Protecting Your Nursing License

Nurses work hard to get their nursing licenses. That’s why it’s so important to protect them. 

State boards of nursing monitor licensed nurses. They hold them accountable for safe, appropriate care. Those who fall short can find themselves in trouble with the nursing board. Or worse yet, they could end up subject to disciplinary actions. 

Here is what nurses need to know about protecting their nursing license.

Complaints 

The boards of nursing exist to protect the public. I’ll say it again: they protect the public, not nurses. To that end, they take reports or complaints against licensed nurses in the state. 

Complaints can come from many sources. Some include:

• Patients
• Coworkers
• Employers
• Other state boards
• Law enforcement

Complaints are received through phone calls, letters, and even online reporting. When someone feels that a nurse did something wrong, it is simple to open a case against the nurse. Nurses need to know that anyone can file a complaint against their nursing license. 

Board Investigations

The boards take complaints very seriously. In most cases, the board will first open an investigation. Then, they will investigate the report and the nurse. This process can include interviews, record reviews, and discussions with the nurse. 

An investigation may also include conferences or hearings. In some states, a court order is issued to the nurse, requiring them to appear. Experts recommend that nurses avoid making statements, answering questions, or appearing at proceedings without legal counsel. Nurses need to know that it is best to seek counsel if they ever become the subject of a board investigation.

After the investigator is satisfied with the details about the allegation, they will compile a report. After the investigation, the board will notify the licensee of the findings. If they could not find sufficient evidence that an offense occurred, then the case is closed. 

State boards vary in terms of how long they keep the reports and whether or not they expunge complaints. 

Charges Indirectly Related to Nursing Practice

A nursing board can take action when they feel a nurse has violated the nursing laws or has posed a danger to the public. The state boards define unprofessional conduct, unsafe practice, or unethical behavior.

Some of these may include:

• Failure to notify the board of criminal convictions or follow mandatory reporting obligations
• Failure to notify the board of name or address change in the required time frame
• Lapse of moral character
• Falsifying medical or business records
• Incomplete or improper documentation
• Fraud or dishonesty when representing oneself or obtaining/renewing a nursing license
• Practicing outside one’s scope or delegating activities that should not be delegated to unlicensed persons
• Refusing to care for patients for nonclinical reasons
• Patient abandonment, abuse, or neglect
• Failure to protect patients from abuse, neglect, or unsafe conditions
• Failure to properly display ID badge showing name and title
• Failure to adequately supervise delegated activities
• Practicing under the influence or while impaired
• Driving under the influence
• Failure to maintain minimum acceptable standards of safe practice
• Drug, alcohol, or chemical dependency
• Failure to cooperate in an investigation of the board
• Violations of privacy
• Misconduct with patients or boundary violations
• Involvement in patient finances
• Misappropriation of supplies, patient medications, equipment, or patient’s personal belongings
• Failure to file accurate and timely tax returns
• Failure to pay spousal or child support
• Failure to repay student loans

As you can see, many charges of professional misconduct do not directly relate to nursing practice. Yet, they can result in disciplinary action against one’s nursing license. Nurses need to know that boards of nursing can take action against nurses who have shown bad judgment, lapses in good moral character, or dishonesty. These raise questions about their ability to practice nursing.

Another concept nurses need to know is called “reciprocal discipline.” It means a board’s action in one state is grounds for other states to take action even if the nurse’s license is inactive. When charged with an offense, a nurse may have to defend themself in each state in which they have ever held a license.

The Outcomes 

Nursing board actions can vary by state. Matters may be closed without sanction, or they may find that disciplinary action is warranted. The board can take a wide range of actions against a nurse. 

Some of the possible actions against a nursing license include:

• Warning, reprimand, or censure
• Mandated continuing education
• Community service
• Remediation of an alternative discipline program
• Citation
• Probation
• Fine or Civil penalty
• Practice monitoring, restrictions, supervision
• Suspension or emergency suspension
• Surrender or relinquishment of license
• Revocation of license

Nurses need to know that even lenient actions by the board can be troublesome. Disciplinary action can create collateral practice barriers. The board may inform other agencies, employers, and the public about the actions. Nurses may be placed on disqualified provider lists and therefore unable to practice in some settings or other states. 

Federal databases like the National Practitioner Data Bank (NPDB) and the Healthcare Integrity and Protection Data Bank (HIPDB) record actions against professional licenses. Then, other state boards, hospitals, and professional societies can identify nurses engaged in unprofessional conduct or malpractice. Getting listed can compromise professional memberships, clinical privileges, and employability.

If a nurse has to leave the profession, it may be hard to get licensed in another field. Authorities may refuse to issue licenses when a previous professional license was surrendered, suspended, or revoked. 

And maybe the most significant effects of action against a nursing license are the mental and emotional effects. Many nurses find their identities in nursing. Board investigations threaten not only a nurse’s livelihood but who they are. 

In Conclusion

Now you know how to stay in good standing with the board. Remember that any action by the board can be disruptive. The board can take action for reports that call into question the honesty or integrity of a licensed nurse, so keep that in mind on and off the clock. If the board ever calls, the best thing is to seek legal counsel right away. And don’t forget, anyone can file a complaint with the board. 

Now you know what to do to better protect that nursing license you worked so hard to get. 

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