It is crucial for registered nursing, nurse practitioners, and advanced practice nurses to understand these laws and regulations to ensure they are providing safe and effective care to their patients. SJ Harris provides nurses with a fundamental understanding and knowledge of the laws and regulations that each nurse should follow below.
The Board of Registered Nursing is governed by the Nursing Practice Act. The act can be found within the California Business and Professions, starting at section 2700. You may be surprised to learn that the laws that govern nursing are not all that different than the laws that govern lawyers and doctors. They are based upon the premise of outlining the role of the BRN, and how to protect consumers from bad nurses.
Agencies like the BRN also have been delegated the power to create regulations. Regulations are just like the laws found in the Business and Professions Code. However, they are housed within the California Code of Regulations, title 16. Most often, the regulations created by the Board are in place to supplement, explain, expand upon, or provide guidance related to the general laws.
There are some key parts of the law that a BRN licensee or applicant may wish to be aware of.
- Business and Professions Code 2761, which outlines the ability of the Board to take Disciplinary Action.
- Business and Professions Code 2762, which governs the obtaining, prescribing, using or otherwise abusing substances, like alcohol or drugs.
- Business and Profession Code 2765, which defines when a conviction can provide the basis for possible discipline or denial of a license.
- Business and Profession Code 2760.1, governs the rights of an individual who has had their license placed on probation, suspended, or revoked. The code specifically outlines when a person may petition the BRN to reinstate a revoked license, seek to petition to modify probation or seek an early termination of BRN probation.
There are important regulations a registered nursing, nurse practitioner, or advanced practice nurse may wish to review. This may include the following.
California Code of Regulations (CCR), Title 16:
- Section 1441 defines Unprofessional conduct to include failure to cooperate in investigations, provide notices, and report to the Board, in addition to standard unprofessional conduct related to the practice of nursing.
- Section 1442 defines Gross Negligence – The regulation reads: As used in Section 2761 of the code, “gross negligence” includes an extreme departure from the standard of care which, under similar circumstances, would have ordinarily been exercised by a competent registered nurse. Such an extreme departure means the repeated failure to provide nursing care as required or failure to provide care or to exercise ordinary precaution in a single situation that the nurse knew, or should have known, could have jeopardized the client’s health or life.
- Section 1443 defines incompetence in nursing. The code reads As used in Section 2761 of the code, “incompetence” means the lack of possession of or the failure to exercise that degree of learning, skill, care, and experience ordinarily possessed and exercised by a competent registered nurse as described in Section 1443.5.
- Section 1443.5 provides the standards of competency for a nurse.
- Section 1444 helps us understand what convictions are considered substantially related to the practice of nursing, such that the convictions can be used to deny or revoke/discipline a license.
The code reads:
- Section 1445 provides the criteria the Board can use to evaluate rehabilitation if a licensee is subject to discipline, revocation, and/or denial. The criteria for rehabilitation include the nature and gravity of the offense, the outcome of a criminal matter, the conditions of any probation that may exist, whether or not there has been education, restitution, or other activities by the licensee, as well as levels of remorse.
Board of Registered Nursing Disciplinary Guidelines
All licensing agencies have published disciplinary guidelines which are to be used by prosecuting attorneys, defense attorneys, licensees, and administrative law judges in arguing the appropriate discipline that should be ordered against a registered nursing licensee deemed to have violated the law. The Disciplinary Guidelines can be found referenced in the California Code of Regulations, title 16 section, 1444.5. They can also be found here.
In the Guideline’s Introduction, the Board States:
The Board carefully considers the totality of the facts and circumstances in each individual case, with the safety of the public being paramount. Consequently, the Board requests that the Administrative Law Judges clearly delineates the factual basis for his/her decision. This is especially important should the ALJ deviate from the recommended guidelines. The rationale for the deviation should be reflected in the decision to enable the Board to understand the reasons therefore and to evaluate the appropriateness of the decision
The Board Also Provides Factors That May Be Considered In Determining The Appropriate Level Of Discipline.
Those factors may include:
- Nature and severity of the act(s), offenses, or crime(s) under consideration.
- Actual or potential harm to the public.
- Actual or potential harm to any patient.
- Prior disciplinary record.
- Number and/or variety of current violations.
- Mitigation evidence.
- Rehabilitation evidence.
- In case of a criminal conviction, compliance with conditions of sentence and/or court-ordered probation.
- Overall criminal record.
- Time passed since the act(s) or offense(s) occurred.
- If applicable, evidence of expungement proceedings pursuant to Penal Code Section 1203.4
Within the Disciplinary Guidelines, one will find various violations of the law and recommended discipline that should result if the violation occurs.
An experienced professional license defense attorney will be able to argue for you for the least penalty and discipline possible. Attorney Scott J. Harris is experienced and has been able to convince the Board and Administrative Law Judges to deviate from the recommended guidelines in the past. Having an experienced attorney can ensure you attack a Board case from every angle.