Investigation Process


The mission of the North Carolina Board of Nursing is to protect the public by regulating the practice of nursing.

North Carolina is a mandatory reporting state. Any person who has reasonable cause to suspect misconduct or incapacity of a nurse or who has reasonable cause to suspect that a nurse has violated the Nursing Practice Act (NPA) (law) shall report the relevant facts to the Board. The complainant is immune from criminal or civil liability for reporting concerns if the report was made in good faith (G.S. 90-171 .47 ). Complaints may come from employers, co-workers, law enforcement, patients, relatives, other agencies, self­reports, or made anonymously to the Board. Not all complaints reported to the Board are grounds for discipline by the Board. The North Carolina Board of Nursing has jurisdiction over licensed nurses and has no authority over employment/workplace issues, concerns about work hours, or co-worker conflicts.

Investigation Process

When the Board receives a complaint, a determination is made as to whether the Board has jurisdiction and whether the reported allegation(s) violate existing laws (NPA) or regulations (North Carolina Administrative Code Rules) that govern a nurse's practice.

Once affirmed, the complaint is assigned to an investigator who will notify the nurse via the contact information on file with the Board. In rare circumstances, notification may be withheld if in doing so would impede the investigation. The nurse may be flagged in NURSYS when the Board is conducting an investigation. Law enforcement or other pertinent agencies may be notified in the course of the investigation as appropriate.

If a nurse elects to retain an attorney, the nurse will be responsible for ensuring that their attorney provides the Investigator with a Letter of Representation on company letterhead. The nurse is responsible for all attorney fees.

The Investigator's role is to collect evidence from a number of sources which may include witness interviews and document reviews/audits, then report the facts in a fair and impartial manner. A nurse is afforded the opportunity to respond to the allegations made against him/her in both an interview and submission of a written statement.

The process used to investigate and act on a complaint may vary depending upon the seriousness of the allegation(s) and the timeliness of the complaint. Investigations may take weeks to months depending upon the complexity and seriousness of the alleged conduct, the ability to locate witnesses, and the response time for record requests.

It is also important to note failure to respond to the Board's inquiries in a reasonable manner or time regarding any matter affecting the license to practice nursing is reason for disciplinary action by the Board. Failure to respond will not deter the Board from making a determination based on the facts available.

Advanced Practice Registered Nurse Investigations

The investigative process for a Clinical Nurse Specialist and a Certified Registered Nurse Anesthetist is the same as for Registered Nurses and Licensed Practical Nurses. Nurse Practitioners are jointly regulated by the North Carolina Board of Nursing and North Carolina Medical Board for which both entities will be involved in the case determination. An investigation involving a Certified Nurse Midwife is completed by the Board while involving the Midwifery Joint Committee.

Last Changed: 14-March-2024