How to Avoid Losing a Nursing License: Tips, Info, and FAQ
Failing a drug test. Documenting care that wasn’t provided. Administering the wrong medication. These are just a few examples of why losing a nursing license can happen more easily than many nurses realize. Often, it’s not a lack of skill or compassion, but a moment of pressure, fatigue, or poor judgment that leads to serious consequences.
So how can you, as a nurse, protect your license and the career you’ve worked so hard to build? This article explores common pitfalls that put nursing licenses at risk — and what you can do to avoid them.
What Are the Top Reasons for Losing a Nursing License?
There is a variety of nursing license suspension reasons that can come into play. State Boards of Nursing (SBON) have the authority to investigate and discipline nurses when there is evidence that they violated the Nurse Practice Act (NPA) or compromised patient safety. If you’re wondering how can you lose your nursing license, here are the common reasons this happens:
1. Criminal Convictions and Related Misconduct
A nurse can have their license revoked for criminal acts that are deemed substantially related to the qualifications, functions, and duties of a licensee such as felonies, violent crimes, theft, or drug offenses. Even convictions outside the workplace (e.g., DUI, theft, and domestic violence) must often be reported and can trigger disciplinary action.
2. Substance Abuse
State boards may take action against nurses who work while under the influence, misuse drugs, or divert controlled substances (stealing medication for personal use, distribution, or sale). Problems with substance abuse are one of the most common causes of professional discipline in healthcare.
3. Unprofessional Conduct
Nurses can lose their license for crossing professional boundaries — this includes sexual misconduct, harassment, dishonesty, or any behavior that breaks ethical standards.
4. Patient Neglect, Abuse, or Safety Violations
Failing to provide competent and safe care, including neglect, physical or emotional abuse, gross negligence, or conduct endangering a patient’s health, can lead to losing a nursing license.
5. Falsifying Records
Falsifying patient charts, medical record documentation, or credential information — such as lying on licensure applications or clinical documentation — is a serious violation and common ground for disciplinary action against nurses.
6. Violation of Patient Privacy Laws
Breaches of federal or state privacy rules like Health Insurance Portability and Accountability Act (HIPAA), including unauthorized disclosure of patient information, can result in losing a nursing license by suspension or revocation.
7. Practicing Beyond the Authorized Scope
Nurses can face disciplinary action if they perform procedures they aren’t trained in or legally allowed to do, prescribe medications, or make clinical decisions that go beyond what their license and state rules allow.
8. Fraudulent Credentials or Educational Misrepresentation
A nurse can have their license revoked if they earned their diploma or degree through a fraudulent program and then failed to report it. Misrepresenting credentials in this way is considered serious misconduct and can trigger disciplinary action.
9. Failure to Complete Mandatory Continuing Education
Most states require nurses to complete continuing education to maintain licensure. Failing to meet these renewal requirements or practicing nursing on an expired license can result in disciplinary action and license suspension.
What Disciplinary Actions Can Be Taken Against Nurses?
Not all nursing mistakes are treated the same — the response can range from a minor slap on the wrist to serious, career-changing consequences. There are a range of disciplinary actions that a SBON can take:
- Fines or penalties
- Referrals to recovery programs
- Public censure
- Remediation requirements
- Limitation of practice
- Suspension of practice for a time
- Complete revocation
Suspension vs. Revocation: What’s the Difference?
In short, suspension is a temporary loss of a nursing license. Revoked license instances permanently prevent the nurse from practicing until, and unless, they are reinstated under state board rules. Here’s how these outcomes differ:
- Nursing license suspension: It’s a temporary loss of the right to practice. The nurse must stop working for a set period or until certain conditions are met, such as completing required education or rehabilitation.
- Revocation of a nursing license: It’s the most serious disciplinary action and means the nurse loses their license and can no longer practice nursing. In some states, nurses may be able to apply for licensure again after a set period — often several years — but the revocation remains part of their official record.
Here are a few examples that show how the process can vary from state to state:
| Missouri | New York | California |
|---|---|---|
| If a nurse’s license is suspended, they are unable to practice for no more than three years; if a nurse’s license is revoked, they are unable to apply to have their license reinstated until a full year has passed since the date of revocation. | A professional whose license has been revoked or suspended often must wait three years before they can apply to have it reinstated. | A nurse must wait one to three years before petitioning the board of nursing to have their license reinstated. |
What Is the Nursing License Suspension Process?
A license can be suspended when a concern is raised about a nurse’s conduct or ability to practice safely. The BON may initiate a suspension process while the issue is investigated. Here’s how it generally works:
- Filing a complaint: A nurse can be reported by patients, employers, coworkers, or members of the public — anyone who believes a nurse may have violated the NPA or safety standards.
- Initial review: Once a complaint is received, the BON reviews it to decide if the board has jurisdiction and whether there’s enough information to justify further action.
- Investigation: The board investigates the allegations, which may involve reviewing medical records, interviewing witnesses, and gathering other evidence.
- Board proceedings: After the investigation, the board may hold informal discussions or formal hearings.
- Board actions: If the board finds sufficient evidence of a violation, it can take disciplinary actions. These may include suspension, depending on the severity of the issue.
- Reporting and enforcement: Final disciplinary decisions are made public and reported to national databases, employers, and other regulatory bodies so that all parties understand the nurse’s licensure status.
All disciplinary actions, including suspensions, are reported publicly. This means that anyone can perform a nursing license suspension lookup to verify the status of a nurse’s license. This is available through Nursys — the national database for nurse licensure and discipline — or directly through your SBON license verification tool.
How Many Nurses Lose Their License Each Year?
Less than 1% of U.S. nurses face any disciplinary action each year, whether it’s a fine, suspension, probation, or revocation. Since there are millions of licensed nurses in the U.S., that small percentage still adds up to a notable number of people, showing that while it doesn’t happen often, it’s a real risk worth taking seriously.
If You Lose Your Nursing License, Can You Get It Back?
Yes — but it’s not automatic and varies by state. Most SBONs allow nurses to apply for reinstatement after a suspension or revocation, but there are specific steps and conditions that must be met before a license can be restored:
- Check to see if your license is eligible to be reinstated. This depends on the severity of the reason why it was suspended and the amount of time that has lapsed since the suspension. It may also be helpful to reach out to an attorney to help explain the reinstatement process and prepare necessary paperwork.
- Complete all required counseling, rehabilitation, or training. Your SBON may require additional information, such as a background check, drug testing, and fingerprints.
- Submit a nursing license reinstatement application.
- Attend a meeting with an SBON representative to answer questions and present evidence to indicate your completion of their reinstatement instructions.
- Pay associated fees.
You’ll typically need to wait a certain period of time before you can start the process. For example, the Texas Board of Nursing won’t consider a reinstatement petition until at least one year after the revocation. Then, you’ll need to submit a formal reinstatement application and include supporting documentation showing they’ve met any conditions set in the original order.
What Are Types of Allegations Against Nurses?
Some of the top allegation categories and subcategories for license defense matters include:
| Types of Allegations | Subcategories |
|---|---|
| Professional conduct allegations |
|
| Scope of practice allegations |
|
| Documentation allegations |
|
How to Protect Your Nursing License
Protecting your hard-earned credential means staying vigilant, proactive, and informed about both legal requirements and professional standards. Here are some key strategies to avoid losing a nursing license:
1. Uphold Ethics
Follow the ethical principles of nursing at all times. Use the ANA Code of Ethics and your state’s guidelines to inform your decisions. And if you’re ever unsure, ask your supervisor — a simple question may help protect your license.
2. Prioritize Safety
Patient safety should always come first. Follow protocols, double-check medications and procedures, and avoid shortcuts. If you’re assigned more patients than you can safely care for, speak up or refuse the assignment. Losing a job stings, but losing a nursing license can derail your entire career.
3. Always Document
Documentation is an essential component of high-quality care. Not only does proper documentation provide a legal record of the care provided, it also supports team communication, billing, and quality assurance.
4. Be Honest
Mistakes happen — it’s how you respond that matters. Report errors immediately and honestly. Being transparent with supervisors and colleagues shows professionalism and can prevent minor issues from becoming serious disciplinary problems.
Many healthcare organizations follow a just culture, which focuses on learning from mistakes rather than punishing staff for honest errors. By reporting issues promptly, you contribute to a safer environment for patients while protecting your license.
5. Honor Your Intuition
When something doesn’t feel right, listen to your inner guidance. A wiser part of yourself could be picking up on something your mind has yet to realize. Double checking doesn’t hurt — in fact, it can be the extra step that helps you avoid losing a nursing license.
6. Work Sober
This is one of the most often reported ways to risk your career as a nurse. Patients trust you with their lives, and even slight impairment can affect your judgment, reaction time, and decision-making. Avoid working under the influence of alcohol, drugs, or any substance that could compromise your ability to provide safe care.
It’s also important to recognize that legal substances — including prescription medications — can impair performance. Healthcare professionals taking certain pain medications, benzodiazepines, or sedatives may experience drowsiness, slowed thinking, or diminished coordination, which can compromise safe practice.
7. Stick to Your Scope of Practice
Don’t perform any tasks outside your nursing scope. Likewise, don’t assign responsibilities that fall under your own duties. Follow the rules of delegation carefully when deciding what to delegate and to whom. Always ask for help and use available resources if a task is beyond your training or abilities.
Stories of Nurses Losing Their License
How can a nurse lose her license? To give you a broader idea of what not to do in your nursing career, here are some real-world examples of nurses who lost their licenses and how their circumstances breached of the ethical principles of nursing:
Professional Misconduct
In 2022, a Nebraska nurse lost his license because he was aggressive with patients and disrespectful to colleagues. His behavior displayed unprofessional conduct and violated hospital policy. Patient safety is the primary concern for nurses. If you disregard the wellbeing of patients or abuse them, you are the antithesis of what being a nurse is all about.
Falsifying Documents
A nurse could lose their license by providing false documentation in order to work at a facility. In the fall of 2021, a nurse manager in Rhode Island submitted a false COVID-19 vaccination card without having received the vaccine. This undermines the ethical principle of veracity, or honesty. Trust is paramount in healthcare, and trust requires honesty.
Substance Abuse
Substance use and substance use disorder are main contributors to nursing disciplinary action, not just for being under the influence, but also in mismanagement of controlled substances. In 2019, three Connecticut LPNs lost their licenses due to substance abuse. Healthcare requires mental clarity and detail orientation. Impairment due to substance use on shift, or the lingering effects of substances used while off the clock, negatively impact patient safety.
This is where the ethical principle of accountability becomes apparent. Although substance abuse is a nuanced topic — see our article, “Can Nurses Smoke Weed?” — nurses whose addictions impact patient care must be held accountable for their actions.
Faking Licenses and Education
In January 2023, investigators uncovered a scheme in Florida in which nursing schools were selling fake nursing degrees. More than 7,600 falsified degrees were identified, and nurses with the fake degrees had their licenses revoked.
Do Everything Possible to Avoid Losing a Nursing License
Protecting your nursing license is essential — and so is finding the right opportunity to make the most of it. Sign up to explore quality nursing jobs tailored to your skills and goals.
Legal Disclaimer: This article contains general legal information, but it is not intended to constitute professional legal advice for any particular situation and should not be relied on as professional legal advice. Any references to the law may not be current as laws regularly change through updates in legislation, regulation, and case law at the federal and state level. Nothing in this article should be interpreted as creating an attorney-client relationship. If you have legal questions, you should seek the advice of an attorney licensed to practice in your jurisdiction.