In past blogs I’ve written about the power and authority of each state’s board of nursing (BON) to discipline nurses. The board has this power as long as an individual possesses a license to practice.
In the following case, an appellate court upholds a BON’s disciplinary decision after questioning an RN’s mental health and revoking her license.
Nurse’s disturbing letters
An RN stops working as a nurse in 2013. Five years later, the nursing board and the state’s attorney general receive nearly two dozen letters from the RN expressing her dissatisfaction with the way her name was listed on her license.
The nurse claimed variations on her name were being used for identity theft. In the letters, she also alleged that individuals had drilled into her teeth to insert doses of mercury and devices. She also claimed chemicals were being used against her and her family to disfigure them and alter their neurotransmitters.
A BON committee held an informal investigative inquiry. The RN told the committee that someone had alleged she was not an RN and that she was at the inquiry not to save her license but to save her life. At the end of the inquiry, the committee renewed the BON’s request for the RN undergo a mental health evaluation. She had refused the initial request but said she would do so upon this second request. Instead, she sent more letters and emails to the nursing board and the attorney general.
Three months after the informal inquiry, the attorney general filed a Complaint to Show Cause and an order seeking to temporarily suspend the RN’s license. The complaint contended that the RN’s letters and emails were, “highly erratic and disturbing,” and that the RN was “impaired” to the extent that her ability to practice nursing with reasonable skill and safety was in question.
A hearing was held, but the RN did not attend. The nursing board temporarily suspended the RN’s license pending a final determination of the allegations in the attorney general’s complaint.
Nursing board holds its own hearing
The case was set for a formal hearing. However, after an in-person status conference was held, the RN informed the administrative law judge assigned to the case that she was “cancelling the hearing” because, she alleged, the deputy attorney general was “tampering with evidence,” including her marriage certificate, social security records, and other legal documents. The RN denied she ever had mental health issues and essentially told the administrative law judge that the state can keep her license.
In January 2020, the BON retained its jurisdiction and decided to conduct its own hearing, which highlighted the RN’s correspondence with the BON and state offices and her failure to seek an evaluation and treatment for what it believed was a mental health condition.
Once again, the RN denied she had a mental health condition and continued to make unsubstantiated and erratic claims. The state entered the RN’s correspondence into evidence and also a report from its expert, a clinical psychologist.
The clinical psychologist could not offer a specific diagnosis because the RN’s hadn’t been evaluated. She did opine, however, that the RN suffered from “persecutory delusional thinking” and “was not it touch with reality to a significant degree.” She also stated that the RN should not be allowed to practice nursing before she undergoes a psychological evaluation because she could pose a risk to the public.
The BON issued a decision to revoke the RN’s license.
RN appeals board’s decision
The RN raised 18 separate issues in her appeal, reiterating the arguments she raised in the years leading up to the appeal. The appellate court stated it could only reverse the board’s decision if it was arbitrary, capricious, unreasonable, or lacked fair support in the record, and there were no grounds for such a reversal.
Points worth remembering
The BON and the attorney general’s office did everything in their respective powers to have the RN’s mental health evaluated. They also provided her with all the due process protections afforded to all nurses when a license to practice nursing is at stake.
Unfortunately, the RN wouldn’t agree to the evaluation. On top of that, she chose to represent herself throughout the entire process. Had she obtained competent legal representation, she may have decided to be evaluated and get treatment, which, in the end, could’ve allowed her to keep her license.
Additional points to remember:
- Always retain legal counsel to represent you in any proceeding and follow their recommendations.
- Always attend all hearings before a board of nursing.
- If you possess a current and active license to practice nursing, but you pose a potential threat to public safety, a state BON can initiate disciplinary proceedings against you.
- If you feel unsure of your well-being in any way, seek help and treatment as soon as possible.
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