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2023 New Hampshire Revised Statutes
Title XXX - Occupations and Professions
Chapter 326-B - Nurse Practice Act
Section 326-B:37 - Disciplinary Action; Misconduct.
Universal Citation:
NH Rev Stat § 326-B:37 (2023)
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326-B:37 Disciplinary Action; Misconduct. –
I. [Repealed.]
II. The board may discipline a licensee or applicant for any one or a combination of the following grounds:
(a) Failing to demonstrate the qualifications or satisfy the requirements.
(b) Conduct that violates the security of the examination, including, but not limited to:
(1) Copying, disseminating, or receiving any portion of an examination.
(2) Having unauthorized possession of any portion of a future, current, or previously administered examination.
(3) Violating test administration.
(4) Permitting an impersonator to take the examination on one's behalf or impersonating an examinee.
(c) Convictions by a court or any plea to a crime in any jurisdiction that relates adversely to the practice of nursing or to the ability to practice nursing.
(d) Employing fraud or deceit in procuring or attempting to procure a license to practice nursing, in filing any reports or completing client records, in representation of oneself to the board or public, in authenticating any report or records in the nurse's capacity as an APRN, RN, LPN, or LNA, or in submitting any information or record to the board.
(e) Unethical conduct including but not limited to conduct likely to deceive, defraud, or harm the public or demonstrating a willful or careless disregard for the health or safety of a client. Actual injury need not be established.
(f) If a nurse's license to practice nursing or a multi-state privilege or another health care related license or other credential has been denied, revoked, suspended, or restricted, or the licensee has been otherwise disciplined in this or any other state.
(g) Conduct including but not limited to failure or inability to perform nursing or nursing assistant practice as defined in this chapter, with reasonable skill and safety.
(h) Unprofessional conduct including but not limited to:
(1) A departure from or failure to conform to nursing standards, including improper management of client records.
(2) Delegating or accepting the delegation of a nursing function or a prescribed health function when the delegation or acceptance could reasonably be expected to result in unsafe or ineffective client care.
(3) Failure to supervise the performance of acts by any individual working at the nurse's delegation or assignment.
(4) Failure of a clinical nursing instructor to supervise student experiences.
(i) Failure of a chief administrative nurse to follow appropriate and recognized standards and guidelines in providing oversight of the nursing organization and nursing services of a health care delivery system.
(j) Failure to practice within a modified scope of practice or with the required accommodations, as specified by the board in granting a modified license under this act.
(k) Any nursing practice that may create unnecessary danger to a client's life, health, or safety. Actual injury to a client need not be established.
(l) Inability to practice safely, including demonstration of actual or potential inability to practice nursing with reasonable skill and safety to clients by reason of illness or as a result of any mental or physical condition.
(m) Actions or conduct that include, but are not limited to, falsifying reports, client documentation, agency records, or other essential health documents, failure to cooperate with a lawful investigation conducted by the board, failure to maintain professional boundaries with clients or family members, use of excessive force upon or mistreatment or abuse of any client, engaging in sexual conduct with a client, touching a client in a sexual manner, requesting or offering sexual favors or language or behaviors suggestive of same, or threatening or violent behavior in the workplace.
(n) Diversion or attempts to divert drugs or controlled substances.
(o) Failure of a licensee to comply with terms of any alternative program agreement made with the board.
(p) Other drug-related actions or conduct that include but are not limited to:
(1) Use of any controlled substance or any drug or device or alcoholic beverages to an extent or in a manner dangerous or injurious to himself or herself, any other person, or the public, or to the extent that such use may impair his or her ability to conduct with safety to the public the practice of nursing.
(2) Falsification or making incorrect, inconsistent, or unintelligible entries in any agency, client, or other record pertaining to drugs or controlled substances.
(3) A positive drug screen for which there is no lawful prescription.
(q) Actions or conduct that include but are not limited to:
(1) Knowingly aiding, assisting, advising, or allowing an unlicensed person to engage in the practice of nursing.
(2) Violating a rule adopted by the board under RSA 541-A, an order of the board, a state or federal law relating to the practice of nursing, or a state or federal narcotics or controlled substance law.
(3) Practicing beyond the scope of practice as stated in this chapter, and failing to report violations of this chapter.
(r) Upon notification by the licensing authority of another jurisdiction that a licensee has been disciplined.
III. [Repealed.]
III-a. The state of New Hampshire confirms its strong support for shared decision making between healthcare professionals and their patients. A licensee may lawfully prescribe an FDA approved drug product for an off-label indication and be held to the same standard of care as when prescribing for on-label indication when:
(a) Off-label use of the drug product for this indication has longstanding common use;
(b) There is medical evidence to support this use and no known evidence contraindicating such use, including but not limited to peer reviewed studies and practice guidelines from relevant medical societies; or
(c) The licensee has provided and the patient, or if the patient is a minor, the patient's parent or guardian, has signed an informed consent form that includes the known potential benefits, known potential risks, alternative treatment options, expected prognosis without treatment, and a disclosure that a prescription is for an off-label indication. The signed informed consent form shall remain part of the patient's medical record.
IV. [Repealed.]
V. Every individual, agency, facility, institution, or organization that employs licensed nursing personnel within the state shall report to the board within 30 days any action by a licensee that willfully violates any provision of paragraph II. The board shall have authority, after notice and the opportunity for hearing, to impose civil penalties of up to $1,000 per violation upon persons found to have willfully violated the reporting requirements of this paragraph.
I. [Repealed.]
II. The board may discipline a licensee or applicant for any one or a combination of the following grounds:
(a) Failing to demonstrate the qualifications or satisfy the requirements.
(b) Conduct that violates the security of the examination, including, but not limited to:
(1) Copying, disseminating, or receiving any portion of an examination.
(2) Having unauthorized possession of any portion of a future, current, or previously administered examination.
(3) Violating test administration.
(4) Permitting an impersonator to take the examination on one's behalf or impersonating an examinee.
(c) Convictions by a court or any plea to a crime in any jurisdiction that relates adversely to the practice of nursing or to the ability to practice nursing.
(d) Employing fraud or deceit in procuring or attempting to procure a license to practice nursing, in filing any reports or completing client records, in representation of oneself to the board or public, in authenticating any report or records in the nurse's capacity as an APRN, RN, LPN, or LNA, or in submitting any information or record to the board.
(e) Unethical conduct including but not limited to conduct likely to deceive, defraud, or harm the public or demonstrating a willful or careless disregard for the health or safety of a client. Actual injury need not be established.
(f) If a nurse's license to practice nursing or a multi-state privilege or another health care related license or other credential has been denied, revoked, suspended, or restricted, or the licensee has been otherwise disciplined in this or any other state.
(g) Conduct including but not limited to failure or inability to perform nursing or nursing assistant practice as defined in this chapter, with reasonable skill and safety.
(h) Unprofessional conduct including but not limited to:
(1) A departure from or failure to conform to nursing standards, including improper management of client records.
(2) Delegating or accepting the delegation of a nursing function or a prescribed health function when the delegation or acceptance could reasonably be expected to result in unsafe or ineffective client care.
(3) Failure to supervise the performance of acts by any individual working at the nurse's delegation or assignment.
(4) Failure of a clinical nursing instructor to supervise student experiences.
(i) Failure of a chief administrative nurse to follow appropriate and recognized standards and guidelines in providing oversight of the nursing organization and nursing services of a health care delivery system.
(j) Failure to practice within a modified scope of practice or with the required accommodations, as specified by the board in granting a modified license under this act.
(k) Any nursing practice that may create unnecessary danger to a client's life, health, or safety. Actual injury to a client need not be established.
(l) Inability to practice safely, including demonstration of actual or potential inability to practice nursing with reasonable skill and safety to clients by reason of illness or as a result of any mental or physical condition.
(m) Actions or conduct that include, but are not limited to, falsifying reports, client documentation, agency records, or other essential health documents, failure to cooperate with a lawful investigation conducted by the board, failure to maintain professional boundaries with clients or family members, use of excessive force upon or mistreatment or abuse of any client, engaging in sexual conduct with a client, touching a client in a sexual manner, requesting or offering sexual favors or language or behaviors suggestive of same, or threatening or violent behavior in the workplace.
(n) Diversion or attempts to divert drugs or controlled substances.
(o) Failure of a licensee to comply with terms of any alternative program agreement made with the board.
(p) Other drug-related actions or conduct that include but are not limited to:
(1) Use of any controlled substance or any drug or device or alcoholic beverages to an extent or in a manner dangerous or injurious to himself or herself, any other person, or the public, or to the extent that such use may impair his or her ability to conduct with safety to the public the practice of nursing.
(2) Falsification or making incorrect, inconsistent, or unintelligible entries in any agency, client, or other record pertaining to drugs or controlled substances.
(3) A positive drug screen for which there is no lawful prescription.
(q) Actions or conduct that include but are not limited to:
(1) Knowingly aiding, assisting, advising, or allowing an unlicensed person to engage in the practice of nursing.
(2) Violating a rule adopted by the board under RSA 541-A, an order of the board, a state or federal law relating to the practice of nursing, or a state or federal narcotics or controlled substance law.
(3) Practicing beyond the scope of practice as stated in this chapter, and failing to report violations of this chapter.
(r) Upon notification by the licensing authority of another jurisdiction that a licensee has been disciplined.
III. [Repealed.]
III-a. The state of New Hampshire confirms its strong support for shared decision making between healthcare professionals and their patients. A licensee may lawfully prescribe an FDA approved drug product for an off-label indication and be held to the same standard of care as when prescribing for on-label indication when:
(a) Off-label use of the drug product for this indication has longstanding common use;
(b) There is medical evidence to support this use and no known evidence contraindicating such use, including but not limited to peer reviewed studies and practice guidelines from relevant medical societies; or
(c) The licensee has provided and the patient, or if the patient is a minor, the patient's parent or guardian, has signed an informed consent form that includes the known potential benefits, known potential risks, alternative treatment options, expected prognosis without treatment, and a disclosure that a prescription is for an off-label indication. The signed informed consent form shall remain part of the patient's medical record.
IV. [Repealed.]
V. Every individual, agency, facility, institution, or organization that employs licensed nursing personnel within the state shall report to the board within 30 days any action by a licensee that willfully violates any provision of paragraph II. The board shall have authority, after notice and the opportunity for hearing, to impose civil penalties of up to $1,000 per violation upon persons found to have willfully violated the reporting requirements of this paragraph.
Source. 2005, 293:1. 2009, 54:4, eff. July 21, 2009. 2018, 270:3, eff. Aug. 17, 2018. 2022, 306:2, eff. July 1, 2022. 2023, 212:26, II, eff. Oct. 3, 2023.
Disclaimer: These codes may not be the most recent version. New Hampshire may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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