Nursing License Suspension Frequently Asked Questions For Georgian nurses
Gaining a nursing license takes years of hard work and dedication. It can be devastating to have your expertise challenged and, worse, your professional license suspended.
Yet every year in Georgia, this affects hundreds of nurses.
Most nurses go about their profession in a competent and caring way according to professional nursing standards. However, there is a swathe of professionals who are investigated by the Board of Nursing for allegations of substance abuse, theft of controlled substances (whether inadvertent or not), duty of care violations, patient abuse, sexual misconduct, privacy violations, documentation fraud, and other misdemeanors outside the healthcare setting (like DUIs, and Violations of Georgia’s Controlled Substances Act).
If a complaint is received, the Georgia Board of Nursing (BON) must investigate. Once the BON’s investigator receives the complaint, they will send you a request for a notarized statement responding to the allegations to be returned within ten days. Before you respond, you should contact the Law Office of Adam D. Brown. Once the investigation is completed, the investigator will send the packet of evidence to the BON for consideration at their next meeting. Depending on what the BON has to consider, whether it is evidence denying / supporting the allegations, or evidence of mitigation, the BON has several options it can take against your nursing license, including suspension.
If you are facing an investigation or nursing license suspension, it helps to know how it might affect you, what your options are with employment, and how to get your license reinstated.
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Am I allowed to continue practicing if my nursing license is suspended?
If your nursing license is suspended, you cannot legally practice nursing. If you continue to practice as a nurse after receiving notice that your license has been suspended, you will be subject to further sanctions. While you cannot be employed in a position that requires a license, you can still generally work in an arena that has a “nurse-preferred” role, so long as the job duties do not include practicing within the scope of Georgia’s Nurse Practice Act, found at OCGA 43-26-1.
A special note: If you chose to continue working in healthcare while not legally allowed to practice as a nurse, one thing to be extremely cautious about is having your employer reduce your level of care to that of a a nursing assistant or medical assistant. As a licensed Professional Registered Nurse, or Licensed Practical Nurse, you were trained exceptionally well in how to care for patients. Your training and habit of caring for patients will very likely “kick in” while taking care of patients as an assistant, and you could find yourself practicing without a license.
Most positions that you take up in a medical environment will require a background check. This will likely flag your suspended nursing license and, depending on the reason for the suspension, it may count against you.
For instance, if you were found to have diverted controlled substances while working as a nurse, it is unlikely that you would be hired in a setting where controlled substances may be readily available. Conversely, if your license was put on probation for an unrelated misdemeanor (like a poorly handled DUI), the adverse license action might not count as heavily against you. However, you may be able to take up administrative roles and use your medical knowledge to good effect that way so long as the administrative role does not require nurse licensure.
Alternatively, you could explore a completely new field beyond clinical environments – at least temporarily until we can work to reinstate your license.
I just got a call from an investigator. What should I do?
A call from an investigator can be an intimidating experience for any nurse. Having your professional expertise called into question is never easy, even if the allegations turn out to be false.
Anyone who believes a nurse has committed some infraction is encouraged to report their suspicions to the Board of Nursing in Georgia. The Board is empowered to investigate claims made against your nursing conduct by an agency, organization, peer, patient, or patient’s family.
As with any legal case, you are entitled to a defense and, regardless of the evidence against you, you are innocent until proven guilty.
The complainant need only have suspicions for an investigation to start. Many allegations are found to be false (or “unsubstantiated”) once the facts of the case are uncovered.
Stay calm. Just because you are the subject of an investigation doesn’t mean you will lose your license. There are many other possible outcomes of the investigation, including: dismissal without BON action; a private letter of concern; referral to the Attorney General’s Office for a negotiated resolution (i.e. probation) or bench trial in front of the Office of State Administrative Hearings.
If you are contacted by an investigator, it is highly advisable to consult with a lawyer experienced in such matters. You may be asked for your version of events and it’s a good idea to discuss this first with an attorney. In Georgia, the content of the BON’s investigation file is kept secret. Ultimately, you may not know who said what. This is why it is in your best interest to consult an attorney to put your best foot forward. In some cases, divulging information to protect your nursing license may put you at risk for a criminal prosecution. At that point you have competing interests in remaining silent or actively defending against the BON investigation.
If your alleged actions are deemed to be of significant risk to the safety of others, the Board can place your license into an immediate suspension (summary suspension).
The investigative process will then begin in earnest as the Board tries to determine if the allegations against you are substantiated.
An official investigator will be appointed and interviews conducted with all parties concerned in the complaint (including you) and documentation and records reviewed. If necessary, drug screens may be performed.
Your name may appear on an “under investigation” list on the Board of Nursing website, which can be upsetting.
However, regardless of the allegations, you have the right to fair treatment, and the opportunity to defend yourself – ideally with a nursing license defense lawyer.
If I’m accused of diverting medication, will there be a criminal investigation?
Drug diversion in the context of nursing is where a nurse illegally transfers prescribed controlled substances from a patient.
If you are accused of this, you may be the subject of a criminal investigation. However, in reality, criminal cases are rare and you are more likely to face an investigation and subsequent penalties from the Board of Nursing than from the criminal justice system.
Even though there have been many years of federal and private efforts to fix inadvertent drug diversion (i.e. having a partial syringe of a controlled substance in your scrub pocket when you go home), it is a common occurrence in the medical world. Many nurses come back to work and properly waste the remaining medication with a witness, and nothing more comes of it except an internal note in the Medication Administration Record (MAR). The advent of computerized MARs has caused this basic mistake to often bloom into a full investigation. If you inadvertently diverted a controlled substance, and you admit to doing so in the BON investigation to attempt to protect your license, your case may well be referred to a detective for criminal prosecution. If that occurs, the issue of “intent” becomes front and center in the criminal prosecution. In these instances you should contact an experienced attorney versed in both nurse license defense and criminal defense, such as the Law Office of Adam D. Brown.
My med count was off, what next?
Having your medication count off is frustrating, especially at the end of your shift when you are ready for bed. You need to take care of your professional license first, though.
First, document everything, both in the facility’s system, and your own private shift book (Adam used to call his shift book his “brain”) with all protected health information (PHI) redacted.
Next, if your facility uses an electronic MAR, cross reference the electronic MAR with the paper MAR, and also check with the pharmacy (if your facility has one) to make sure the last count was accurate (perhaps it’s someone else’s mistake?).
Check all prior documentation, and with other nurses (as well as residents) to see if a medication was given PRN without it being documented.
There are several other steps you can take, but the goal (just like in treating patients) is to find the etiology of the medication count discrepancy, and document it.
For your own records, make sure to document who else was on shift with you, who was on shift before you, and who was on shift after you–those may be powerful witnesses in your favor.
What happens if the charge nurse accuses you of being under the influence?
One of the most serious accusations against a practicing nurse is that you were under the influence of a substance and your performance on the job was impaired.
Whether this involves illegal drugs or alcohol, it can put patients and fellow professionals in danger.
Suspicions may be aroused if signs of impairment are observed, such as:
- Extended absence or frequent lateness
- Excessive trips to the restroom
- Frequent errors with medication
- Inappropriate outbursts
- Diminished alertness or somnolence
- Physical signs like bloodshot eyes (hello night shift, I see you), excessive perspiration, excitability, certain odors like alcoholic beverages or burnt marijuana,
Typically, you will be asked by the facility to perform a drug test immediately. This request is usually given by the house supervisor (which may be a Director of Nursing, Assistant Director of Nursing, or other person). If you test positive or you refuse the test, the facility will likely report you to the BON for investigation. You will also likely be placed on leave until the facility’s determination can be made if you are safe to return to work.
As soon as you leave the facility following a drug screen request, you should call the Law Office of Adam D. Brown. You may want to immediately get a more exact drug test, such as a blood test, or hair follicle test.
A quick note on alcohol – If the facility’s (and Board’s) concerns are based on suspected alcohol intoxication, the quick urine screening they do at the facility will be based on unconfirmed EtG-u testing, and you should immediately get a private PEth test and possibly a hair follicle test performed. You should also get a private EtG-u test performed roughly 12-18 hours AFTER your shift ends, as there is research to suggest that using healthcare-grade alcohol-based hand sanitizer can result in a high result on an end-of-shift EtG-u screen, but that same EtG will be processed out through your urinary system. This is why getting multiple competing tests is beneficial – urine, hair, blood.
If the facility allows you to return to work, it may be in a restricted capacity initially and include regular check-ins with a nursing leader, reports to the Board, and restrictions on the types of nursing practice.
There are many other actions you can take to defend your professional license, but you should contact an experienced attorney to advise you on which measures may or may not be appropriate for you.
How do I renew my license if I was arrested/convicted since my last renewal?
Because the BON has a responsibility to protect public health, safety, and welfare, established policies and procedures exist for who may become or remain a licensed nurse.
Whether you need to apply for your first license after graduating from nursing school or renew your nursing license, a blemish on your criminal record can create problems.
You must declare any arrest or conviction on your application or renewal to the Board. The outcome mainly depends on the nature of your arrest or conviction – most importantly, if it was a felony crime or misdemeanor and how long ago it happened.
Any felony conviction is grounds for denial of your license.
When considering your renewal, the Board will look at:
- The severity of the crime – for instance, if you were convicted of a violent crime involving assault, battery or robbery, the Board may feel that you would be a risk to public safety.
- How long ago the incident occurred – a recent conviction could call into question your character or physical/mental condition, though your age at the time of the incident will be considered.
- Whether you completed the court sentence after your conviction.
- Whether a boundary violation occurred – if you were convicted of a crime involving sexual misconduct, theft or forgery, this will be treated seriously by the Board and could jeopardize your license renewal.
- Whether controlled substances were involved – if you were convicted of a crime involving controlled substances, mandatory license suspensions or even revocations (for repeat offenders) may apply. This includes crimes involving marijuana.
Even a DUI conviction can impact your nursing license renewal as it may indicate a problem with alcohol or illegal substances that would question your fitness to perform duties as a nurse.
In any instance, you will need to submit a “Letter of Explanation” to the BON, at renewal or application for initial licensure. While many nurses submit a simple letter, the best outcomes result from intense preparation of a full letter with numerous exhibits of explanation or mitigation attached.
What disciplinary actions can the Board of Nursing take?
The Georgia Board of Nursing has the responsibility to enforce the Nursing Practice Act and sets minimum standards for nursing practice and nursing education.
It will conduct investigations into complaints against nurses and adjudicate these complaints. The Board has many options available if a nurse is found to have committed some form of misconduct, such as:
- Issuing a private letter of concern
- Issuing a public reprimand
- Issuing a letter of concern to the nurse’s employer
- Issuing a monetary fine (including reimbursement of legal and administrative fees to the Board)
- Issuing a civil penalty
For more serious cases, the following penalties may be applied:
- A provisional renewal (pending an outcome of a criminal case)
- A temporary suspension (pending findings of the Board)
- An indefinite suspension of the license
- A suspension for a specific period
- A probationary period with or without practice restrictions
- A conditional suspension based upon a nurse’s submission to counseling or treatment
- Permanent license revocation
- Refusal to renew a license
Regardless of the decision of the Board, your lawyer can help you attempt to get your license reinstated if it is suspended or revoked.
During this period, you may not receive pay and it helps to have the support of a seasoned lawyer fighting to defend your professional license..
Adam D. Brown is an experienced nursing defense lawyer and criminal defense lawyer. Prior to becoming a lawyer, he practiced as an Intensive Care Unit Registered Nurse. He was previously licensed in Tennessee, California, North Carolina, and maintains current licensure as an RN in Georgia.
Many of our clients are still practicing nurses with unencumbered licenses doing the job they love despite facing investigations, criminal allegations, and criminal convictions in the past.
Call us for a free and confidential evaluation of your case, whether it involves criminal charges or a Georgia Board of Nursing investigation.