How to Protect Your Nursing License

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A nurse gets a DUI. Another makes a medication error that claims the life of a patient. A student nurse snaps a photo of a patient and posts it on social media. A director of nursing for a nursing home has falsified documentation and failed to create care plans to address serious issues. All of those nurses were required to appear before their state nursing board to either defend their licenses or protect their ability to apply for one. The best way to defend yourself against the state nursing board is never to have to appear.

Who is the State Nursing Board?

The nursing board wields a lot of power. Not only can they strip a license from a nurse temporarily or permanently, they can impose a number of different restrictions on the license that can negatively impact the nurse’s ability to work. The job of the state nursing board is to regulate the state’s nursing practice. Each state's legislature enacts a set of laws, known as the Nurse Practice Act, which governs nursing practice. These laws are enforced through the state's regulatory agency, the Board of Nurses. The Board may be independent or part of a larger regulatory entity, such as a Professional Registration Board or Licensing Board. The Board members are volunteers and are physicians, nurses, and other members of the community. To find information on one of the individual state boards of nursing visit: https://www.ncsbn.org/contactbon.htm.

Know you aren’t immune

Healthy fear is a good thing. The threat of appearing before the board can be intimidating, but it also serves as a powerful reminder to be the most professional nurse we can be. After all, the board can summon even very good nurses. An employer may file a complaint against a nurse, but so may a disgruntled client. Protect yourself against common mistakes that may lead a nurse to appear before the board: failure to document, failure to appropriately assess a patient, failure to intervene when needed, ignoring a facility’s policies and procedures, such as failing to use two patient identifiers when giving medication and a significant medication error is made.

Call out unsafe work practices

If you are being asked to work in an unsafe work environment, it is your responsibility to speak out. Every state has their own rules regarding when a nurse is permitted to leave her clients, but most states require that any nurse who has received report has taken responsibility of patients and may not leave them without having abandoned them, regardless of how unsafe the setting may be. If you receive report and find that you are being asked to care for too many acute patients than you can safely manage, contact the house supervisor or manager immediately. Put your concerns in writing, including the patient census, staffing levels, and how nursing care had to be prioritized because of the shortage. If you’ve gotten report, stay put and do your best. In some states you can choose to refuse responsibility to the patients without putting your license at risk, but you may still face repercussions from your employer. Know what your state laws are regarding patient abandonment.

Address addiction related issues

If you have a problem with drugs or alcohol, getting help before you get caught can help protect your license. If you don’t, and you get arrested for a drug or alcohol-related incident, expect the nursing board to come calling. Also, if you are accused of diverting medications from work, the nursing board is likely to be informed. A DUI, for example, does not automatically mean you will lose your license, but it is likely the state board will require you to be evaluated by an addiction specialist and to follow their treatment recommendations. Getting help before you are forced to will protect you, your license, and your patients.

Your personal life isn’t private

A nurse in Texas lost her license for hosting a pornographic website. Another had an affair with her supervisor. Nursing boards can accuse you of unprofessional conduct, and if you have evidence of poor judgment, especially run-ins with the law, don’t be surprised if they request the pleasure of your company at an upcoming meeting. Some state boards require nurses who have any type of conviction, including misdemeanors, to appear before the board. Unprofessional conduct covers a multitude of sins, so keep your house in order in and out of your scrubs.