Facing State Board of Nursing (SBON) Complaints: Making Your Case and Mitigating your Risk

No nurse wants to contemplate being on the receiving end of any type of disciplinary action. However, any nurse—regardless of dedication and competence—could end up facing an SBON complaint and prudence dictates that you have in place a way to defend against an allegation should that occur.

As a nurse, you could be subject to a claim of malpractice, but also to a complaint filed with your state board of nursing (SBON). In that case, you’ll need to defend against the claim. In this article, we’ll look at how SBON complaints work and the steps you can take to mitigate the risk of such actions.

SBONs Are “Vital to Nursing”

As you know, an SBON governs nursing practice. The SBON’s primary edict is to protect the public and promote the progress of the profession, notes Georgia Reiner, senior risk specialist with Nurses Service Organization. The role is “vital to nursing,” she says.

SBONs ensure that licensed nurses practice safely, competently, and ethically, notes Reiner. And it is from this role that an SBON complaint can arise. The SBON can take multiple actions against a nurse, up to and including revoking the nurse’s license.

SBON Complaints versus Malpractice

Both malpractice claims and SBON complaints are aspects of your professional liability. However, in a malpractice lawsuit “the patient or plaintiff has to prove that negligence occurred, and there’s a pretty high legal bar that they have to clear in order to prove that,” says Reiner.

For an SBON complaint, allegations can be directly related to a nurse’s clinical responsibilities and the professional services that he or she offers, notes Reiner, but they can also be of a nonclinical nature, such as substance abuse, unprofessional behavior or billing fraud — “things that aren’t directly related to patient care,” Reiner says.

Complaints are on the Rise

When it comes to the type of SBON complaint a nurse might receive, professional conduct, scope of practice, and documentation error or omission account for 67 percent of all license protection closed matters, according to the Nurse Professional Liability Exposure Claim Report: 4^th Edition from CNA/NSO. This report uses a 2020 claim report dataset of license protection matters that closed between January 1, 2015 and December 31, 2019 that resulted in a defense expense/payment of at least one dollar.

The number of license protection matters, notes the report, has increased 22% from the 2011 claim report to the 2020 report. What’s more, the average cost ($5,330) of defending allegations against a nurse’s license increased 59 percent compared to the 2011 report. The 2020 report also finds that about 55 percent of license board matters led to some type of board action against a nurse’s license, similar to the 2011 and 2015 reports.

Get Help from an Attorney

The first notice you may receive about an SBON complaint is a letter, email, or call from the SBON. At that stage, “that’s when it’s critical that the nurse contact their professional liability insurer or an attorney before they respond or appear for any interview,” Reiner says. This helps ensure that your best interests are kept in mind and that you don’t inadvertently worsen the situation.

Mitigating Your Risk

Obviously, you’ll want to do all you can to avoid receiving an SBON complaint. To mitigate your risk, ensure that you’re practicing within the requirements of your state’s nurse practice act, says Reiner. In addition, make sure to comply with your employer’s policies and procedures and to practice within the standard of care.

If any of those requirements or policies differ, “the nurse is responsible for ensuring that they comply with the most stringent of those applicable regulations or policies,” Reiner says. If you’re ensure, you could contact the state board of nursing, a specialty professional nursing association, or your organization’s risk manager or legal counsel.

“Beyond that, we always say documentation is the best defense, not only in malpractice cases, but in state licensing matters as well,” Reiner says. That can include patient care assessments, observations, communication with other care providers, and actions taken.

“It’s also great practice to maintain files that can be helpful with respect to the nurse’s character,” Reiner says. Those could include copies of letters of recommendation, performance evaluations, thank you notes from patients, records of volunteer work, and continuing education certificates. “All of those are great records to keep on hand in the event that the nurse is involved in some type of licensing board action, because those can speak to the nurse’s character and competence, and can make a difference when it comes to the board deciding whether or not to impose disciplinary action.”