duty. These infractions are found under the misconduct section of the rules because, one can see that these are moral and ethical issues. You made a commitment to repay the money borrowed to go to school. You are responsible to provide for the care of your children. If one is unable to meet these commitments, making some effort to address the problem with the proper authorities would be indicated instead of simply ignoring the situation. Ignoring the situation will not make it go away. Remember that we are the most trusted of the professions and are therefore held to a high standard. This includes our actions “at the bedside” and in all arenas. Feedback and comments are welcome.