The process for petitioning for license reinstatement after a substance abuse issue is specific to each state in which the nurse practices. A nurse typically must complete a mandatory waiting period, submit their petition to the nursing board, provide proof that they have adequately rehabilitated their substance abuse issue, and accept any conditional terms the board requires for reinstatement.
In this article, we will review how several state nursing boards handle the reinstatement process. We will also review the disciplinary pathways that may necessitate a reinstatement petition, as well as the avenues that may allow a nurse to avoid license revocation.
Nurses who are presently struggling with substance use, or who have previously struggled and are now facing the professional fallout of substance abuse, aren’t on their own. They have the LLF National Law Firm Professional License Defense Team to lean on.
Our firm helps nurses at all stages of the recovery continuum, including its intersection with professional discipline. Wherever you are, we can help—whether you’re seeking to avoid severe discipline or get your license back after revocation.
Call the LLF National Law Firm Professional License Defense Team today at 888-535-3686 or contact us online, and don’t wait.
What Do Nursing Boards Consider a Sanctionable Substance Abuse Issue?
Alcohol. Cocaine. Prescription opiates. Methamphetamine. Over-the-counter drugs. Whether it is an illegal substance, something the doctor prescribes, or a product that is legal for even those under the age of 18, nurses can fall into unhealthy substance use patterns just as easily as any other American.
While many of us tend to think of healthcare professionals as almost superhuman, they are not. Nursing boards throughout the United States recognize nurses’ fallibility through substance-related prohibitions that include:
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Practicing while impaired, as Florida statutes (and many other states’) consider it “grounds for denial of a license or disciplinary action” for a nurse to practice while impaired by “alcohol, drugs, narcotics, or chemicals”
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Misappropriating controlled substances, as addiction can sometimes compel nurses to handle narcotics and other controlled substances in a manner they should not—possibly including taking controlled substances for themselves
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Unprofessional conduct related to substance abuse, which might include smelling like alcohol at work or appearing disheveled due to drug impairment while on the job
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Endangering or harming a patient, which is generally viewed as the most serious consequence of nurses’ substance use disorders
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Being convicted of a criminal offense, particularly a felony-level offense that casts doubt on a nurse’s ability to practice safely and effectively
There are many more specific violations of nurse-specific laws and regulations that disproportionately pertain to nurses suffering from a substance use disorder. While simply suffering from substance abuse may not expose a nurse to professional discipline, committing these or other related offenses very well could.
The discipline a nurse may face for substance-related violations may include the revocation of their license—a license they have dedicated their professional life to obtaining and maintaining.
Before Revocation and Reinstatement: How Substance Abuse Issues Lead to Professional Sanctions
Before we discuss how you may reinstate your license, let’s quickly examine how a substance-related problem can deprive you of that license. We will use the Mississippi Board of Nursing’s (MSBN) procedures as an illustrative example of the disciplinary process:
The Board’s Legal Division Investigates the Complaint
The MSBN Legal Division “has the authority to bring charges against any licensee or applicant who allegedly commits any act in violation of the Nursing Practice Act…” Many states have a similar investigative and charging body that oversees alleged violations by nurses.
The Nurse May Engage in an Agreed Settlement Proposal (ASP)
After the accused nurse is notified that they have been accused of professional misconduct, they may have the chance to:
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Admit they are suffering from a substance use issue
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Accept responsibility for any formal violations they have been accused of
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Accept proposed sanctions from the adjudicative body
In Mississippi, these disciplinary agreements are called Agreed Settlement Proposals. Many nurses accept sanctions and accept responsibility to avoid the most serious professional sanctions, including license revocation.
A Hearing Takes Place
When nurses do not accept any proposed sanctions, they have a right to a hearing. In Mississippi, a three-member panel of MSBN representatives facilitates and oversees the hearing.
The Nurse May Be Sanctioned After the Hearing
If the three-member panel does not rule in the nurse’s favor, they may impose disciplinary sanctions ranging from a formal reprimand to license revocation. The MSBN panel could also order non-disciplinary action, such as a Letter of Concern.
The Nurse May Appeal an Adverse Ruling
Mississippi nurses who disagree with the three-member panel’s ruling may appeal to the Full Membership of the Board. If they disagree with the Full Membership’s ruling, the nurse can then appeal to the Chancery Court in the county in which the nurse lives.
When nurses voluntarily surrender their license or fail to succeed in their post-hearing appeals, they may eventually find themselves needing to reinstate their nursing license after paying the professional price of their substance use disorder.
Alternative-to-Discipline (ATD) Programs: Not Every Case of Substance Abuse Leads to Sanctions.
If you are reading this, we suspect you may already have suffered professional sanctions. You might already have lost your license. We will soon explain how you can seek the reinstatement of your license (with our help).
First, though, we want to address a critically important option for:
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Nurses currently suffering from unreported substance abuse who fear seeking help due to the possible revocation of their license
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Nurses who have been accused of substance-related misconduct (but have yet to be disciplined)
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Nurses who voluntarily reported their substance-related struggles but have yet to learn whether they might be disciplined
Alternative-to-discipline (ATD) programs are the primary way for nurses with substance use disorders to avoid license revocation. These programs are:
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Typically operated by nursing boards or affiliated institutions
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Subject to entry criteria and conditions
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Explicitly meant to help nurses with substance use disorders and certain other conditions that impede their ability to practice effectively
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Essentially mandatory for nurses who have acknowledged a substance use disorder and want to keep their license
Nurses who have not caused harm to patients or committed other major professional violations are often admitted to ATDs. If those nurses submit to evaluation, regular monitoring and testing, and other conditions of enrollment in an ATD, they may return to work after successful completion of the program—without formal discipline being recorded on their records.
We said that participation in ATD programs is “essentially” mandatory for nurses seeking to keep their license in the midst of substance abuse revelations. While enrollment in these programs is almost always voluntary, nurses who decline to participate in an ATD are often funnelled directly to the formal disciplinary process.
The threat of formal discipline makes enrollment in ATDs a no-brainer decision for many nurses seeking to retain their license while simultaneously getting treatment for their disorders.
When Might a Nurse Need to Seek the Reinstatement of Their License?
Nurses may need to actively seek reinstatement of their license if their substance use led to:
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Voluntary surrender of their license
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A license suspension
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License revocation
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Removal from an ATD program (which often leads to suspension, revocation, or other types of removal from nursing practice)
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Administrative inactivation
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A violation of professional probation terms (which may also trigger formal discipline such as suspension or revocation)
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Any other action that prevented the nurse from practicing
When nurses bear the burden of reinstating their licenses, they should turn to our Professional License Defense Team to lead the reinstatement process.
Are There Any Obligations I Must Meet Before Seeking Reinstatement of My Nursing License?
Your state’s nursing statutes, as well as the mandates of the nursing board, should explain which obligations you must fulfill before becoming eligible for reinstatement. Some of the standard requirements for reinstatement are:
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Waiting for the specified period (typically multiple years) of time dictated by your suspension or revocation terms
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Completing a rehabilitation program (whether or not your state’s nursing board oversees the program)
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Submitting to drug or alcohol testing, depending on the nature of your substance problem
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Undergoing a comprehensive psychological evaluation to determine your fitness to return to practice
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Avoiding substance-related arrests or convictions during the period in which you were without your license
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Completing any professional education courses ordered by the nursing board
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Paying any fines or costs associated with your rehabilitation and reinstatement
Perhaps more than anything else, a nursing board wants to see proof of rehabilitation before it trusts the nurse to return to the workforce. Proof of participation in a treatment program, ongoing participation in support groups and counseling, and expert testimony can be among the evidence you furnish to prove your progress in recovery.
These are just examples of the types of hurdles a nurse must clear before getting their license back. You may face more or fewer requirements in seeking to re-obtain your nursing privileges. As your representatives, our Professional License Defense Team will identify precisely what you must do to give yourself a shot at returning to nursing.
How Might the Reinstatement Process Unfold?
California’s Board of Registered Nursing provides one example of how a nurse may petition for reinstatement. The Board’s literature sets a clear expectation that nurses must be their own advocates. “The burden of proof is on you,” the junket reads in bold lettering.
Nurses seeking to regain their license to practice in California need to:
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Fulfill the required waiting period, which is three years after a license revocation (or two or one year in certain other cases, including a one-year waiting period for licenses revoked due to mental or physical illness)
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Complete every term of the initial discipline
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File their petition for reinstatement (or a petition for the reduction of a penalty, in appropriate cases), complete with any letters of recommendation, drug test results, and other required components
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Complete a hearing with an Administrative Law Judge (ALJ), at which the nurse will present all available proof of their rehabilitation, relevant witness testimony, and evidence that they are prepared to return to practice safely
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Wait for the ALJ to provide their recommendation to the state board of nursing
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Wait for the nursing board’s decision regarding the petition for reinstatement
Nurses in California who are reinstated after substance-related discipline are not typically reinstated without limit. They usually endure a multi-year probationary period, during which time they may be regularly monitored and tested, restricted in their privilege to handle narcotics, and subjected to other requirements.
While your state nursing board’s reinstatement procedures will likely differ from California’s in at least one way, this example provides you with a general idea of what to expect when seeking to return to work.
What Are the Possible Outcomes of My Request for Reinstatement?
When you petition for reinstatement, you should be prepared for the possibility of:
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Reinstatement without probation or limitations
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Reinstatement with probation
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Reinstatement with limitation
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Conditional statement (meaning the board does not believe you have completed every step necessary to be reinstated)
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Reinstatement with simultaneous enrollment in an ATD program
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Outright denial of the reinstatement request
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Denial, with the option for you to re-petition after a waiting period
If the nursing board denies your petition for reinstatement, our Professional License Defense Team will identify the reason(s) for denial. We will help you exhaust all appeal options available to you, which may include judicial review.
Should I Engage the LLF National Law Firm Professional License Defense Team to Help Me Seek Reinstatement?
Yes, absolutely. The LLF National Law Firm Professional License Defense Team handles reinstatement issues (and other professional license-related matters) day in and day out.
Such consistent dedication to helping nurses and other professionals makes for stellar outcomes, and our experience will be an asset in your effort to reinstate your license.
Do not delay, as your return to nursing should not have to wait any longer. Call the LLF National Law Firm Professional License Defense Team today at 888-535-3686 or contact us online.
Remember that we help nurses facing potential disciplinary action, too. Call us if you are seeking to avoid license revocation related to a substance use disorder.