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

Is My Nursing License At Risk?

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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TheCommuter

About TheCommuter, BSN, RN

TheCommuter, BSN, RN, CRRN is a longtime physical rehabilitation nurse who has varied experiences upon which to draw for her articles. She was an LPN/LVN for more than four years prior to becoming a Registered Nurse.

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Specializes in ER.

I'll bite...

So your theory is that because the nurses that you know that got their licenses revoked all did something illegal/ very serious that all nurses who have their licenses revoked did something implicitly illegal and/or very serious?

Think that logic is a little faulty there sister!

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Specializes in Case mgmt., rehab, (CRRN), LTC & psych.

By the way, the following is a link to the recent disciplinary action page on the BON website for the state where I live. Just click on any license number to read the stories that led up to disciplinary action being taken against the licensee (nurse).

https://www.bon.state.tx.us/disciplinaryaction/recentaction.html

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Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
I'll bite...

So your theory is that because the nurses that you know that got their licenses revoked all did something illegal/ very serious that all nurses who have their licenses revoked did something implicitly illegal and/or very serious?

Think that logic is a little faulty there sister!

Well, I'll bite back because I'm not your sister and that's not my theory. . .:down:

Anyhow, it would be nice if the nurse who has lost his/her license for dealings with difficult families, short staffing in nursing homes, or giving meds late would come forward and share his/her story. However, I kinda suspect that nurses who lose their licenses for minor issues are rare.

My point is that the vast majority of license revocations in my state of residence occur due to issues with impairment or diversion. I regularly read the disciplinary web pages on the website of my state's BON.

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I think the point was to show these nurses that it takes a very serious offense to lose your license , not missing a B12 injection. Even a serious med error probably wouldn't cause you to lose your license.

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Specializes in Emergency & Trauma/Adult ICU.
My point is that the vast majority of license revocations in my state of residence occur due to issues with impairment or diversion. I regularly read the disciplinary web pages on the website of my state's BON.
Browsing the disciplinary actions of my state BON yields the same results. I would say greater than 90% are related to substance abuse/impairment.
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Specializes in Med/Surg, Academics.

I looked over my state's report for September. Here's the breakdown.

Documentation re: patient care and policies (5): 5 reprimands

Drugs (6): 4 indefinite suspensions, 1 indefinite probation, and 1 refusal to renew

Failure to Report (6): 1 reprimand for false information on application, 1 fine for failure to report another state's disciplinary action, 1 reprimand for failure to report termination and unprofessional conduct, 1 indefinite suspension and 1 reprimand for late reporting of felony convictions, 1 indefinite probation for being audited w/ no CEs

Actual Patient Care (1): 1 reprimand for failing to notify physician of a change in patient status

And, drumroll please...

THIRTY refusals to renew and FOUR indefinite probations for defaults on student loans

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I agree with commuter - the vast majority of disciplinary actions have to do with actual illegal actions - from diversion to passing bad checks to dui's. Falsification of records is now being caught more often in these days of electronic charting. Rare is actual patient care issues, and certainly not a missed B12 shot!

The only two people I knew that had action against their licenses - one was diversion, and the other had a meth lab in her house!

What I really resent is when a management type threatens a nurse by saying they will report her to the BON for some minor screw-up on the floor.

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Specializes in PICU.

I totally understand and agree with the OP. It is the newer nurses who make these statements but on the contrary, in all my years as a nurse I can only think of one nurse that I knew who actually lost her license and it was for a myriad of issues. Eh, make that two maybe and yes, the second was for + UDS.

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Specializes in ER, progressive care.

I think part it comes from nursing school, because instructors constantly remind students "if you dont' do this, then blah blah blah" and suddenly everyone fears for their license.

I am a "newer" nurse (17 months of experience) but I have feared for my license before because of a patient issue. In fact, it was a safety issue. This patient was admitted for acute ETOH intoxication and also had Dilaudid and Ativan prescribed PRN. The patient constantly asked for those meds, often together...patient was oriented and totally with it, just doped up from getting those meds around the clock. The real kicker was when this patient would keep going downstairs to smoke, numerous times during the day and at night. I told the patient that if they were to get pain medicine or something for anxiety, they could not leave because it was a safety issue...but they left anyway. Then started to refuse telemetry monitoring. I notified my supervisor and the attending MD and all I could really do was document everything to cover my butt. What if something happened? Thankfully nothing didn't. I know most hospitals automatically sign the patient out as AMA if they leave the floor especially to go out and smoke. Most hospitals are also non-smoking facilities. My facility does NOT sign out a patient as AMA. I think that issue has been discussed many times but no one ever follows through with it because it is bad for "satisfaction scores."

And besides, if you are well enough to be going downstairs to smoke, you shouldn't be on a progressive care unit...

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I am a brand new Nurse orienting at my first job in LTC. When we were in school I think they put a fear in us about losing our licenses over trivial matters. Yes, my friends and I have discussed this possiblity since we graduated and many of us are working in LTC. I have worried about what if someone goes downhill or I miss something when I have 25-30 residents? Last week one of my residents was sent out to hospital about 6 hours after my shift. I worried about it because it was my very first day caring for her, I never saw anything that alarmed me or would make me call the Doctor. These are situations that I worry about losing my license over in LTC. We are not in a hospital enviroment and these residents are not all Q shift charting (Thank God!) and they do not and should not need a physical assessment on a daily basis. Im actually a little bit relieved to hear this discussion. The way we heard it in school from our instructors made us feel our license is constantly at risk and its very stressful to say the least.

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"Abandon all hope ye who enter here"

LTC will throw you under the bus just to keep the beds full and the bucks rolling in.

Dear BON, our LTC facility's pish-poor staffing, impossible assignments, 20:1- pt: nurse ratios, didn't have anything to do with Mr Xs death, it is solely the nurse who is to blame.

Hogwash.

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