How to Avoid Losing a Nursing License

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Written by Ayana Dunn, BSN, RN Content Writer, IntelyCare
Reviewed by Rachel West, MHA, MSN, RN Director of Education - IntelyEdu, IntelyCare
Male nurse reading a paper on how to avoid losing a nursing license.

Obtaining a nursing license is no easy task. After navigating the rigors of nursing school and passing the NCLEX-RN exam, losing a nursing license would feel like a nightmare come true. Surely you want to avoid playing a lead role in another of the stories of nurses losing their licenses. Below is an overview of some of the disciplinary actions that can be taken on your license (up to losing it) and suggestions about how to restore it after it’s been suspended.

Types of Nursing License Discipline

To start, it’s important to understand that the response to nursing license issues can differ in severity depending on the situation. There are a range of disciplinary actions that a state board of nursing (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

How Can You Lose Your Nursing License?

Unfortunately, there are a variety of ways to lose a nursing license. Curious about the most common reason nurses have their license suspended? Some of the top allegation categories and subcategories for license defense matters include:

Professional Conduct Allegations

  • Drug diversion and/or substance abuse
  • Professional misconduct as defined by the state
  • Criminal act or conduct

Scope of Practice Allegations

  • Failure to maintain minimum standards
  • Provision of services beyond scope of practice
  • Failure to supervise

Documentation Allegations

  • Fraudulent/falsified patient care or billing records
  • Failure to document treatment/care as required by regulatory agencies or facility’s policy
  • Documentation does not accurately reflect patient care and services

It’s not unusual for the words suspension and revocation to be used interchangeably when referring to the loss of a nursing license. Both designations require the nurse to cease practicing. But the words can mean different things in different states, and the disciplinary actions taken by a state board of nursing vary by instance.

  • In Missouri, 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.
  • In New York, a professional whose license has been revoked or suspended often must wait three years before they can apply to have it reinstated.
  • In California, a nurse must wait one to three years before petitioning the board of nursing to have their license reinstated.

To get a better understanding of what can lead to temporary or permanent loss of licensure — as well as the conditions under which your license may be reinstated — in your state, check your SBON website.

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 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, 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. Becoming a competent nurse requires knowledge derived from both clinical hours and coursework. This training makes you a nurse, not the certificate itself. If you haven’t been to nursing school, you likely haven’t learned about the ethical principles of nursing or had the opportunity to see them in action during clinical rotations.

To avoid losing a nursing license, keep these tips in mind:

  1. Uphold ethics
  2. Prioritize safety
  3. Always document
  4. Be honest
  5. Honor your intuition
  6. Work sober
  7. Stick to your scope of practice

Tips to Keep Your Nursing License in Good Standing

1. Uphold Ethics

As part of a nurse’s initial licensure requirements, many states stipulate that a nurse must be of good moral character. The ANA Code of Ethics is a great resource for nurses who want to avoid losing a nursing license. It provides a framework for safe and compassionate care.

2. Prioritize Safety

Nothing is more important in clinical decision making than patient safety. Keeping safety top of mind protects both you and the patient.

3. Always Document

You’re only human, so you might not remember exactly what you did on a given day. Documentation is an essential component of high-quality care. Not only does proper documentation provide a legal record of the care provided, it can also be used for billing, for questions, and during any potential legal disputes. Keeping an accurate, timely, and complete record of care improves safety and quality of care.

Proper documentation is also imperative to medical practice so that other members of the healthcare team receive up-to-date information about a patient’s status. Be sure to focus on documentation best practices throughout your shifts.

4. Be Honest

It’s better to tell the truth about a mistake than be caught in a lie down the line. For example, a nurse accidentally administers the wrong dose of a medication. The pill looks identical regardless of the dose, and they feel confident there will be no adverse reaction because the patient has taken it many times before. To be safe, the nurse informs their supervisor. Due to the organization’s just culture, the supervisor is understanding and shows the nurse the steps for processing medication errors. Because they were honest, the nurse has peace of mind.

It’s also important to be honest with yourself about what you need. You may be able to lessen the chances of unprofessional responses to frustrating behaviors if you recognize your physical and emotional needs throughout a shift.

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

If you’re wondering, How can a nurse lose her license?, this is one of the most often reported ways. Patients are entrusting you with their lives. It’s important for your mind to be clear, and being even the slightest amount buzzed is still a degree of inebriation that can and will affect your judgment and reflexes. Save those activities for times when you won’t interact with patients (or even other team members) until you are totally clear.

7. Stick to Your Scope of Practice

Don’t perform any actions outside of your nursing scope. In addition, don’t assign someone a task that you should be responsible for. Remember the rules of delegation when choosing what and to whom you might delegate. (The Nurse Practice Act and the scope of practice outline this very clearly.) Remember to ask for help and use your available resources if a task is beyond your abilities.

If You Lose Your Nursing License, Can You Get It Back?

Oftentimes, you can get your nursing license restored. You may want to consider reaching out to a nurse advocate or an attorney who has experience with nurse license defense cases or healthcare law to help you get through this process.

States are responsible for protecting the public. Part of that responsibility includes validating license requirements and recommending disciplinary actions within the state practice act and other existing regulations. Many states use nursing license lookup tools that employers use to verify standing. Each SBON has its own protocol for nursing license restoration, but there are some overarching commonalities.

  • 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.
  • 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.
  • Your SBON may require additional information, such as a background check, drug testing, and fingerprints.

Do Everything Possible to Avoid Losing a Nursing License

You’ve gained some valuable advice about how to keep your nursing license. Take this knowledge to your workplace, and build a flexible schedule with IntelyCare.

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.