Can a Single Mistake or Error Lead to the Suspension or Revocation of My License?

Nursing is an incredibly demanding job. Whether you work at a hospital, long-term care facility, or any other clinical setting, you’re on your feet all day working exhausting shifts caring for several patients.

Stress and exhaustion can easily lead to mistakes. Even if you can stay fully alert at all times, your workplace may have changed your usual routines and processes without your knowledge. Attending physicians can also make mistakes or misinform you in giving orders, and then the patient unfortunately suffers as a result.

Yes, your nursing license is at risk of suspension or even revocation for making a mistake that ends a patient’s life or causes them grievous harm. State nursing boards take these matters seriously, and you may face a formal disciplinary hearing and sanctions in the event of an error that has far-reaching impacts.

You worked incredibly hard to build your nursing career, and a single mistake can certainly impact your ability to work. State nursing boards do not presume your innocence, and you should not represent yourself if you are facing, or expect to face, board proceedings. The LLF National Law Firm advocates for nurses nationwide. Our experienced Professional License Defense Team represents nurses facing potential disciplinary action, and we can represent you even if you have a complex case. Call us at 888-535-3686 or fill out our online intake form to tell us about your case.

Errors and Mistakes in Nursing

Errors and mistakes in nursing practice are wide-ranging, and they encompass ministerial issues, medication errors, failure to follow procedures, and mistakes that arise from inadequate facilities or training. Generally, an error results from systemic problems, like a software glitch or another party’s actions, while a mistake is an action you took that was not intentional.

Ministerial errors include the following:

• Patient’s medical history is incomplete or incorrect

• Documentation errors, such as omission of medications given or stopped

• Instructions for follow-up care not given

• Chart for incorrect patient is used

Medication errors will involve:

• Incorrect dosage of medication is given to the patient

• Medication intended for one patient is accidentally given to a different patient

• Incorrect medication is dispensed without regard to patient’s medical history and drug allergies

Procedural errors and mistakes include:

• Failure to follow your employer’s protocols or state laws to control infectious diseases

• Disregard of workplace safety procedures, whether intentional or not

• Patient improperly transferred to and from equipment and hospital beds, causing injury or death

• Safeguards to prevent medication errors did not prevent the error and it resulted in a patient’s death or bodily harm

While these lists are not exhaustive, they are the most common types of workplace mistakes and nursing errors that can result in a state nursing board inquiry. Documentation, like your employer’s policies, nursing union rulebooks, state nursing board regulations, nursing society guidelines, and your state’s Nurse Practice Act, may provide additional context in differentiating unintentional errors and mistakes from willful neglect and malpractice.

Even if the state nursing board opens a case, you may not necessarily be in violation of any of these frameworks depending on the nature and severity of the situation. The LLF National Law Firm’s Professional License Defense Team will examine the facts and circumstances of your case to build a defense tailored to your situation, the criteria of your specific state nursing board.

State Nurse Practice Acts and Board Regulations on Mistakes and Errors

Every state has a Nurse Practice Act and a nursing board. This type of law is generally referred to as a Nurse Practice Act, but your state may call it a different name, like Nursing Statutes or Standards of Nursing Practice.

While systems like the National Nurse Licensure Compact aim to make U.S. nursing licenses more portable than they historically have been, you are generally held to the standards of the state-level Nurse Practice Act where the accusation took place. Travel nurses and nurses who regularly practice across state lines need to be particularly mindful of this. Depending on the rules of the state nursing board in which you received your original nursing license, you may face administrative inquiries from this board for mistakes and medication errors.

Your state’s Nurse Practice Act may differentiate neglect from mistakes, but most of the finer nuances of medical errors and nursing mistakes are typically left to your state nursing board. State nursing board regulations may provide detailed disciplinary guidelines and procedures for medication errors, mistakes, and nurses who provide inadequate care as a result of systemic problems they could not control.

Additionally, you may be in violation of any codes of conduct for nursing societies and professional organizations you belong to. These organizations may suspend your membership while you are under investigation or sanctions.

Notable State Nursing Board Guidelines on Mistakes and Medication Errors

Each state nursing board has its own procedures for nursing mistakes and errors. Some boards only examine these inquiries on a case-by-case basis, while others take a more utilitarian approach. In some cases, nurses may face charges for legal violations in addition to discipline from the state nursing board.

California

California nursing regulations define gross negligence as an extreme departure from the standard of care that would ordinarily be exercised by a competent nurse. Medication errors and mistakes can be construed as gross negligence depending on the level of precaution for the situation, or if the nurse had good cause to know that this action could’ve put the patient’s life in danger.

Florida

Florida nurses who do not meet the minimum requirements for safe practice, such as the ability to administer the correct medication to the correct patient at the correct dosage, will have their licenses suspended for either a defined timeframe or until you can demonstrate your ability to practice safely.

Tennessee

Generally, state nursing boards handle disciplinary aspects while civil courts adjudicate legal violations, but Tennessee became the first state to criminalize medication errors.

In 2017, Tennessee nurse RaDonda Vaught mistakenly obtained a drug from an electronic medication cabinet by typing the letters of the drug’s brand name instead of the generic. When the cabinet did not dispense the required drug, Vaught triggered an override and accepted an incorrect medication despite the warnings given. The patient died, and Vaught was charged with reckless homicide, in addition to revocation of her nursing license. In 2022, Vaught received three years of supervised probation with judicial diversion, and her charges were reduced to gross neglect of an impaired adult and negligent homicide. However, she still lost her job and her nursing license.

How Nurses Can Prepare for Board Actions

If you made a mistake and are now accused of medical neglect or causing grievous harm, your nursing license may be in jeopardy. Even if the patient was not harmed, a board inquiry may still be opened, and it can have far-reaching impacts on your career.

You may panic at this realization. However, there are steps you can take right now to increase your chances of achieving a more favorable outcome with the nursing board. Here’s what you should do once you receive a letter from the board:

• Arrange representation as early as possible. Most state nursing boards will notify you in writing if a party filed a complaint against you. Complaints don’t automatically mean you will face sanctions: the complaint could get dismissed, especially if the patient was unharmed or any harm was mitigated once you realized there was a mistake. But you do not want to delay arranging representation once you receive this letter. Contact the LLF National Law Firm right away so we can prepare your response and advocate for you through every step of the disciplinary process. The earlier you arrange representation, the more likely you are to successfully get the complaint dismissed or a lesser sanction if an investigation proceeds and then escalates.

• Thoroughly examine your state’s Nurse Practice Act, employer policies, and board regulations. You need not comb through every single statute, but look at your state Nurse Practice Act and other relevant regulations. Some board regulations are overly broad, while others are purely on a case-by-case basis. Review your employer’s policies on medication errors and mistakes to determine what they consider to be neglect or an honest mistake.

• Gather as much evidence as possible that the mistake was unintentional. What ultimately separates an honest mistake from willfully neglecting a patient is that you did not intend to cause them harm. If you violated your employer’s safety protocols, you may have done so to save the patient’s life in a fight-or-flight decision. Gather as much evidence as you can about the situation, such as testimony from other patients and co-workers, photos, emails, internal communications, and other potential corroborating evidence.

• If the mistake arose due to circumstances of your workplace, carefully note them. Nurses can make mistakes due to being overloaded at work. If your patient load is very high, fatigue can make it difficult to maintain a safe standard of care. Find evidence of your employer’s shortfalls wherever possible, such as chronic short-staffing and overscheduling, inadequately-maintained equipment, technological changes that frequently result in incomplete documentation, and other factors that prove you did not intentionally cause harm.

• Stay calm and professional. You may be angry and afraid right now. Emotions are running high because your future is hanging in the balance. Despite the gravity of the situation, it’s best to remain calm and professional in your interactions with the nursing board, your employer, and any other parties involved in the complaint or investigation.

How the Professional License Defense Team Will Strive to Protect Your Nursing Career

Nurses are unfortunately disciplined for honest mistakes and medical errors that can result from overwork, poor training, or failures of safeguards in place. Depending on the severity of the situation, you may face a minor reprimand with a request for some additional training and supervision, or punishment as severe as having your nursing license suspended. Regardless of the severity of the accusations against you, you do not want to represent yourself. Nursing boards do not presume your innocence as a court of law does.

Here’s how the LLF National Law Firm’s Professional License Defense Team will advocate for you before any state nursing board:

• Initial Complaint: The state nursing board will notify you if a complaint was filed against you. Depending on state laws and how your specific nursing board handles complaints and enforcement, you may receive several details about the complaint, including who filed it. Regardless of how much information you receive, you should contact the LLF National Law Firm right away. There is a chance the board will dismiss the complaint, but arranging a defense in advance improves your chances of a better outcome if an investigation opens.

• Nursing Board Correspondence: In most states, you will need to respond to the board within 15-30 days of the date on your complaint letter. If you are unsure how to respond to the board, the Professional License Defense Team can help with an effective written appeal. Depending on the nature and severity of the accusation, the board may dismiss the complaint after your response. They may also dismiss the complaint after an investigation concludes that no violations occurred. In cases of medication errors and workplace mistakes, state nursing boards tend to examine whether you’ve exhibited a pattern of these mistakes throughout your nursing history.

• Stipulated Agreements: If the complaint escalates to an investigation, and the complaint is not dismissed afterwards, you will have a more complex case. Medication error cases where a patient died or experienced grievous harm are likely to lead to disciplinary hearings, where the Professional License Defense Team can negotiate a stipulated agreement. Stipulated agreements are the professional licensing board equivalent of out-of-court settlements, where we will negotiate the terms of your agreement and how to proceed with your nursing license intact. Stipulated agreements may include probation or temporary suspension with remedial education, rehabilitative treatment, counseling, or other remedies, depending on the nature of the case. This is a form of lesser sanctions than what the board originally had in mind.

• Adjudication: Most disciplinary proceedings for nurses remain at the board level and do not make it to a courtroom. However, if there are legal violations, such as violations of state and federal privacy laws or severe Nurse Practice Act violations, you will face a formal hearing before an administrative law judge. In extreme cases, such as RaDonda Vaught in Tennessee, there may be criminal charges as well. We can represent you before the board and in criminal and civil courts, with a goal of negotiating lesser charges.

The LLF National Law Firm’s Professional License Defense Team provides comprehensive representation at every step of the disciplinary process, from written responses to the initial complaint to adjudication if your case cannot be resolved at the board level.

Providing care to patients is strenuous. You intend to help your patients stabilize and be well again, but individual nurses tend to be blamed for systemic problems or for simply making honest mistakes. The LLF National Law Firm is ready to advocate for our nation’s hard-working nurses and achieve the best outcome possible for your case. Call us today at 888-535-3686 or reach out via our online contact form.