License Defense for North Carolina Certified Registered Nurse Anesthetists

Certified Registered Nurse Anesthetists (CRNAs) are crucial to the North Carolina health system. According to the American Association of Nurse Anesthetists, CRNAs comprise more than 80% of anesthesia providers in rural areas nationwide. The same is true in North Carolina. Rural hospitals and medical practitioners in North Carolina rely on CRNAs, a category of Advanced Practice Registered Nurses, to provide anesthesia care for patients. This means that, as an important part of North Carolina's medical community, your work is essential and highly valued in small towns like Hillsborough, Banner Elk, and Asheville and larger communities like Raleigh-Durham, Charlotte, Greensboro, and Fayetteville. 

You've also spent years completing your education and training, including an advanced nursing degree, critical care experience, and extensive training to become a CRNA. On top of that, you may have also spent years establishing your professional reputation and building an independent practice in your area. An allegation of professional misconduct can undo all of your hard work. That's why you should hire the skilled Professional License Defense Team from the Lento Law Firm to protect your professional reputation, standing in the community, and career. Call 888.535.3686 or contact us online to schedule a consultation right away. 

Licensing for CRNAs in North Carolina 

In North Carolina, the Board of Nursing (BON) is responsible for licensing and regulating all registered nurses and advanced practice registered nurses, including CRNAs. The BON ensures that all nursing professionals comply with the Nursing Practice Act and state regulations.  

CRNA Licensing in North Carolina 

In North Carolina, nurse anesthetists are a category of nurses with advanced education and training known as Advanced Practice Registered Nurses (APRN). The BBBBB oversees APRN and CRNA licensing in the state. To qualify as a CRNA, you will need: 

  • An active nursing license in good standing in North Carolina or another nursing compact state, 
  • At least one year of critical care experience, 
  • A master's or doctorate in nursing anesthesia from a school certified by the American Association of Nurse Anesthetists (AANA) Council on Accreditation of Nurse Anesthesia Educational Programs, 
  • A criminal background check, and 
  • A certification from the National Board of Certification and Recertification for Nurse Anesthetists. 

In North Carolina, there are six major CRNA programs offering either master's or doctorate programs. The schools include: 

  • Western Carolina University in Asheville, 
  • University of North Carolina, Charlotte 
  • Duke University, 
  • Raleigh School of Nurse Anesthesia in Greensboro, 
  • Eastern Carolina University in Greenville, and 
  • Wake Forest University in Winston-Salem 

RN Licensing in North Carolina 

To receive a nursing license in North Carolina, you need: 

  • A bachelor's in nursing, an associate degree in nursing, or an advanced nursing degree, 
  • A passing score on the National Council Licensure Exam (NCLEX-RN), 
  • To complete the state application, and 
  • To complete a criminal background check. 

You can also obtain a North Carolina nursing license through endorsement with:  

  • Proof of passage of the NCLEX,  
  • Passage of a criminal background check, 
  • A fee of $150, 
  • Proof of compliance with continuing education requirements, and 
  • A completed application. 

Professional Standards for CRNA and APNs in North Carolina 

North Carolina holds its APRNs and CRNAs to high professional standards. You can face disciplinary action for any of the following: 

  • Giving false information or withholding material information from the Board in an application or while attempting to procure a nursing license, 
  • A conviction, guilty plea, or nolo contendere for any crime “which indicates that the nurse is unfit or incompetent to practice nursing or that the nurse has deceived or defrauded the public,” 
  • Being unable to “practice nursing with reasonable skill and safety to patients by reason of illness, excessive use of alcohol, drugs, chemicals, or any other type of material, or by reason of any physical or mental abnormality,” 
  • Engaging in conduct that can endanger public health, 
  • Being unfit to practice nursing because of negligent or deliberate actions or omissions, even if no patient was actually harmed, 
  • Deceiving, defrauding, or harming the public as part of your professional activities, 
  • Unprofessional conduct that doesn't conform to acceptable nursing standards and ethics, 
  • Dishonesty, immorality, or injustice in the course of your nursing practice and outside the course of practice, 
  • Having your license rescinded, suspended, revoked, or limited in any jurisdiction, including relinquishing your license voluntarily as part of a settlement. The BON can take action based on the factual findings from the other jurisdiction, 
  • Failing to respond to a BON inquiry in a reasonable time and manner, and 
  • Violating any provisions of the Nursing Practice Act or the regulations promulgated under the law. 

Moreover, in North Carolina, you must self-report certain arrests and indictments within 30 days. Failure to do so will result in disciplinary charges. You must report: 

  • Any felony indictment or arrest, 
  • An arrest for driving under the influence or while impaired, 
  • An indictment or arrest for “the possession, use, or sale of any controlled substance.” 

North Carolina's Disciplinary Process for CRNAs and APNs 

In North Carolina, the disciplinary process typically starts with someone filing a complaint with the BON. Anyone can file a complaint, including general members of the public, colleagues, patients, and healthcare facilities. Anyone who believes in good faith that a nurse is violating the NPA must report it to the BON. As long as they make the complaint in good faith, they are immune from civil and criminal liability. The BON will evaluate any complaint after first looking to see whether the board has jurisdiction and whether the allegations, if true, would violate the Nursing Practice Act.  

Investigating CRNA BON Misconduct Complaints in North Carolina 

If the North Carolina BON determines that it has jurisdiction and the complaint alleges a violation of the Nursing Practice Act, it will assign an investigator. The investigator will notify you of the allegations unless it would harm the investigation. The investigator may also notify law enforcement or other agencies if necessary. 

The investigator will collect all relevant information regarding the complaint, including contacting the complainant, interviewing witnesses, and collecting evidence. The investigator may also ask you for an interview or to complete questions in writing or interrogatories and ask for relevant documents. You will also be able to review the documents collected during the investigation during a scheduled interview. However, they won't be available for copies unless you contest the board's decision. 

It's important to note that if you fail to respond to a BON inquiry regarding a licensing matter in a “reasonable manner or time,” you can also face board disciplinary action. However, that doesn't mean you should attempt to handle an investigation on your own. You need the skilled Professional License Defense Team from the Lento Law Firm to protect your rights and your license. 

Informal CRNA Disciplinary Conferences in North Carolina 

In some cases, after an investigation, if the BON believes that an allegation has merit, they may offer you a Settlement Committee meeting. The Settlement Committee Meeting is an informal meeting with BON members who review your case and allow you to present any extenuating or mitigating circumstances that warrant a less serious sanction. However, the facts of the case will not be in dispute. In this process, the parties may agree to a consent order with an agreed-upon sanction. Sanctions can range from a reprimand to a suspension or restriction on your license, or you can agree to surrender your license. However, you should never sign a consent agreement without consulting the Lento Law Firm's experienced Professional License Defense Team. 

Formal CRNA Disciplinary Hearings in North Carolina 

If you disagree with the BON's decision, you can request an Administrative Hearing. An Administrative Hearing is a formal public hearing with members of the BON. Both sides can present evidence and introduce and cross-examine sworn testimony. The BON will then decide and impose a sanction if necessary. If the BON finds you violated the Nursing Practice Act or its rules, they will charge you $300 an hour for your administrative hearing. 

BON Penalties for CRNA and APRN Misconduct in North Carolina 

Penalties the BON can impose on CRNA for law or rule violations will vary depending on the severity of the violation. Some sanctions may be unpublished, including:  

  • Dismissal: This is typically the result when there isn't enough “clear and convincing” evidence to support a violation of the NPA. 
  • Private letter of concern: If the BON has cause for concern, but there is no “clear and convincing evidence” of a violation. 
  • Non-disciplinary consent order: This educational remedy is used to “improve and maintain” safe nursing practices. The BON typically offers this remedy if you acknowledge your action or inaction in the complaint. 

Sanctions from the BON may also be published, including: 

  • Published letter of concern: This is a warning letter that the BON publicly reports. 
  • Published consent order: If there is “clear and convincing evidence” of a violation, the BON may reprimand you publicly, monitor your practice, limit your ability to practice, suspend you, or revoke your license. 

The BON must publicly report any public sanction to: 

  • NURSYS: the BON national database used across the country, 
  • The North Carolina BON website, 
  • The National Practitioner Data Bank, and 
  • The Office of the Inspector General. 

Appealing a North Carolina CRNA or APRN License Disciplinary Action 

After the BON's final disciplinary decision, you can appeal to your local superior court within 30 days after you receive the board's decision. Your appeal should state all ”all exceptions to the Board's decision.” The BON will then prepare and file the record, charges, testimony, documents, evidence produced at the hearing below, and the board's decision. The administrative law judge will review your case based on the record below, including the findings of fact and conclusions of law.  

The ALJ will decide the case based on a preponderance of the evidence. Still, it can only overturn the BON's decision if it was “arbitrary and capricious” or otherwise not in accordance with the law. The ALJ's final decision goes back to the BON, and If the agency fails to follow the ALJ's decision, or if the ALJ decides against you, you can appeal the final decision to the courts. 

The Enhanced Nurse Licensure Compact and CRNA Disciplinary Actions  

Forty jurisdictions in the U.S., including North Carolina, are members of the Enhanced Nurse Licensure Compact (eNLC). The compact allows nurses with licenses in good standing to more easily obtain licenses in all participating states or to practice in participating states without going through the application process in a new state. However, disciplinary action against your license in one state will follow you to the other states. This can result in the denial of a license in a new state or disciplinary action in North Carolina for something that happens while practicing as a CRNA in another state. The eNCL requires the North Carolina BON to report all of its investigative results, disciplinary actions, and sanctions in the Nursys system. 

You Need an Experienced Professional License Defense Team 

As an Advanced Practice Registered Nurse or Certified Registered Nurse Anesthetist practicing in North Carolina, an allegation of professional misconduct under the Nursing Practice Act or its rules and regulations can devastate your career. You could face an in-depth investigation and questioning of your patients, co-workers, and colleagues. Even if the BON later dismisses the charges, the damage to your personal and professional reputation could still be severe. You could also potentially lose your license or face invasive sanctions.  

But you don't have to handle BON investigations and charges alone. You need the Lento Law Firm's skilled Professional License Defense Team to protect your license and career. They've been defending professionals like you nationwide for years. Find out how they can help you, too. Call the Lento Law Firm's Professional License Defense Team at 888.535.3686 or contact us online to schedule your consultation today. 


Attorney Joseph D. Lento and the Lento Law Firm are committed to answering your questions about Physician License Defense, Nursing License Defense, Pharmacist License Defense, Psychologist and Psychiatrist License Defense, Dental License Defense, Chiropractic License Defense, Real Estate License Defense, Professional Counseling License Defense, and Other Professional Licenses law issues nationwide.
The Lento Law Firm will gladly discuss your case with you at your convenience. Contact us today to schedule an appointment.

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