The Advanced Practice Registered Nurse (APRN) Compact is an agreement between several states where participating compact states recognize nursing licenses and credentials from other member states. If your credential was granted in an APRN compact state, you can practice in member states without getting a state-specific license. However, that mobility comes with important caveats. Losing your license or being disciplined in any compact state carries the same effect in all other compact states.
Are you an APRN facing sanctions, investigation, or potential license discipline? Did you know that if you're sanctioned in any APRN compact state, those sanctions carry over to every other participating compact state? You may also have to defend your license against multiple nursing boards. An attorney with experience in APRN license defense could help you save your license. Call the Lento Law Firm Professional License Defense Team at 888-535-3686 or contact us online today.
How The APRN Compact Works
APRNs are important parts of any healthcare team, but they are in short supply in many states. This is largely due to the high standards and rigid qualification processes most state nursing boards establish to become an APRN. With that in mind, four states formed the APRN compact. As a licensed APRN from a compact state, you can explore career opportunities in other areas without applying for a new license.
The participating state gets an opportunity to remedy its APRN shortage by casting an employment net wider than just the APRNs licensed by that state's nursing board. In that sense, it's a win all around. However, there is an elevated risk level for APRNs working in a compact state. All APRNs must abide by the rules of the individual nursing board where they practice and where they were originally licensed.
Potential Complications of Being an APRN
You must report any discipline you receive from any participating state to your original licensing board. More importantly, if your license is sanctioned or suspended by just one APRN compact nursing board, their discipline will apply to all compact states. That means you won't be able to practice at all. It also means your license discipline will be on your record, which could negatively impact your future employment opportunities.
This is why you should act immediately and consult with the Lento Law Firm Professional License Defense Team as soon as you find out you are being investigated or subject to any license discipline. Our team has experience defending nursing licenses in board investigations nationwide, including APRN compact states. Discipline or investigation by one state could lead to you fighting for your license in another.
Being represented by an attorney who knows how individual nursing boards work can make a difference in your case. Nursing board decisions to sanction or not sanction an APRN can come down to one vote by a board member. The scary part about that is the decision to recommend discipline and turn your case over to the board for sanctions is often made by just one person.
The Importance of Professional License Defense
In many APRN compact states, it only takes an anonymous complaint to begin an investigation. It's easier than you think for someone to make a good-faith mistake and jeopardize your career. Remember, Nursing Boards are public health agencies, which means they will always defer to what they perceive as being in the interest of the public good. Your license and career are secondary to a Nursing Board's core mission of protecting the public.
That's why it's in your best interest to have us working for you as early as possible in the investigative or disciplinary process. Even if you don't believe you did anything wrong or have anything to hide, going unrepresented during a nursing investigation is a high-stakes gamble. You stand to lose a license you worked a lifetime to earn, along with the ability to support yourself and your family if there is an adverse ruling.
What States Participate in the APRN Compact?
The APRN consists of the following four member states:
The APRN is currently seeking to add new states to the compact. However, if you hold an APRN license from any of the four current compact states, you can practice in one of the others. This compact benefits the participating states because they are either small in terms of size (Delaware) or population (the Dakotas).
Disciplinary Sanctions and Investigations in the State Where You Are Originally Licensed
It's illegal to practice as an APRN without a license. That means your ability to practice in APRN compact states is contingent on you maintaining your license in good standing in whatever compact state it was originally issued. So, if your APRN license was granted in Delaware, and you moved to practice in Utah, a Delaware Board of Nursing sanction would prevent you from working in Utah.
Even if you're no longer practicing in the state where your APRN was originally granted, you must respond to Board of Nursing investigations or charges from that state. For example, if your home state requires you to file a written response to an allegation (which is standard practice in many states), simply failing to respond could be grounds for license discipline or a default ruling against you.
However, many APRNs who are practicing in other states under the compact find it difficult to keep up with deadlines and file responses promptly. Our team can help by keeping track of the relevant deadlines in your case. Trying to file a written response on your own during your off hours may not be the best idea in the first place. Remember, everything you say to the Board or one of their representatives can be used as evidence in your case.
You would be surprised how many APRNs jeopardize their license with their written response to an investigation. Our professional license defense team can work with you to ensure that your written response addresses the allegations without volunteering information that hurts your case. We can give you the peace of mind that comes with knowing that your investigation is properly handled while you work in another compact state.
Disciplinary Sanctions in the APRN Compact States
Your APRN license allows you to practice in participating compact states, but you must adhere to the standards and guidelines of whatever compact state where you practice. Anyone who believes you have violated the state's rules (usually found in a document called the Nurse Practice Act) may report you to the board, which is legally obligated to get to the bottom of the complaint.
That procedure usually involves advising you of the charges against you and requesting a written response within a certain time. The Board will usually assign your case to an investigator who collects evidence and assesses the allegations. If the investigator believes you've committed wrongdoing, they may forward your case to the Board or a disciplinary committee for consideration.
If the committee or disciplinary board agrees with the investigator, they will decide on the appropriate sanctions. At this point, the state where you originally attained your APRN certification may open another investigation. You could easily find yourself fighting for your license against two Nursing Boards simultaneously. This is complicated work, but something that the Lento Law Firm Professional License Defense team has experience doing successfully.
What Types of Infractions Can Lead to APRN License Discipline?
APRNs can't provide quality healthcare without maintaining high standards in their professional and private lives. This makes perfect sense, considering that in addition to providing patient care, APRNs have access to controlled substances and sensitive medical information. Because of this, many infractions could result in investigation and board sanctions. They include, but are not limited to, the following:
- Negligence-Failing to maintain a standard of care that would be reasonably expected of an APRN (e.g., failure to administer medication on schedule, allowing the patient's condition to worsen without informing their doctor)
- Patient Abuse or Neglect- An APRN's primary role is as a caregiver. Accordingly, patient abuse of any nature, whether physical, verbal, or sexual, is completely unacceptable.
- Incompetence- The inability to adequately perform your duties as an APRN (regardless of the cause) is grounds for license discipline.
- Working Under the Influence of Controlled Substances-APRNs are prohibited from practicing while intoxicated or under the influence of controlled substances of any kind. This could also include the overuse of prescription medications while working.
- Improper Record Keeping-Failure to make proper notations on medical charts or altering treatment records
- Diversion or Theft-Removing controlled substances or other items from the hospital or medical facility to sell or keep them for yourself
- Felony Convictions-Being charged with and convicted of a felony offense while licensed is grounds for many Nursing Boards to take disciplinary action.
One of the most difficult aspects of these potential violations is that many of them are subject to individual interpretation. When it comes to a felony conviction, that discipline would only happen after a jury finds you guilty (and our Criminal Defense Team can help you here). However, medicine is an inexact science. It's possible to make a good-faith decision based on your experience that yields an adverse outcome for a patient.
That does not necessarily mean you were negligent, but a current or former patient (or their family) can still file a complaint with the Board of Nursing. There are other ways an APRN can find themselves in the crosshairs of a Board of Nursing investigation. As an APRN, you must follow the treatment plan dictated by your patient's physician.
If the patient or their family decides to pursue legal action after an adverse outcome, they may seek to hold you liable. Filing a complaint with the Board of Nursing is a potential avenue for a plaintiff's lawyer to have the matter investigated by a third party at no cost. They could then seek to use the evidence collected by the Board in their legal action. Scenarios like this are why you must protect yourself.
Almost Anyone Can Refer an APRN to the Board of Nursing
You may be surprised to know that anyone you come into contact with while practicing your profession can file a complaint with the Board of Nursing. That's an exhaustive list of people that includes:
- Hospital staff
- Doctors
- Insurers (or their representatives)
- Current Patients
- Former patients
- Families members of current or former patients
It's key to remember that Nursing Boards are formed to preserve public health and maintain high professional standards among licensed professionals. Because of this, Nursing Boards encourage people who believe they've witnessed a violation to report it by making that process as easy as possible. In many cases, they can file complaints online or simply by filling out a form and sending it to the Nursing Board.
If an orderly or patient thought your eyes were red because you were under the influence instead of simply tired from a double shift, they could easily file a complaint. The Nursing Boards would be duty-bound to investigate it. More to the point, the Nursing Board would have to be fully satisfied that there was no substance to the allegations before they ruled in your favor.
This is what many APRNs may not realize about Nursing Board investigations. It's not a criminal trial where you can only be punished if your guilt is proven beyond a reasonable doubt. You and your attorney will not have any voir dire or the ability to disapprove of potentially hostile jury members. Your complaint and, by extension, your career will be in the hands of people who are employed to advocate for the public, not you.
The Nursing Board is Not Here for Your Benefit
Nursing board members and representatives know there will be potential political and legal fallout if an APRN they've previously cleared in an investigation is involved in a case where a patient is harmed. This explains why they may be inclined to sanction your license if there is even the slightest doubt about your innocence. That's also why you want to benefit from an experienced license defense team like ours.
The Lento Law Firm Professional License Defense Team can help you present a strong case that resonates with the Nursing Board. We know how to dispute evidence in Nursing Board investigations and ensure that overzealous board members respect your rights during the investigative process. When the decision whether to sanction your license could come down to one vote, having effective representation matters.
Would You Be Better Off With Local Counsel in Board Investigations?
There is a theory among some criminal defense lawyers that defendants are better off with a local lawyer who has a working relationship with the prosecutors and judges in the jurisdiction. Although that familiarity might help in plea negotiations, it's never been proven in terms of yielding not-guilty verdicts. However, being represented by local counsel may not help you during a Nursing Board investigation for several reasons.
First, it's not a criminal trial, and Nursing Board investigations have a different legal standard than beyond a reasonable doubt. Nursing Board investigations also have procedures that are different from criminal trials. That means the most effective counsel will be someone experienced with Nursing Board procedures. It's also important to note that the Nursing Board draws many of its employees from the ranks of former professional nurses or healthcare providers.
That makes it unlikely that a local criminal defense attorney will have a working relationship with Nursing Board members. Even if they did, that relationship would not cancel out a Nursing Board member's primary obligation to serve the public. Lastly, you must remember that as an APRN, you may need professional license defense from more than one Nursing Board at the same time.
It's unlikely that a local attorney defending your license will have experience defending it in another state. The Lento Law Firm Professional License Defense Team has that experience, and we offer nationwide license defense. That means we can coordinate your license defense across multiple Nursing Board investigations while maintaining continuity with you and delivering the same quality defense in both states. These factors could be difference-makers in your case.
Why Representing Yourself is a Risk
Your career and reputation are on the line in any Nursing Board investigation. If you are an APRN, you know how much work, time, and effort you put in to get your license. More importantly, you know your APRN license gives you a degree of knowledge and experience that unlicensed people don't have when it comes to patient care and medical treatment. The same thing is true about our firm.
Nationwide professional license defense is what we do! We have a track record of professional experience and an understanding of Nursing Board procedures that can tilt the outcome of a Nursing Board investigation in your favor. Many people mistakenly assume there is no risk in representing themselves in a Nursing Board investigation because they have done nothing wrong and, therefore, have nothing to hide. Is that a risk you want to take?
If your experience as an APRN told you someone had a dangerous medical condition, would you advise them to treat it themselves or seek professional medical attention immediately? The answer is obvious, and so is the reason why. Medical problems can be more complex than they seem at first glance, and so can professional license defense. The sooner that knowledgeable professionals are working for you, the better off you are likely to be.
When Should You Seek Out Professional License Defense?
In our experience, the sooner we get involved in a case, the better our chances of positively impacting the outcome for our client are. Considering that an adverse ruling in a Nursing Board investigation could cost your career, we suggest you contact us as soon as you find out you are under investigation. Many Nursing Board investigations begin with a notification from the Board that you're being investigated.
This notification usually lays out the charges against you and gives you a deadline to make an official response. In some states, failure to present a written response by the deadline could mean you accept the charges via default. That's why we recommend you contact our Professional License Defense team as soon as you are notified about the investigation. Let us help you with your response. It will become part of the record in your case.
How Can the Lento Law Firm Help?
The Lento Law Firm Professional License Defense Team will dedicate themselves to helping you keep your license in a Nursing Board investigation. By contrast, the members of the Nursing Board will be looking for reasons to take your license away. We take a fine-toothed comb to the evidence in your case and isolate any weak points. That's in addition to presenting you to the Board in the best light possible.
We will also coordinate closely with you to make sure you are prepared for hearings, interviews, or any other interactions with Nursing Board officials. We'll defend your right to due process and ensure that the Nursing Board treats you with the respect you deserve. Our team can coordinate this effort across multiple Board investigations, and more importantly, we have experience defending nursing licenses nationwide.
You worked all your life to become an APRN. Our team is just as dedicated to professional license defense and standing up for you when the chips are down. That's what we do every day. We pride ourselves on our record and our commitment to client service.
When you hire the Lento Law Firm, everyone on our team makes the maximum effort on your behalf. That's the ethic you take to work every day as an APRN. It only makes sense to have an attorney who will bring that same mindset to the table when it comes to defending your license. Call the Lento Law Firm Professional License Defense Team at 888-535-3686 or contact us online today!
