The Kansas Board of Nursing Was Just Overhauled: Unpacking the Implications

Kansas State Board of Nursing Saga

Boards of nursing are state-empowered bodies that exist to set standards of practice for nurses and protect the public from them. They wield great power and determine who can join the profession, set regulations, and discipline nurses for professional misconduct.

They operate in the complex, dry world of administrative law, and most nurses rarely think about their state board of nursing beyond their regular license renewal.

But for the minority of nurses who have had to interface with them regarding a complaint or accusation, their actions can end their careers.

And that matters, because absolutely anyone can submit a formal complaint against a nurse. Worse still, most states have no statute of limitations for professional misconduct, leaving significant room for improper or retaliatory board complaints.

Accusations Against the Kansas State Board of Nursing

For years, a growing list of Kansas nurses say they’ve been on the receiving end of gratuitous professional discipline from the Kansas Board. Boards of nursing exist to safeguard the public from dangerous nurses, but according to these Kansas nurses–and nurses across the country–many boards are instead operating as gleeful dealers of draconian harm.

In Kansas, dozens of nurses came forward to testify before local legislators that they had been slapped with ‘professional misconduct’ demerits for simple clerical errors, such as checking the wrong box on a form or allowing their licenses to lapse due to family emergencies.

This is crucial because once a nurse has been labeled with that demerit, the discipline becomes part of the public record; it shows up on background checks, the board publishes their name in a public safety newsletter, and it can become impossible for that nurse to be hired or obtain malpractice insurance.

That’s because most boards of nursing do not differentiate demerits into separate categories. A nurse who had an inappropriate sexual relationship with a patient or stole their medications is labeled exactly the same as a nurse who filled out a form incorrectly.

One of the leading voices in this fight is Amy Siple, a nurse practitioner of 32 years whose license lapsed while she was caring for her ailing husband, who was battling cancer. She was not working as a nurse at the time. Once she was ready to return to work, she applied to renew her license and paid the fee. But she was then shocked to receive a notice from the board informing her she was being investigated for practicing nursing without a license.

Eventually, the board asked her to sign a consent agreement, a binding contract in which the nurse admits guilt to the accusations and accepts whatever discipline the board deems appropriate. Since then, Siple has filed a lawsuit against the board seeking to have this disciplinary action removed from her license.

Throughout the ordeal, Siple and many other nurses who’ve had run-ins with state boards of nursing have been cautioned to sign consent agreements because these bodies are “notoriously vindictive” and will “make an example” out of any nurses who fight back.

Unpacking House Bill 2528

After years of advocacy by nurses and a series of heated testimony sessions before the Kansas Government Oversight Committee, legislators were appalled by the nurses’ testimony and vowed to take action. Eventually, this led to the passage of House Bill 2528, which does the following:

• Prohibits the Kansas Board of Nursing from taking retaliatory action against a licensee based on certain lawful actions
• Requires all current board members to be terminated on Jan. 1, 2027
• Voids nonpractice disciplinary actions against nurses from 2005 to 2026
• Redefines “professional misconduct” to only include actual nursing practice actions and things that affect patient safety
• Creates a reinstatement pathway for late license renewals

Proponents of the law hail this as a victory for nurses against bureaucratic overreach, while opponents say its language is too broad and it may cause problems in the future.

Cambria Nwosu, DNP, RN, LNC, is a doctorally prepared nurse administrator and legal nurse consultant who has been closely following the situation in Kansas. She agrees with many of the law’s changes but has some reservations: “My concern with HB2528 is that it is too broad. There needs to be a differentiation between administrative issues like those faced by Amy Siple, versus ethical or professionalism issues like racism and patient harm. It is crucial that nursing discipline be non-partisan and rooted in our ethics.”

Unraveling the Complex World of Administrative Board Law

Nurse and legal experts across the country have been sounding the alarm about what they view as foundational issues in how boards of nursing operate and how disciplinary procedures are handled.

The friction stems largely from differences between administrative and criminal law and from how those differences affect the complaint investigation process. Because criminal law imposes much more severe punishments, proceedings require strict constitutional protections to ensure citizens’ rights. Conversely, because administrative law involves government agencies and “lesser consequences,” they utilize a more flexible process and require a lower burden of proof to maximize efficiency.  

Maggie Ortiz, RN, MSN, is a legal nurse, advocate, educator, and speaker who has unique expertise on state boards of nursing because she served as a board investigator in Texas.

Ortiz says, “Administrative law is very different from criminal law, and many nurses are surprised by that. I’ve seen nurse after nurse often tell me it feels like they have to prove their innocence instead of the Board having to prove its case. While Boards of Nursing have a responsibility to protect the public, nurses also have constitutional rights and are entitled to due process.”

Nurse advocates point to foundational legal concepts and procedures governing these boards as key areas that could be reformed to create a regulatory environment that is fair and just for nurses and patients alike. 

Here are the most important legal concepts nurses must understand regarding state nursing board proceedings, explained by legal nurse consultant Dr. Cambria Nwosu.

Due Process

Due process is a constitutional right that states the government shall not “deprive any person of life, liberty, or property without due process of law”. Regardless of the type of law being practiced, the government must follow a set of rules when taking action against the accused. In criminal law, this means the state must prove guilt beyond a reasonable doubt, and the defendant has rights, including the right to a jury and to be appointed legal counsel, amongst other rights.

Due process in the world of administrative law is completely different. For example, the burden of proof that must be supplied against the defendant is lower. In addition, nurses under board investigation are not provided legal counsel or expert witnesses, but must instead procure and pay for them themselves. They are also not guaranteed to be tried in front of a jury of their peers, but rather, a small private board made up of individuals typically appointed to their positions, not elected.

Statutes of Limitations

According to the American Association of Nurse Attorneys (TAANA), a Statute of Limitations is a law that bars claims after a specified period of time. Their purpose is to: 

1. Require diligent prosecution of complaints
2. Provide finality and predictability in legal affairs
3. Ensure that complaints are resolved while the evidence is reasonably fresh and available

Most states do not have a Statute of Limitations for nursing board complaints, which can lead to ineffective investigations, relitigation of already settled issues, and prolonged suffering for nurses whose issues have already been adjudicated.

Retained Jurisdiction

In the world of nursing boards, retained jurisdiction refers to the ultimate authority the Board maintains over a nurse’s license even after the nurse leaves the state, allows their license to expire, or retires. In theory, this is important to prevent nurses from escaping discipline. In practice, Boards without codified limitations on retained jurisdiction statutes can act in perpetuity, even decades later.

Reciprocal Actions & Double Jeopardy

TAANA describes yet another significant concern nurses face in board proceedings: reciprocal action. Nurses can apply for licenses in other states, and under the current system, they can be subject to reciprocal action by the new state’s Board of Nursing.

This is referred to as double jeopardy, a legal protection that ensures an individual cannot be tried or punished twice for the exact same offense. TAANA says in no uncertain terms,

Courts have determined that double jeopardy only applies in criminal cases due to the differences in actions taken. Yet, when the goal of public protection is outweighed by significant harm caused to those being repeatedly disciplined, it begins to look more like cruel and unusual punishment. 

Many nurses’ lives have been destroyed due to the harsh burdens placed upon them by having to repeatedly defend their licenses for the conduct for many years, sometimes decades after the fact.

Deference Doctrine

According to Dr. Nwosu, 

Courts frequently defer to administrative agencies, including boards of nursing, under principles of administrative law. The idea is that agencies possess specialized expertise within their regulatory domain. As a result, courts often do not fully “re-try” the facts of a disciplinary case. Instead, they evaluate whether the board acted within its authority and whether there was substantial evidence supporting the decision.

For nurses, this creates a significant imbalance because boards: investigate, prosecute, adjudicate, and discipline, while courts reviewing those actions may still defer heavily to the board’s interpretation and findings. That imbalance is one of the central issues driving many current conversations around nursing regulation and due process.

Immunity for Employers & Boards of Nursing

As if this David vs Goliath legal process wasn’t difficult enough for nurses facing board investigations to navigate, there are also structures in place to protect employers and the board further, even if they cause immense harm. 

Dr. Nwosu says, 

Boards of nursing and their agents often have significant immunity protections because they are acting as state regulatory entities performing quasi-governmental functions. 

Depending on the jurisdiction and the specific action involved, individual board members, investigators, or attorneys may have qualified immunity when acting within the scope of their duties, [and] certain adjudicatory or prosecutorial functions can receive quasi-judicial or quasi-prosecutorial immunity, which can function similarly to absolute immunity. 

This makes civil lawsuits against boards extraordinarily difficult, even when nurses allege serious procedural harm.

Dr. Nwosu points out that many states offer statutory immunity for employers reporting nurses in “good faith,” but that can be hard to define: “The practical problem is that ‘good faith’ can be interpreted broadly, which can make it difficult for nurses to prove retaliatory intent, even when the timing and surrounding circumstances strongly suggest workplace retaliation. In union-related or whistleblower contexts especially, this creates concern that protected activity can become intertwined with licensing complaints.”

The Fight for a Better System

It’s clear that the injustices faced by nurses in Kansas are not unique, but instead represent issues faced by nurses across the country when facing regulation by their state board of nursing. After their experiences with the state board of nursing, both Matthew Bady and Maggie Ortiz have dedicated themselves to helping nurses navigate the sometimes hostile, always complex world of administrative license board law.

“Nurses deserve a fair process that evaluates the facts, the evidence, the systems issues involved, and the credibility of allegations being made,” Ortiz says. That’s why she founded Advocates for Nurses PLLC, an instructive platform that empowers nurses through education, advocacy, and unity.

The Kansas State Board of Nursing overhaul is just the tip of the iceberg that shows just how badly nursing regulation needs to be reformed. Dr. Nwosu, Ortiz, and Bady all made calls for boards of nursing to increase transparency into their processes and procedures. They also recommended that nurses seek education to learn their rights, and that due process rights be strengthened for nurses under investigation.

“I think it is important to note that none of this means all boards act improperly. Many fulfill an essential public protection role appropriately. However, these legal structures can make it extremely difficult for nurses to challenge allegedly retaliatory, disproportionate, or procedurally flawed actions once they are initiated,” Dr. Nwosu says.

“Oversight doesn’t end when legislation passes or recommendations are made. Nurses deserve transparency. Nurses deserve education. Nurses deserve due process. And the public deserves the confidence to know that the regulatory system is operating fairly for everyone involved,” says Ortiz.