In this chapter, the following terms have the meanings indicated. Terms Defined. Abandonment. “Abandonment” means: Termination by a nurse of a client assignment which had been accepted by the nurse, without reasonable notification to the immediate supervisor to allow for the continuation of the client’s care; In the case of a natural disaster or a federal, State, county, or city declaration of an emergency, refusal by a nurse of an assignment, mandatory overtime, or both; or In the case of a private duty assignment or hospice, if the nurse is the sole provider of care, failure to report for assigned duty or leaving the client unattended at the end of the assigned shift without prior notification to the nursing supervisor, the cognitive capable adult client, or the client’s designated representative. “Abandonment” does not include the declining by a nurse of employer-stipulated mandatory overtime. “Accepting a client assignment” means a nurse has arrived on duty and assumed responsibility for client care based on the nurse’s reasonable and prudent professional judgment and the standards of nursing practice. “Board” means the Board of Nursing. “Client” means a patient, resident, or recipient of care. “Electronic devices” means, but is not limited to, any of the following: Telephones with recording and picture-taking ability; Digital cameras or any other device that can record pictures and data; Facsimile machines, photocopiers, and scanners for copying; and Recording devices. “Multistate licensure privilege” has the meaning set forth in COMAR 10.27.01.01B. “Nurse” means a registered nurse, licensed practical nurse, or advanced practice registered nurse as defined in Health Occupations Article, §8-101, Annotated Code of Maryland. “Social media” means any form of electronic communication, including, but not limited to, communication by use of websites for social networking and blogging through which users create online communities to share information, ideas, personal messages, and other content such as videos. A nurse shall: Provide services with respect for human dignity and the uniqueness of a client unrestricted by consideration of social or economic status, religious affiliation, personal attributes, or the nature of health problems; Safeguard a client's right to privacy by maintaining confidentiality of information; Act to safeguard a client and the public if health care and safety are affected by the incompetent, unethical, or illegal practice of any person; Promptly report a breach of confidentiality or privacy; Assume responsibility and accountability for individual nursing judgments and actions; Maintain competence in nursing; Exercise informed judgment and use individual competence and qualifications as criteria in seeking consultation, accepting responsibilities, and delegating nursing activities to others; and Inform the Board regarding unethical conduct by another licensed nurse. A nurse may not, when acting in the capacity or identity of a licensed nurse: Knowingly participate in or condone dishonesty, fraud, deceit, or misrepresentation; Engage or participate in an action that violates or diminishes the civil or legal rights of a client; Perform new techniques and procedures without adequate education and practice; Assume duties and responsibilities in the practice of nursing without adequate preparation or without maintaining competency; Practice nursing if unfit to perform procedures or make decisions because of physical or mental impairment, including, but not limited to, the effects of prescription drugs; If engaged in research, coerce or pressure a subject to participate or continue to participate in the research; or Abandon a client. A nurse may not engage in behavior that dishonors the profession whether or not acting in the capacity or identity of a licensed nurse, including, but not limited to: Verbal abuse, including use of racial or ethnic slurs, directed toward a coworker, employer, Board staff member, client, or client’s family member; Physically abusing, threatening, or intimidating a coworker, employer, Board staff member, client, or client’s family member; Deceiving, defrauding, or stealing from a coworker, employer, client, or client’s family member; Diverting any medication or providing false or misleading information to an authorized prescriber or a pharmacist to obtain or attempt to obtain any medication; Knowingly employing another person to practice or engage in or attempt to practice or engage in an occupation or profession licensed under this title if the employee is not licensed to do so under Health Occupations Article, Title 8, Annotated Code of Maryland; Performing acts beyond the authorized scope of the level of nursing practice for which the individual is licensed; Obtaining or copying any part of a client’s health record for purposes other than: Providing health care to the client; Conducting quality improvement activities; Complying with legal requirements such as a subpoena; or Allowing a nursing student to use records for educational purposes if client identification has been redacted or disguised; Using, possessing, supplying, administering, or attempting to use, possess, supply, or administer prescription drugs or controlled dangerous substances without valid medical indication; Reporting for employment under the influence of alcohol or a controlled dangerous substance or submitting a pre-employment sample that is positive for alcohol or a controlled dangerous substance without having provided evidence of valid prescriptions for all controlled dangerous substances in the sample; Reporting for employment under the influence of an illicit drug or submitting a pre-employment sample that is positive for an illicit drug; Using the power, influence, or knowledge, inherent in or obtained during the nurse-patient relationship, for the nurse’s personal gratification or benefit; Engaging in unprofessional or immoral conduct; Misrepresenting or concealing a material fact in obtaining a license, renewing a license, or reinstating a license; or Committing an act of moral turpitude, dishonesty, or corruption when the act directly or indirectly affects the health, welfare, or safety of the citizens of this State, and, if the act constitutes a crime, conviction thereof in a criminal proceeding is not a condition precedent to disciplinary action. A nurse may not engage in sexual misconduct. Sexual misconduct includes, but is not limited to: Sexual behavior with a client in the context of a professional evaluation, treatment, procedure, or service to the client, regardless of the setting in which the professional service is rendered; Sexual behavior with a client under the pretext of diagnostic or therapeutic intent or benefit; Solicitation of a sexual relationship, whether consensual or nonconsensual, with a client; Sexual advances toward, or the request of sexual favors from, a coworker, student, employer, client, or client’s family member; Discussion of nontherapeutic sexual matters while treating a client; Taking photographs of a client for a sexual purpose; Sexual harassment of a coworker, student, employer, client, or client’s family member; Sexual contact with an incompetent or unconscious client; Intentionally exposing any of the nurse's sexual body parts; and Intentionally exposing any of the client’s sexual body parts for a nontherapeutic purpose. Electronic devices, including but not limited to telephones, may not be used to record medical records and take pictures or videos of clients without written client authorization. A nurse: May not make use of electronic devices and social media to transmit or place any client information online; and Shall adhere to the following principles for the use of electronic devices and social media: Every nurse has an obligation to understand the nature, benefits, and consequences of the use of electronic devices and participating in social media networking; Nurses are bound to observe ethically prescribed client-nurse boundaries online as in any other setting; Client information shall be maintained in separate encrypted and secured files on personal computers and online; A nurse has an obligation to report any electronically generated material that could harm a client’s privacy rights; and The standards of professionalism are the same when using electronic devices and social media as in any other circumstance. Violation of this chapter may result in the Board taking disciplinary action against a nurse pursuant to Health Occupations Article, §8-316, Annotated Code of Maryland. Health Occupations Article, §§8-205 and 8-316(a)(25), Annotated Code of Maryland Effective date: July 1, 1996 (23:13 Md. R. 944) Regulations .01—.04 repealed and new Regulations .01—.03 adopted effective September 16, 2002 (29:18 Md. R. 1443) Regulation .01B amended effective December 11, 2014 (41:24 Md. R. 1428); July 2, 2018 (45:13 Md. R. 667) Regulation .02 amended effective December 11, 2014 (41:24 Md. R. 1428) Regulation .03 amended effective July 2, 2018 (45:13 Md. R. 667)