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retaining her or his license. These programs are designed to refer nurses for evaluation and treatment, monitor the nurse’s compliance with treatment and recovery recommendations, monitor abstinence from drug or alcohol use, and monitor their practice upon return to work. Alternative programs work to return nurses to practice while protecting the public. Various models of alternative programs exist, and their use varies among BONs. Some programs provide services via the BON, a contracting agency, a special committee of the BON, or a peer-assistance program of a professional association or a peer-assistance employee program (NCSBN, 2012f). For all other grounds, the final decision reached by the BON is based on the findings of an investigation and the results of the complaint process. The language used to describe the types of actions available to BONs varies according to state statute. Although terminology may differ, board action affects the nurse’s licensure status and ability to practice nursing in the state taking action. BON actions may include the following: ⦁ Fine or civil penalty ⦁ Referral to an alternative-to-discipline program for practice monitoring and recovery support for those with drug- or alcohol-dependence or some other mental or physical condition ⦁ Public reprimand or censure for minor violation of the NPA, often with no restrictions on license ⦁ Imposition of requirements for monitoring, remediation, education, or other provision tailored to the particular situation ⦁ Limitation or restriction of one or more aspects of practice, such as probation with limits on role, setting, activities, or hours worked ⦁ Separation from practice for a period of time (suspension) or loss of license (revocation or voluntary surrender) ⦁ Other state-specific remedies (NCSBN, 2012g). BON actions are considered public information, and many BONs have determined that it is in the public interest to publicize their actions against nurses’ licenses and actions that reinstate licenses. BONs use a variety of methods to communicate this information, including newsletters and websites. Also, federal law requires that adverse actions taken against a health care professional’s license be reported to federal databanks. The National Practitioner Data Bank and Healthcare Integrity and Protection Data Bank are two federal databanks created to serve as repositories of information about health care providers in the United States (NCSBN, 2012h). Being Informed About Your NPA Ignorance of the law is never an excuse! The NPA is not something one can study in a prelicensure nursing education program and then put aside. The act is a dynamic document that evolves Figure 1 Board of Nursing Complaint Process Filing a complaint Initial review of complaint Investigation Board proceedings Board actions Reporting and enforcement 40 Journal of Nursing Regulation and is updated or amended as changes in scope of practice occur. “Inherent in our current healthcare system are changes which relate to demographic changes (such as the aging of the “baby boomers”); advances in technology; decreasing healthcare dollars; advances in evidence-based healthcare procedures, practices and techniques; and many other societal and environmental factors” (NCSBN, 2012i). Your state BON is a resource for the NPA. Links to NPAs are available on most state BON websites. Some BONs attempt to provide new information to nurses via their website or newsletter (Tedford, 2011). For example, the Virginia BON posts a list of frequently asked questions to help nurses navigate the various aspects of licensure and posts announcements regarding practice or licensing changes on their homepage (Satterlund, 2012). The practice of nursing is a right granted by a state to protect those who need nursing care. The guidelines of the NPA and its rules provide safe parameters within which to work and protect patients from unprofessional and unsafe nursing practice (Brent, 2012, p. 5). More than 100 years ago, state governments established BONs to protect the public’s health and welfare by overseeing and ensuring the safe practice of nursing. Today, BONs continue their duty, but the law cannot function as a guide to action if almost no one knows about it. “politics in nursing and health care (6th ed.). St. Louis, MO: Saunders. Satterlund, M. (2012). Staying up-to-date on changing requirements. Virginia Nurses Today. Retrieved from ded%5CNewsletterFiles%5CVA2_12.pdf Tedford, S. A. (2011, October). When was the last time you read the nurse practice act? ASHN Update. Retrieved from democratprinting.com/publication/index.php?i=83957&m=&l=& p=4&pre=&ver=swf UNC TV. (2012). North Carolina Nurses: A century of caring. Retrieved from dnow.html Kathleen A. Russell, JD, MN, RN, is Associate, Nursing Regulation, National Council of State Boards of Nursing, Chicago, Illinois. Volume 3/Issue 3 October 2012 www.journalofnursingregulation.com 41 Nurse Practice Acts Guide and Govern Nursing Practice Learning Objectives ⦁ Recall the history of nurse practice acts (NPAs). ⦁ Describe the eight elements of an NPA. ⦁ Discuss disciplinary action, including grounds and possible actions. The authors and planners of this CE activity have disclosed no financial relationships with any commercial companies pertaining to this activity. Ce CE Posttest Nurse Practice Acts Guide and
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