On August 1, 2014, the Department of Safety and Professional Services enacted several changes to the regulations which govern licensing and Rules of Conduct for Wisconsin nurses. One of the most dramatic changes was the repeal of Wisconsin Administrative Code Sections N 7.03 and N 7.04, which had set forth the definitions of “negligence” and “misconduct or unprofessional conduct” for nurses. The topic areas of both prior sections were seemingly combined into the new Wis. Admin. Code Section N 7.03 which now covers the grounds for denying renewal and disciplinary actions against licensed nurses by the Board of Nursing.
Comparing the Old and New Nursing Rules of Conduct
Under the old Rules of Conduct for nurses, “negligence” was defined to include acts such as:
- Violating the nursing standards of practice;
- Failing to observe the conditions, signs and symptoms, of a patient;
- Executing an order which the licensee knew or should have known would harm the patient; and
- Performing services as a nurse for which the nurse was not qualified,
in addition to other actions.[i] Similarly, “misconduct” was formerly defined as “any practice or behavior which violates the minimum standards of the profession necessary for the protection of the health, safety, or welfare of a patient or the public.” The Board of Nursing also provided several specific examples of what actions fell with that definition, such as:
- Abusing a patient by any single or repeated act of force;
- Falsifying or inappropriately altering patient records; or
- Impersonating another licensee.[ii]
By contrast, the new Rules of Conduct for Wisconsin nurses are drafted to explicitly set forth a wide variety of reasons that could lead to a nurse’s discipline or denying the renewal of a nurse’s license. Eight separate subsections are included in the new Rules of Conduct that can lead to the Board of Nursing’s discipline or denial of license renewal, including:
- Noncompliance with federal, jurisdictional, or reporting requirements;
- Violating or aiding and abetting a violation of any law substantially related to the practice of nursing or being convicted of any crime substantially related to the practice of nursing;
- Confidentiality, patient privacy, consent, or disclosure violations;
- Misconduct or abuse;
- Fraud, deception or misrepresentation;
- Unsafe practice or substandard care;
- Improper supervision or allowing unlicensed practice; and
- Improper prescribing, dispensing, or administrating medication or drug related offenses.[iii]
In addition, each of these eight subsections includes specific examples of the types of acts which would justify discipline under it. As examples, “[m]aking statements or disclosures that create a risk of compromising a patient’s privacy…” is included as a form of Confidentiality, patient privacy, consent, or disclosure violations while “[i]nadequate or improper infection control practices” falls under Unsafe practice or substandard care violations.[iv]
The Result of Changes to the Wisconsin Nursing Rules of Conduct
It remains to be seen what effect such sweeping changes to the Rules of Conduct will have on nurses in disciplinary proceedings before the Board of Nursing.
On the one hand, it appears the Board of Nursing has attempted to provide a more exhaustive list of actions that violate Wisconsin’s nursing Rules of Conduct. As a result, nurses may be able to gain a better understanding of their duties as licensed nurses and what they need to do in order to ensure they do not jeopardize their licenses in performing those duties.
On the other hand, the newly enacted Rules of Conduct are still incredibly broad and leave room for interpretation. From the example above, it is not hard to imagine most nurses run the risk of “[m]aking statements or disclosures that create a risk of compromising a patient’s privacy” in the course of performing their daily duties.[v]
However these changes play out in practice, nurses should be aware of these changes and the practical effect they may have on the manner in which they perform their duties. If you are a nurse facing possible disciplinary action before the Board of Nursing and would like to talk to an attorney about your rights, please contact one of Hawks Quindel’s employment attorneys as soon as possible.
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