Changes to the BON’s Rules on Unprofessional Conduct after Sunset Review

This is the fourth part in an ongoing series in which we review some of the changes to Board of Nursing (BON) rules after its recent Sunset review. On December 8, 2017, the Board of Nursing proposed changes to Rule §217.12 regarding Unprofessional Conduct. These rules became effective on February 25, 2018. Like its review of the BON’s Good Professional Character and Criminal History Licensure rules, the Sunset Commission found that the statutory provision in the Nursing Practice Act (NPA) related to unprofessional conduct and the associated Board rule defining the term included broad and subjective language that extended the Board’s reach beyond the practice of nursing. The BON described its own actions by saying it “eliminated tenuous connections and subjective language and requirements not specifically related to the practice of nursing from the rule.”

For example, in the purpose of the rule, the rule no longer states that “unprofessional or dishonorable” behaviors are targeted, but instead states that behaviors “in the practice of nursing” are under consideration. See the below excerpt, with the added language underlined:

The purpose of these rules is to identify [unprofessional or dishonorable] behaviors in the practice of nursing [of a nurse] which [the board believes] are likely to deceive, defraud, or injure clients or the public.

Likewise, subsection (2) ties unprofessional conduct to specific standards “required by federal or state law or regulation or by facility policy,” rather than the more vague “appropriate and recognized” standards.

(2) Failure of a chief administrative nurse to follow [appropriate and recognized] standards and guidelines required by federal or state law or regulation or by facility policy in providing oversight of the nursing organization and nursing services for which the nurse is administratively responsible.

Unlike the other recent rule changes, the BON also expanded the scope of the Unprofessional Conduct rules in subsections (1)(B) and (4) by removing the requirement that such conduct be “careless or repetitive” on the belief that unprofessional conduct may be dangerous without being either “careless or repetitive”:

(1)(B) Failing [Carelessly or repeatedly failing] to conform to generally accepted nursing standards in applicable practice settings;

(4) Conduct [Careless or repetitive conduct] that may endanger a client’s life, health, or safety. [Actual injury to a client need not be established.]

If you would like to read more about these rule changes, you can find more information at the Sunset website.