244 CMR, § 9.03 - Standards of Conduct for Nurses
Each nurse licensed by the Board and engaged in the practice of nursing shall have knowledge and understanding of the Standards of Conduct for Nurses set forth in 244 CMR 9.00, all state laws and Board regulations governing the practice of nursing, and all other state and federal laws and regulations related to such practice.
The Board may take disciplinary action against the license of any nurse licensed by the Board or against any APRN authorization, or both, or against the nurse's right to renew such license, upon the nurse's failure to comply with the Standards of Conduct for Nurses or with any other laws and regulations related to the practice of nursing.
(1)
Practice Under Valid
License. Except as provided by M.G.L. c. 112, §§ 80, 80A
and 81, a nurse shall only engage in the practice of nursing in Massachusetts
with a valid license.
(2)
Practice as Advanced Practice Registered Nurse (APRN).
A Registered Nurse may only engage in advanced practice registered nursing in
Massachusetts after receiving written authorization from the Board in
accordance with
244 CMR 4.00: Advanced
Practice Registered Nursing.
(3)
Practice Following Loss of
License. A nurse licensed by the Board shall not engage in the
practice of nursing in Massachusetts, or in any way represent himself or
herself as a Registered Nurse or Licensed Practical Nurse, after the effective
date of:
(a) license expiration;
(b) license surrender under the terms and
conditions of a written agreement entered into with the Board;
(c) a license suspension order or license
revocation order contained in a final decision and order issued by the Board;
and
(d) a summary suspension order
issued by the Board in accordance with
244
CMR 7.05: Summary Suspension of
License, Advanced Practice Nursing Authorization, or Right to Renew
License.
The practice of nursing in Massachusetts, after the occurrence of any of the events set forth in 244 CMR 9.03(3)(a) through (d), shall constitute the unlicensed practice of nursing.
(4)
Practice of Nursing in
Another Jurisdiction Using Telecommunications Technology. A nurse
licensed by the Board who, while physically located within
Massachusetts, provides a nursing service using telecommunications technology
to a person physically located outside Massachusetts, shall
also be governed by the licensure and practice laws and regulations of the
state or jurisdiction in which the recipient of such a service is
located.
(5)
Adherence
to Standards of Nursing Practice. A nurse licensed by the Board
shall engage in the practice of nursing in accordance with accepted standards
of practice.
(6)
Compliance with Laws and Regulations Related to
Nursing.
(a) A nurse who holds a
valid license shall comply with M.G.L. c. 112, §§ 74 through 81C, as
well as with any other laws and regulations related to licensure and practice.
Examples of such laws include, but are not limited to, the following:
1. M.G.L. c. 19A, § 15 (obligation to
report elder abuse);
2. M.G.L. c.
19C, § 10 (obligation to report abuse of disabled person);
3. M.G.L. c. 38, § 3 (report of death to
medical examiner);
4. M.G.L. c. 46,
§ 9 (death pronouncement);
5.
M.G.L. c. 62C, § 47A(d) (obligation to pay state taxes);
6. M.G.L. c. 71, § 55A (obligation to
sick school child);
7. M.G.L. c.
71, § 55B (obligation to file report certifying freedom from tuberculosis
in communicable form);
8. M.G.L.
94C (Controlled Substances Act - requirements for possessing, dispensing,
administering, and prescribing controlled substances);
9. M.G.L. c. 111, § 70E (Patients' or
Residents' Rights);
10. M.G.L. c.
111, § 70F (HTLV-III Tests);
11. M.G.L. c. 111, § 72G (obligation to
report abuse of patient or resident);
12. M.G.L. c. 111, § 110 (obligation to
report infant with swollen, red, or inflamed eye(s) or with unnatural discharge
within two weeks after birth);
13.
M.G.L. c. 111, § 110B (obligation to report examination or treatment of
child with Reyes syndrome);
14.
M.G.L. c. 111, § 191 (obligation to report lead poisoning);
15. M.G.L. c. 112, § 12CC (obligation to
provide patient records);
16.
M.G.L. c. 112, § 61 (obligation to pay student loans);
17. M.G.L. c. 119, § 51A (obligation to
report child abuse);
18. M.G.L. c.
119A, § 16 (obligation to pay child support);
19. M.G.L. c. 123, § 12 (requirements
for commitment of mentally ill person);
20. M.G.L. c. 123, § 21 (requirements
for use of restraint and seclusion of mentally ill person); and
21. M.G.L. c. 123B, § 8 (requirements
for use of restraint and seclusion of mentally retarded person).
(b) A nurse licensed by the Board
who no longer holds a valid license shall comply with 244 CMR 9.03(6)(a)5.,
16., and 18., as well as with the good moral character requirement contained in
M.G.L. c. 112, § 74 (RNs) and § 74A (LPNs).
(7)
Aiding Unlawful
Activity. A nurse licensed by the Board shall not aid any person
in performing any act prohibited by law or regulation.
(8)
Identification
Badge. A nurse who holds a valid license and who examines,
observes, or treats a patient in any practice setting shall wear an
identification badge which visibly discloses at a minimum his or her first
name, licensure status and, if applicable, advanced practice registered nurse
authorization.
(9)
Responsibility and Accountability. A nurse licensed by
the Board shall be responsible and accountable for his or her nursing
judgments, actions, and competency.
(10)
Acts within Scope of
Practice. A nurse who holds a valid license and is engaged in the
practice of nursing in Massachusetts shall only perform acts within the scope
of nursing practice as defined in M.G.L. c. 112, § 80B, and
244 CMR 3.00:
Registered Nurse and Licensed Practical Nurse.
(11)
Performance of Techniques
and Procedures. A nurse licensed by the Board shall perform
nursing techniques and procedures only after appropriate education and
demonstrated clinical competency.
(12)
Competency. A
nurse who holds a valid license shall only assume those duties and
responsibilities within his or her scope of practice and for which he or she
has acquired and maintained necessary knowledge, skills, and
abilities.
(13)
Discrimination. A nurse licensed by the Board shall
not withhold or deny nursing care based on age, ancestry, marital status, sex,
sexual orientation, gender identity, gender expression, race, color, religious
creed, national origin, diagnosis, or mental or physical disability.
(14)
Asepsis and Infection
Control. A nurse licensed by the Board shall adhere to standard
precautions and to principles of asepsis and infection control, and shall not
place a patient, himself or herself, or others at risk for the transmission of
infectious diseases.
(15)
Patient Abuse, Neglect, Mistreatment, Abandonment, or Other
Harm. A nurse licensed by the Board shall not abuse, neglect,
mistreat, abandon, or otherwise harm a patient.
(16)
Patient Confidential
Information. A nurse licensed by the Board shall safeguard patient
information from any person or entity, or both, not entitled to such
information. A nurse licensed by the Board shall share appropriate information
only as required by law or for the protection of the patient.
(17)
Patient Dignity and
Privacy. A nurse licensed by the Board shall safeguard a patient's
dignity and right to privacy.
(18)
Participation in Research. A nurse licensed by the
Board who enrolls subjects in a research study or conducts such a study, or
both, shall verify that a board, committee, or other group designated by an
institution to ensure the protection of human subjects has approved the study
in accordance with accepted standards for the protection of human
subjects.
(19)
Exercise
of Undue Influence. A nurse licensed by the Board shall not
exercise undue influence on a patient, including the promotion or sale of
services, goods, appliances or drugs, in such a manner as to exploit the
patient for financial gain of the nurse or a third-party.
(20)
Borrowing from
Patients. A nurse licensed by the Board shall not borrow money,
materials, or other property from any patient.
(21)
Undue Benefit or
Gain. A nurse licensed by the Board shall care for, and refer, a
patient without undue benefit or gain to the nurse or a third-party.
(22)
Advertising. A
nurse licensed by the Board shall not engage in false, deceptive, or misleading
advertising related to the practice of nursing.
(23)
Sexual Contact.
A nurse licensed by the Board shall not have sexual contact with any patient
with whom he or she has a nurse/patient relationship or with any former patient
who may be vulnerable by virtue of emotional status, age, illness, or cognitive
ability.
(24)
Professional Boundaries. A nurse licensed by the Board
shall establish and observe professional boundaries with respect to any patient
with whom he or she has a nurse/patient relationship. A licensed nurse shall
continue to observe professional boundaries with his or her former patients who
may be vulnerable by virtue of emotional status, age, illness, or cognitive
ability.
(25)
Relationship Affecting Professional Judgment. A nurse
licensed by the Board shall not initiate or maintain a nurse/patient
relationship that is likely to adversely affect the nurse's professional
judgment.
(26)
Duty to
Report to the Board. A nurse who holds a valid license and who
directly observes another nurse engaged in any of the following shall report
that nurse to the Board in accordance with Board guidelines:
(a) abuse of a patient;
(b) practice of nursing while impaired by
substance misuse; and
(c) diversion
of controlled substances.
(27)
Change of Personal
Data. A nurse who holds a valid license shall inform the Board
within 30 days of any change of his or her name, address of record, or Social
Security number.
(28)
Action against Certificate. A nurse who holds a valid
license and who holds a certificate issued by a certifying body related to the
practice of nursing shall report to the Board in writing within 30 days any
action against, or surrender of, his or her certificate issued by such
certifying body.
(29)
Examinations. In connection with any examination
related to the practice of nursing, an applicant to the Board for licensure or
a nurse licensed by the Board shall not:
(a)
impersonate or act as proxy for an applicant for nurse licensure, APRN
authorization, or certification;
(b) disclose the contents of any examination,
or solicit, accept, or compile information regarding the contents of any such
examination before, during, or after its administration, or in any other way
compromise or attempt to compromise the integrity of any such examination;
or
(c) in any other way cheat on
any examination.
(30)
Practice under a False or Different Name. A nurse who
holds a valid license shall engage in the practice of nursing only under the
name in which such license has been issued.
(31)
Falsification of
Information. A nurse licensed by the Board shall not knowingly
falsify, or attempt to falsify, any documentation or information related to any
aspect of licensure as a nurse, the practice of nursing, and the delivery of
nursing services.
(32)
Fraudulent Practices. A nurse licensed by the Board
shall not engage in any fraudulent practice including, but not limited to,
billing for services not rendered or submitting false claims for
reimbursement.
(33)
Impersonation. A nurse licensed by the Board shall not
impersonate another nurse or other health care provider, or knowingly allow or
enable another person to impersonate him or her.
(34)
Misrepresentation of
Credentials. A nurse licensed by the Board shall not misrepresent
his or her credentials related to the practice of nursing including, but not
limited to, those indicating education, type of nurse licensure, APRN
authorization, or certification related to the practice of nursing.
(35)
Security of Controlled
Substances. A nurse licensed by the Board and engaged in the
practice of nursing shall maintain the security of controlled substances that
are under his or her responsibility and control.
(36)
Practice While
Impaired. A nurse licensed by the Board shall not practice nursing
while impaired.
(37)
Unlawful Acquisition and Possession of Controlled
Substances. A nurse licensed by the Board shall not unlawfully
obtain or possess controlled substances.
(38)
Administration of
Drugs. A nurse licensed by the Board shall not administer any
prescription drug or non-prescription drug to any person in the course of
nursing practice except as directed by an authorized prescriber. 244 CMR
9.03(38) shall not apply where a Registered Nurse authorized by the Board to
practice as a nurse anesthetist administers anesthesia or perioperative
medications, or both, under protocols required by
244
CMR 4.06(1)(c) and
(d).
(39)
Documentation of Controlled
Substances. A nurse licensed by the Board shall document the
handling, administration, and destruction of controlled substances in
accordance with all federal and state laws and regulations and in a manner
consistent with accepted standards of nursing practice.
(40)
Circumvention of
Law. A nurse licensed by the Board shall not receive from, or
offer, give, or promise anything of value or benefit to, any official to
circumvent any federal and state laws and regulations related to the practice
of nursing.
(41)
Compliance with Board Order. A nurse licensed by the
Board shall comply with any order for disciplinary action issued by the Board
against his or her license to engage in the practice of nursing or right to
renew such license, except as otherwise may be determined by the appropriate
court in the course of an appeal of a Board final decision and order.
(42)
Compliance with
Agreements. A nurse licensed by the Board shall comply with all
provisions contained in any agreement he or she has entered into with the
Board.
(43)
Violence. A nurse licensed by the Board shall not
endanger the safety of the public, patients, or coworkers by making actual or
implied threats of violence, or carrying out an act of violence.
(44)
Documentation.
A nurse licensed by the Board shall make complete, accurate, and legible
entries in all records required by federal and state laws and regulations and
accepted standards of nursing practice. On all documentation requiring a
nurse's signature, the nurse shall sign his or her name as it appears on his or
her license.
(45)
Alteration or Destruction of Records. A nurse licensed
by the Board shall not inappropriately destroy or alter any record related to
the practice of nursing.
(46)
Responsibilities of Nurse in Management Role. A nurse
licensed by the Board and employed in a nursing management role shall adhere to
accepted standards of practice for that role. The responsibilities of the nurse
employed in a nursing management role are to develop and implement the
necessary measures to promote and manage the delivery of safe nursing care in
accordance with accepted standards of nursing practice.
(47)
Other Prohibited
Conduct. A nurse licensed by the Board shall not engage in any
other conduct that fails to conform to accepted standards of nursing practice
or in any behavior that is likely to have an adverse effect upon the health,
safety, or welfare of the public.
Notes
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No prior version found.