According to the Model Nursing Practice Act (upon which state nurse practice acts are based), grounds for discipline include engaging in unprofessional conduct, described as a departure from, or failure to conform to, standards of professional nursing for which actual injury to a patient need not be established.5 (Such unprofessional conduct or rule-bending becomes negligence when a patient suffers harm as a result.
Experienced nurses may assume that there will be legal consequences to rule-bending (such as a malpractice suit) only if the rule-bending results in a bad patient outcome. Nurses are often shocked to learn that they may be subject to sanction against their licenses even if the rule-bending did not harm the patient.
Consider, for instance, the situation one group of nurses found themselves in. A group of nurses who worked at a long-term care facility had developed a practice of "borrowing" meds when they had an off-hours admission. (The facility didn't have a full-time pharmacist.) This wasn't done furtively; the nurses would carefully document the fact. This practice, which went on for years, was discovered by an outside survey of the facility. Dozens of nurses and one administrator received administrative complaints against their licenses from their BON. A year-long legal battle to get those complaints dismissed followed. The battle was successful, but the process was expensive and stressful.