The North Carolina Board of Nursing ("NCBON") is empowered by law to regulate the practice of nursing in order to provide safe nursing care to the public. 

When the NCBON receives a complaint regarding a nurse's practice or conduct, it must determine whether there is a violation of the Nursing Practice Act or rules and, if so, how to best address the conduct.  It goes without saying that learning about an investigation being opened against a license is stressful.  A license is a property right.  But, more acutely important, it is the basis of the nurse's livelihood.  Nurses with a North Carolina license, or privilege to practice ("PTP") in North Carolina pursuant to a multistate license issued from another compact state, should take seriously any letter issued by the NCBON indicating a complaint has been filed against them.  This article will provide insight on what to expect if you receive a letter like this from the NCBON and guidance on how best to approach it and conduct yourself with the Board.

Who Investigates Complaints

The NCBON legal staff and investigators handle all complaints and investigations regarding nursing practice, whether the nurse accused of wrongdoing is a Registered Nurse ("RN"), Licensed Practical Nurse ("LPN"), or Advanced Practice Registered Nurse ("APRN").  APRNs are Nurse Practitioners, Nurse Midwives, Nurse Anesthetists, and Clinical Nurse Specialists.  Nurse practitioners are jointly regulated by the NCBON and the North Carolina Medical Board ("NCMB").  The two boards have agreed to share the duty of investigating complaints against those nurses.  The NCBON staff, however, remain primarily responsible for the majority of the cases opened.

On their website, the NCBON has information on what to expect in the complaint/investigation process.  When the NCBON receives a complaint about a nurse, the NCBON staff will determine if the complaint alleges a violation of the law and rules that govern nursing practice for the RN, LPN, and APRN.  If so, a case is opened, and an investigator is assigned.  The NCBON's investigators are usually nurses; however, there are non-nurse investigators as well, and a few are former members of law enforcement. 

It's worth mentioning that nefarious individuals may pose as investigators from the NCBON.  The NCBON is aware of these predators and encourages their regulated population to contact the Board directly to verify complaint investigations should they become suspicious about a communication purportedly from the NCBON. 

Dealing With a Complaint

When a case is opened, the assigned investigator will contact the nurse in writing at the address provided to the NCBON.  Keeping the NCBON informed of a current address, phone number, and email address is the duty of every nurse licensed in North Carolina.  It becomes important should the NCBON need to contact the nurse regarding a complaint. 

Always respond if contacted by NCBON.  Failure to respond to an inquiry of the NCBON can itself result in action by them.  Failure to respond also does not stop the investigation from proceeding, even to a full hearing, before the board members in the nurse's absence.  Likewise, moving to another state in hopes of avoiding an investigation may only make matters worse.  All boards of nursing in the United States communicate through a coordinated licensure system known as Nursys®.  Nursys® allows real-time notification to boards of nursing on matters from initial licensure to suspension of a license pursuant to a disciplinary investigation.  Failure to respond to the investigation is the most assured way to have the license suspended.  Most, if not all, states have the ability in their law to take reciprocal action to impose the same sanction.  This can result in a domino effect of reciprocal action in other states where a license is held.

During the investigation, nurses should remain professional and respectful with NCBON staff and board members.  It is important to remain mindful of any deadline for a response or information requested.  An interview with the investigator will likely be offered, and the nurse should be truthful, cooperative, and not argumentative.  A nurse who is remorseful and accepting of poor choices or errors is far more likely to gain the benefit of any mitigation in outcome from staff or the board members.  At the close of an investigation, legal and investigative staff will determine what action is required.  They will weigh what sanction is the most appropriate to meet the remediation aspects and seriousness of the actions of the nurse.  Sometimes that is a private letter of concern, a remediation course, or a restricted probationary license, and sometimes that is a suspension of the license for a period of time. 

How to Respond Strategically to a Threat to Your Professional License

The NCBON does not provide an attorney to nurses facing allegations.  However, it is the right of every nurse to have this representation should they choose to retain a professional licensing attorney for this purpose.  Insurance generally is available to help defray the expense of hiring an attorney, but it almost always must be purchased before the conduct complained about took place. 

Attorneys knowledgeable of the law of nursing regulation can be very helpful in navigating what may be one of the most stressful times in a nurse's career.  Experienced attorneys can provide valuable assistance at every stage in the process.  For example, an attorney can assist a nurse with preparing the nurse's initial response to the NCBON.  This will ensure that the nurse makes a good first impression.  Similarly, attorneys can be very helpful in preparing a nurse for interviews with investigators and then attending those interviews with the nurse.  Attorneys who regularly work with the NCBON understand what types of questions may be asked during interviews and how to best provide truthful answers to those questions.