BON Investigations: What Every Nurse Needs to Know (And How to Handle False Complaints)

The Unthinkable: A Letter from the BON

It’s every nurse's worst nightmare: a letter from the Board of Nursing (BON). It arrives unexpectedly, and with it, a flood of thoughts—will I lose my license? How will this affect my career? What if these accusations are completely false? The fear, frustration, and confusion are real, but there’s a silver lining: you can navigate this process and come out stronger, with the right help.

As Advocate Maggie, I’ve helped many nurses who are under investigation by the BON or dealing with false complaints. I may not have personally experienced what it’s like to be investigated, but I have firsthand experience with the process. Before becoming an advocate for nurses, I worked as a prior investigator for a Board of Nursing, which means I understand the process inside and out. I’ve seen firsthand how these investigations unfold. I’ve guided nurses through the maze of procedures and provided them with crucial knowledge to protect their careers.

What Exactly is the Board of Nursing (BON)?

The Board of Nursing (BON) is a state-level governing agency responsible for overseeing the licensure and practice of nursing in that state. They are the authority that ensures nurses are competent and practicing safely. The BON is empowered to enforce regulations, investigate complaints, and take disciplinary actions, which could include probation, suspension, or revocation of a nursing license.

Here’s an important point to understand: Boards of Nursing are not always made up of nurses. Often, non-nursing staff and administrative personnel are involved in these investigations. While they are tasked with upholding public safety, they may not always understand the intricacies of nursing practice. This is why it’s vital to have legal counsel—to ensure that you are represented fairly, even more so if a complaint is unfounded.

"I know from experience that many investigations fail to fully consider the reality of nursing practice. When you're facing an accusation, you need someone who can explain your side of the story, not just rely on the facts presented to the BON." — Advocate Maggie

What Can Trigger a BON Investigation?

The triggers for BON complaints might surprise you. Some of the most common include:

• Patient Complaints: Even a bad outcome unrelated to your care can lead to a report.
• Coworker Allegations: Workplace drama can escalate into official complaints.
• Personal Issues: Vindictive exes, custody battles, or neighbor disputes can spark investigations.
• Random Audits: Documentation reviews can unearth errors or raise questions.

Yes, They Can Go Back Decades
That medication error from your first year of practice? Technically, it’s still fair game. Complaints don’t have a statute of limitations when it comes to your professional license.

What If the Complaint Is False?

Let’s be clear: false allegations happen. The BON investigates every complaint to determine its validity, which means you may have to spend time, money, and emotional energy proving your innocence.

This is why professional liability insurance is critical. Policies like those offered through NSO can cover your legal fees, allowing you to focus on protecting your license without the added financial burden.

Did you know nearly half of all BON investigations are triggered by employer reports? It’s true—this can happen to even the most diligent nurses. Employers are often required to report certain incidents to the BON, and nursing leadership may have no choice but to comply.

An investigation by the BON typically begins when a complaint is filed, which could stem from an employer, patient, coworker, or even a member of the public. Anyone can file a complaint, and it's important to remember that the mission of the BON is to protect the public—not the nurse. A hard reality, but one you need to understand.

The Investigation Process: What Happens Next?

“Did you know that nearly half of BON investigations are triggered by employer reports? This can happen to any nurse, even those with the most impeccable work history. Employers are often required to report certain incidents to the board, even if they don’t want to. Sometimes, they’re left with no choice but to comply.”

• Real Example – California: One of the most alarming cases I encountered involved a nurse in California. After a medication error on a busy night shift, the nurse was reported to the BON by their employer. Despite being a seasoned professional, the nurse was thrown into a complex investigation that lasted nearly a year. The nurse was required to undergo several hearings, submit multiple written reports, and take additional education courses on medication administration. In the end, they avoided a suspension, but the financial and emotional toll was significant. Without professional liability insurance, the nurse would have had to cover all legal fees out-of-pocket—expenses that can easily exceed $20,000.

An investigation by a governing body, such as the BON, usually begins when a complaint is filed. This complaint could come from an employer, patient, coworker, or even a member of the public. Anyone can file a complaint. The mission of the BON is to protect the public, not the nurse—a hard truth that many nurses learn when they face a complaint.

Key steps include:

• Notification of Investigation: The BON will reach out to you through phone, email, or certified mail, notifying you of the investigation and often requesting a response within 30 days. It’s easy to panic during this time, but don’t act in haste.
  WWMD? "Pull out your professional liability insurance and call them immediately. Time is of the essence."

When a complaint is filed with the BON, it sets off a formal investigation process. Nurses can feel powerless, but it’s crucial to remember that the process is not a predetermined outcome. Your response to the investigation can make a significant difference.

1. Initial Review and Screening: The BON begins by reviewing the complaint to determine whether it warrants a full investigation. Not every complaint gets this far—sometimes, complaints are dismissed early in the process. However, if the complaint is deemed valid, it proceeds to the next step.
2. The Investigation: The BON will assign an investigator who will gather evidence, review documentation (including medical records), and interview witnesses. Keep in mind that this process isn’t always straightforward or fair. Many BON investigations are administered by non-nurses who may not fully grasp the context or nuances of clinical nursing practice. This is why it’s essential to have legal counsel involved from the very beginning.

3. Notice of Allegations: If the BON determines there is enough evidence to move forward, they will issue a Notice of Allegations. This document outlines the complaint and provides you with details on the investigation. At this stage, you’ll have the opportunity to respond. If you don’t have legal support, this can feel overwhelming—but remember, it’s crucial to respond thoughtfully and with guidance from your legal team.
4. Outcome: Once the investigation is complete, the BON will determine the next steps. If they find insufficient evidence, they might drop the case. But if they conclude that action is necessary, it could result in probation, suspension, or even revocation of your license. The most important thing to remember is that you are allowed to defend yourself. You have rights, and having the right support ensures that those rights are protected.

What Are the Possible Outcomes of a BON Investigation?

A BON investigation can have a number of outcomes, ranging from no action at all to serious disciplinary consequences. Here are the key possibilities:

1. No Action Taken (Best Case Scenario)

The best-case scenario is that the BON dismisses the complaint after their initial review or investigation. This could happen if the investigation reveals no merit in the accusations or if the evidence doesn’t support the complaint. But don’t take this for granted—many complaints that seem minor can still result in lengthy investigations.

2. Probation or Monitoring

In some cases, the BON may decide to issue a probation rather than revoking your license. Probation could include restrictions like regular reports, additional training, or mandatory monitoring. This may feel like a “punishment,” but it is a way to continue working while proving you can meet the BON’s standards.

"Probation can feel like a hurdle, but it’s also a chance to prove that you’re committed to your profession and your patients. With the right guidance from your legal team, you can navigate this successfully." — Advocate Maggie

3. License Suspension

A suspension temporarily takes away your right to practice nursing. Depending on the severity of the complaint, this could last for several months or even years. While you cannot work as a nurse during the suspension, there is often a chance for reinstatement if you take the right steps.

4. License Revocation

Revocation is the most serious outcome. In this case, your license is permanently revoked, and you are no longer legally allowed to practice nursing in that state. This can be devastating, but even in cases of revocation, there are often opportunities for reinstatement later, depending on the circumstances.

5. Settlement or Consent Agreement

In some cases, the BON may offer a settlement or consent agreement, which allows you to resolve the issue without a formal hearing or prolonged investigation. You may agree to certain terms, such as additional training or probation. But be cautious—always consult with your legal team before signing any agreements, as the terms might limit your ability to defend yourself fully.

Why Nurses Are Unprepared

Here’s the reality: Across the U.S., nurses often lack a foundational understanding of the investigative process and what it means to hold a professional license. While states like Texas and New Mexico require a jurisprudence exam, this education is rarely enough.

In my experience as both a former BON investigator and an advocate, this gap in knowledge is a systemic issue. That’s why it’s essential to teach nurses how to protect themselves through documentation and emphasizing what it means to hold the privilege of a professional license.

For example, do you know if your board operates under the state’s Department of Health, Health and Human Services, or Attorney General’s office? These distinctions matter. Understanding the administrative structure of your board can be critical in protecting your license.

The Reality of BON Complaints: The Stakes Are High

Quite honestly, I hear almost daily from nurses who say they can’t believe this is happening to them. Errors happen—human error is real. But boards can sometimes act egregiously. Here’s some data:  the national average for reports in for example Texas is 16,000 annually and top complaints include documentation issues, medication errors, and boundary violations”

This isn’t meant to scare you— it’s meant to empower you! What you do and don’t document matters. You have options and resources, and you don’t have to face this alone.

Key Facts and Data

• Thousands of nurses face BON investigations annually, according to the National Council of State Boards of Nursing (NCSBN, 2023).
• A 2020 survey revealed that 68% of nurses lack a clear understanding of their scope of practice, a frequent trigger for BON complaints (Smith & Jones, 2020).
• Common allegations include medication errors, patient abandonment, documentation deficiencies, and professional misconduct (NCSBN, 2023).

Why You Need Legal Counsel

The most important advice I can give you is to never face a BON investigation alone. The process can be complicated, emotionally draining, and potentially damaging to your career. Legal counsel is a critical part of your defense. While I am not a lawyer, my experience as an advocate allows me to work alongside your legal team to ensure you have the right strategies and knowledge to defend your license and career.

"Just because a complaint is false doesn’t mean the process is simple. Boards of Nursing often rely on people who don’t understand the complexities of nursing practice. That’s why it’s so crucial to have the right advocate and legal team in your corner." — Advocate Maggie

Having the right legal counsel ensures that your rights are protected and that you have the opportunity to present your case fully. I’m here to help you understand your options, give you the tools to fight false complaints, and ensure your future in nursing is secure.

Legal Counsel: Your Lifeline

Nurses, unfortunately, don’t always get the benefit of a fair process. That’s why you need a lawyer who understands administrative law—the type of law that governs boards like the BON. Here’s why seeking legal help is non-negotiable:

• Expert Guidance: A skilled lawyer will guide you through each step of the process, ensuring that you’re not lost in the legal maze.
• Protection of Rights: Legal counsel will protect your rights—ensuring you are not coerced, misrepresented, or dismissed unfairly.
• Building a Strong Defense: Your lawyer can help gather evidence, interview witnesses, and build a defense strategy tailored to your case.
• Negotiation: If your case moves toward disciplinary action, a lawyer can help negotiate the terms, possibly reducing the severity of the consequences.

Real-Life Example: When Things Go Wrong

Consider the case of Mary, a nurse accused of falsifying patient records. In reality, the error was a result of a documentation mistake, and the patient was never harmed. But due to the way the BON’s investigation unfolded, Mary was unable to present the right evidence early on. Her license was suspended for six months before the issue was resolved. Mary had to fight tooth and nail to get her license reinstated, and even then, the scars from the investigation stayed with her.

What You Can Do If You’re Under Investigation

If you ever find yourself facing a BON investigation, here’s what you need to do:

1. Seek Legal Counsel Immediately: Don’t wait. Contact an attorney who specializes in nursing law to ensure that your case is handled properly from the start.
2. Know Your Rights: Learn about the process, the allegations, and the possible outcomes. The more informed you are, the better you can defend yourself.
3. Document Everything: Gather all the evidence, emails, records, and communication that might help your case.
4. Stay Calm and Professional: Throughout the investigation, keep your emotions in check. Respond to all communications promptly and professionally.

Conclusion: Protecting Your Career Starts Now

While a BON investigation can be a daunting experience, you don’t have to face it alone. With the right support from your legal team and me as your advocate, you can navigate the process and protect your career.

Maggie’s Advocacy: Your First Step Toward Protection

As I’ve always said, "Knowledge is power, and advocacy is protection." When you face an investigation, having a clear, structured response plan is essential. I advocate for nurses to help you through every step of the process—from understanding the complaint to securing your future. My work isn’t about just solving the problem—it’s about empowering you with knowledge and providing emotional support during this critical time.

As Advocate Maggie, I’m here to guide you through the investigation process, step by step. Whether you're dealing with a false complaint or simply trying to understand what’s at stake, remember: you have the power to protect your future. Don’t let a false complaint define your career—take action now to ensure the best outcome. KNOWLEDGE IS POWER!

🤔 Nurses, leave your thoughts and questions in the comments below.