Is My Nursing License At Risk?

Many nurses express the fear of losing their hard-earned licenses. However, I suspect that much of this fear might be overrated. I have decided to share four stories of former coworkers who have had their licenses permanently revoked. You will notice that three of the stories involve addiction, impairment, or theft of narcotics. Nurses Professionalism Article

I often listen as certain coworkers, usually the nurses with zero to two years of experience, chime about the dangers to their hard-earned nursing licenses. "I'm putting my license on the line by dealing with that difficult patient!" "I forgot to give a vitamin B12 shot yesterday, so is my license at risk?" "The staffing at this facility is so bad that I think I'm going to lose my license if I continue working here!"

Personally, four of my former coworkers have had their nursing licensure revoked in recent years. To give newer nurses an idea of the various offenses that frequently lead to revocation of one's nursing license, I will share the stories of these four nurses.

NOTE: Some readers might be concerned about privacy issues. To respect the privacy of these four individuals, I used pseudonyms to obscure their real names and will be purposely vague about the details that lead to action being taken against their licenses.

However, keep in mind that their real names, license numbers, last known addresses, last known workplaces, educational backgrounds, and exact circumstances that lead to loss of licensure all appear on the board of nursing's (BON) website of the state where I reside since all of this is public information.

Story Number One - Samantha

Samantha, a registered nurse in her mid-thirties, had approximately three years of experience as an ER nurse at a popular acute care hospital when she accepted a job at the local nursing home where I was working at the time. Her employment with the hospital had been terminated because she had been caught stealing hydrocodone, tramadol, and other medications from the Pyxis. In addition, her urine tested positive for these drugs.

The unit manager at the hospital referred her license number to the state BON, and after an investigation was completed, Samantha was placed on a peer assistance program for impaired nurses. Other local hospitals did not want to deal with the restrictions surrounding her peer assistance order, so she took a job at the nursing home where she was not allowed to handle controlled substances or hold the key to the narcotic box. Her license was revoked one year later after she repeatedly tested positive for hydrocodone and failed to satisfactorily complete the peer assistance program.

Story Number Two - Leanne

Leanne, a registered nurse, was the director of nursing (DON) at a nursing home where I once worked. After an extremely dismal state survey that resulted in multiple immediate jeopardy citations, she was escorted out of the facility by federal surveyors. Her license number was referred to the state board of nursing for falsifying documents, fabricating information, and failing to care plan serious issues. Her license was revoked by default because she failed to appear to the BON hearing where the formal charges filed against her would have been discussed if she had been present.

Story Number Three - Melissa

Melissa, a licensed vocational nurse in her late twenties, tested positive for prescription narcotics. She was employed on the busy rehab unit of a local nursing home, and management noticed that her behavior became increasingly bizarre over her three years of working there. Soon after the assistant director of nursing referred Melissa's license number to the BON, she ended up at a local psychiatric hospital after having attempted suicide. Her license was revoked by default because she failed to appear to the BON hearing where her case would have been discussed if she had been present.

Story Number Four - Betsy

Betsy, a licensed vocational nurse in her late twenties, was caught diverting massive amounts of hydrocodone and alprazolam (Xanax) from the nursing home where she worked. The pharmacy calculated that she diverted almost $10,000 worth of prescription drugs over a 12-month period. Her license number was referred to the state BON for diversion and defrauding the facility and patients of the cost of the medications. Her license was revoked by default because she failed to appear to the BON hearing where her case was to be discussed if she had shown up.

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Specializes in LTC (LPN-RN).

NOt showing up is a big indicator. Just shows you how fast things can turn against you for not showing up.

Diversion can be the outcome of forgetting to chart a Narc on a busy unit. If you test clean on a drug test there is a good chance you we be assumed to have diverted for a loved one. The BON must do what they have been hired to do (protect the patient). However there is a chance that if you have angered someone you will be reported even if others on the unit have committed the same offense. Can you use this to excuse yourself or to state existing prejudice? I wouldn't. On the other hand this is how petty managers get away with unethical behavior which appears to be rampant in business ( yes you can call hospitals a business now ) today. Please don't judge each other without full knowledge.

Your nursing license should be in jeopardy if you diagnose someone in your family, give them your own prescription pills and then threaten them if they don't want to take them (and against your doctor's wishes). That really should be against the law if it isn't already.

Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
Your nursing license should be in jeopardy if you diagnose someone in your family, give them your own prescription pills and then threaten them if they don't want to take them (and against your doctor's wishes). That really should be against the law if it isn't already.
Your viewpoint on this issue is interesting. Thanks for taking the time to share.

Something like that isn't minor, and I would think that a nurse would have been trained to understand something that simple. It's common sense. Would like to see an article that goes more deeply into the issue because losing a license is losing a livelihood and something you have put years into studying. Your life can be ruined by these missteps. I doubt that nurses are all addicts but some may have other problems that they're keeping hidden. Would be interesting to explore some of the other things that can threaten a license. It was interesting to see how a lot of comments found more small/petty infractions not to be punishment worthy, though losing your license should be the ultimate punishment (besides jail if that's necessary).

However, I do personally know of a case where a nurse who (perhaps foolishly) commented on some questionable practice by a nursing home where she went via a staffing agency--and had her license tarnished forever in retaliation.

She was "caught" the next day and reported to the BON for doing something almost universally done in those days--such as pre-pouring meds prior to an evening med pass. Meanwhile, every other nurse there was doing the same, but someone just "happened to notice it" in her case and make an issue of it, while everyone else scuttled away with their own med carts and "pre-poured" meds. (This was in the days when bubble packs were used in ECFs, vs. individually-labeled blister-wrapped pills, so pre-pouring meant actually popping them out of a big weekly bubble card into the med cup.)

She didn't have her license revoked, of course, but she did suffer a BON hearing, a formal reprimand for the breach of regulations in pre-pouring ("setting up" meds in advance) and the nursing home got away with punishing her for expressing concern about poor care! Thus she is ow the one with the "history, and even though the nursing home still has a crummy record, no one there had their licenses sullied in any way.

I have also talked at length with a pharmacist at a hospital where I worked, who had perosnally seen a peer fired for reporting missing drugs; they were being diverted by a nurse relapsing into addiction, but the hospital was angry he documented it and reported it properly, vs. sneaking under the table to help the hospital just let her go quietly and hide the whole event. In this case, a pharmacist lost his job, the public and BON didn't hear about a dangerous nurse, and his advice to me to keep quiet when I found something questionable in the narcotics wastage record was pretty compelling. (That dilemma resolved itself, I was very relieved to see.)

"Reporting you to the Board" is a fairly common threat from the very people and agencies who need reporting themselves, and it is used as retaliation against a potential whistle-blower.

It's not hard to catch most nurses taking shortcuts to cope with lack of resources. They should not take them, it's true; neither should the Board ignore such mistakes because the reporting person or facility might have ulterior motives.

But the "report you to the Board" threat and punitive action should be more openly discussed and acknowledged as one too-effective way of keeping nurses quiet about substandard care--especially outsiders such as traveling nurses, student nurses, etc.

Oh, and, a footnote, in case anyone is tempted to say, "just a reprimand?"

That nurse spent money for legal representation at the BON hearing, but could not have afforded an appeal. Her attorney told her afterward, too, that, "If your case is held before a class of nursing students..."--and hers was--"...they throw the book at you, to make a lasting memory for the students about cutting corners...and you're lucky they didn't do worse, for that reason", after initially telling her the charges were so ridiculous and lacking in evidence, and her actual real offense of pre-pouring medications so common and relatively minor she'd likely be "in and out of there in 10 minutes!"

She lost her job (making legal funds further out of reach, no doubt), and was turned down by others. She would have had trouble joining the military, adopting a child, working for the actual government, for a VA hospital or clinic, or an agency such as the BON, and (ironically) any inspection organization for facilities.

The higher-up the position, or the more important the need for "relationships" with other agencies in a job role, the more weight any disciplinary history would have, too, of course...so there might be no problem working as a staff nurse, but as a manager or representative? Well. She might be denied entrance to a higher school of nursing, too.

She would always be of limited value as a "whistle-blower" witness, because it could seem she had a vendetta against employers or providers, if she complained or provided evidence in another case.

Regardless, forever after she is required to let every employer know who cares to ask. If she were to apply for licensure by an endorsement to another state, it would take time, money, and embarrassment to gather the necessary extra information. Sometimes this would including multiple letters of reference from supervisors and other professionals who "know her history" attesting to her "rehabilitation".

There could always be a question in employers' minds, too, of whether the Board suspected (but lacked proof of) more than what was she was finally reprimanded for. Why? The Board has the discretion to decide the correct action based on circumstances surrounding the basic facts, and yet apparently decided to set a firm example with her case.

(I say this because others "only" reprimanded, per the disciplinary records on state BON sites, have done some pretty shocking things to "only" be reprimanded!) For that reason, some will wonder, understandably, what else she REALLY did to be judged harshly, and presume there just must not have been quite enough evidence.

In responding to probing questions, if there are any, there's another a lose/lose risk: If she went into too much detail about the retaliation aspect of what happened, instead of focusing on the lesson she learned, or if she mentioned that the nursing home was substandard, etc.,and she had foolishly tried to effect changes, she might leave a worse impression. Not only will she be seen as lacking in adequate remorse for what she did undeniably do--pre-pour medications--and lacking in improved judgement, but some employers would be scared to hire a potential whistle-blower.

So even a seemingly small "tarnish" on a nurse's license is no small thing, and it is all too easy to set someone up for one. That's pretty ironic when you know that some employers will let a criminal or addict go quietly (and unreported) to protect themselves.

It is easy to say "Do everything right, and you'll have nothing to worry about." True, except that not only are people human enough to make relatively minor procedural slips (especially smaller than pre-pouring medications) even when usually quite conscientious, but when errors are made, it's often the "why?" that determines whether a nurse was negligent or careless, vs. simply making a mistake. Isn't it?

I'm not sure of the solution, but maybe a healthy skepticism about complaints to the BON in some situations is called for. Spending much time setting examples for students of what happens when you violate procedure might be important. But for other, much more serious types of cases (mentioned in the media), oversight and control is inadequate due to lack of time, resources, personnel, and probably due to legal limits to investigation and tracking. Perhaps more of these scarce resources might be used for tracking those nurses, and investigating those major offenses.

I can't find this reference in the thread. Surely, though, this is something that might understandably cost someone his/her license, starting with practicing medicine and dispensing medication, both without a license, and for abuse of another person.

I'm petrifiedm HELP! I'M a PCt aka NA 11 in NC. £worked (resigned) 48 hrs ago becauae the drama was so bad it put me in a State of anxiety so bad that I couldn't perform my job correctly. 2 cna 1's were following me around harassing me, making up loes saying I was photographing idk wht but alao that I was a snitch becauae I reported a cna who continued to not tell the Nurses about a man who kept having chest pain. I"Ll NEVER DO THAT AGAIN you become the snitch and lives dont mater just their a $$$$es do. So that next day they tried to say I hurt a resident by grabbing her around the neck. LIE, lie, lie..she even called the DON Director of nuraing on me in the facility. After that wpisode of retaliation I told and BEGGED the DON to go home. I couldn't think, my heart was racing, and I needed to go home! She again said no. I ended up literally (ratio was about 14) from 3 pm to check and tone had a brown ring around her the other was wet. I DID NOT want to be there. I was being harrased, followed around, and I MESSED UP! Yes another cna coming on at 8 reported me. Am I going to lose both my licences now? The DON, AND ADMIN have been doing their invesigation.

Let me add. 3 weeks prior to this one of those CNA's threatened to beat me up and other cna's heard her say it in the hallway..their little invesitgation let her stay even with witnesses. Also that same cna left the facility one night for over an hour and left the patients Im assuming she denied it Idk?

Am I pretty much doomed?

Specializes in Telemetry.
I'm petrifiedm HELP! I'M a PCt aka NA 11 in NC. £worked (resigned) 48 hrs ago becauae the drama was so bad it put me in a State of anxiety so bad that I couldn't perform my job correctly. 2 cna 1's were following me around harassing me, making up loes saying I was photographing idk wht but alao that I was a snitch becauae I reported a cna who continued to not tell the Nurses about a man who kept having chest pain. I"Ll NEVER DO THAT AGAIN you become the snitch and lives dont mater just their a $$$$es do. So that next day they tried to say I hurt a resident by grabbing her around the neck. LIE, lie, lie..she even called the DON Director of nuraing on me in the facility. After that wpisode of retaliation I told and BEGGED the DON to go home. I couldn't think, my heart was racing, and I needed to go home! She again said no. I ended up literally (ratio was about 14) from 3 pm to check and tone had a brown ring around her the other was wet. I DID NOT want to be there. I was being harrased, followed around, and I MESSED UP! Yes another cna coming on at 8 reported me. Am I going to lose both my licences now? The DON, AND ADMIN have been doing their invesigation.

Let me add. 3 weeks prior to this one of those CNA's threatened to beat me up and other cna's heard her say it in the hallway..their little invesitgation let her stay even with witnesses. Also that same cna left the facility one night for over an hour and left the patients Im assuming she denied it Idk?

Am I pretty much doomed?

I honestly can't quite understand a lot of what you are trying to communicate. Perhaps calm down some and rewrite your concerns/questions?

Also, you wrote this post in another thread (https://allnurses.com/patient-care-technician/pct-aka-na-1032435.html)

something I want to clear up.

As a Nurse Assistant )II, you are not, repeat NOT basically an LPN. LPNs are licensed nurses who completed a nursing program and passed NCLEX-PN.

I NEVER said I was a nurse I said we do close to what an lpn does. I am on the BON we suction, do wound care, catheters, g-tube feedings, I can draw bllod.. extra..if it came off that way totally sorry. We mostly work in hospital settings. Here lpn's are rarely hired in hospitals idk why?

Anyway, not sure what you don't get? I literally did not clean up a resident meaning she was wet and it turned into a brown ring round the chuck. Q time I asked the lpn to go clean she said you can't clean while the food tray is rooms. I asked B resident with that tray if I could please remove her tray and bring it back she kept saying no? I had infact cleaned them both around 4:30ish. My shift ended in an hour it at 7 it was now 8. I happen to still be there the new cna reported me at 8..that tray was still there trays came at about 5:45..I told the DON I wanted to go home aro u bd 3:30 to much drama and I was being harrased... the Don said no..I've NEVER been neglectful, I love what I do I'm being honest but I'm scared now because they said they'll let me know tommorow. I know I coud of handled this better. My question is can they take my licence's now? I feel horrible and possibly will never now be able to start the Rn program either.

Specializes in Telemetry.
I NEVER said I was a nurse. I am however on the BON we suction, do wound care, catheters, g-tube feedings extra..if it came off that way sorry.

Not sure what you don't get? I literally did not clean up a resident meaning she was wet and it turned into brown a brown ring round the chuck. Q time I asked the lpn to go clean ahe saod you can't clean while the food tray is in tokm. I asked B resident if I could please remove her tray and bring it back in my shift ended in an hour it was now 8 I was off at 7 trays came at about 5:45..i told the DON I wanted to go to much drama...I'm honest but I'm scared now because I know I coukd of handled this better. My question is can they take my licence now?

I now live in the State of NC hopefully temperarely lol sorry NC. I know Ca has CNA 1'S

But does Ca also have PCT's aka CNA 11?

***Here in NC. a NA 11 is registered on the BON and can do about 80% sometimes more but very close to the equivalent of an LPN.***

Please tell me they have it there ao I can transpher

My licence lol?

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You said you are close to the equivalent to an LPN and that is not true, regardless of how many "tasks" you may be able to do.

You aren't technically "licensed" so not sure what you can expect.

And yes your OP really is difficult to decipher.