Substandard Nursing Care: Court Upholds Revocation of Nurse's License
Legal Eagle Eye Newsletter for the Nursing Profession
January 1998
Quick Summary: The board of nursing does not have to have testimony from an expert witness defining the standard of care for registered nurses in the practice of their profession, to be able make the decision to revoke a nurse’s license for substandard conduct in the course of carrying out the nurse’s professional duties.
A professional licensing board may use its own experience, technical competence and specialized knowledge to evaluate a situation presented to the board for a ruling.
The knowledge of the board of nursing includes knowledge of the standard of care for nurses. The board consists of registered nurses, licensed practical nurses, a physician and a member of the public.
The board must consider the facts. The facts may or may not show evidence of failure to set appropriate care priorities, failure to communicate with other professionals, failure to supervise staff, etc.
But the board of nursing uses its own expertise to interpret the facts. SUPREME COURT OF NORTH CAROLINA, 1997.
A registered nurse was brought up on charges before the state board of nursing for what the board would rule were two significant lapses in professional judgment. The board revoked the nurse’s license for a period of one year. The nurse filed an appeal in court. The Superior Court agreed with the board. The Court of Appeal disagreed with the Superior Court and reinstated the nurse’s license. The board appealed to the Supreme Court of North Carolina. That court had the final say and it upheld the board.
The Supreme Court ruled the Court of Appeals was wrong for seeing the board’s actions as flawed because the board did not consider expert testimony defining the standard of care for nursing practice.
In both of the incidents which ultimately caused the registered nurse in question to lose her license, she did not respond to reports from licensed practical nurses under her supervision that there were grounds for immediate grave concern for the conditions of patients the LPN’s were watching. One patient’s respirations had dropped from twenty to eight. Another had blood in his urine.
In the first incident, the LPN went over the RN’s head to the house supervisor, who went to the room and called a physician who came and gave Narcan. In the second incident, the RN in question told an LPN not to call the urologist even though another RN had told the LPN to do so.
The charges filed with the board against the nurse were failing to set her priorities appropriately in determining which patients presented the greatest danger and most needed her care, failing to recognize her patients’ conditions, failing to supervise appropriately the care given her patients by the LPN’s and failure to make patient information available to other healthcare professionals, that is, failing to communicate with the house supervisor and with the physicians. Leahy vs. North Carolina Board of Nursing, 488 S.E. 2d 245 (N.C., 1997).