My Story of A Board Investigation

I worked for a dermatologist for about three years in a large practice—a 10,000-square-foot facility with four providers, 50 employees, and 13 treatment rooms. As a registered nurse (RN), I needed good faith exams to perform injections. I understood how critical this was because, at my previous job, they weren’t doing good faith exams, and I’d heard about the board conducting undercover investigations and citing nurses for noncompliance.

At this practice, there was one dermatologist and a physician assistant who refused to do good faith exams for me. They didn’t want to assume liability and believed RNs shouldn’t be injecting at all. They even approached the Medical Director, arguing that I should only perform laser treatments, not injections. They never reserved time on the schedule for me to get good faith exams, leaving me to track down a provider whenever I needed one.

Eventually, my Medical Director instructed me to perform the good faith exams myself if a provider wasn’t available. He told me to leave the completed patient profile sheets on his desk, and he would sign off on them later. In hindsight, I should never have followed that directive, but having his instructions in writing ultimately protected me from losing my license. I was simply following the orders of my Medical Director.

One morning, after dropping my kids off at their elementary school, I heard about a school shooting at the nearby high school—about a mile away. Three students tragically lost their lives. Despite the shock, I still went into work. My first patients that day turned out to be undercover investigators from the Board of Consumer Affairs. I was already panicked and emotional about the shooting, desperate to get through my appointments and pick up my kids.

Because of the chaos that morning, I attempted to perform a treatment without first finding a doctor for the good faith exam. I had written instructions allowing me to do the exams myself, so I thought I was covered. But just as I was about to inject, the investigators stopped me. They revealed they were undercover and said there had been a complaint about our practice not following protocol.

The investigators also cited our aesthetic consultant for diagnosing melasma without proper credentials. This led to court proceedings and hiring attorneys to defend us. During the process, I learned the complaint had been filed by someone with the same last name as a competing doctor in the area—a highly uncommon surname. However, the complainant refused to cooperate with the investigation, which worked in our favor. I have heard of other investigations, where the nurses werent as lucky and were escorted out of their office in handcuffs. Registered nurses can be charged for "practicing medicine without a license" and possibly suspension or revokation of their license.

I spoke openly about my experience at the ISPAN conference in 2023 "My Story of a Board Investigation"

In the end, the case was dismissed, but I had to complete 50 hours of community service. The experience taught me an invaluable lesson: always protect my nursing license and thoroughly understand the laws governing my practice. I should never have relied solely on someone else’s word, even if it was my Medical Director’s. Following proper procedures and prioritizing my professional integrity will always be my responsibility.