Most Common Reasons for Board of Nursing Discipline | Nurses Disciplinary Boards

What is the most common reason a nurse gets disciplined by the board of nursing? In my mind, all discipline stems from clinical and behavioral categories. Let’s break down each one. Regarding getting in trouble for a clinical incident, any deviation from the standard of care, practicing outside of scope, missed medication, documentation errors, and patient abuse are to be considered. Those are probably the five most common ways to get into trouble clinically. Remember that when a complaint is filed, it will come from the patient, the patient’s family, a coworker, or the employer. They’ll come from one of those four sources. 

What Will Happen If the Board Gets Their Complaint?

And in that case, what will happen is the board will get their complaint, and then they’ll send notice to the nurse. And then, they’ll likely simultaneously subpoena the employment file from the nurse’s employer along with subpoenaing any patient records that would be a part of the investigation. One thing to keep in mind, and this is general. It goes for the process for almost all the states. It can vary from state to state, but this is the general process. The board will likely send a subpoena to your employer. Many times, if a nurse is dismissed from a position due to a clinical incident, they get a new job. When they put that new job down on the questionnaire the board wants from the nurse, they’re likely to send a subpoena to your new employer. 

• So, that’s something to consider when addressing the employer’s complaint. 
• In the case of a clinical issue, once they get all the records, 
• They get the employment file, 
• They’re going to look to see if the nurse ever any previous problems with discipline at work had, 
• Any corrective action, 
• Verbal coaching counseling, 
• Any similar incidents 

Maybe it’s a missed medication. Have they done that in the past? And then ultimately, when they have all that information gathered, they’ll likely interview the nurse. And then, at some point, it’ll either be disposed of or forwarded to the board for a review.

Chelle Law’s experience in working with the Arizona Board of Nursing makes them an ideal choice for nurses seeking legal representation.

Behavioral Issues

The other type of, I guess, why a nurse would get in trouble is behavioral, and there’s a bunch of things under behavioral. One could be a criminal charge or conviction. It could be substance abuse issues. It could be mental health problems. Or it could be just the inability to get along with people at work and boundary issues involving a sexual relationship with a patient. I’m also going to lump in diverting narcotics into this. I guess you could put that in either category, but it’s probably a lot more than anyone expects. Many nurses diverge narcotics, and I find that’s almost ninety-five times out of a hundred due to personal substance abuse issues. Very rarely would it be them diverting for either resale or for maybe a family member? I’ve had a couple where they were doing it for their significant other. 

What Does the Nurse Have to Do in Case the Nurse Is Reported to the Board?

As far as behavior goes, this varies state by state, but some states require a nurse to report a charge. Other states require a nurse to report a criminal conviction immediately. Then others wait to report the criminal conviction until whenever their renewal is. So, based upon the criminal outcome and what it was, that can easily lead to discipline. The most common for nurses are domestic violence/assault, shoplifting, and DUIs. That makes up most of the criminal incidents among nurses. Some states have a rule that states if the nurse is convicted of a felony, it’s an automatic revocation of a license. Something considered many times is when we have a nurse convicted of a felony. The main goal is for their criminal defense attorney to get that knocked down to whatever they can that would not be considered a felony.

So, criminal stuff, behavioral issues, it could be, as I said before, mental health or the inability to get along with coworkers or substance abuse. I guess all the states have confidential monitoring programs, which would involve random drug tests, supervision at work, AA/NA participation, and counseling. This is a good option for nurses who want to keep their records clean and don’t want permanent discipline on their records. And it also provides them with the structure to hopefully get over whatever their issues are. Many alternative discipline programs can be for substance abuse, mental health, and physical issues. That broad category of behavioral concerns can lead to board discipline.

Words of Advice on How to Handle an Investigation

Here are some words of advice on how to handle an investigation. Maybe a nurse who comes to me after submitting a response or an interview tends to overshare, especially in the written response. It’s better to keep it short and sweet. There are some serious considerations about what to disclose if there’s a pending criminal action. Because simultaneously, the board will investigate the criminal and track what is happening. And what you don’t want is to disclose a bunch of things on the nursing board and then maybe share with the police. And then that would lead the police to act against you. If you had to choose between going to jail and losing a license, it’s an obvious choice. So, those are how a nurse can be disciplined, or at least the most common ways.

Other Blogs Interest

• Nursing Law: Can a Felon Become a Nurse?
• Disciplinary: How Long Does Discipline Stay on a Nursing Record?
• Medical Boards: What Is the Most Common Medical Board Complaint?
• Which is the Most Frequent Reason for Revocation of a Nurse’s License?

Can You be a Nurse with a Misdemeanor Drug Charge?

Can you be a nurse with a misdemeanor drug charge? This question is not going to be state-specific. I’m just going to give you general tips and things to consider if you apply for your nursing license. Many people who read these blogs may also think of going to nursing school and think, ” All right, well, maybe I can get into nursing school. Still, I couldn’t get a license and wasted time and money. So, I will talk more about applicants or those considering nursing school. It is not going to be directed toward currently licensed nurses.

Alright, so you have a past misdemeanor drug charge that could be possessing different drugs or even distribution. There are some misdemeanor distribution charges as well. If you’ve been convicted, you’ve gone to trial and lost. Or, more than likely, reached a plea bargain with the prosecutor. Then you had to do community service, pay fines, get drug counseling, get treatment, whatever. The board cares about convictions for the most part and not just charges.

It doesn’t mean you’ve ultimately been found guilty if you’re just charged with a crime. Most boards find that the nurse, in their minds, would be convicted. So, if you’ve had one misdemeanor possession of marijuana from 20 years ago, that will not keep you from getting your nursing license, let’s say.

What Do the Nursing Boards Usually Look For in Drug Charges?

When a board looks at the criminal pass of a nurse, they’re going to run two things. They will ask in the application, which changes from state to state. Still, usually, they’ll ask: do you have any felony convictions? And then two, potentially, do you have any misdemeanor charges involving substance abuse? It does vary from state to state. You need to look at the specific language in the application of the condition that you’re looking to apply to and then see what you have to disclose. And then, the board is also going to write a criminal background check. Then anything that pops up in that criminal background check will likely reach out to you. And ask you to summarize what happened and maybe even potentially provide them with the police records or court documents, so keep that in mind. 

What Do Disciplinary Boards Care More About Nurses?

Now, in a board’s mind, what they care about is that they’re going to license safe nurses that don’t have drug problems. And the board’s stated mission is to protect the public. They’re not there to protect the nurse, so they will see how many different misdemeanor drug charges or convictions they have? If you’ve had 15 in the last three years, that is a big problem, and you will probably not get your license.

If you had, as I said before, maybe one from 20 years ago, almost no chance you wouldn’t get your license. It’s a sliding scale. It would help to consider how much time had elapsed from when you had your last conviction until when you applied and how many you have. You can also think that if you did have a drug problem at the time, what have you done to fix the problem?

If a nurse is addicted to methamphetamine doesn’t mean you won’t get your license. Still, the board wants to know, alright, if you had addiction issues, what did you do to solve that problem? Did you go to AA or NA, or did you go to counseling? Did you seek treatment, maybe you went into inpatient rehab, or maybe you went into an intensive outpatient treatment program in IOP. Perhaps you’ve made some lifestyle changes, have a different friend group, or got away from an abusive spouse or something like that. There must be a change if there’s just a big cluster of drug problems at a time. There must be some rehabilitation change for the board to feel comfortable with issuing a license.

When Charges Are Frequent and More Than Just a Misdemeanor

Let’s say it’s a recent number of drug charges, and they think this nurse hasn’t done what they need to do. It’s possible they could issue the license and put the nurse on simultaneous probation for drug issues. Most states would include random drug testing, supervision at work, continuing education, a nurse recovery group, counseling, rehab, whatever. I mean, there’s a variety of things they could do. But even if you’ve had a bunch of recent items, but you’re willing to do what it takes to get your license, the board can, as I said before, issue the license but put you on probation. It could be anywhere from 12 to 36 months, sometimes more. And if you were to get through that period, your license would no longer be burdened. 

One Caveat About Being Placed on Probationary Practice

Now, one bad thing about being placed on probation is if an alternative to a discipline program is not available for you, in an alternative discipline program in most states. There’s a confidential monitoring program where you can do everything I just listed, but it wouldn’t be public. And it wouldn’t be considered formal discipline. If the board only offers you proper discipline, that will stay in your record, at least in most states.

So, you need to think about, alright, even if I do get a license, if I have this blemish on it forever, is that going to dampen the chances of me possibly getting the job I want to get? I would say no, but it is more difficult to find a job if you have a disciplinary history. 

Before Attending a Nursing School, Get an Attorney to Review Your Drug Charges or Drug Conviction

In Summary

So, in summary, you’re probably fine if you have one or two misdemeanor drug convictions. The closer to the date you apply, the more scrutiny you will get from the board. But overall, every situation is a little bit different. What I would suggest, I’m in Arizona, so I only help nurses with the Arizona board.

Before you even apply to a nursing school, it might make sense to reach out to someone in the state you’re considering using, someone with experience with nursing board issues. And say, hey, have you had a similar scenario in the past? And then what is the likelihood of me getting a license once I apply? No one is going to be able to give you a 100% accurate guess. Still, if someone’s been doing the nursing board for a long time, they can usually give you a precise, decently, I guess, estimation of whether they think you would get licensed or not. And then maybe if there was disciplinary action attached to that or not

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 already licensed by the state. This video will be a general discussion of, alright, maybe I’m thinking of attending nursing school, or perhaps I’ve completed nursing school. Now, I must apply to a board. What things in my past can 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 and probably the most obvious thing 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. No matter what, they’ll have a general guideline. But, any violent crimes, if you were a maybe heavy distributor of drug diversion in some way. For instance, sexual misconduct is brutal to rehabilitate from, or at least in the eyes of the board. And so, having those in your past can be a barrier to getting a license. 

Getting a Nursing License After A Crime

It may not feel like it when I talk to nurses who are always concerned about DUIs, marijuana possessions, theft, domestic violence, disorderly conduct, and an assault charge, but these are relatively low-level crimes. Because you’ve had those in your past, they generally will not disqualify you from getting a license in the future. Now, if you’ve had 20 assault charges, it’s probably not going to happen for 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 would almost always offer 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. Then their license is unencumbered. That’s what happens typically. 

I guess the timing of the felony would matter. Some states require a certain period after either the felony. I think 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 to be eligible to reapply or apply for a nursing license.

Nursing Background Check, Criminal Records, and State License

The first things are heinous crimes, and two, high adverse publicity events. Boards of nursing are very concerned about the public image of nurses. And suppose there’s been a past incident with an applicant that negatively impacts the nursing profession. In that case, that board will be much less likely to issue the license. Most of those end up being criminals. Still, it would help if you considered that these are political agencies and the politics of issuing permits to people gives the eye. Either dangerous or incompetent is not something most boards are willing to do. 

When the State Revokes Your Nursing License 

Lastly, if you’ve had another healthcare license and you’ve been placed on the OIG exclusionary list. So the inspector general’s office 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 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 ways of getting off it after a period and jumping through certain hoops. It would be best if you investigated doing that disqualify as well. 

Very few things can completely disqualify a nurse from getting a license. Most of the boards want to see if something terrible happened. Have you learned from it? Did you take steps to remediate the behavior in some way? If it was maybe drugs or alcohol, 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? 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 boards want to see.