For any nurse, finding out that you are under investigation by the BRN is a terrifying experience. Your RN license is what enables you to work, but for nurse practitioners, your NP certification is so much more! Being a nurse practitioner is not just a career, it is who you are and what defines you. Having your NP certification and RN license jeopardized in any way can have true life-altering consequences for you.
WHAT TRIGGERS A BRN INVESTIGATION?
The only thing that will ever cause you to be under investigation by the BRN is having a complaint filed against you. This can happen for a number of reasons:
- Your employer files a complaint. These occur most frequently as a result of being disciplined or terminated by your employer for charting errors, medication discrepancies or suspicion of diversion of medication. Your employer will also file a complaint about patient care issues, or violating company protocol or procedures.
- A co-worker or colleague files a complaint. Sometimes a co-worker may report you to the BRN. Typically, these complaints occur for the same reasons that an employer would file a complaint, but we have seen co-worker complaints if the colleague suspects you are working impaired or for having mental health issues that are keeping you from practicing safely. Occasionally, a coworker may file a complaint to be malicious or to try to get you fired.
- A vindictive ex-spouse or partner or family member complains. A few times a year, I receive calls from nurse practitioners who have had a complaint reported to the BRN by an ex who is trying to ruin their lives. I’ve seen it during divorces as a weapon in custody battles. I’ve seen it following a divorce as just pure malicious meanness. Usually, these complaints have little or no merit, but that doesn’t mean the BRN won’t investigate.
- A patient or patient’s family member files a complaint. Patients or their families will make a complaint about any number of reasons, sometimes as a precursor to a malpractice claim, sometimes because they are upset about the level of care they received from the hospital and you get blamed because you are the person they saw the most of.
- A criminal conviction or arrest. When you are arrested, you are typically fingerprinted and because you are an NP, you have been Livescan fingerprinted. This means that when you are fingerprinted at the arrest, the arresting agency notifies the Department of Justice (DOJ) and the DOJ immediately notifies the BRN.
HOW DO I KNOW IF I AM UNDER INVESTIGATION BY THE BRN?
Once the BRN receives a complaint, they must investigate it. Every single complaint made to the BRN will be reviewed. A complaint involving drugs or alcohol or mental health will be referred to the Diversion or Intervention program first. The Diversion program moves quickly and they will contact you within a few weeks of the arrest or complaint and offer you the diversion program. They may contact you by phone, letter or even email. Please read more on the Diversion program elsewhere on the blog. If you decline the Diversion program, your case will be assigned to an investigator.
The investigator will get to it about 4-6 months after receiving the complaint because they have 100 other cases before yours. The BRN investigator may review and quickly dismiss the complaint if they can determine it is meritless on its face, and you may never even know you were ever under investigation at all. More likely, the BRN investigator will review the complaint and want to speak to you regarding it. They will contact you via letter or phone and ask you to meet in person for an interview and to sign a release for authorization of your records. If the investigation has progressed to the point that the BRN is contacting you, that means they have already reviewed your complaint, looked into the allegations and determined that there may be a violation of the Nurse Practice Act.
WHAT SHOULD I DO IF I AM UNDER INVESTIGATED BY THE BRN?
If you have received a phone call or a letter notifying you that you are under investigation, the absolute worst thing you can possibly do is begin talking to the investigator. The second, or equally damaging thing you can do, is sign the authorization for release of records. It is critical that you understand that your NP certification and license are on the line. There has been a complaint filed against you alleging a violation of the nurse practice act (NPA) and the BRN has already decided that you may be guilty of the complaint. At this point, you know very little to nothing about the complaint itself. The investigator knows all of the details. They have all the charts, all the files, the police report, the arrest report, the statement from co-workers, the affidavit from the hospital… and they have you on the line. THE ONLY REASON THEY ARE CONTACTING YOU IS TO GET YOU TO ADMIT TO MAKING A MISTAKE! They may sound like the nicest person on the planet and will lead you to believe that they are trying to help you. They are NOT there to help you at all. The investigator works for the BRN and it is their job to find you guilty of a mistake.
Please do NOT do their job for them by admitting to anything or signing anything!
If you discover you are being investigated by the BRN, you need to know what your rights are. You need to find out what the complaint entails. You need to determine if it is in your best interest to meet with the investigator. You need to know if the allegation could land you in trouble criminally. You need to know what “records” you are agreeing to have released. If you value your NP certification and your career, you very likely need an attorney at this stage.
CAN’T I JUST IGNORE THE BRN INVESTIGATION?
Actually, in a few cases, you can! If the complaint is stemming from an arrest and you get contacted by an investigator, that investigator is jumping the gun. The BRN cannot discipline your license unless they have some sort of proof that you violated the NPA and in the situation of an arrest, they should allow the criminal process to run its course before they contact you. Remember that little phrase “innocent until proven guilty?” Right! Until you are convicted of a crime, you are still innocent and the BRN will not move to discipline you… unless of course you decide to spill the beans that you had been drinking, that you did get in argument with your spouse, that you did drive on your prescription meds, etc. Until the criminal process is finalized, the only person who can close the BRN investigation is you by admitting guilt to an investigator… who is trying to get you to do exactly that.
In most cases, you cannot ignore an investigation. Even in the arrest case I just mentioned, you still have to acknowledge the investigator and provide a reason why you are declining to give a statement. In fact, failure to comply with a BRN investigation is considered Unprofessional Conduct, and you guessed it, that all by itself is a violation of the NPA and cause for disciplinary action against your license.
Let’s get really real for a minute. Let’s say you know flat out that you diverted, or made a number of charting errors or deviated from the standard of care. Let’s say you unequivocally know you blew it and you know that you do not want to meet with the investigator or sign anything. Even then, you cannot decline participation in the interview without Good Cause. Good Cause is a legal term of art, it does not mean, as most people believe “a good reason.” You need an attorney to provide Good Cause why you are declining the interview, and you can’t very well provide your own, now can you? You can’t say “I decline to participate in the interview because I will incriminate myself by doing so.”
WHAT HAPPENS AT THE BRN INVESTIGATION INTERVIEW?
If you and your attorney determine that it is in your best interest to participate in the interview (to be honest, most of the time it IS NOT!) You will schedule a time and location to meet with the investigator. For an in-depth look at the interview process, click here.
WHAT HAPPENS AFTER THE BRN INVESTIGATION IS OVER?
There are only 3 outcomes following a BRN investigation:
- The investigator closes the case without merit. This means that the investigator has looked into the complaint, talked to witnesses, looked over charts, met with you and determined there is nothing there. There is no violation of the NPA at all. The case is closed. Here’s the clincher though… and this is so frustrating… they usually DON’T TELL YOU THE CASE IS DROPPED! That’s right, you get to stay in stressful limbo for the next year or so, checking your mail like a crazy person for a letter that will never come. Know that if you don’t hear from the BRN for about 18 months following an investigation, you are probably in the clear.
- The complaint has merit and an Accusation is filed against your NP certification. When the investigation concludes, the case is referred to the BRN’s attorney to build the case against you. The case that they establish is called an Accusation and it will be served to you, just like any formal court document. The Accusation will establish the proof of the violation of the NPA and will call for revocation or suspension of your nurse practitioner license. For more on Accusations, click here.
- The Complaint has merit but is not a gross violation of the NPA. If this is the case, the BRN may issue a Citation and Fine in lieu of filing an Accusation. A citation and fine from the BRN is like a traffic ticket against your NP license. It is not formal discipline, it will not show up attached to your license on the Breeze system and you do not have to report it or disclose it to your employer. In short, it’s a great deal if you can get it.
Obviously, your goal in having investigation representation is to avoid having an Accusation filed against your NP license/certification because Accusations all by themselves are problematic. They are public record, they never go away, they making finding new employment more difficult, at the very least, they are embarrassing. However, sometimes an Accusation is unavoidable and in these cases, it might be even more important to have proper representation at the investigation stage. The investigation is the only point in the BRN disciplinary process where you have a chance of influencing the final outcome of an Accusation and having an attorney represent you, who has handled hundreds of cases like yours, ensures that the final outcome will be better for you, not worse.
If you are a nurse practitioner under investigation by the BRN, please give me a call. I will confidentially listen to the details of your specific situation, give you an idea of exactly what you can expect moving forward and offer you a way to defend yourself and your NP certification as well as your RN license for an affordable, flat fee.
Don’t hesitate! Get yourself legal protection that will help save your nursing license. Contact RN Guardian today or call us at (800) 506-9766 to speak with legal a nurse attorney.