Two Nurses Were Fired for Giving Each Other IVs. An NLRB Judge Said It Was Legal.
An NLRB administrative law judge ruled on April 24, 2026, that Johns Hopkins Medical Associates lawfully fired two registered nurses after finding the hospital proved they were terminated for an unauthorized IV-fluids incident, not for workplace complaints about staffing and supplies.
The case, first reported by Law360, has bounced through the NLRB system for nearly three years. According to the agency’s docket, the original unfair labor practice charge was filed on July 19, 2023, just weeks after the firings. A related companion case, 05-CA-319331, was filed by a second nurse on May 31, 2023.
According to the NLRBÂ case file, the charges were filed under Section 8(a)(1) of the National Labor Relations Act, which protects employees who engage in “concerted activities” with coworkers. The General Counsel’s complaint, issued on March 28, 2025, alleged that the nurses were fired in retaliation for raising group concerns about shortages of supplies, inadequate staffing, and mandatory overtime at the surgery center.
Those workplace gripes are exactly the kind of communication that the National Labor Relations Act shields, regardless of whether nurses are unionized. The General Counsel argued the IV story was a pretext, pointing to evidence that nurses at the facility had reportedly practiced inserting IVs on one another for years without consequence.
Johns Hopkins, represented by attorneys from Littler Mendelson, the country’s largest management-side labor law firm, told the judge that the firings had nothing to do with protected complaints. The hospital’s position was that the nurses were dismissed for unauthorized administration of intravenous fluids, a serious clinical and policy violation discovered during a corporate investigation visit on May 8-10, 2023. Both nurses were terminated on May 24, 2023, two weeks after the on-site review concluded.
According to the Law360 report, Administrative Law Judge Arthur J. Amchan found that, while the nurses had engaged in protected activity, the hospital established that the IV incident was the actual driver of the discharge decisions. The decision is still subject to exceptions and further Board review, so it is not yet a final merits ruling by the full NLRB.
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The decision lands in the middle of a much larger labor fight over Johns Hopkins and its nurses. The flagship Johns Hopkins Hospital in Baltimore reached a 2023 settlement with National Nurses United after the NLRB found merit to allegations that the hospital had unlawfully restricted RNs from discussing the union at work, surveilled organizers, and barred off-duty nurses from break rooms during an organizing drive.
The Baltimore Sun previously reported that two unionizing Hopkins nurses had been retaliated against, including one who said she was fired while seven months pregnant. The Lutherville case is separate from those campaigns but adds to the pattern of NLRB scrutiny of Johns Hopkins workplaces.
For the labor movement, this week’s ruling is a setback. Wright Line, the legal framework the NLRB uses for mixed-motive discharge cases, requires the General Counsel to show that protected activity was a substantial factor in the firing. The burden then shifts to the employer to prove it would have fired the worker anyway. The Lutherville decision indicates the judge believed Johns Hopkins met that burden.
This case is a reminder that protected concerted activity is powerful, but it is not a shield from clinical policy violations. Nurses can complain, organize, and even walk together to the boss’s office to demand more staffing without fear of legal retaliation. They cannot, however, count on those complaints to insulate them from discipline if they also break a clear safety or scope-of-practice rule, even one that is widely ignored on the unit.
Administering an IV to another adult, including a coworker, is a medical act. Doing it outside a documented order, without consent procedures, and without an authorized provider exposes the nurse to license discipline from the state board, not just employer discipline. If “practicing on each other” is a normal part of orientation at your facility, ask leadership to put it in writing, in policy, with named supervising clinicians. Verbal permission disappears the moment HR opens an investigation.
If you do believe you were retaliated against for raising group concerns about staffing, supplies, or overtime, you have six months to file a charge with the NLRB, and you do not need to belong to a union to do it.
