17 Reasons to Report a Nurse to the Board of Nursing

Can you file a complaint against a nurse? If you witness unsafe or unethical behavior from a nursing professional, you can take action by making a report to your state board of nursing (BON). But filing a report is a serious decision that requires careful consideration, and it’s not always the first course of action. How can you know whether a situation requires a BON report? Here are some of the top reasons to report a nurse to the board of nursing in your state.

Nurses have a duty to provide safe care. If a nursing professional exhibits poor behavior, there are a few ways they can be reported and disciplined if necessary. Disciplinary action in nursing may come from a range of organizations:

• The employing healthcare facility, which can impose penalties like suspension or termination. Depending on the infraction, facilities may or may not report poor behavior to the state nursing board.
• Professional organizations that grant specialty or advanced practice certifications may also investigate misconduct and revoke credentials.
• State boards of nursing are responsible for handling reports related to violations of nursing practice laws, which could result in fines, probation, license suspension, or revocation.
• Legal authorities may become involved if criminal behavior is suspected, such as drug diversion or abuse.

Reporting a nurse to your state board isn’t always the first course of action. Taking an issue up the nursing chain of command may be enough, and many facilities have an internal review board to make this decision.

On the other hand, mandatory reporting laws mean that certain behaviors must be reported, but not necessarily to the BON. If you witness abuse of vulnerable populations or become aware of certain infectious diseases, in many cases you’ll need to report these incidents to local or state authorities, and sometimes the board of nursing as well. Refer to your facility’s mandatory reporting training and your state’s laws for more information.

17 Reasons to Report a Nurse to the Board of Nursing

1. Patient Neglect

If a nurse fails to provide necessary care, either through inaction or carelessness, this can harm a patient. Neglect could include ignoring medical or personal needs, leading to physical and emotional distress.

Examples of patient neglect include:

• Failing to reposition a bedridden patient, resulting in pressure sores or ulcers.
• Not following hygiene protocols, such as delaying cleaning patients up after they’ve soiled themselves.
• Missing assessments, vitals checks, or lab draws.

2. Medication Errors

A medication error happens when a nurse administers the wrong drug, dose, or route, potentially endangering the patient’s health. These errors may result from distractions, misunderstandings, miscommunication, or willful errors.

Examples of medication errors include:

• Scanning in a medication for one patient and giving it to someone else.
• Giving the wrong dose of a medication, such as administering 10mLs of insulin when 10 units are ordered.
• Administering medications via the wrong route, for example giving an oral dissolved medication through a PICC line.

3. Substance Abuse

If a nurse is misusing drugs or alcohol, patients may be put in danger. Reporting substance abuse is crucial for patient safety and provides an opportunity for the nurse to receive help through recovery programs.

Examples of potential substance abuse include:

• Showing up to work intoxicated or under the influence.
• Withdrawal symptoms at work, such as shaking and sweating.
• Failing to comply with treatment programs that result from disciplinary action.

4. Diversion of Narcotics and Other Medications

Diversion is the unlawful transfer of prescription medications for personal use or sale, and it’s a serious violation of nursing ethics and legal standards. When nurses divert narcotics and other controlled substances, they compromise foundational nursing principles like veracity and accountability.

Examples of potential medication diversion include:

• Requesting a witness to a dose that has already been wasted.
• Taking medications from a patient’s personal supplies under false pretenses, such as claiming they are being given to someone else.
• Administering saline or another substitute while telling the patient they are receiving their medication.

5. Falsifying Records

Falsifying records is a serious ethical violation that undermines the trust placed in nursing professionals and the healthcare system as a whole. Incorrect documentation can lead to mistaken treatments, incorrect diagnoses, and inappropriate care plans. Changing records after an event is one of the top ethical reasons to report a nurse to the board.

Examples of records falsification include:

• Altering vital signs, medication administration records, or care plans to misrepresent what actually occurred.
• Omitting critical information, such as a change in patient status or adverse reaction to treatment.
• Writing notes for interactions that never took place or fabricating assessments to cover up negligence.

6. Unprofessional Conduct and Boundary Violations

While nurses may provide an intimate level of care, they still have a duty to maintain professional boundaries and nursing conduct. Overstepping relationships and failing to act professionally can harm relationships with patients and other staff.

Examples of unprofessional conduct include:

• Using offensive language, engaging in verbal abuse, or disrespecting patients, families, or colleagues.
• Forming personal or inappropriate relationships with patients, including romantic involvement.
• Ignoring institutional protocols, such as not using personal protective equipment (PPE) or refusing to follow orders from supervisors.
• Bypassing safety procedures or ignoring alarms.

7. HIPAA Violations

A violation of HIPAA (Health Insurance Portability and Accountability Act) occurs when a nurse mishandles protected health information. These breaches compromise patient privacy and trust, resulting in severe legal and professional consequences.

Examples of HIPAA violations include:

• Viewing a patient’s medical records without a need to know.
• Discussing patient details with unauthorized individuals or on social media.
• Failing to safeguard devices that contain patient information, such as laptops or tablets.

8. Incompetence

Nurses must have the skills and knowledge to perform their role and keep patients safe. Incompetence puts patients lives and health at risk, and is one of the reasons to report a nurse to the board of nursing.

Examples of incompetence in nursing include:

• Failing to follow medication or administration protocols like blood administration orders.
• Improperly cleaning or dressing wounds, leading to infections.
• Failing to recognize changes in a patient’s condition that require intervention.

9. Violating Practice Scope

Practicing outside the nursing scope of practice involves performing tasks or making clinical decisions that are not authorized for the nurse’s role. This can endanger patient safety, erode the plan of care, and lead to harmful outcomes.

Examples of practice scope violations include:

• A CNA performing an incision and drainage on a patient.
• Prescribing or holding medications without a provider’s order.
• Educating a patient about a procedure or diagnosis that the nurse is not equipped to explain.

10. Abandonment

Abandonment in nursing occurs when a nurse leaves their assigned patients without proper notice or handoff. It’s considered a serious violation of duty, especially in situations where patients depend on continuous care.

Examples of abandonment include:

• Leaving mid-shift without notifying supervisors.
• Not giving a report or transitioning care to another nurse.
• Refusing an assignment after accepting it.
• Abandoning patients during a disaster without permission.

11. Failure to Report Abuse

Nurses are legally and ethically required to report suspected abuse, including child abuse, elder abuse, and abuse of developmentally impaired persons. Failing to report abuse allows harmful situations to perpetuate and puts vulnerable patients at risk. If you know a nurse is willfully not reporting abuse, you should report it to the state and report the nurse to the state board.

Examples of reporting failures include:

• Ignoring signs of malnutrition, poor hygiene, or lack of medical care.
• Not reporting unexplained bruises, burns, or fractures.
• Waiting too long to notify appropriate authorities, further endangering the patient.

12. Improper Delegation

Delegation is essential for efficiency and time management. Improper delegation can occur when nurses assign tasks to individuals who lack the necessary skills, training, or legal authority to perform them. Even if this doesn’t result in harm, it’s one of the reasons to report a nurse to the board of nursing.

Examples of improper delegation include:

• Assigning medication administration to an unlicensed assistant.
• Instructing a CNA to conduct patient assessments.
• Requesting that an RN place a central line on a patient.

13. Failure to Communicate

If a patient’s status changes, nurses have a duty to communicate this information to other members of the healthcare team and potentially the patient and their family. Failing to do so can lead to misunderstandings, errors, or delayed treatment. This is one of the most common reasons to report a nurse to the board.

Examples of failing to communicate include:

• Failing to provide handoff reports during shift changes.
• Not updating a physician about changes in patient status.
• Not reporting critical lab results in a timely manner.

14. Fraudulent Licensing

Operating under an expired or false nursing license is a criminal act. This misconduct can lead to legal consequences, disciplinary action by nursing boards, and potentially jail time. If you suspect someone is operating with a fraudulent license, alert your supervisor and the board as soon as possible.

Examples of license fraud include:

• Using a falsified nursing license to gain employment without proper qualifications.
• Misrepresenting educational achievements (e.g., claiming a nursing degree they never earned).
• Borrowing or using another nurse’s license number to pass licensure verification processes.

15. Criminal Convictions

Criminal convictions can have serious implications for a nurse’s ability to practice safely and ethically. If a nurse is convicted or accused of a crime, they have a duty to report it to the state board of nursing.

Examples of criminal convictions:

• DUI or DWI charges can lead to questions about nurses’ fitness to practice safely.
• Assault or violent crimes may prevent a nurse from obtaining or maintaining a license.
• Felony charges related to drug trafficking or possession can lead to automatic scrutiny from the nursing board.

16. Improper Use of Social Media

Nurses on social media represent the profession. Giving health or medical advice, revealing patient information, or acting unprofessionally can be valid reasons to report a nurse to the board.

Examples of social media misuse include:

• Posting identifiable patient information, even without names, violates HIPAA regulations and breaches patient confidentiality.
• Engaging in unprofessional interactions with patients or their families online.
• Sharing inappropriate comments or images related to work or patients.

17. Discrimination or Harassment

Patients and other clinicians have a right to be respected. Treating patients and staff disrespectfully based on their gender, race, sexual orientation, age, disability, looks, or other characteristics is discriminatory and a violation of nursing conduct.

Examples of discriminatory or harassing behavior include:

• Making derogatory remarks about a colleague’s or patient’s ethnicity, gender, or sexual orientation.
• Creating a workplace atmosphere that is intimidating or offensive through bullying or verbal abuse.
• Refusing to treat a patient because of their background or identity.

How to Report a Nurse to the Board of Nursing

Anyone — other nursing professionals, physicians, family members, patients, and administrators — can report a nurse to the state board. The process varies by state, but generally, if you visit the government website for the state nursing board, there will be a complaint form available. You can also call the state board of nursing to file your complaint verbally.

If you’re planning to report, prepare documentation about the specific incident you want the board to know about. This includes names, dates, locations, witnesses, and any other details. After submitting your complaint, you may want to follow up to ensure it’s being reviewed. But remember, unless the complaint is an acute emergency, the nursing board may take time to review it.

How to Report a Nurse Anonymously to the BON

According to the National Council of State Boards of Nursing (NCSBN), most boards keep the information of the complainant confidential. However, if the complaint is serious, you may be asked to be a witness either in criminal court or with the nursing board.

Reasons to Report a Nurse to the Board of Nursing: FAQs

What issues are not reportable to the board of nursing?

Not every example of poor behavior by nurses or care facilities is within your BON’s jurisdiction. For example, absent some impact on patient care, these types of issues aren’t managed by the nursing board:

• Impolite behavior or rudeness
• Complaints about dress or appearance
• Interpersonal conflicts
• Relationships between employees and employers
• Pay disputes
• Complaints against non-nursing professionals
• Labor issues

What are the most common reasons to report a nurse to the board?

According to the Nurse Professional Liability Exposure Claim Report — published by Nurses Service Organization and CNA Healthcare Underwriting — these are the most common claims against nurses:

• Failure to communicate pertinent information
• Failure to monitor
• Breaching scope of practice
• Falsifying or misrepresenting in documentation
• Medication administration issues
• Issues in treatment and care
• Assessment gaps or neglecting to assess
• Issues with patient rights, abuse, and professional misconduct

The most common reasons also depend on the state, since each state BON operates independently. Remember, not every claim against a nurse results in action or loss of license.

Seeking a Role in a New Facility?

Now that you’ve learned more about the reasons to report a nurse to the board, you might be curious about new roles for nursing professionals like yourself. IntelyCare puts the power in your hands by sending you the latest nursing opportunities straight to your inbox.

Legal Disclaimer: This article contains general legal information, but it is not intended to constitute professional legal advice for any particular situation and should not be relied on as professional legal advice. Any references to the law may not be current, as laws regularly change through updates in legislation, regulation, and case law at the federal and state level. Nothing in this article should be interpreted as creating an attorney-client relationship. If you have legal questions, you should seek the advice of an attorney licensed to practice in your jurisdiction.