Indiana Board of Nursing Continuing Education Requirements | Nurses

Many those working as a nurse in Indiana may wonder about the various requirements to renew their license. The Indiana Board of Nursing doesn’t require additional continuing education courses for Registered Nurses (RNs) and Licensed Practical Nurses (LPNs) for renewals. However, as of September 15, 2016. The exception to this rule states that RNs and LPNs with an expired license of three years or more. And have no active licenses in any other state or jurisdiction to take refresher courses. This includes a clinical component to complete the continuing education requirements. It’s also important to note that as a Certified Nurse Midwife (CNM), obtaining continuing education is not necessary to renew a limited license to practice. Along with Licensed Nurses, CNMs must only “maintain skills and knowledge sufficient to remain competent to practice.”

Contact an Indiana Board of Nursing Attorney

Other Requirements for RNs and LPNs

In addition to continuing education requirements, Indiana requires RNs and LPNs with a license expired for 3 years or more with no licenses in other states to come before the board. This is necessary because the board evaluates the candidate for renewal. This hearing occurs after a candidate completes a renewal form and submits it to the Indiana Professional Licensing Agency (IPLA) with a $100 fee.

Special Requirements for Advanced Practice Nurses With Prescriptive Authority

Advanced Practice Nurses (APNs) in Indiana must obtain at least 30 hours of continuing nursing education, at least eight hours of which must be in pharmacology. It’s in the best interest of APNs to keep records of their continuing nursing education in case of an audit by the board. APNs should only attend continuing nursing education programs or events approved by a nationally approved sponsor of continuing nursing education. Suppose a candidate has an initial grant from prescriptive authority less than 12 months before its expiration date. Then no continuing nursing education is necessary.

However, suppose an authority gets granted more than 12 months before the expiration date. In that case, applicants must submit proof of at least 15 hours of complete continuing nursing education. These hours:

1. Must be complete before the expiration date and after the authority has been granted.
2. Include at least four hours of pharmacology
3. Need to be approved by a national sponsor of continuing nursing education for nurses and approved by the board.

Additionally, since July 1st, IC-48-3-3.5 has stated that APNs must have at least two hours of continuing education in opioid prescribing and abuse. These hours must also be from an approved sponsor and can count towards a pharmacology requirement.

Learn more about the Indiana Board of Nursing’s continuing education requirements. 

If you have questions about protecting your professional license, contact Chelle Law to set up a consultation.

Other Blogs of Interest

• Pros and Cons of Alternative to Discipline Programs for Nurses | Nursing
• Your Nursing License was Revoked. Now What? | RN License Revocation
• What Is the Most Common Medical Board Complaint? | Medical Boards

Does a DUI Affect your Nursing License? | Professional 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 will be a general discussion of the things you need to consider 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, our nurses must report it here in Arizona when they get charged, not even when convicted. A charge is when you get a DUI criminal case 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 get 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 get reported. Now, when they need to get 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 get 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 got 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 get a DUI case, 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 health 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 terrific. 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 discipline a nurse for something like that formally. If it’s a third DUI case 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 the board 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 healthcare 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 medical programs, 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 criminal case 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.

Can You Be a Nurse With a DUI? | Nursing License DUI

First, let’s talk about what it means to have a DUI. You could’ve been charged with the DUI but never convicted. That’s not going to prevent you from becoming a nurse. I’m just talking about convictions here, meaning you either pled guilty through a plea agreement, went to trial, lost, and were found guilty. That’s what I mean. Or, maybe you reached a pretrial diversion program, which most boards consider a guilty outcome. Now, first, this is just general information. Every state has its own specific rules as far as kind of criminal background.

Thinking of Enrolling or Just Enrolled in a Nursing School?

Background. I never thought about it. Can you get your license? So, delay any significant fear. 99 times out of 100, yes, if you have a DUI in your past, you’ll still be able to get your nursing license. Now, it may be under some conditions. Still, it’s infrequent unless it’s a felony DUI that would prevent you from getting your nursing license completely. Let’s just kind of break down what a board will search for if you have a past drunk driving incident.

Usually, when you apply state-specific, it’ll say, have you had any convictions regarding substance abuse or alcohol or something like that? A DUI is, yes, considered one of those. And it’s going to say, alright, tell us when it happened, where it happened, and give us a short statement about what happened. And then they may even want the nurse to provide them with a criminal record. There are two parts to any record of the police documents and the court documents.

And they’re separate. They are usually not in the same place. You’ll have to request them from both. Once you have all of that, you’ve submitted a statement, then depending upon the length of time that you elapsed since you had the DUI, what your BAC was. Do you have three DUIs versus one? Do you have any other kind of substance abuse-related, some drug charges, possession sales, a lot of disorderly conduct, or domestic violence-related incidents involving alcohol? 

Is It One DUI or an Underlying Substance Abuse?

Suppose there are any major red flags beyond that I’ve had one regular DUI in my past. Then what a board will typically do is they’re going to investigate. The investigation will be kind of a review of all of the criminal and court documents. And then they’ll usually ask to speak to the nurse. What happened here? What was going on in your life at the time? Did you have to do any rehabilitation? Did you go into rehab, maybe an IOP, or have you been doing AA? What are your current drinking habits?

Those are the questions they’re going to ask to determine whether you have a problem or not. I mean, the stated purpose of every board of nursing is to protect the public, not the nurse. They’re not there for you. They’re there to protect the public.

Suppose they’re going to license somebody with a criminal background involving a DUI. In that case, they want to ensure that you don’t continue to have substance abuse-related problems that may bleed into the clinical side of providing patient healthcare. Or, if you had issues in the past, you must fix them somehow. As I said before, doing rehab or an IOP or counseling, AA, all those things.

The Number of DUIs Matter

Just because you’ve had one DUI in your past doesn’t mean you need to do all those things. Well, you probably don’t need to go to rehab or AA or do anything if you just had one DUI 10 years ago and made a stupid decision. Now, if you’ve had three DUIs and you had a very high, like over 0.2 BAC, at least in Arizona, it’s a super extreme DUI.

Yes, you probably need to do those things to show the board that you have dealt with the issues and that you no longer have those problems. They’re going to ask about all your current drinking habits, so how much do you drink now? When I talk to a nurse and say, okay, you’ve had one DUI, fine. It’s a grand scheme of things. That’s not a big deal, but what are your current drinking habits? And they say I drink a six-pack every night before bed. Okay, but most boards will describe that as someone with a substance abuse problem.

Think of them as the parish organization; anything above regular social drinking will shoot up red flags for them. Now, suppose they think you may have an issue. In that case, some boards will have a nurse get a substance abuse evaluation from a psychologist. Maybe a substance abuse counselor to get an opinion on whether they have any substance abuse problems. And whether that professional believes they need a monitoring program. 

Worst Case Scenario for Nurses Who’ve Had a DUI

That’s usually, the worst-case scenario for a nurse with DUI in their background is that the board will essentially force them to go on probation for a period. And they’ll grant the license simultaneously. They’ll say, yes, you can be a nurse, but you’ll be on probation for 12 months and have to do random drug screens, AA, recovery group, and supervision at work. You can’t use your multi-state privilege if your state offers that.

That’s usually the worst-case scenario for a nurse to get denied entirely a license based upon a single DUI in their past is extraordinarily rare. Almost for sure would-be other factors involved beyond just that one incident. So, take a deep breath. If you’ve had one DUI, it doesn’t mean the end of the world, and it doesn’t mean you’re never going to get a nursing license, but there may be some things you’ll have to explain.

Suppose you do have an extensive criminal history. In that case, it’s probably a good idea to contact an attorney in your state who handles the board stuff or devises a plan. Do I need to do these things before applying for my license? That would make the most sense. As I said before, I’m only in Arizona, so I can only assist nurses here in Arizona. But this is good general advice for any nurse who had a DUI.

Common Board of Nursing Disciplinary Actions | Complaints

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 spectrum of disciplinary actions. So, my talk today is going to be general. This means it may be different in the state that you’re in. But this is the standard structure of what kind of disciplinary action is for the board. There are usually three options for non-disciplinary actions, and I think I should go through those first. Suppose you filed a complaint, a case may get dismissed, and it could get dismissed for several reasons.

Two Most Common Forms of Dismissal

There are two common reasons for dismissal. One, the board doesn’t have jurisdiction over the complaint. Then two, the conduct alleged in the complaint is not a violation of the nurse practice act. The other way of dismissing the case is after an investigation. It may get 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 advisory letter. It goes by different names, but I’ll call it a letter of concern. It’s simply a letter that goes in your file on the board. It states concern about the incident, but it’s not considered formal disciplinary action. It wouldn’t get 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 then decide whether they need to take additional action. Some boards also offer an administrative penalty, which would be considered non-disciplinary. Suppose a nurse files for the renewal late, or they don’t provide the necessary fee. In that case, some boards will give a fine typically or admit a straight penalty. Most of the time, that’s not considered disciplinary action. The last option would be a non-disciplinary agreement for continuing nursing education. Now, not every state requires continuing nursing education for nurses. It’s not an option in every state. But many states offer non-disciplinary continuing nursing 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 common disciplinary options, and I’ll go through those. Most states have what’s usually called a decree of center or letter of reprimand. It’s a formal document that states the nurse violated the state law somehow. But it doesn’t rise to the level where the nurse is on probation. It’s like a formal slap on the wrist. It gets reported to the database, and nurses and the nurse would have to report it in the future. If on any employment application, it stated, have you ever got disciplined by a board? 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 the 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 possibility, depending 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. In this case, the clinical problem may have risen to the level that the board felt required to put on the record. And so, a disciplinary order for continuing education is another option. Implementing a civil penalty in many states is like a fine, usually between $500 and $2,000. 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. 

Probationary

Anything after that, for the most part, would be probationary. If a nurse, let’s take, for instance, a nurse who had substance abuse problems and she had several DUIs, and the board felt it was necessary to put her on probation. Regular probation would include well, for substance abuse, random drug testing, AA participation, and some level of monitoring at work. Maybe you can’t pass narcotics for a period, and perhaps they’ll make the nurse do counseling. They could add continuing education to a consent agreement as well. Probation can usually last from a year up to three years or more. And then, after the probationary period is over. The nurses fulfilled all of the obligations of the probation. They’re no longer on probation, their licenses unencumbered, and they can work freely without any requirements.

Suspension of License

The levels after that are bad. One would be a suspension. A nurse may get suspended in several ways. 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. If there’s a nasty incident, the board can take a summary suspension where the board will take emergency actions to suspend a nurse’s license. Those are kind of two ways the board can suspend a license. And then finally, revocation is the worst-case scenario for a nurse. That is discipline. Suppose, once again, they violate the terms of a current consent agreement. In that case, many boards have an automatic option where the nurse’s license gets revoked. Once again, if there’s a heinous incident, it could also lead to a quick revocation.

Voluntary Surrendering of License

It’s not typical for a nurse’s license to get revoked. I mean, less than a fraction of 1% of nurses how their license revoked. It must be not easy and concerning conduct to get to that level. But it is always an option, and I guess there’s one more. 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 uninterested in going on probation or fulfilling the terms of the offer consent agreement. And they can give up their license. It’s called surrender. Therefore, they no longer have their license. Typically, there would be a fixed 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 and for disciplinary actions from the board of nursing. There’s a broad spectrum of things they can do. 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 within. But suppose you search for an attorney, and you ask that question. In that case, it’s difficult to answer because every situation is unique.

How Long Does Discipline Stay on a Nursing Record? | Disciplinary

How long does discipline stay on a nurse’s record? Well, first, this is very state-dependent. Each state may have a policy on how long the discipline will stay. This is state-dependent, but this will be a general discussion of discipline where it gets reported. Then how long does it stays up? First, you need to define what discipline is. Every state is going to have unprofessional conduct. And even though a nursing board has issued a decision against the nurse, it doesn’t always mean they’re considered formal disciplinary actions. In most states, it could be called a letter of concern, an advisory letter. A low-level document goes to the nurse that’s not formal discipline. And won’t be reported to the national databases, nursys, and then the national practitioner database.

There could also be a non-disciplinary continuing education order. In that scenario, that doesn’t get reported either. We’re talking about today if you’ve been given formal discipline in your practice. So either decree of censure, a civil penalty, letter of reprimand, probation suspension, revocation, or voluntary surrender. All those things are considered formal discipline and will get reported to the national databases. There are a few states left that host their reporting. And in that scenario, that’s up to the nursing board. How long do they want to keep the discipline on their website? 

When the State Can’t Expunge Past Disciplinary Actions and Complaints 

But the national data banks have some very set standards. Let’s take nurses, for example. If a nurse is disciplined and receives disciplinary actions or complaints, it gets reported to that database. And if anyone were to verify the license of that nurse, all the states the nurse’s license would pop up. Then any discipline they’ve received during their practice would also pop up. And it would state what happened on the date of it. Then, they’ll often link the document so someone can pull it up and look. Now, if your state has no mechanism for deleting or removing discipline, it will stay up there permanently. There’s no way of removing it. For instance, I live in Arizona and represent Arizona nurses before the board. We have no way of deleting a case or removing discipline.

So, if any nurses report to nurses or the national practitioner database, there is no way of removing that discipline. It’s there forever, which is frustrating for a nurse. The only way that we could get that changed would be by changing the law. 

Dealing With Past Disciplinary Actions Throughout Your Career

We’d have to lobby with state officials and try to get a change to the law so that we can have cases deleted or removed after a period. But right now, we can’t. If you’ve received formal discipline, it will likely stay on your record permanently or for a reasonably long period. It’s not fair. If you got disciplined 20 years ago, this would follow you for the rest of your career. It’s not fair. The reasons why it can come up are if any employer verifies your license. It pops up. They’re going to see it. Two, those job applications will state, have you ever been formally disciplined by a licensing board? 

In that case, even if you’re in a state where it can get removed. You’ll likely have to answer that question affirmatively because it happened. But having the licensure verification available for anyone to see and pull up and read the facts of the situation. Something that happened a very long time ago in your practice. Nurses had no problems for a decade or two. It’s tough to deal with that for the rest of your career.

Disciplinary Background in Nursing Likely to Remain for a Long Time

People make mistakes. Just because a nurse gets formally disciplined doesn’t mean they’re a terrible nurse. It doesn’t mean there’s a behavioral problem with them. People screw up in medicine all of the time. And most of the time, it’s not some action expected from the nurse. It could just be an honest mistake that led to discipline. But it will still follow them around for the rest of their career. I wish I had better news. If you received formal discipline, it likely would stick around for a long time. How to handle that with an employer? If you have received formal discipline, the employer will find out about it and ask you about it. You need to have a story to deal with it.

What the Disciplinary Commission Wants to Hear

You need to say. This is where I was in my life at the time. This is what happened. And these are the things that I’ve done, the programs I’ve joined, to ensure it doesn’t happen again. That’s what the employer wants to hear. They don’t want to listen to a bunch of excuses. They don’t want a big, long, complicated story. All they want to hear the nurse say is, “I screwed up. I got disciplined for it. I learned from it.” Here’s what I’ve learned and why it will never happen again.

Now, there are situations where the nurse can talk their way around. Well, this wasn’t my fault for these reasons. But I find, for the most part, the most effective way of dealing with it’s just straightforward. I screwed up, learned from it, and won’t do it again. That’s what the employer wants to know.

Any employer wants to know that a nurse is coachable, or the board calls it regulatable. They want to see that you can recognize if there have been issues. That this is something that you’ve grown from. It’s tough for some nurses to swallow their pride and admit that they screwed up. Well, I mean, this goes for any profession. I’m not singling out nurses here. It’s just hard for people who are professionals to admit an error or that they screwed up in some way. But it’s the best way of handling a situation like that. That is, if it’s remote if something happened decades ago. An employer, if they’re a good employer, they’re going to understand things happen. And they’re going to show compassion to a nurse who’s just explaining the situation. And I guess establishing that they’ve grown from it.