Can a Nurse Practitioner Discharge a Patient After a Board Complaint?
Nurse Practitioners (NPs) frequently face complex questions when a complaint is filed with the North Carolina Board of Nursing (NCBON). If you're an NP dealing with a board complaint, knowing how and when you can discharge a patient is critical for safeguarding both your practice and your license. The process is governed by clear rules from both the NC Nursing Board and NC Medical Board, as nurse practitioner discipline in North Carolina falls under the jurisdiction of both through a Joint Sub-Committee.
Board Guidance for Patient Discharge
Both boards provide guidance on the nurse-patient relationship and patient dismissal. NPs should familiarize themselves with the Board’s official position statements. However, as a summary:
Written Notice: Always provide a written notice to the patient detailing the reason for discharge, the date of termination, an offer to continue care for at least 30 days following the termination, and assistance in finding a new provider.
30-Day Care Term: During the 30-day notice period, the NP should be prepared to provide necessary care—including prescription refills, diagnostic testing, and urgent specialty referrals.
Support During Transition: Although not required, the Board recommends giving the discharged patient a list of local providers currently accepting new patients to ensure continuity of care.
Avoiding Allegations of Retaliatory Dismissal
Discharging a patient after a board complaint can create a perception of retaliation. The board's position statements do not prohibit patient dismissal following a complaint, but any such action will be closely scrutinized—potentially during a formal hearing. The best defense against claims of retaliatory discharge is having a robust, consistently applied written policy in place.
Proactive Policy Creation: Develop discharge policies well before any complaint arises. Clear guidelines help set patient expectations and offer legal protection if the discharge is later challenged by the board.
Documentation: Ensure every attempted contact and any updates regarding the patient's status are carefully logged in the medical record. Proper documentation supports your actions if called into question.
What Makes an Effective Patient Discharge Policy?
A comprehensive discharge policy should include:
Behavioral and Compliance Expectations: List the types of patient conduct or circumstances that may lead to termination. Put these in writing at the start of care.
Communication Protocols: Outline the process for patient contact, missed appointments, and follow-ups.
Customized for Your Practice: Tailor policies according to the population served—chronic pain, controlled substances management, pediatrics, etc..
Consult with a nursing license defense attorney for guidance on establishing policies that align with board requirements and your practice’s needs. Working proactively ensures both regulatory compliance and strong legal defense if a board complaint and patient discharge coincide.
Navigating Board Scrutiny During Patient Dismissal
Patient dismissal—especially in the context of a pending board complaint—requires nurse practitioners to demonstrate adherence not only to clinical standards but also to ethical and legal expectations set by both the North Carolina Board of Nursing and Medical Board. Board investigators are particularly attentive to whether a termination decision is justified, clearly communicated, and fully documented. Even the appearance of retaliation or abandonment can complicate a practitioner’s defense and jeopardize licensure.
The risk of a secondary allegation, such as patient abandonment, often rises if the NP fails to provide continuous care, adequate notification, or sufficient opportunities for the patient to find alternative providers. Practitioners should recognize that the board may request specific evidence of the steps taken before dismissal, making careful recordkeeping and a standardized process essential.
Mitigating Legal Risk Through Proactive Practice Policies
Creating and implementing robust patient discharge policies before a complaint emerges is a key strategy for nurse practitioners. Such policies should not only comply with board position statements, but also protect the provider in cases of legal scrutiny. When a discharge is necessary, reference to these established policies helps demonstrate good faith and consistency rather than retaliation.
Best practices include documenting the circumstances leading to dismissal, all communications with the patient, and any resources or referrals provided. Maintaining this documentation, and referencing standardized policies, serves as critical evidence during investigations and can substantially strengthen a nurse practitioner’s defense against both board and civil complaints.
Collaboration With A License Defense Attorney
Nurse practitioners navigating board complaints and patient dismissals should regularly consult with a professional license defense attorney. Legal counsel offers essential guidance on compliance strategies, policy drafting, and risk management. Attorneys help practitioners anticipate board concerns, assemble necessary documentation, and prepare responses to board inquiries.
Early involvement by a nurse practitioner license defense attorney also ensures that patients’ rights are protected, reducing the risk of escalated disciplinary action or reputational harm. Ultimately, working with an attorney is one of the most effective ways for NPs to safeguard their practice, their nursing license, and their professional future during periods of heightened scrutiny.
Why You Need a Nurse Practitioner License Defense Attorney
Defending a complaint before the NCBON or NCMB is stressful, with both your reputation and career at stake. An experienced nursing license defense attorney or professional license defense attorney can:
Advise on compliance with board rules and best practices.
Help create effective written discharge policies.
Represent you if your actions regarding patient dismissal are challenged by the board.
Help develop your written response to the Board.
If you have received a board complaint, are planning to discharge a patient, or want help creating or updating your practice’s policies, contact Brooks Peterson PLLC through the online consultation form or call (919) 616-3317 to protect your career and license today.
This is not legal advice. If you do need legal representation call the office at: 919-616-3317