North Carolina Board of Nursing

Discipline & Compliance

Employer Complaints

Just Culture Overview

The Board has made concerted efforts to move from the traditional regulatory culture of blame and shame to a culture of quality improvement and patient safety. All complaints are taken very seriously. All allegations are evaluated with respect to the merits of the individual case and actual or potential risk to the public as a result of the individual nurses’ behavioral choices. The Board can only take formal action if there is clear and convincing evidence that the nurse violated state nursing laws or rules.

The Board has adopted a “Just Culture” which promotes a learning culture that supports patient safety while assigning accountability for behavioral choices. The Board uses “Just Culture” concepts when reviewing practice events or errors and when identifying appropriate resolutions that promote practice enhancement and patient safety.

The Complaint Evaluation Tool (CET) was developed by the Board of Nursing to identify and clarify when practice events require a report to the Board. The CET serves as a framework through which employers, nursing leaders, and the Board of Nursing can evaluate and analyze practice events or errors with consistency and fairness. The CET is designed for use only when evaluating clinical practice events or issues involving nurses.

NOTE: Confidentiality, fraud, theft, drug abuse, impairment on duty, drug diversion, boundary issues, sexual misconduct, mental/physical impairment are not appropriate for evaluation using NCBON CET. These events/issues are conduct and health-related issues, not practice incidents or events, and MUST be reported to NCBON.

Use of the CET and consultation with Board staff guide the employer and nurse leaders to evaluate whether the practice event/issue was the result of human error, at-risk behavior, or reckless behavior, and further determines whether the behavioral choices warrant consoling, counseling, remediation, or discipline.

Learn more about Just Culture