Legal Liability for Nurses in the United States of America: A Comprehensive Guide

Criminal liability arises when an individual or organization violates a criminal law. The state prosecutes the offender, and penalties may include fines, imprisonment, or community service. In the United States, nurses can face criminal liabilities when their actions or omissions violate state or federal criminal laws. These liabilities often arise when a nurse’s conduct breaches the trust and standards of care expected in the nursing profession, causing harm to patients or violating public safety laws. Criminal charges can range from misdemeanors to felonies, depending on the severity of the act and its consequences.

In the United States, felonies are serious criminal offenses that carry severe penalties, including lengthy prison sentences, heavy fines, and long-lasting professional and personal consequences. For nurses, felonies typically involve actions that result in significant harm to patients or violate the law in a way that severely breaches professional standards and ethical guidelines. Below are common felonies that nurses can be charged within the USA.

• Drug Diversion: Nurses who illegally take or distribute prescription drugs or narcotics meant for patients can face felony charges. This is a serious offense, especially if it involves controlled substances like opioids, sedatives, or stimulants. For example, a nurse is taking painkillers or narcotics from the hospital supplies and using them for personal use or selling them.
• Drug Fraud: Falsifying prescriptions or altering medication records to steal or divert drugs for personal gains. For example, a nurse forging prescriptions for controlled substances or creating false documentation to cover up drug theft.
• Physical Assault or Battery: Nurses can be charged with felony assault or battery if they intentionally harm a patient or use excessive force while administering care or touching a patient without permission or verbal consent. For example, a nurse intentionally strikes or injures a patient during a routine procedure or argument or a nurse examines without the client’s permission.
• Sexual Assault: A nurse who engages in inappropriate or non-consensual sexual conduct with a patient can face felony charges for sexual assault, including rape or molestation. For example, a nurse assaults a sedated or unconscious patient.
• Murder: If a nurse intentionally causes a patient’s death through malicious actions or criminal negligence, they could be charged with second-degree murder or even first-degree murder, depending on the circumstances. For example, a nurse intentionally administers a lethal dose of medication to a patient that becomes the cause of death.
• Manslaughter: It is a legal term for homicide that is considered less culpable than intentional murder. If a nurse’s reckless actions (not deliberate but grossly negligent) result in the death of a patient, they could be charged with manslaughter. For example, a nurse administering the wrong dosage of a medication that leads to the client’s death is liable for manslaughter.
• Theft of Patient Property: Stealing money, personal items, or medications from patients can result in felony charges, particularly if the theft is systematic or involves a pattern of behavior. For example, a nurse steals personal valuables from patients’ belongings while they are under care.
• Healthcare Fraud: Nurses can face felony charges for engaging in fraudulent activities, such as submitting false billing information, overbilling for services, or falsifying records for financial gain. For example, a nurse submits fake claims for procedures not performed or inflates the cost of medical services.
• Sexual Exploitation: Nurses can be charged with felony sexual misconduct if they exploit their position of trust to engage in sexual activities with patients, especially when the patient is vulnerable or incapacitated. For example, a nurse uses their authority and position to initiate inappropriate sexual relationships with patients under their care.
• Practicing Without a License: Nurses who continue to practice after their nursing license has expired, been revoked, or suspended can face felony charges, especially if they knowingly perform acts that fall under the scope of nursing practice without valid licensure. For example, nurses practicing after their license has been revoked for prior misconduct, continue to provide patient care illegally.
• Child or Elder Abuse: Nurses who physically harm children or elderly patients may be charged with felony abuse. For example, a nurse physically restraining or hitting a vulnerable child or elderly patient under care.
• Tampering with Medical Records: Falsifying medical records, particularly when it involves deliberate misrepresentation of care or billing can result in felony charges. For example, a nurse alters medical charts to cover up an error or misrepresent care that was never provided.

• Prison Sentences: Felony charges typically carry significant prison time, often exceeding one year. In severe cases, sentences may last for many years.
• Fines: Nurses convicted of felonies may be subject to substantial fines, which can be in addition to or instead of imprisonment.
• Loss of Nursing License: A felony conviction can lead to automatic revocation or suspension of a nurse’s professional license, effectively ending their nursing career.
• Probation: In some cases, a nurse may be placed on probation instead of serving time in prison. This means they must adhere to specific conditions set by the court.
• Restitution: Convicted nurses may be ordered to pay restitution to victims (e.g., patients or healthcare organizations) to compensate for financial losses caused by their criminal actions.
• Disqualification from Employment: A felony conviction may prevent a nurse from obtaining or maintaining employment in healthcare settings. Many hospitals and healthcare institutions conduct background checks and may refuse to hire someone with a criminal record

Misdemeanors for nurses in the United States are less severe offenses than felonies but still involve breaches of the law that can result in significant consequences, including fines, short-term imprisonment, probation, or professional disciplinary action. These offenses often stem from negligence, minor breaches of professional standards, or actions that reflect poorly on a nurse’s ethical responsibilities. While they may not be as severe as felonies, misdemeanors can still harm a nurse’s career and reputation.

• Failure to Follow Protocols: Minor lapses in adhering to hospital policies or procedures that result in patient discomfort or minor harm can lead to charges. For example, administering medication without double-checking the prescription, leads to mild side effects.
• Neglect of Duties: Failing to provide timely care or attention to a patient’s needs, though not resulting in severe harm. For example, forgetting to change a patient’s dressing as scheduled.
• Theft of Small Items: Taking minor items such as medical supplies, gloves, or low-value patient belongings. For example, pocketing gauze, syringes, or other non-controlled hospital supplies for personal use.
• Misuse of Workplace Resources: Using hospital resources or facilities for personal purposes without authorization. For instance, utilizing hospital equipment to print personal documents without prior permission.
• Patient Privacy Violations (HIPAA Breaches): Accidentally, intentionally or unintentionally sharing patient information without proper authorization. For example, discussing a patient’s condition in a public area where others can overhear.
• Unauthorized Access: Accessing a patient’s records without a legitimate reason. For example, accessing a friend’s or celebrity’s medical file out of curiosity.
• Minor Falsification: Making errors or small misstatements in medical records without causing significant harm. For example, documenting that vital signs were checked when they weren’t but no harm occurred.
• DUI (Driving under the Influence): Being charged with driving under the influence of alcohol or drugs can result in a misdemeanor and raise questions about the nurse’s ability to practice safely. For example, a nurse was arrested for DUI outside of work hours.
• Mandatory Reporting Violations: Failing to report suspected child abuse, elder abuse, or domestic violence as required by law can result in a misdemeanor. For example, not reporting obvious signs of abuse in a vulnerable patient.
• Unprofessional Behavior: Engaging in disruptive or inappropriate behavior, especially while on duty or in a healthcare setting. For example, yelling at colleagues or patients in a public area, that causes a disturbance.
• Verbal or Minor Physical Altercations: Getting into arguments or disputes that escalate into minor physical confrontations. For example, pushing a colleague during a heated disagreement.
• Public Health Violations: Improper disposal of medical waste or bio-hazardous materials. For example, disposing of needles in regular trash instead of a sharps container.
• Inappropriate Use of Social Media: Sharing patient details on social media, even if no specific identifiers are included. For example, posting about an unusual medical case in a way that violates privacy laws.
• Rough Handling of Patients: Using unnecessary force to restrain or move a patient, even if no severe harm occurs. For example, grabbing a patient roughly during a procedure.

The penalties for misdemeanors vary by jurisdiction and the nature of the offense but generally include:

• Fines: The cost usually varies, typically ranging from a few hundred dollars to several thousand dollars, depending on the specific circumstances and requirements.
• Imprisonment: Jail time, often under one year, served in a local jail rather than a state prison.
• Probation: A period of supervised release, often with conditions such as community service, education programs, or counseling.
• Professional Discipline: Nursing boards may impose additional penalties, such as temporary suspension or revocation of the nursing license, mandatory continuing education, remediation programs, fines, or formal reprimands.
• Restitution: Payment to compensate victims for any losses caused by the nurse’s actions.
• Criminal Record: A misdemeanor conviction can remain on a nurse’s record, potentially impacting future job opportunities.