Registered nursing in California is a profession regulated by several legislations, including the California Code of regulations and the nurses’ practice act. The law stipulates the scope of the professional responsibilities of a registered nurse and the circumstances that could lead to disciplinary action. Facing a disciplinary action as a registered nurse increases the risk of losing your professional license.
The San Diego License Attorney helps you protect your license by providing defense services. The attorney also helps you if you are facing criminal charges that increase the risk of losing your professional license.
The Board of Registered Nursing
The board of registered nursing is the body, which enforces the implementation of the Nursing Practice Act. The board aims at protecting the public in performing its functions. Some of its functions include:
- Setting the educational standards of registered nurses
- Approving registered nursing educational programs
- Evaluating applications for licenses
- Issuing and renewing RN licenses
- Issuing certificates
- Taking disciplinary action against offenders
The responsibilities of a registered nurse include:
- Assessing all patients to direct the patient’s care
- Performing all functions of a nurse independently, dependently and interdependently depending on the situation
- Interpretation of information from the client and other persons to initiate and perform complex thinking processes
- Identify the accuracy and reliability of the provided information to formulate a care plan that is beneficial to the patient. The registered nurse is responsible for coming up with an appropriate plan, including the actions to take in implementing the care plan.
A registered nurse serves as an advocate for the needs and well-being of the patient. He or she should oversee the care plan alongside the physician. The registered nurse must monitor and evaluate each phase of the treatment to ensure it matches the needs and preferences of the patient.
Common Ways a Registered Nurse Can Lose a License
Health care professionals are held at higher standards and must meet various expectations of their licensing agencies, the law, and the public. Even the most competent and careful registered nurses might face legal action and risk losing their licenses.
Some of the common reasons a registered nurse could lose a license include:
- Failure to respect the patient’s right to privacy. Nurses must protect and secure the records of patients to prevent access by unauthorized persons. The law covers either print (or written) and electronic records. Some of the information that nurses must protect and secure includes the patient’s name, address, social security number, diagnosis, test results, and treatment.
- Receiving kickbacks for referring patients (or fraud)
- Gross negligence
- Use of illegal drugs in a way that puts the public at risk
- Convictions for certain crimes that are substantially related to health care. These crimes include those involving assault, abuse, theft, fraud, deceit, and drug-related offenses.
- You faced disciplinary action from another state
- Failure to make child support payment if the district attorney notifies the Consumer Affairs Support Unit and you fail to make payment arrangements within 150 days of the notice
The board learns of your violation mostly through a report from the public or another healthcare professional. When the board receives the report of a possible violation, it will serve you with an accusation. Before serving the accusation, the BRN and its attorneys will gather sufficient evidence to prove that you have violated the Nurse Practice Act.
The accusation is the formal notice to you from the BRN. The accusation also serves as a notification to the public that disciplinary action against you is pending. You are supposed to respond to the notice to get a chance to defend your license. If you fail to respond, the BRN will revoke or suspend your license through a default decision.
Usually, most nurses who respond to the accusation save their licenses. The best way to approach the accusation is by having a license attorney who understands the issues related to registered nurse licensing. An attorney will evaluate the evidence the BRN has and develop a strategy to defend you.
In most cases, the BRN looks for as many issues as possible that show that you are a threat to the public. These issues do not reflect on your side of the story; instead, they are biased towards the mistakes or errors you have made. In some cases, the accusations might be inaccurate.
When you receive an accusation, contact an attorney as soon as possible. You have only 14 days to respond with a notice of defense. The notice of defense informs the BRN of your intention to defend yourself against the accusation.
You have nothing to lose by filing a notice of defense. It gives you a chance to avoid license revocation. Once you send the notice of defense, you and your attorney can request the BRN for the evidence against you. During the discovery process, you will also present the board with the evidence you wish to use in your defense. You must request and submit the evidence within the deadlines. If you miss these deadlines, you could miss the chance to present crucial evidence to safeguard your license.
In the notice of defense, you will also request a hearing or a stipulated settlement. A stipulated agreement or settlement is a negotiation between you and the board (similar to a plea deal or an out-of-court settlement). You can have your attorney represent you during the agreement. The attorneys from both sides negotiate and come up with an agreement, which the BRN can approve or reject. When approved, the BRN will adopt the settlement.
If not approved, you will have to attend the hearing. A BRN hearing is an administrative hearing over which an administrative law judge presides. The BRN attorneys, witnesses, an expert, some law, and nursing students attend. You may represent yourself or hire an attorney to handle the legal matters.
The attorneys from both sides will present their evidence as happens in a criminal case. Witnesses and experts may also present their testimonies. The judge will then base his or her decision on the facts provided.
A BRN hearing is a serious matter that will determine the trajectory of your career. Therefore, you must prepare adequately, meet all deadlines, and attend the hearing. Most nurses who lose their RN license do so because they underestimate the seriousness of these hearings.
Most importantly, have an experienced license attorney working on your case. Lawyers have different areas of expertise; therefore, choose one who deals with RN licenses.
After the hearing, the judge will review the evidence and give a recommended decision to the BRN. The board will choose whether to adopt or reject the decision. If rejected, the board will determine the type of disciplinary action to take.
A hearing has many uncertainties. The board may reject the final decision, even if it is in your favor. In most cases, license attorneys go for a stipulated settlement. In the settlement, the attorneys from both sides negotiate increasing the chances that your attorney will convince the BRN attorney.
The negotiations could include your attorney explaining inaccuracies in your accusations, mistakes, and negotiating a lesser disciplinary action. The major advantage of a stipulated agreement is that the BRN is more likely to adopt it compared to a judge’s decision.
The BRN will take disciplinary action against you if it determines that you are a threat to public safety. In other cases, the disciplinary action is based on a default decision for failing to respond to BRN notifications. The severity of the disciplinary action depends on the severity of the violation and the mitigating evidence you provide.
The common disciplinary actions include:
1. Public Reprimand
A public reprimand is a letter from the BRN, which is attached to your RN license after a violation of the Nursing Practice Act. It is the least severe formal disciplinary action compared to probation and license suspension.
A public reprimand is a public record visible to anyone who looks up your RN license. The reprimand includes details of the accusation, the mitigating evidence you presented, and a statement that you are not a threat to the public. The BRN also signs and dates the reprimand.
The advantage of getting a public reprimand is that you get to keep your job. Getting a public reprimand requires that you attend an administrative hearing. Previously, public reprimands were issued in the stipulated agreement.
During the administrative hearing, you are to convince the judge and the BRN that a public reprimand is appropriate for your case. When issued, the letter of public reprimands stays attached to your RN license for three years (counted from the date you clear all the fines). The BRN does not allow the early removal of the public reprimand.
Probation is a form of disciplinary action taken in place of license revocation or suspension. What this means is that the BRN will not revoke your license if you adhere to the conditions of probation for several years. Probation is a common disciplinary action, which is more lenient than a license suspension.
Some of the conditions of probation include:
- You must obey all the laws
- You must comply with the probation program by the BRN
- You must report, in person, to the probation officer assigned to you, you must contact the officer to learn what you are expected to do.
- Your probation period does not count when you are practicing or residing out of state
- You and your employer must submit quarterly written reports to the BRN
- You must work as a registered nurse or in a job that requires an RN license. To meet this requirement, you must work for at least 24 hours every week for six months. If you are having difficulties in getting a job, you can volunteer as an RN to meet the requirement. The BRN might also increase your probation period to help you meet this requirement.
- The BRN must approve your job; therefore, you have to report where you are currently working and all the places in which you are looking for employment
- You must be supervised while on the job. This also means that you cannot supervise other nurses
- You must comply with the employment limitations by the board, such as not working as a traveling nurse, a private RN, for a nurse registry, or as a home health nurse. If you wish to work in such capacities, you must contact the BRN for approval.
- You must complete one or more nursing courses
- You must refund the board any money the board spent on your case
- You must comply with all conditions of probation (probation violation could lead to the suspension of your license)
- You might voluntarily surrender your license which is similar to retiring from nursing ( the board may reject the surrender and revoke your probation and license)
The above conditions apply in all cases of BRN probation and are mandatory. The conditions below are negotiable and usually apply in drug and alcohol-related cases:
- You must go for a physical exam within 45 days. The exam must be conducted by a BRN-approved doctor to determine whether you are physically fit to continue practicing
- Enroll in a treatment program for chemical dependency for six months. You must enroll within nine months of starting probation. The BRN program is different from the treatment program imposed by the court as part of a criminal conviction.
- You must abstain from using mood-altering drugs unless with a prescription. You must also inform the board of the prescription and take the medication as per the prescription.
- You must submit to random tests and samples. Failure to submit the sample is a probation violation.
- You must have a mental health evaluation conducted by an approved mental health practitioner within 45 days
- You must attend therapy or counseling if the mental health practitioner recommends it
- The BRN may suspend your license for a maximum of one year as a condition of probation
The BRN usually gives probation for three years. However, it can increase the period to five years or reduce it to two years. You might apply for early termination of probation, but the process takes a long time. The board has great control over the terms of your probation; therefore, your lawyer can only do so much to change these terms. However, he or she can negotiate on your behalf to get probation as a disciplinary action instead of a license suspension.
3. License Suspension
License suspension after an accusation is the most severe disciplinary action. Your license may be suspended:
- As a response to a probation violation
- If you fail to respond to an accusation
- Immediately following a criminal conviction according to California PC 23
When the BRN suspends your license, you cannot work as an RN or in a job that requires an RN license. You can save your license from suspension by requesting for lesser disciplinary action such as probation.
The California Diversion Program
One of the responsibilities of the BRN is managing the registered nurses' diversion program. The program is an intervention initiative offered to nurses whose practice could be impaired by substance use disorders or mental illness.
The program is a voluntary and confidential one usually offered to nurses who have been reported or have self-reported problems with substance abuse.
The BRN could refer you to a diversion program upon receiving a complaint that your practice could be compromised by your mental health problems or substance use disorder. If you agree to enroll in the program, the board will stay any disciplinary action against you. It will also suspend your license.
You can withdraw from the program at any time. However, your records and information you provided will be submitted to the BRN for review. The BRN might file an accusation against you.
If you complete the program successfully, the records of your diversion program are destroyed. Your license is activated, and you can continue practicing without being a threat to public safety.
You may be ineligible for the program if:
- You have faced previous disciplinary action for substance abuse or mental illness
- You were previously suspended from a diversion program due to non-compliance
- You sold drugs
- Caused harm or death to a patient
Before enrolling in the program, contact an attorney to help you weigh your options and determine whether the program is right for you.
Find a Registered Nursing License Attorney Near Me
Registered nursing is a highly regulated profession in California to protect the public. Such regulations make it easy for you to lose your license or face disciplinary action for minor issues. The Board of Registered Nursing monitors nurses to ensure that they act professionally and competently.
Allegations of violations can arise from minor errors and could cost you your career. If you receive a warning or an accusation from the BRN, contact an attorney immediately to get help. The BRN communicates with you before taking action against your license. The sooner you respond, the higher your chances are of protecting your license and job.
At the San Diego License Attorney, we help registered nurses in California in defending their licenses. We have worked for years in the region and understand the common defenses you can use to fight the accusations against you. If you are having issues with your RN license, contact us at 619-728-7448.