Nursing is one of the most in-demand professions in healthcare--and even more so in recent years. As a licensed registered nurse (RN), licensed practical nurse (LPN), or nurse practitioner (NP), you've spent years studying, training, and dedicating yourself to the mastery of your profession, not to mention sitting for the NCLEX exam and qualifying for licensure and possibly other specialized credentials. In short, your license is hard won.
Yet, with the great demand for qualified nurses, a nursing license can be revoked more quickly and easily than you think. State boards of nursing take seriously their commitment to public health and safety, and they will aggressively investigate allegations of misconduct and impose discipline based only on a preponderance of the evidence. It may only take a single complaint against a nurse to culminate in the permanent revocation of their license.
If you're a nurse dealing with licensing issues, we understand that facing the possibility of losing a license is a serious and stressful experience. But with the right information, guidance, and support, it's possible to address the situation and, in many cases, prevent the worst outcomes. The Lento Law Firm's Professional License Defense Team has nationwide experience helping nurses like you defend their licenses, and they have an excellent track record of success. To schedule a consultation, call 888-535-3686 or fill out our online contact form.
What Does It Mean to Have a Nursing License Revoked?
When a nursing license is revoked, it means a nurse permanently loses the legal right to practice in their field. This is the most severe disciplinary action that a nursing board can take. Revocation differs from suspension or probation. Suspension temporarily bars a nurse from practicing, often until specific conditions are met. Probation might allow a nurse to work but under strict guidelines and monitoring.
The state board of nursing, the regulatory body responsible for licensing and overseeing nurses, may revoke a license for serious misconduct, violations of professional standards, violations of that state's Nurse Practice Act, or other reasons. Once revoked, the nurse can no longer legally work as a nurse unless they successfully apply for reinstatement.
Common Reasons a Nursing License May Be Revoked
There are many reasons why a state board may consider revoking your nursing license. Below are some of the most common causes.
Professional Misconduct
Professional misconduct refers to actions that breach the ethical or professional standards nurses are expected to follow. Examples include:
- Falsifying patient records to conceal errors or mislead others.
- Abandoning patients without proper handover to another healthcare provider.
- Violating patient confidentiality under HIPAA regulations.
For instance, a nurse who alters a patient's medical records to protect themselves from a malpractice claim is engaging in misconduct. Such breaches of trust can have serious repercussions and might lead to revocation.
Substance Abuse and Impairment
The stressful nature of nursing can sometimes lead individuals to develop substance abuse issues. While addiction is a medical condition, working while impaired can seriously harm patients. However, even observations of alcohol or drug abuse while not on duty can prompt someone to file a complaint against a nurse, leading to a board investigation.
Many states offer voluntary rehabilitative programs for nurses facing substance abuse issues as an alternative to license revocation--for example, California's BRN Intervention Program, the Texas Peer Assistance Program for Nurses (TPAPN), or New York's Statewide Peer Assistance for Nurses Program (SPAN). However, refusing to participate in one of these programs, or a recurrence of abuse after completing the program can result in license revocation.
Criminal Convictions
Criminal convictions, whether related to nursing or not, can significantly impact a nurse's ability to retain their professional license. While minor offenses, such as minor traffic violations or misdemeanors, might not result in severe penalties from the nursing board, more serious charges can lead to disciplinary actions. Serious offenses include:
- Fraud or embezzlement, which involves deceiving others for financial gain;
- Theft or other felonies, which indicate a breach of trust;
- DUI/DWI, which shows a disregard for laws and public safety; or
- Crimes involving violence or abuse, which raise concerns about the nurse's ability to provide safe and compassionate care.
These serious offenses reflect directly on a nurse's professional conduct and integrity. For example, a nurse convicted of elder abuse or financial fraud against a patient would likely face immediate and severe repercussions, such as suspension or revocation of their license, fines, or mandated rehabilitation programs. It's crucial for nurses to understand that their actions, both in and out of the workplace, can have lasting effects on their careers.
Fraudulent Licensing or Credentials
Presenting false credentials or misrepresenting qualifications during licensure applications or renewals is considered a serious offense with significant consequences. This includes actions such as falsifying clinical hours on an application, fabricating academic transcripts, or lying about attending or completing a nursing program. These deceptive practices undermine the integrity of the profession and can lead to the revocation of one's license or the imposition of fines and penalties once such misinformation is discovered. Furthermore, individuals caught engaging in these unethical practices may face difficulties in obtaining licensure in the future, tarnishing their professional reputation and credibility in the field.
Patient Abuse or Neglect
Patient abuse can take many forms, including physical harm, such as hitting or unnecessary use of restraints, and emotional mistreatment, which may involve belittling, humiliating, or ignoring the patient. Verbal intimidation can include threats or shouting, creating a hostile environment for the patient.
Neglect, on the other hand, refers to failing to provide necessary care, such as not administering medication or ignoring a patient's needs, which could lead to increased suffering, deterioration of health, or even death. Such actions are antithetical to a nurse's professional duty, which is to care for and protect patients, and can trigger severe consequences, including loss of license.
Other Regulatory Violations
Additional reasons for revocation may include:
- Practicing without an active license.
- Failing to complete mandatory continuing education.
- Not reporting prior disciplinary action in another state.
Whatever the cause, understanding the rules within your jurisdiction is crucial to avoiding potential risks.
The Revocation Process
When a complaint or concern arises, the state Board of Nursing follows a structured process to determine a nurse's fate.
Investigation of Complaint
Most cases start with a complaint, whether from an employer, colleague, patient, or other source. This triggers an investigation, which depending on the state is conducted by the state board of nursing, Department of Health, or other regulatory agency. The investigation could include issuing subpoenas for documentation, conducting interviews, or gathering witness statements. The nurse is typically notified of the investigation and given a chance to respond.
Option for Informal Resolution
In many cases, the board may offer a chance for informal resolution of the complaint, usually through an agreement called a consent order, consent agreement, stipulated settlement, or another term. Whatever the name, this agreement involves the nurse effectively admitting to the violation and voluntarily accepting the board's recommended sanctions. This outcome isn't always the best option, but it can work in the nurse's favor if disciplinary action is likely, especially when a good professional license attorney negotiates for lenient terms or a path to reinstatement.
Disciplinary Hearings
If the investigation finds evidence of wrongdoing and no informal resolution is agreed to, the case may proceed to a formal hearing, either before the board of nursing, an Administrative Law Judge, or a Hearing Officer, depending on the protocols of the state. The hearing concludes with a determination of guilt or innocence, typically based on the preponderance of the evidence standard (meaning you can be found at fault by only a 51 percent likelihood that you committed the violation). If a judge or officer hears the case, they will usually issue a recommendation to the board regarding appropriate disciplinary action.
Outcomes and Appeals
After the hearing, possible outcomes by the board include:
- Fines.
- Formal Reprimands.
- Mandatory corrective actions like completing rehabilitation programs or additional education.
- Temporary suspension or probation.
- Permanent revocation of your license.
If you disagree with the board's decision, you can typically file an appeal, requesting a review of the case. This process also differs from state to state.
The Consequences of Losing a Nursing License
The loss of a nursing license can affect your personal and professional life in profound ways.
Impact on Career
Without a license, it's illegal to work as a nurse, posing an immediate barrier to employment. Additionally, revocation often damages a nurse's reputation, making it difficult to secure jobs even outside nursing.
Financial and Personal Strain
Losing a license means losing income, often while facing legal fees, fines, or other expenses. The emotional toll—stress, guilt, and uncertainty—can affect both the nurse and their family.
Broader Effects
The repercussions of license revocation may extend beyond one state. Many state boards require disclosure of past disciplinary actions. In addition, any adverse actions taken against you (including having your license revoked) will be reported to national databases like Nursys and the National Practitioner Data Bank (NPDB), which licensing boards and employers may consult when considering your application. If you hold a multi-state license through the Nurse Licensure Compact or you hold reciprocal licenses in several states, having your license revoked in one state usually translates to losing your licensure in other states, as well. Working in other healthcare roles may also become challenging because of background checks or licensing requirements.
How to Prevent Nursing License Revocation
While some situations may be unavoidable, there are steps nurses can take to minimize their risks of license revocation. Consider the following:
- Stay Educated on Regulations: Keep up-to-date with professional standards and legal requirements in your state. Regular training ensures you understand evolving rules and expectations.
- Maintain Accurate Documentation: Always keep clear, honest, and comprehensive records of patient care to protect yourself if disputes arise.
- Report Issues Promptly: Transparency about mistakes or safety concerns demonstrates professionalism and can sometimes prevent disciplinary action.
- Seek Help When Needed: If you're struggling with addiction, mental health concerns, or other challenges, reach out for help. Many employers and professional organizations offer support programs.
- Consult Legal Counsel Early: If you're contacted by the state board or anticipate a possible issue, involving an experienced legal professional from the start can improve your chances of receiving a favorable outcome and a quick resolution of the issue.
What to Do If Your License Is in Jeopardy
Stay Calm and Proactive: Facing disciplinary action is overwhelming, but it's critical to address the situation head-on. Avoid ignoring notices or warnings from the board, as this usually results in disciplinary action by default.
Engage with the Board Professionally: Provide responses in a timely manner, showing respect and a willingness to cooperate. Failing to engage professionally can only worsen your situation.
Hire a Professional License Defense Attorney: Consulting a lawyer who has experience in licensure defense can improve your odds of navigating the process successfully. Hiring an attorney is not considered an admission of guilt but rather an acknowledgment that you take the complaint seriously (as you should).
The Lento Law Firm's Professional License Defense Team has nationwide experience in license defense with a strong track record of helping licensed nurses avoid having their licenses revoked.
Regaining Your License After Revocation
While not always feasible, reinstatement may be an option for some nurses. The process involves applying to the state board (usually after a waiting period) and meeting any required conditions, such as completing rehabilitation programs or paying fines. However, reinstatement can be challenging and may take significant effort and time. For best results, consult the Lento Law Firm's Professional License Defense Team so we can help coordinate your reinstatement application and improve your chances of success.
While having one's nursing license revoked is the worst possible outcome of a complaint, don't make the assumption that it's unlikely in your case. State boards of nursing typically have no problem revoking a nurse's license even for minor infractions if they believe the nurse's continued practice could jeopardize patient safety or the public trust. Once a license is revoked, it can be very challenging, if not impossible, to resume your nursing career. Fortunately, taking proactive steps at the first sign of trouble can quite often help you avoid this outcome. The Professional License Defense Team at the Lento Law Firm has many years of proven nationwide experience helping nurses keep their licenses intact. To schedule a consultation, call us today at 888-535-3686 or reach out via our online contact form.
