What is the most frequent reason for a nursing board to revoke a nurse’s license? I’m going to talk generally about how most boards work. I’m not going to talk about a specific board, so this will be a general overview of how most boards handle complaints and then the process and goes into the revocation of the nurse’s license. If there is a complaint from a patient, from a patient’s family member, or a colleague, there’s a criminal incident that must be reported, maybe some mental health issues. Whatever leads to the complaint, it’ll go to the board, and it’ll get assigned to an investigator. The investigator will reach out to the nurse and ask for more information.
They’ll usually send a questionnaire that needs to be filled out with employment information, education history, contact information, usually a written statement about whatever the complaint is about. Most of the time, there’ll be an interview between the investigator and the nurse. And then ultimately, if it’s not disposed of at that level, it will work its way up to the board. And then the board at the board meeting will discuss the case, and then make their decision as far as what the ultimate outcome is. It could be non-disciplinary, disciplinary, suspension, revocation, which are both disciplinary as well. In my opinion, the most frequent way that a nurse’s license is revoked is violating the terms of a current probation. If a nurse, let’s just say someone with substance abuse issues goes before the board, the board says, we’re not going to take your license away.
However, you’re going to be monitored for let’s just say two years. The nurse will have to sign an agreement that says for this two-year period, they will do certain things. It could be random drug testing, AA participation, maybe some kind of supervision level at work, maybe they can’t pass scheduled drugs. I mean, it could be a variety of things if the nurses are within that agreement and then just don’t follow what’s in there, then most of the time they may be given a second chance, if not, the board may just move forward with revocation. And most states, if they’re going to revoke a nurse’s license, it must go through an appeal and hearing process. Like here in Arizona, if the board’s going to revoke a license, then it goes before a hearing in front of an administrative law judge. Other blogs of interest include:
- Most Common Reasons for Board of Nursing Discipline
- What Happens When a Nurse is Reported to the Board?
And then it gets shot back to the board. The board can accept, reject, or modify that decision. And then ultimately, the nurse’s license is revoked. So, the first way is if they just violate the terms of whatever probation they’ve signed. Another way would be if there’s a heinous crime, every board has the option of what’s called a summary suspension. Kind of the threshold is if a nurse is an imminent threat to the health, safety and welfare of the public, the board can issue a summary suspension, which would essentially immediately suspend a nurse’s license then it gets forwarded to the hearing. In that scenario, it’s almost always for revocation if there’s no settlement reached between the nurse and the board or board’s attorney. If there is a heinous crime, most boards will have language about what happens.
If a nurse has a felony, I know here in Arizona, if a nurse is convicted of a felony, that’s it, they’re losing their license. Nothing I can do about it. If the state has language that states, if they get a felony, it’s an automatic revocation, then that’s going to happen. And the license is going to be revoked. Even if it’s not a felony, if it’s maybe a high publicity case that may shed a bad light upon the nursing profession, the state can lead to the board deciding to move forward with revocation proceedings. People who have substance abuse issues, maybe diversion. Fentanyl is a hot button drug right now that I find most states are going out after. If the nurse is caught diverting fentanyl or any other kind of analgesic or opiate that could then lead to not only criminal issues, but also board issues as well.
If they’re diverting it for sale, that’s one thing versus just diverting a small amount for personal use. The board will take that into account as well. Mental health issues, if the nurse simply is unsafe to practice due to mental health concerns such as violating an order, heinous crime, mental health issues, substance abuse, those are the main reasons why a nurse with their license revoked. It’s very rare that a nurse would have their license revoked due to clinical issues.
Unless there is an extreme pattern of clinical problems that continue and have been remediated, and then it happens again. And then there’s maybe some kind of education that happens again, that would get to the point where the board would likely act and revoke. But the percentage of nurses that have their license revoked due to ongoing clinical issues is very small. Now, if a major event happens, so if a nurse has a major medication error that leads to the death of a patient, it’s possible that could lead to a revocation as well. So, those are the main reasons how a nurse can have their license revoked by a nursing board.
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