NPs typically come to the attention of investigators for the Board of Nursing
in one of two ways.
In the first scenario, the Board learns of a malpractice damage award against
an NP through the National Practitioner Data Bank. A malpractice award
against an NP will not necessarily be investigated by the Board of Nursing.
However, if the damage award is large, or there is some other indication that
the NP may be incompetent or grossly negligent, the Board of Nursing may
choose to investigate.
In the second scenario, an audit of a facility, such as a nursing home, turns
up irregularities involving an NP. It is the second scenario which is most
NPs working in nursing homes and hospitals--settings where care is audited by
state agencies-- are advised to ascertain that progress notes 1) reflect
appropriate follow-up of diagnostic work-ups and therapy and 2) detail the
NP's thought processes when ordering unusual treatments. The auditors often
are not NPs or MDs, and may not appreciate the gray areas of clinical
This tip is exerpted from The Gold Sheet, a monthly newsletter on quality
issues for NPs, produced by the Law Office of Carolyn Buppert. To subscribe
to The Gold Sheet, or to its companion newsletter, The Green Sheet, which
addresses compensation issues, send a check to Law Office of Carolyn Buppert,
1419 Forest Drive, Suite 205, Annapolis, MD 21403. Each newsletter is $25 for