Deficient professional conduct by nurses is a marginal phenomenon but can seriously risk patient safety and affect nursing careers and public trust. Knowledge about its supervision is lacking. As a result, there is a need to advance the understanding of this issue. This study aimed to explore and synthesize the knowledge of deficient professional conduct by nurses and related supervision at the nursing administration and supervisory authority levels.

The study was conducted with a multi-method design which included two phases. A synthetical phase was an integrative review of previous studies (n = 24) about nurses who were disciplined by their supervisory authorities, analyzed with inductive content analysis. An empirical research phase included two data sets of a retrospective document analysis. The first was conducted to the national supervisory authority’s disciplinary decisions for registered nurses (N = 324) with descriptive statistics, and the second, to early intervention procedures to registered nurses (N = 43) based on one Finnish university hospital’s documents with inductive content analysis.

Deficient professional conduct by nurses was described as a nurse-based issue concerned with their well-being at work and how they implemented patient care, complied with the work framework and behaved ethically and possible endangered patient safety (Papers I, II and IV). Administrative supervision of nurses’ professional conduct included early intervention and sanctioned actions (Papers III and IV). The nurses were described according to their key background factors and influenced by personal, professional and work-related factors (Papers I and II). They were subjected to different forms of disciplinary decisions by their supervisory authorities (Papers I and III).

The supervision of professional conduct of nurses is a chain but contains certain gaps and the complexity of deficient professional conduct involves some challenges to related supervision. The development of professional supervision of nurses’ deficient professional conduct at different levels requires a more precise definition of the phenomenon and supervision process in the future.