Each year, the California Board of Registered Nursing (BRN) receives an average of 7,715 complaints about nurses and other professionals licensed by the Board. In a three year period from 2014 through 2017, the BRN handled a total of 3,333 disciplinary cases. Each of these cases involved a potential discipline of public reproval, probation, suspension, or revocation/nursing license revoked.
A revocation is the highest level of discipline handed out by the BRN. If your nursing license is revoked, you will no longer be able to practice as a nurse. You are also prohibited from using the title of nurse.
If you are under investigation by the BRN for a violation of the Nursing Practice Act (NPA) — or think that you may be investigated by the BRN — your first step should be to contact a seasoned California nursing license defense attorney. With the assistance of a compassionate, skilled lawyer, you may be able to protect your license as well as your livelihood.
The BRN may begin an investigation into a nurse under its jurisdiction after receiving a complaint from a member of the public, a patient or loved one, a colleague, a hospital, and ex-friend/significant other, or another person or entity. It may also begin an investigation after learning that a nurse has been charged with a criminal offense via the Department of Justice (if you have been fingerprinted), or convicted of a misdemeanor or felony (as the Court, Prosecutor, and Nurse all have a requirement to notify the Board – you may learn more about disclosures, here).
You may learn that you are under investigation when investigators conduct interviews of co-workers or begin to gather evidence related to the alleged violation. You may also receive a letter, email or phone call from an Investigator tasked by either the BRN or the California Department of Consumer Affairs’ Division of Investigations.
If you are contacted by an investigator or otherwise discover that you are under investigation, you should contact an attorney immediately. In some cases, the matter may be resolved at the investigation stage, particularly if your lawyer is experienced and knowledgeable in licensing matters. It is important to note that investigations are “confidential;” as such, if the matter is resolved during the investigation phase, the allegations against you will not be published to the BRN’s website.
Keep in mind that while the investigation is confidential, anything that you say to the investigator is not. Your words could be used in the BRN case against you – or even provided to prosecutors in a related criminal case. For this reason, you should not talk to investigators or sign paperwork until you have had a chance to consult with a California nursing license defense lawyer.
After investigation, the BRN may determine that no violation was committed. If it believes that a violation occurred, the BRN will initiate disciplinary proceedings. This is done by filing an Accusation. A copy of the Accusation will be sent to you at the address you have listed on Breeze. If your address is outdated, the Board will send the Accusation to your old address, and you may lose your opportunity to defend against the Accusation, and may ultimately lose your license via a Default Decision.
An Accusation is a formal document that lists the reasons why the BRN is seeking authority to discipline you. At the end of the Accusation, the BRN will request that your license be revoked. Reading this document can cause tremendous anxiety, particularly when you are afraid that you will lose your ability to practice as a nurse and continue to care for patients and their families.
If you receive an Accusation, you need to be proactive so that you can protect your license from revocation. There are a number of steps that an experienced nursing license defense attorney can take at this stage, from raising affirmative defenses to filing the Notice of Defense to preparing both for a hearing and for a possible settlement to allow you to keep your license.
Getting a letter in the mail that states that your nursing license may be revoked is incredibly scary. It is important to understand that it is possible to defend against the allegations and to get a better outcome than a revocation. The worst thing that you can do when you receive an Accusation is fail to act. Doing nothing may lead to your nursing license being revoked – even in situations where it may be possible to resolve your case with a lesser level of discipline.
There is a range of reasons why the BRN may revoke a nurse’s license. It is a recommended disciplinary action for the following violations:
In addition, if an Administrative Law Judge decides at a hearing that a nurse is not capable of safe practice, then the BRN recommends license revocation.
As demonstrated by the above list, your nursing license may be revoked for a litany of different reasons — from failing to report suspected abuse to improper medication waste, to even a criminal arrest or conviction. For every potential violation of the Nursing Practice Act (NPA), the recommended maximum discipline is either revocation or revocation stayed for 3 years with probation. As such, even what you may consider to be a relatively minor violation could potentially result in losing your nursing license.
Significantly, while the BRN recommends revocation in these matters, there is still an opportunity to argue that the disciplinary action should be something less than revocation, such as probation or public reproval instead. In some cases, it may also be possible to argue that no disciplinary action is warranted, and the Accusation should be withdrawn.
The BRN considers a number of factors in deciding whether a nurse’s license should be revoked or suspended, or if they should be placed on probation. These factors include:
Each situation is different — which makes it possible for an experienced California nursing license defense attorney to make a case for why your nursing license should not be revoked. The key is to consult with a lawyer as soon as possible so that you can collaborate on a factual and legal defense to the allegations against you and help to develop mitigating evidence.
Mitigating evidence is particularly important in defending against disciplinary actions. While this evidence might not refute the substance of the allegations, it can help to explain it – and may lead to a lower level of discipline. For example, your lawyer might introduce evidence to demonstrate that your hospital unit was chronically understaffed, which may help to explain why alleged gross negligence occurred.
Alternatively, if you were charged with a crime like DUI or drug possession, your California healthcare license defense attorney might solicit testimony from loved ones about unusual stressors in your life, such as the death or serious illness of a loved one. Again, this type of evidence is not meant to say that the violation does not matter. Instead, it explains why it might have occurred.
At the same time, evidence of rehabilitation can be critical to your case. The BRN knows that even the most conscientious nurses may make a mistake or go through a difficult time. Rehabilitation evidence can be used to show that you recognize the conditions that led to your error in judgment and are taking steps to ensure that it will not happen again. This might include things like going to therapy or to a drug or alcohol rehabilitation program.
The BRN also offers its own Intervention Program as an alternative to formal discipline in cases involving substance abuse disorder and/or mental illness. If you choose to enroll in this voluntary program, you may be able to receive recovery services instead of discipline. However, it is important to understand the benefits and drawbacks of the program before going this direction.
The Intervention Program may allow you to avoid formal discipline. However, the program is difficult to complete, costly, and requires you to put your nursing license on inactive status for a minimum of 30 days. Failure to complete the program will also result in the disciplinary process moving forward, with the possibility of discipline being imposed. If you are facing disciplinary action for an allegation related to substance abuse and/or mental health issues, you should talk to your California nursing license defense lawyer about whether this program is a good alternative for you.
In addition to presenting mitigation and/or rehabilitation evidence, your attorney can also make arguments about other elements of the case. Because actual or potential harm to the public and/or patients is a key factor in determining whether or not to revoke a nursing license, your lawyer may work with experts and introduce evidence to show that there was no – or minimal – harm to the public/patients. This may result in a lesser disciplinary sanction, such as probation or suspension, rather than revocation.
Although revocation is always a possibility in a BRN disciplinary action, it is not a foregone conclusion. A skilled California nursing license defense attorney can develop a strong legal and factual defense to the allegations against you. They may be able to negotiate a stipulated settlement or will present your defense in an administrative hearing to seek a more favorable outcome.
There are few experiences more daunting than learning that your nursing license may be revoked. When you are in this position, you need an advocate who you can trust, and who has significant skill in handling these matters. The Law Office of Nicole Irmer offers compassionate, adept representation for nurses at all stages of the disciplinary process before the BRN.
Based in San Diego, our team focuses on helping California nurses who are facing investigations, formal Accusations, and possible license revocation. We take a holistic approach to professional license defense, working to develop strategies that demonstrate our clients’ competence and qualifications as a nurse. As a nurse, you are more than your worst mistake — and we can help you prove it.
For a confidential, no-risk discussion of your legal options, we encourage you to contact us right away at (619) 237-6310 or email us at any time.
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