Everything You Need to Know about California’s Nursing Practice Act

| Posted in Licensing Defense on December 29, 2022

When you decided to become a nurse, you probably focused on the practical skills and academic knowledge that you would need to pass the NCLEX. You may not have realized that you would also have to familiarize yourself with the laws and regulations surrounding the practice of nursing. 


California’s Nursing Practice Act governs all aspects of nursing in the state, from establishing the nursing board to licensure to education. It also sets forth standards for disciplinary action. If you violate this law, it could lead to censure, citation, reprimand, probation, suspension, or even revocation of your nursing license.

Having an understanding of the Nursing Practice Act can help to reduce the chance of disciplinary action against your license. If you are under investigation for a violation of California’s nursing laws, a compassionate San Diego professional license defense can help you defend your license and your livelihood.

What You Need to Know about the California Nursing Practice Act

The Nursing Practice Act (NPA) is the California law that authorizes the Board of Registered Nursing (BRN) to determine the scope of practice and responsibilities for registered nurses (RNs) in the state.

The NPA is a set of laws that covers all aspects of nursing, including education, licensing, scope of practice, and discipline. The NPA also establishes the BRN and sets out guidelines for Board action. The California Code of Regulations (CCR) provides additional guidance for the BRN.

The NPA is broken into thirteen sections, known as articles. These include:

  1. Administration, which establishes the BRN;
  2. Scope of Regulation, which provides definitions and sets out the scope of the NPA;
  3. Nurse-Midwives, which sets forth the standards for nurse-midwives;
  4. Disciplinary Proceedings, which lays out the basis for disciplinary action by the BRN against a licensee;
  5. Intervention Programs, which establishes intervention programs for registered nurses who are suffering from mental health and/or substance abuse issues;
  6. Nursing Corporations, which sets out the rules regarding nursing businesses;
  7. Nursing Schools, which establish standards for nursing education in California;
  8. Penal Provisions, which lists potential criminal violations related to nursing (such as practicing without a license); 
  9. Revenue, which establishes a BRN fund;
  10. Public Health Nurse Certification, which outlines the requirements to obtain this certification;
  11. Nurse Anesthetists, which sets forth the standards for nurse anesthetists;
  12. Nurse Practitioners, which sets forth the standards for nurse practitioners; and
  13. Clinical Nurse Specialists, which sets forth the standards for clinical nurse specialists.

If you are licensed as an RN in the state of California – or are seeking to become licensed – you should have a general understanding of what the NPA is and what obligations it places on nurses. In particular, you should review the article on disciplinary proceedings so that you are aware of potential issues that may lead to a public reprimand, probation, suspension, revocation, or other disciplinary action against your license.

Of course, California is not the only state with a law that regulates the practice of nursing. If you aren’t practicing in California, it’s important to be familiar with your own state’s nurse practice act. You can find links to each state’s nurse practice act through the National Council of State Boards of Nursing (NCSBN).

Top Reasons to Lose Your Nursing License Under the NPA

Even the most dedicated nurse may make a mistake or have a bad day. There are a number of potential grounds for discipline, disciplinary action, or rehabilitation. As nursing license defense lawyers, we most frequently represent nurses who have been accused of:

  1. Unprofessional conduct, professional misconduct, or negligence: one of the most common reasons to lose your nursing license is a failure to meet the standards of competent performance set forth by the NPA.  These types of allegations may be made by patients, family members, coworkers, or employers.
  2. Charting errors: a failure to keep adequate records, falsifying medical records or other charting errors may lead to a formal Accusation by the BRN. This may include a failure to accurately record patients’ vital statistics, drug administration history, or changes in a patient’s condition.
  3. HIPAA violations:  patient privacy is incredibly important. Violating the Health Insurance Portability and Accountability Act (HIPAA) may lead to disciplinary action, even if the nurse did so unintentionally.
  4. Drug diversion: misappropriating or otherwise diverting controlled substances may lead to both criminal charges and disciplinary action by the BRN.
  5. Criminal activity: a criminal conviction or arrest for an offense related to the practice of nursing – or a failure to report an arrest or conviction – may result in Board disciplinary action. This includes offenses that may appear to be unrelated to a nurse’s job, such as a DUI. If you have been accused of or convicted of a criminal offense as a registered nurse, you should contact a healthcare license defense attorney as soon as possible.
  6. Refusal to take a drug test or failure of a drug test: many nurses are subject to random drug testing as a condition of employment. If you fail a drug test or refuse to take a test, it could be the basis for disciplinary action. This applies to all types of drugs, including marijuana, even though it is legal in California.
  7. Disciplinary action in another state: California will impose discipline on a nurse licensed in the state if they are disciplined or censured in another state.
  8. Inappropriate social media activity: the rise of social media can often lead to errors in judgment. If you post anything online that violates patient privacy, shows drug and/or alcohol use, or even contains an opinion on a controversial health topic, it could lead to disciplinary action.
  9. Failure to get fingerprinted: The CCR requires the submission of fingerprints either on the initial application for a nursing license or a renewal. If you fail to do so, the BRN may take disciplinary action.
  10. Failure to pay state taxes: California maintains a list of the 500 top tax delinquents in the state. Any licensed professional – including nurses – who appears on that list could find their license in jeopardy.

If an Accusation is filed against your nursing license, you should take it seriously. An investigation and/or Accusation by the BRN is a formal legal process that could lead to disciplinary action, up to revocation of your nursing license. A skilled nursing license defense lawyer can help you formulate a strategy and work with you to protect your license and livelihood.

How Our Law Firm Can Help

Working as a nurse can be mentally, physically, and emotionally taxing – particularly during an era when many healthcare systems are struggling with staffing shortages. Even the best nurses may make an error at work or in their personal lives. If that mistake violated the NPA, our law firm is here for you.

At the Law Office of Nicole Irmer, we advocate for registered nurses and other healthcare professionals who are facing investigations from their licensing board. We use our experience and knowledge of California law to effectively advocate for their rights before the Board.  For a confidential, no-risk discussion of your legal options with a compassionate nurse license defense attorney, call us at (619) 237-6310 or email us at any time.