Or. Admin. Code § 851-045-0070

Current through Register Vol. 63, No. 11, November 1, 2024

Section 851-045-0070 - Conduct Derogatory to the Standards of Nursing Defined

Conduct derogatory to the practice of nursing is conduct that adversely affects the health, safety, and welfare of the public; that fails to conform to OAR 851-045 scope and standards of practice; or that fails to conform to accepted standards of the nursing profession. Such conduct includes, but is not limited to:

(1) Conduct related to general fitness in the practice of nursing:

(a) Demonstrated incidents of violent, abusive, intimidating, neglectful or reckless behavior; or

(b) Demonstrated incidents of dishonesty, misrepresentation, or fraud.

(2) Conduct related to achieving and maintaining clinical competency:

(a) Failing to recognize standards of acceptable and prevailing nursing practice. Actual injury need not be established;

(b) Exceeding scope in the practice of nursing for license type;

(c) Performing activities, interventions, or roles within the practice of nursing that are not within one's individual scope of practice;

(d) Accepting an assignment when individual competency necessary to safely perform the assignment has not been established or maintained; or

(e) Failure to remove oneself from practice when unable to practice with professional skill and safety.

(3) Conduct related to the client's safety and integrity:

(a) Developing, modifying, or implementing policies that jeopardize client safety;

(b) Failing to take action to preserve or promote a client's safety based on nursing assessment and clinical judgment;

(c) Failing to develop, implement or modify the plan of care;

(d) Failing to develop, implement or modify the focused plan of care;

(e) Assigning work that:

(A) Exceeds scope in the practice of nursing for the recipient's license type;

(B) Exceeds the recipient's individual scope of practice;

(C) Exceeds authorized duties for one's nursing assistant certification; or

(D) Is not authorized to be performed in the context of care.

(f) Failing to adhere to OAR chapter 851, Division 47 when delegating the performance of a client's nursing procedure to a UAP;

(g) Failing to provide supervision per the context of care for:

(A) Work that has been assigned to practice team members; or

(B) The performance of a nursing procedure that has been delegated to a UAP practice team member.

(h) Assuming duties and responsibilities within the practice of nursing when competency in the performance of those duties and responsibilities has not been established or maintained;

(i) Accepting an assignment and then leaving or failing to complete the assignment, including a supervisory assignment, without notifying the appropriate personnel and confirming that assignment responsibilities will be met;

(j) Failing to make a report per ORS 676.150 of facts known regarding prohibited or unprofessional conduct of any health care provider;

(k) Failing to respect the dignity and rights of the client, inclusive of the client's social or economic status, age, race, religion, gender, gender identity, sexual orientation, national origin, nature of health needs, physical attributes, disability, or personal choice;

(l) Failing to honor the client's right to decline an intervention or medication;

(m) Failing to honor the client's right to decline to participate in research;

(n) Failing to report actual or suspected incidents of abuse, neglect or mistreatment;

(o) Engaging in or attempting to engage in sexual contact with a client in any setting;

(p) Engaging in sexual misconduct;

(q) Failing to establish or maintain professional boundaries with a client;

(r) Using social media to communicate, post, or otherwise distribute protected client information or data including client image or other client identifiers; or

(s) Failing to report to the person in the workplace who holds the authority to institute corrective action, one's knowledge of a licensee whose practice of nursing:

(A) Exceeds scope in the practice of nursing for their license type; or

(B) Fails to meet established standards of safe nursing practice.

(4) Conduct related to communication:

(a) Failure to document the practice of nursing in a timely, accurate, thorough, and clear manner;

(b) Failure to document the practice of nursing using one's name of record;

(c) Failure to document data and information pertinent to a client's status;

(d) Failing to document a late entry within a reasonable time period;

(e) Entering inaccurate, incomplete, falsified, fabricated or altered documentation into a health record or employer record. This includes but is not limited to:

(A) Documenting the practice of nursing that did not occur;

(B) Documenting the occurrence of events that did not occur;

(C) Documenting using another person's name of record or identification;

(D) Falsifying data;

(E) Altering words or characters within another person's established document or record entry;

(F) Altering words or characters within another person's established document or record entry to mislead the reader; or

(G) Entering late entry documentation into a non-electronic health record that does not identify the date and time of the event being recorded, the date and time the late entry is placed into the record, or one's name of record

(f) Destroying a client or employer record:

(A) To conceal a record of nursing or other services provided; or

(B) To conceal the omission of nursing or other services;

(g) Directing another person to falsify, alter or destroy a client or agency record or any document to conceal a record of services provided or to conceal the omission of services;

(h) Directing another individual to enter false information into an agency record, a client's health record, or both;

(i) Failing to communicate information regarding the client's status to members of the practice team in an ongoing and timely manner as appropriate to the context of care; or

(j) Failing to communicate information regarding the client's status to other individuals who are authorized to receive information and have a need to know.

(5) Conduct related to the client's family:

(a) Failing to be respectful to the client's family and the client's relationship with their family;

(b) Using one's title or position as a nurse to exploit the client's family for any reason;

(c) Stealing money, property, services or supplies from the client's family;

(d) Soliciting or borrowing money, materials or property from the client's family; or

(e) Engaging in unacceptable behavior towards, or in the presence of, the client's family. Such behavior includes, but is not limited to, using derogatory names, derogatory or threatening gestures, verbal threats or profane language.

(6) Conduct related to practice team members, co-workers and students:

(a) Engaging in violent, abusive or threatening behavior towards a practice team member, co-worker or student; or

(b) Engaging in violent, abusive, or threatening behavior towards a practice team member, a coworker, or a student that impacts the delivery of safe nursing services or other services provided in the context of care.

(7) Conduct related to impaired function:

(a) Practicing nursing when unable or unfit due to:

(A) Physical impairment as evidenced by documented deterioration of functioning in the practice setting or by the assessment of an LIP qualified to diagnose physical condition or status; or

(B) Psychological or mental impairment as evidenced by documented deterioration of functioning in the practice setting or by the assessment of an LIP qualified to diagnose mental conditions or status.

(b) Practicing nursing when physical or mental ability to practice is impaired by stress, illness, the use of any drug, prescription or non-prescription medication, alcohol, or a mind-altering substance; or

(c) The use of any drug, prescription or non-prescription medication, alcohol, or a mind-altering substance, to an extent or in a manner that:

(A) Is dangerous or injurious to the licensee or others; or

(B) Impairs the ability to conduct safely the practice of nursing.

(8) Other conduct derogatory to the practice of nursing:

(a) Violating any law, rule, or regulation intended to guide the conduct of nurses;

(b) Aiding, abetting, or assisting an individual to violate or circumvent any law, rule or regulation intended to guide the conduct of nurses or other health care providers;

(c) Violating the rights of privacy, confidentiality of information, or disclosing knowledge concerning the client, unless required by law to disclose such information;

(d) Discriminating against a client based on age, race, religion, gender, gender identity, sexual preference, national origin, disability, health care beliefs or health care decisions;

(e) Abusing a client;

(f) Neglecting a client;

(g) Failing to report suspected or observed incidents of abuse to the appropriate state agency or agencies;

(h) Failing to report suspected or observed incidents of abuse or neglect through the proper channels in the workplace;

(i) Engaging in other unacceptable behavior towards or in the presence of a client. Such conduct includes but is not limited to using derogatory names, derogatory gestures, profane language or threats;

(j) Soliciting, borrowing, or stealing money, materials, services, supplies or property from a client;

(k) Except as authorized through a medical order written by a person authorized to prescribe the medication:

(A) Possessing, obtaining, or attempting to obtain a prescription medication or controlled medication; or

(B) Furnishing or administering a prescription medication or controlled medication to any person, including oneself;

(l) Unauthorized removal, attempted removal, or stealing of medications, supplies, property, or money from any person in the practice setting or one's employer;

(m) Unauthorized removal of client records, client information, facility property, policies or written standards from the practice setting;

(n) Using one's role as a nurse for personal gain or to defraud a person of their personal property or possessions;

(o) Violating a person's rights of privacy and confidentiality by accessing their information without proper authorization or without a demonstrated need to know;

(p) Engaging in unsecured transmission of protected client data;

(q) Engaging in unauthorized transmission of protected client data;

(r) Failing to administer medications in a manner consistent with state and federal law;

(s) Failing to dispense medications in a manner consistent with state and federal law;

(t) Failure to release a client's health record within 30 days from receipt of written notice for release of records. This includes requests for records after closure of practice;

(u) Improper billing practices including the submission of false claims;

(v) Failing to properly maintain records after closure of practice or practice setting;

(w) Failure to notify client of closure of practice and of the location of their health records;

(x) Failure to report to the Board the licensee's arrest for a felony crime within 10 days of the arrest;

(y) Failure to report to the Board the licensee's conviction of a misdemeanor or a felony crime within 10 days of the conviction; or

(z) Failure to report to the Board any suspected violation of ORS 678.010 to 678.410 or any rule adopted by the Board.

(9) Conduct related to licensure violations:

(a) Resorting to fraud, misrepresentation or deceit at any time during the licensing process;

(b) Practicing nursing without a current Oregon license;

(c) Practicing as an NP, CRNA, or CNS without a current Oregon license in the specific advanced practice registered nurse specialty;

(d) Allowing another person to use one's nursing license for any purpose;

(e) Using another person's nursing license for any purpose;

(f) Impersonating an applicant or acting as a proxy for the applicant in any nurse licensure examination; or

(g) Disclosing the contents of a nurse licensure examination, soliciting, accepting or compiling information regarding the contents of the examination before, during or after its administration.

(10) Conduct related to the licensee's relationship with the Board:

(a) Failing to fully cooperate with the Board during the course of an investigation;

(b) Failing to answer truthfully and completely any question asked by the Board. This includes:

(A) During the licensing process;

(B) During the course of an investigation;

(C) During the course of a nursing education or nursing assistant program survey; or

(D) While under monitoring by the Board via Board order.

(c) Failing to provide the Board with any documents requested by the Board;

(d) Violating the terms and conditions of a Board order; or

(e) Failing to comply with the terms and conditions of a Board order or stipulated agreement.

(11) Conduct related to advanced practice nursing:

(a) Ordering laboratory or other diagnostic tests or treatments or therapies for oneself;

(b) Prescribing for or dispensing medications to oneself;

(c) Providing advanced practice registered nursing services to one's family member in the absence of adherence to OAR Chapter 851, Division 55 including prescribing, dispensing or providing medications;

(d) Using self-assessment and diagnosis as the basis for the provision of care which would otherwise be provided by a client's professional caregiver; or

(e) Ordering unnecessary laboratory or other diagnostic test or treatments for the purpose of personal gain.

Or. Admin. Code § 851-045-0070

BN 4-2008, f. & cert. ef. 6-24-08; BN 2-2010(Temp), f. & cert. ef. 4-19-10 thru 10-15-10; BN 12-2010, f. & cert. ef. 9-30-10; BN 5-2012, f. 5-7-12, cert .ef. 6-1-12; BN 8-2017, f. 7-7-17, cert. ef. 8/1/2017; BN 3-2024, amend filed 06/20/2024, effective 7/1/2024

Statutory/Other Authority: ORS 678.150

Statutes/Other Implemented: ORS 678.150, 678.111 & 678.390