What should a nurse do after a nursing license is revoked? Well, the first question is, why was it revoked? Normally, a nurse’s license would be revoked because they violated the consent agreement terms if a nurse were to get in trouble or have a substance abuse issue. Usually, a board would put them on probation, which would be through a document called a consent agreement. And then in that agreement, it would have terms of, let’s say, a nurse has an opiate addiction or something like that. And then, they were caught diverting, and the board found out and put them on probation. Usually, those would include random drug testing, supervision at work, AA or NA attendance, a nurse recovery group, or something like that.
Nursing Board License Suspension Consequences
Maybe they can’t work nights or home health. In this scenario, a nurse failed a drug test. The agreement states that it automatically revokes their license if they fail a drug test. Normally, in each agreement, it’s going to say if it’s revoked. This is how long the license is revoked until you can reapply. I want to discuss some strategies and tips on what a nurse should do during that revocation period. These tips would put them in a better position to get their license back once that period ends. In most states, it’s usually somewhere between three to five years. If a nurse has a license revoked, after that period ends, you can then reapply. Well, why the license was revoked depends on what you need to do in the interim.
When Your Nursing Board License Is Revoked
So, it would help if you thought about it like, okay, you violated an agreement for a reason; this would put you on a contract for a reason. What was the reason? Substance abuse is an easy thing to handle. If they are concerned that you have a substance abuse problem, they put you on that agreement and show you what they want you to do to be safe to practice. Let’s say you had your license revoked because you violated the terms of an agreement and you were an alcoholic. Well, during that period, you need to work on the addiction. Meaning you need to go to AA, and you need to get a sponsor. It would be best if you documented all the times you went there. I don’t usually suggest doing random drug screens. Other blogs of interest
They can get expensive. And I don’t think it’s necessary. Getting a random drug screen through that entire period would be helpful if you want to do everything possible. I mean, if you’re going to do that, then I’d probably only do that in about six months leading up to one year or two. Talk about continuing to go to a nurse recovery group or changing lifestyles, eating better, getting into shape, and dealing with stress. Most of the time, they’re concerned that a stressor leads the nurse to drink for whatever reason. Another great thing to do would be counseling, so meeting with a licensed professional counselor, substance abuse counselor, or psychologist and dealing with those issues.
Nurse’s Revoked License Probable Reinstatement
Generally, the psychologist would then state that you don’t need to come to me anymore after a period. Then you want a letter from that person saying the nurse completed this many sessions. I don’t believe that they need to continue counseling. And then, when you reapply, you would send that letter to the board. Suppose the board wanted you to go into rehabilitation or an intensive outpatient treatment program. In that case, If you didn’t do it before the suspension of your license, you should do it right away.
What are some strategies if substance abuse is involved? If it’s a clinical issue, recovering from it is more challenging. If you had your license revoked purely due to a clinical problem, it’s tough to rehab that, right? You could do continuing education, but after a period, you’ll always have to do a refresher course if they allow you to get your license back. But, only continuing education is the only thing you can do if it is an ongoing clinical issue. Or going back to school and showing success is another thing you can do.
Action That Prevents a Nurse From Regaining Their Licensure
There are some things that a nurse cannot recover. Usually, physical abuse towards a patient, sexual misconduct, and some major criminal issues result in a felony. There are just certain things that if a nurse does, regardless of the time, they will never get their license back. If it’s a high-profile case, I find the boards like I’m in Arizona. For instance, there have been a few high-profile cases. And I think from the board’s perspective, they kind of feel like it would be bad publicity if they took someone’s license away for whatever the issue was.
And then, after five years or ten years, they gave it back to that nurse simply because what they did initially was. I guess so bad that they wouldn’t want to seem like they were lenient in, I think, facilitating that behavior and giving them their life license back. That doesn’t happen very often. A nurse rarely does something so wrong that no board would give them a second chance. Still, some things happen. Unfortunately, suppose you did one of those I listed. In that case, regardless of its state, you may never get your license again.
Summary From An Attorney
So, in summary, think of it like, alright, what led to the revocation? And then what can I do in that period to show the board that I’m taking the initiative, I’m dealing with my issues. Document everything you’ve done because they will want to see that when you reapply and try to fix whatever the problems were. If you were on a consent agreement and violated the contract, reapply in whatever period. It is almost 100% certain that you will be placed back on a consent agreement, regardless of how much you had rehabilitated over that period. They’re just not going to take the nurse’s word for it, and they’ll want to see at least some level of supervision or probation for a period. And then, after that, the nurse would be kind of free from any of those probationary requirements.
Ask an Attorney
Arizona Nursing License Suspension: Nurses contact our office and frequently ask our attorneys, does state law allow the Arizona State Board of Nursing to suspend a nurse’s license? The short answer is yes. The board can issue a license suspension based upon ARS 41-1092.11. That statute states nurses can be suspended (and ultimately have their license revoked):
“B. Revocation, suspension, annulment, or withdrawal of any license is not lawful unless, before the action, the agency provides the licensee with notice and an opportunity for a hearing following this article. Suppose the agency finds that the public health, safety, or welfare imperatively requires emergency action and incorporates a finding to that effect in its order. In that case, the agency may order a summary suspension of a license pending proceedings for revocation or other action. These proceedings shall be instituted and determined.”
Nursing Board Discipline
So, in short, yes. The Arizona Board of Nursing has the power to suspend your license if it determines you are an immediate threat to the public’s health, safety, and welfare. Some usual reasons for a nursing license suspension include:
- Diverting narcotics.
- Healthcare problems.
- Criminal issues (felony, misdemeanor).
- Past disciplinary issues.
- Substance abuse (alcohol, prescription medications, illegal drugs).
- Sexual misconduct.
- Mental health disorders necessitate immediate action.
AZ Nurse Complaint for an RN, LPN, or LNA
Many ask Can a Nurse Continue to Work if Suspended by the Arizona Nursing Board? No, a nurse cannot work as a nurse if the board suspends their license. The Arizona State Board of Nursing (“Board”) protects the medical welfare of the people of Arizona. They do this by ensuring each Medical professional with a nursing license in Arizona can practice safely. If the board believes a nurse cannot practice safely, they can initiate a summary suspension.
A summary suspension can occur when the board believes that the public health, safety, or welfare imperatively requires emergency action necessitating the immediate suspension of a nurse’s license. Examples of actions that can lead to a summary suspension:
- Substance Abuse
- Sexual Misconduct
- Mental Health Concerns
- Refusal to Follow Board Order
Board grants the summary suspension of a nurse’s license; the nurse must immediately cease providing care as a nurse. A hearing will then be scheduled (within 60 days) in front of an Administrative Law Judge at the Arizona Office of Administrative Hearings.
Criminal Report
A misdemeanor criminal charge would likely not reach the threshold needed for the Bd to initiate a summary suspension (such as a misdemeanor DUI or Disorderly Conduct charge).
Other Blogs of Interest
- Nursing Law: Pros and Cons of Alternative to Discipline Programs for Nurses
- Easiest Way For a Nurse to be Suspected of Diverting Narcotics
- What Does it Mean When a Nurse is Suspended?
Does a DUI Affect your Nursing License?
Can a DUI affect your nursing license? As in all my other blogs, this is a general discussion. This is not state specific. Every state has its own rules and regulations as far as when and how to report. So, this is just going to be a general discussion of the things you need to think about that may affect your nursing license if you get a DUI.
Charge vs. Conviction
First, you need to identify whether your board in nursing has a reporting requirement. For instance, here in Arizona, our nurses have to report it when they’re charged, not even when they’re convicted. A charge is when you get a DUI and a ticket with an arraignment date; that’s considered a charge. Sometimes, they’ll wait to charge you if they’re waiting for a blood test. But when you are charged, it just means when they decided to move forward with whatever the violations were.
A conviction is when you’re guilty, or you sign a plea agreement, or a pretrial diversion program, or at least most boards consider a pretrial diversion program a conviction. Like an end to whatever the criminal conduct was, that isn’t a complete dismissal. For the most part, those need to be reported. Now, when they need to be reported varies from state to state. Some require it upon renewal, and some require it upon conviction; then, as I said before, it’s when they are charged, regardless of whether they’re ultimately convicted. That’s the first thing you need to identify.
When Do Nurses Need to Report DUIs?
Alright, when do I need to report it? If I need to report it, then how do I need to report it? For the most part, it needs to be in writing. And I would not submit a long story about all the details, like I went out to dinner with Sally and had this many drinks. That is not going to help you.
It would help if you stuck to the facts. I was charged with this on this date, and my arraignment date is this; I’ll supplement in the future with more information. Or I was convicted of this on this date, which is what I’ve done. And leave it at that. You don’t want to give them any more information than you must. And the essential requirement is that you let them put them on notice of what happened criminally. Still, it doesn’t mean you must give every detail about what happened.
Is It Substance Abuse or a Deeper Issue?
Some broad thoughts on substance abuse and DUI: the biggest concern of any board of nursing is that if you do get a DUI, you have a substance abuse issue. The stated purpose of nearly every board of nursing is not to protect the nurses. It’s to protect the public. And so, they don’t want a nurse with substance abuse issues providing patient care. Now, just because you have one DUI doesn’t mean that you have substance abuse issues, but it could be that you do. Let me say this delicately. I always speak to people with what I would consider chronic drinking problems. And they think it’s wonderful. For example, if you have a six-pack or a bottle of wine every night, the board of nursing will consider that a substance abuse problem.
Suppose you just went out, went to dinner, had a few drinks with friends, you occasionally drink socially a couple of times a month. In that case, you don’t drink too much intoxication; that’s just regular alcohol consumption. That’s not a substance abuse problem, but the board will think that no matter what, they will start at this person as an alcoholic and then work their way down. So, suppose it’s just your first-time regular DUI. In that case, you have a relatively low BAC, and most boards of nursing aren’t going to formally discipline a nurse for something like that. If it’s a third DUI and you had a super extreme BAC level here in Arizona, that’s above 0.2.
What Will Happen if a Nurse Commits Third DUI?
The board is going to be concerned. And what they would do here is have the nurse undergo a substance abuse evaluation with the psychologist. Then that psychologist would write recommendations to the board. And then, the board would incorporate those recommendations into probation if they thought they had substance abuse issues. It’s implausible that a nurse with a low-level DUI will lose their nursing license. I mean, it’s infrequent.
There must be more underlying things to end up with that result. But, if you have chronic problems, a criminal problem with alcohol or drugs, that could lead to a board decision. We don’t want this person to provide care anymore. Now, they’re almost always going to give the nurse at least the option of going on probation or entering a confidential monitoring program. Most states call it an alternative to discipline or something like that. In a worst-case scenario, at least at the beginning, you’d have the option of doing that.
Confidential Monitoring Program
Where most nurses get in trouble with persistent problems with alcohol, they’re in the confidential monitoring program, have a positive drug screen for alcohol, and get kicked out of that program. They get put on formal disciplinary probation. The same thing happens, then they get their nursing license suspended. And then, if you continue to violate the terms of the probation, it could end up in revocation. If you’ve had one DUI as a nurse, it will not end your career. It’s most likely not going to prohibit you from getting jobs in the future.
You must be aware of this. You cannot let it happen again, but if you screwed up, I find the best defense for people who have screwed up, and it’s a lower-level thing, is to admit, you know what? I just made the wrong decision. I don’t have a drinking problem if it’s just one night, and I’ve learned from it. These are the things I’ve learned from it. These are the things I’ll do now to prevent it. And then, this is what I will do in the future. And that’s what most boards of nursing want to hear. Is that if there is an identifiable problem, you have learned from it and then incorporated that into your practice and move forward in the future.
On Complaints: Common Board of Nursing Disciplinary Actions
What are the options for a board to discipline a nurse? Now, before I get started, this topic is very state-specific. Every state has its own spectrum of disciplinary actions. So, my talk today will be general, meaning the state you’re in might make a difference. But this is the standard structure of what kind of disciplinary action is for the board. There are usually three options for non-disciplinary activities, and I think I should go through those first. There are several reasons a case can be dismissed and could be dismissed in filing a complaint.
Two Most Common Forms of Dismissal
Usually, the two most common reasons for dismissal are, one, the board doesn’t have jurisdiction over the complaint. Two, the conduct alleged in the complaint is not a violation of the nurse practice act. And then the other way of dismissing the case is obviously after an investigation. It can be dismissed if they believe there are no grounds to discipline the nurse. Most boards will then have a non-disciplinary option. I know here in Arizona, it’s called a letter of concern. It could be a reprimand or an advisory letter. It goes by different names. Still, I’ll call it a “letter of reference.” It’s simply a letter in your board file stating concern about the incident. Still, it’s not considered formal disciplinary action and wouldn’t be reported to any databases, nurses, or national practitioner databases.
Non-Disciplinary Continuing Education
It would just be kind of on file with the board. And if the nurse were to get in trouble in the future, they would look back at the letter of concern and decide whether they needed to take additional action. Some boards also offer an administrative penalty, which would be considered non-disciplinary. Other boards will give a fine or admit a straight liability if a nurse files for the renewal late or doesn’t provide the necessary fee. Some boards will give a fine, typically, or admit a straight penalty. The last option would be a non-disciplinary agreement for continuing education. Most of the time, that’s not considered disciplinary action. Not every state requires continuing education for nurses. Still, many states offer non-disciplinary continuing education where they’d have to take a course in documentation, nursing ethics, assessments, etc.
Common Disciplinary Action Options
Decree of Center
Those are all the non-disciplinary options. We’re here for the standard disciplinary options, and I’ll go through those. Most states usually have a decree of center or letter of reprimand. It’s a formal document that states the nurse did violate the state law in some way, but it doesn’t rise to the level where the nurse is put on probation. It’s like a formal slap on the wrist. It is necessary to report it to the database, and nurses and the nurse would have to register it in the future. Suppose any employment application states, “Have you ever been formally disciplined by a board?” In that case, they’d have to answer “yes,” but it’s a decent outcome in many cases. I guess the two choices were probation or decree of center. The decree of center is the better route to go.
Disciplinary Order for Continuing Education
Another disciplinary option is disciplinary order for continuing education. There’s a non-disciplinary potential and then a disciplinary potential. It would just depend upon the facts of the situation. I mean, the order would be the same. They must do a certain amount of continuing education where they could get in trouble. But in this case, maybe the clinical problem rose to the level that the board felt they needed to put on the record.
And so, a disciplinary order for continuing education is another option. Usually, somewhere between $500 to $2,000 is used as a civil penalty in many states, just like a fine. The difference between what led up to a complaint that ended up in a decree center and a civil penalty is maybe the civil penalty route was a little more concerning to the board, but that’s another option as well. Anything after that, for the most part, would be probationary.
Probationary
Let’s take, for instance, a nurse with substance abuse problems and several DUIs. The board felt it was necessary to put her on probation. Normal probation would include testing for substance abuse, random drug testing, AA participation, and some level of monitoring at work. Maybe you can’t pass narcotics for a period. Maybe they’ll make the nurse do counseling. They could add continuing education to a consent agreement as well. Probation can last from a year to up to three years or more. And then, after the probationary period is over. The nurses fulfilled all of the obligations of probation. They’re no longer on probation, their licenses are unencumbered, and they can work freely without restrictions.
How Can a License Be Suspended?
The levels after that are wrong. One would be a suspension. Several ways to suspend a nurse. If they were on a consent agreement and they violated the terms of the agreement. Most boards have the option to suspend the nurse’s license. The board can take a summary suspension if there’s a nasty incident. The board will take emergency action to suspend a nurse’s license. Those are kind of two ways the board can suspend a license. And finally, revocation is the worst-case scenario for a nurse. That is discipline. Suppose they violate the terms of a current consent agreement once again. In that case, many boards have an automatic option where the nurse’s license is revoked. Once again, if there’s a heinous incident, it could lead to a quick revocation.
Voluntary Surrendering of License
It’s not common for a nurse’s license to be revoked. I mean, less than 1% of nurses have their license revoked. It must be challenging and concerning conduct to get to that level. But it is always an option. A nurse can voluntarily surrender their license. That is considered a disciplinary action. I have nurses sometimes, and maybe they’re toward the end of their careers. They’re not interested in going on probation or fulfilling the terms of whatever their offer of consent agreement is. And they can give up their license. It’s called surrender.
Therefore, they no longer have their license. Normally, there would be a period when they could reapply if they wanted to. But a voluntary surrender is considered a disciplinary action as well. Those are the common reasons for a board of nursing. I guess the common reasons for disciplinary actions from the board of nursing. There’s a wide spectrum of things they can do.
Summary
I get asked, what’s your win rate, or what are your outcomes? I mean, it’s impossible to answer as an attorney who represents nurses. Getting a nurse on probation and not getting their license revoked can be a huge win. Getting somebody dismissed versus a decree of center could also be a huge one. It just depends upon the conduct. And most boards will have a range. I mean, I can see a case and understand, alright, this is where it will fall. But suppose you’re looking for an attorney, and you ask that question.
In that case, it’s difficult to answer because every situation is unique. And so, one outcome could be enormous for one person and a terrible outcome for another. It just depends upon the situation. Some states require a certain period after either the felony. I guess the nurse or potential nurse was either convicted of the felony or completed the probationary requirements. I know here in Arizona, someone must have at least three years from the date of termination of probation for a felony case to be eligible to reapply or apply for a nursing license.
The first things are heinous crimes, and two, high negative publicity events. I know it sounds strange, but boards of nursing are very concerned about the public image of nurses. And if there’s been a past incident with an applicant that sheds negatively upon the nursing profession, that board will be much less likely to issue the license. Most of those end up being criminal in nature. Still, you need to consider that these are political agencies and the politics of issuing licenses to people that are looked at as either dangerous or incompetent is not something most boards are willing to do.
When the State Revokes Your RN License
Lastly, if you’ve had another healthcare license and you’ve been placed on the OIG exclusionary list, so the office of the inspector general has this list where if you’ve had a license revoked, suspended, voluntary surrender, or a certain number of crimes, they can exclude you from billing under Medicare or Medicaid. The nursing boards, for the most part, don’t care about that at all. However, the employers, or at least some employers, will. If they can’t bill for you, they will not employ you. So, you need to think, alright, what happened to put me on that exclusionary list? And then you also need to consider there are ways of getting off it after a period and, I guess, jumping through certain hoops. You need to investigate doing that disqualify as well.
Very few things can completely disqualify a nurse from getting a license. Most nursing boards just want to see if something bad happened, have you learned from it? Did you take steps to remediate the behavior in some way? If it was maybe drugs or alcohol like DUI, did you go to AA? Did you go to counseling? Did you go to an intensive outpatient treatment program or rehab? Have you made just healthy changes in your lifestyle so that you can deal with stress better? Do you exercise discipline over your life? These are the things the boards want to hear. Just because you’ve had one bad thing happen in your past, if you’ve learned from it and incorporated positive things into your life, that’s what the nursing boards want to see.
What Can Disqualify You From Being a Nurse?
What can disqualify you from becoming a nurse? I’m only going to talk about applicants, not people the state has already licensed. This is just going to be a general discussion. Maybe I’m thinking of going to nursing school, or perhaps I’m still a nursing student, or I’ve completed nursing school. Now I must apply to a board. What things in my past could disqualify me from being a nurse in the future? Lastly, this is not going to be state-specific. It’s just going to be a general discussion.
The first, probably the most apparent, is some heinous criminal incidents in your past. Almost none of the boards in any state contain a list of things like, if you’ve done these things, you can’t get a license as a nurse. No matter what the case, they’ll have a general guideline. But, any violent crimes, if you were a possible heavy distributor of drugs in some way, sexual misconduct. These are things that are hard to rehabilitate, or at least in the eyes of the board. And so, having those in your past could be a barrier to ever getting a nursing license.
Getting a License After A Crime
It may not feel like it when I talk to nurses. Who are always concerned about DUI, marijuana possession, theft, domestic violence, disorderly conduct, and assault charges. But these are relatively low-level crimes. And just because you’ve had some of those in your past generally will not disqualify you from getting a nursing license. Now, if you’ve had 20 assault charges, it’s probably not going to happen to you. Still, if it’s a handful of things from 20 years ago, it will not hinder you from getting your nursing license.
And even in this scenario, where the board was very concerned about past behavior, they almost always offered the nurse a probationary license, meaning they would grant the license. Still, they would simultaneously put them on probation for one to three years. And at the end of that probationary period, their license is unfettered. That’s usually what the case is.
The Board Is Concerned About Public Image
People make mistakes. But if the same thing keeps happening and you’re not learning from it. I mean, at some point, you’ll likely have an interview with an investigator from a nursing board if you’ve applied to some criminal history. You state I was set up, making excuses. Those are not the things that they want to hear.
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