AC/DC. A classic band. I may be giving my age away here, but it is one of the first bands I remember listening to with my older sister and her boyfriend (now husband). A band that I regret not seeing live since Brian Johnson is no longer with the band. (Other bands that I wish I would have seen live include The Eagles, The Who, Def Leppard, Led Zeppelin, and maybe Sir Mick and the guys of the Rolling Stones, but that's a post for a later date.)
In my opinion, AC/DC had some creative names for songs. So, for this post, I am going to use those song titles to briefly describe what happens when a nurse is investigated for violating a section of the Nursing Practice Act. (See also Board of Nursing Provisions under the Texas Administrative Code.)
The first thing that occurs in a Board of Nursing Investigation is the Board has to receive a complaint or a notice from another licensing board stating that a nurse was a "Problem Child" or for "Breaking the Rules", or was involved in an incident that may or may not have been his/her own doing. For example, a nurse may have had a disagreement with his/her supervisor, and as a retaliatory action, the supervisor reports the nurse to the board for a minor infraction that normally would not be reported. Or, a nurse practitioner may have been reported to the NPDB for some reason, and the NPDB then reports to the Board of Nursing.
When the Board receives a complaint/notice, the matter is assigned an investigator and the investigator acts like he/she is on a "Rock 'N' Roll Train" and begins working the investigation. This involves gathering information from the reporting entity/individual and sending a formal notice to the nurse that is under investigation.
When the nurse receives the formal notice, she/he may be "Thunderstruck" and may think that she/he is on the "Highway to Hell." It is normal to be shocked by the notice; however, the absolute worst thing a nurse can do is ignore the formal notice. Ignoring the notice is akin to signaling for "Hells Bells" to ring because the notice gives the nurse an opportunity to respond a tell her/his side of the story within a certain time period. At this point, a nurse can hire an attorney to represent them in the investigation, or the nurse can "Shoot to Thrill" and forgo legal representation. Either option is available to the nurse. (We are going to assume no legal representation has been hired for this post.)
After a response is submitted to the Board, the investigator assigned to the case reviews the response and continues the investigation. After the investigator completes the investigation, an agreed order with findings from the investigation is sent to the nurse for signature. At this point, a nurse may think that he/she is "Back in Business" and he/she signs the agreed order. However, this could be a big "Danger" and could jeopardize the nurse's employment resulting in the nurse being "Shot Down In Flames."
An agreed order from the Board of Nursing can contain various sanctions. Some of the most common sanctions include supervision for a period of time, a certain number of continuing medical education courses, and because "Moneytalks", a fine. (Moneytalks is my favorite AC/DC song by the way.)
If the nurse does not agree with the agreed order because he/she feels the Board of Nursing has "Walk(ed) All Over You", an informal conference may be requested. If the Board of Nursing grants the request for an informal conference, a date is selected and the nurse sits down in front of a panel of individuals from the Board of Nursing and tells her/his side of the story again. The panel also asks the nurse questions during the informal conference. Unfortunately, an informal conference is not something the Board of Nursing always grants.
After the informal conference, the panel issues a decision. The decision may be a complete dismissal of all allegations, to which the nurse normally says, "Have a Drink On Me." Or, the panel may reduce the allegations and sanctions but does not completely dismiss them and a new agreed order is drafted. Or the panel may keep things the same as the initial agreed order.
If the nurse still believes that the Board of Nursing does not have it correct and says "You Ain't Got a Hold On Me," the nurse does not sign the agreed order issued after the informal conference. At this point, the nurse is formally charged by the Board of Nursing and the matter is handed to the State Office of Administrative Hearings. The nurse will then have to undergo a formal hearing over the charges. At the end of the hearing, SOAH issues its order.
As stated above, this is a brief explanation of what happens when a nurse is investigated by the Board of Nursing. I hope this has been somewhat educational. So, "For Those About to Rock (We Salute You)." Until next time, which I doubt I will be "Back in Black." (Had to find a way to work that song in.)
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