Nurse Practice Act: 3 Key Aspects

Review your State’s nurse practice act, reflect on legal mandates presented and why these are important as a practitioner as well as a consumer
Discipline/Compliance – Grounds for discipline, incompetence, misconduct, continued neglect of duties
Denial, suspension, or revocation of license 
What is the nurse practice act and what does it do?

What is an important aspect of the act that affects interaction with patients/clients?
What are legal constraints when caring for patients? Use the link: https://govt.westlaw.com/mdc/Browse/Home/Maryland/MarylandCodeCourtRules?guid=N1D93D6109B6D11DB9BCF9DAC28345A2A&originationContext=documenttoc&transitionType=Default&contextData=(sc.Default)

Maryland Nurse Practice Act

The nursing profession is generally open to extensive risks of harm. This is especially true considering that the practice calls for specialized skill, knowledge, and independent decision-making. The nurses work in a constantly changing environment and a society that is asymmetrical for consumers thereby making the risks of harm even more pronounced.

As such, nurse competency is paramount for safe service delivery to the public. Most states have put measures in place to ensure that their citizens are safe from incompetent and unprepared nursing professionals.

In the state of Maryland, laws have been enacted to oversee the safe practice of nursing thereby protecting the health and welfare of the public. The guiding principles of the laws include public protection, practitioner competence, ethical decision-making, strategic collaboration, shared accountability, and evidence-based regulation.

The Nurse Practice Act and Discipline/Compliance

Disciplining occurs whenever a nurse violates the nurse practice act. An action is taken after the nursing board conducts its research and finds sufficient information implicating a nurse in the violation of the act or regulations.

Some of the punishable violations include obtaining or attempting to obtain a license deceptively or fraudulently and using a license fraudulently or deceptively. The act also prohibits the provision of professional services when one is under the influence of alcohol or is using any narcotic or controlled dangerous substance.

All actions which amount to misconduct are listed in Section 8-316 of the act. The actions are punishable through license denial, suspension, or revocation. After a complaint is filed against a nurse, and before the board takes any action, that specific nurse has a right to a hearing as specified in section 8-317.

Other prohibited acts which can amount to disciplinary action are outlined in Subtitle 7 of the Maryland Health Occupation Annotated Code. Some of the violations include practicing without a license, representing oneself to the public without authorization, selling or fraudulently obtaining nursing-related documents, obtaining records, licenses, or diplomas fraudulently, and knowingly employing an unlicensed person.

Violation of any section of this subtitle can warrant for the issuance of a public cease and desist order; the imposing of a civil fine not exceeding $20,000 per offense, or both. A violation of these provisions amounts to a misdemeanor and conviction can attract a jail term not exceeding 5 years. All these punishments are subject to appropriate hearings and appeals provisions.

The Nurse Practice Act and Licensing

Before practicing nursing in the State of Maryland, one must be licensed by the Maryland Board of Nursing. To qualify for a license, one must submit a criminal history records check. Section 8-302 of the Annotated Code of Maryland outlines the qualification requirements for licensing as a registered nurse, an advanced practice nurse, and a licensed practical nurse.

A license is issued after one passes the licensure examination and proves proficiency in the English language. The examination can be waivered if a person has a license from another country or state but upon the review of the board. Sections 8-310 and 8-311 of the Act outline the authorized activities for a registered nurse license and licensed practical nurse license respectively.

Subsection (a) of Section 8-316 of the act outlines the grounds for license denial, suspension, or revocation. The subsection has 37 provisions that can warrant the denial of a license, or issuance of a license that is subject to reprimand probation, or suspension. Some of the actions which can lead to such punishments include using a license deceptively or fraudulently, gross negligence, submitting inaccurate information to collect a fee, failing to report suspected child abuse, habitual intoxication, physical or mental incompetence, professional incompetence, violation of board regulations, and patient’s property or facility misappropriation.

The board can also impose a penalty not exceeding $5,000 instead of or in addition to revocation or suspension of the license, reprimanding of the violator, or placing them on probation. If a nurse is not happy with the board’s decision, they can apply for a judicial review as outlined in section 8-318.

Subsection (a) of Section 8-319 outlines the grounds under which a revoked or suspended license can be reinstated. For reinstatement, 1 year must have passed since the license was surrendered. The board can either reinstate the license, reinstate it subject to terms and conditions, or deny the reinstatement.

The Nurse Practice Act and Patients Interaction

An important aspect of the act that affects interaction with patients is licensure requirements. When offering services to the public, a nurse must offer them according to the license they have. This means that a nurse can be restricted by their license. Licensing is also required for other nursing-related professions such as electrology, nursing assistants, medication technicians, medication aides, and direct-entry midwives.

Unless a person is certified by the board to undertake those roles, they cannot take any action related to them. This can be limiting when a person has the skill and a patient is in need, but lack a license to do so. However, this aspect of the act is important since it prevents nurses from performing actions that are beyond their license and skills.

Interaction with the public is also affected by Section 8-307. Subsection (a) of the section deters one from representing to the public as if they are authorized to practice in the state unless they are. Unless authorized, one cannot represent themselves to the public as a registered nurse, a certified nursing assistant, a licensed practical nurse, a medication technician, or a medication aide.

The Nurse Practice Act and Legal Constraints

Legal issues in the nursing practice are usually with respect to licensure, state and federal laws, as well as the scope of practice. In Maryland, the scope of practice and licensure are addressed in the Nurse Practice Act. A nurse is usually expected to practice as per their license, education, and professional standards.

Exposure to litigation occurs when a nurse’s performance is below the acceptable standards of care and competence. Legal implications can be warranted by gross negligence, malpractice, and professional negligence. The legal implications are usually in addition to license review by the state’s licensing board. Section 8-710 outlines the fines and penalties which a nurse is subject to if they perform below the acceptable standards of care and competence as outlined in Sections 8-701, 8-703, 8-704, and 8-705.

State laws that pose legal constraints while caring for patients include the Family Law Article and the Criminal Law Article. According to the Family Law Article, Section 5-704, a nurse can be subject to litigation for consciously refusing to report suspected child abuse.

Litigation can also be as a result of addiction or habitual use of narcotic or controlled dangerous substances as outlined in the Criminal Law Article Section 5-101. Legal constraints from the Federal government arise from acts such as the Health Insurance Portability and Accountability Act (1996), the Privacy Act (1974), and the Health Care Quality Improvement Act (1986).

Reference

Maryland Nurse Practice Act 2017. Retrieved from https://govt.westlaw.com/mdc/Browse/Home/Maryland/MarylandCodeCourtRules?guid=N1D93D6109B6D11DB9BCF9DAC28345A2A&originationContext=documenttoc&transitionType=Default&contextData=(sc.Default)

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