You've worked hard to earn your registered nurse license and rise through the ranks of this demanding profession.
But now someone has lodged a complaint against you, or prosecutors have filed criminal charges, and you're wondering what to do. Will you lose your license? How can you protect your livelihood?
Our California Criminal Defense Lawyers represent people accused of crimes, including driving under the influence and drug-related crimes. We also enjoy a tremendous amount of experience in helping nurses avoid losing their licenses in disciplinary actions.
This article is about registered nurse (RN) discipline, criminal convictions and license revocation in California. If you have questions after reading it, we invite you to contact our criminal defense lawyers for a consultation.
This article covers:
(Click on a title to proceed directly to that section)
The nine-member Board of Registered Nursing is charged with protecting the public in matters relating to nurses. In accordance with the Nursing Practice Act, the BRN regulates nurse education and practice, grants registered nurse licenses and carries out disciplinary actions (for misconduct as well as criminal convictions).
The BRN also runs a voluntary and confidential diversion program for nurses dealing with chemical dependency or mental health issues. Over 1,000 registered nurses have successfully completed this rigorous program, which involves monitoring for an average of three years but ends with destruction of program records.
BRN under scrutiny
The Board of Registered Nursing recently came under intense media scrutiny and criticism for failing to adequately carry out its public protection mission. The Los Angeles Times and ProPublica joined together in an exhaustive series of articles on nurse misconduct and lack of nurse discipline in California.
The articles cite systemic inadequacies leading to patient death, permanent disability and suffering. According to the reports, nurses came drunk on the job, stole drugs, didn't know how to operate machines and abused patients without notice or meaningful discipline by the Board.
It remains to be seen what impact all this will have on future disciplinary proceedings, but it seems reasonable to expect heightened vigilance.
A registered nurse in California can be disciplined when he or she engages in unprofessional conduct in ways that could adversely impact the nurse's ability to safely function as nurse.
Unprofessional conduct includes:
- incompetence or gross negligence
- using drugs illegally or in a way that threatens the public
- being convicted of certain kinds of crimes
- engaging in certain kinds of fraud
- being disciplined by a board in another state
- being careless with respect to blood-borne diseases
Let's look at an example:
Example: Marni is an R.N. who works at a hospital in Central California. Her supervisor notices that Marni is signing out controlled substances like Demerol and Morphine without a physician order. No patients seem to get these drugs. The hospital files a complaint with the BRN. The Board initiates disciplinary proceedings against Marni by sending her an accusation specifying the charges. Marni fails to return a notice of defense. The Board issues a default decision against Marni and revokes her registered nurse license.
It looks like Marni engaged in unprofessional conduct in violation of Business and Professions Code Section 2762(a) - obtaining or possessing controlled substances without a prescription. We won't ever know if the charges were actually true or not because Marni did not exercise her right to have a hearing and present evidence in her defense.
If Marni had pursued a defense, her case may have been resolved in a less severe way. For example, Marni might have been placed on probation or even had the charges dismissed.
What kinds of criminal convictions are covered?
If you have been convicted of a crime that is "substantially related" to the qualifications, functions, and duties of a registered nurse in a way that implicates public health and safety concerns, the conviction could trigger discipline by the Board of Registered Nursing. These acts include:
- assaultive or abusive conduct
- theft, dishonesty, fraud, or deceit
- drug-related crimes
In regards to triggering nurse disciplinary actions in California, criminal convictions include no contest pleas and grants of probation that might later be deferred or expunged under California Penal Code 1000 drug diversion or California Penal Code Section 1203.4.
Let's look at an example:
Example: Paul is a registered nurse in Los Angeles. He's convicted of elder abuse on his aunt as well as petty theft. Paul also is less than stellar on the job. On several occasions he has not washed his hands before and after drawing blood and he has been observed using the same needle for multiple blood draw attempts on the same patient. When Paul comes up for license renewal, he fails to disclose the convictions.
Paul can be disciplined by the Board of Registered Nursing and have his license revoked. Not only was he convicted of crimes substantially related to the practice of nursing, but he lied on his renewal application. His failure to follow proper blood draw protocol amounts to unprofessional conduct.
Change the facts: Paul is an R.N. with an advanced practice certificate as a nurse anesthetist. He has worked in several hospitals without incident for the past eight years. In fact, he has received only positive evaluations and is well regarded all around. One weekend afternoon Paul is stopped for speeding and issued a $100 speeding ticket.
Paul does not need to report this traffic infraction on his renewal application. The offense did not involve alcohol or a controlled substance and the fine was less than $300.
Child support non-payment
According to the BRN website, there is no obligation to disclose non-payment of child support on applications.
However, if your case is with the district attorney, the DA will notify the Consumer Affairs Support Unit and your nurse's license will be issued on a temporary basis. Failure to set up payment arrangements within 150 days will result in suspension of your registered nurses license.
Disciplinary actions for Nursing Practice Act violations, from least to most serious, include:
- public reprimand
- probation, including drug tests
- license suspension and probation
- license revocation
Disciplined individuals also may be on the hook for investigation and enforcement costs, which can be several thousands of dollars or more.
Accusations and disciplinary orders are published on BRN's website, so they are available to interested parties with just a click of the mouse.
Depending on the nature of your case, you might be able to settle things with the Board of Registered Nursing informally pursuant to a settlement agreement.
But you do have the right to an administrative hearing, which is similar to a criminal or civil court trial. An administrative law judge presides over the proceedings and makes a recommendation to the Board.
The Board will be represented by a lawyer from California Attorney General's Office. You have the right to a lawyer too, at your own expense.
You or your attorney will be able to call and cross-examine witnesses and introduce evidence to make your case.
You can read more about administrative hearings and appeal procedures in our related article Professional License Disciplinary Actions.
Our California Criminal Defense lawyers Can Help.
If you or loved one is charged with a crime and are a nurse and you are looking to hire an attorney for representation, we invite you to contact us at Shouse Law Group. We can provide a free consultation in office or by phone. We have local offices in Los Angeles, the San Fernando Valley, Pasadena, Long Beach, Orange County, Ventura, San Bernardino, Rancho Cucamonga, Riverside, San Diego, Sacramento, Oakland, San Francisco, San Jose and throughout California.
1Our California Criminal Defense Lawyers have local offices in Beverly Hills, Burbank, Glendale, Lancaster, Long Beach, Los Angeles, Pasadena, Pomona, San Diego, San Francisco, Torrance, Van Nuys, West Covina, and Whittier. For information on the unauthorized practice of nursing in Nevada, see our article on the unauthorized practice of nursing in Nevada.
2The Board of Registered Nursing also regulates advanced practice certification of clinical nurse specialists, nurse anesthetists, nurse practitioners and nurse-midwives. Licensed vocational nurses and psychiatric technicians are regulated by the California Board of Vocational Nursing and Psychiatric Technicians.
3See California Business and Professions Code Section 2700 et seq. See also California Code of Regulations, Title 16, Division 14 (Board of Registered Nursing).
4California Business and Professions Code Section 2761 provides: "The board may take disciplinary action against a certified or licensed nurse or deny an application for a certificate or license for any of the following: (a) Unprofessional conduct, which includes, but is not limited to, the following: (1) Incompetence, or gross negligence in carrying out usual certified or licensed nursing functions. (2) A conviction of practicing medicine without a license in violation of Chapter 5 (commencing with Section 2000), in which event the record of conviction shall be conclusive evidence thereof. (3) The use of advertising relating to nursing which violates Section 17500. (4) Denial of licensure, revocation, suspension, restriction, or any other disciplinary action against a health care professional license or certificate by another state or territory of the United States, by any other government agency, or by another California health care professional licensing board. A certified copy of the decision or judgment shall be conclusive evidence of that action. (b) Procuring his or her certificate or license by fraud, misrepresentation, or mistake. (c) Procuring, or aiding, or abetting, or attempting, or agreeing, or offering to procure or assist at a criminal abortion. (d) Violating or attempting to violate, directly or indirectly, or assisting in or abetting the violating of, or conspiring to violate any provision or term of this chapter or regulations adopted pursuant to it. (e) Making or giving any false statement or information in connection with the application for issuance of a certificate or license. (f) Conviction of a felony or of any offense substantially related to the qualifications, functions, and duties of a registered nurse, in which event the record of the conviction shall be conclusive evidence thereof. (g) Impersonating any applicant or acting as proxy for an applicant in any examination required under this chapter for the issuance of a certificate or license. (h) Impersonating another certified or licensed practitioner, or permitting or allowing another person to use his or her certificate or license for the purpose of nursing the sick or afflicted. (i) Aiding or assisting, or agreeing to aid or assist any person or persons, whether a licensed physician or not, in the performance of, or arranging for, a violation of any of the provisions of Article 12 (commencing with Section 2220) of Chapter 5. (j) Holding oneself out to the public or to any practitioner of the healing arts as a "nurse practitioner" or as meeting the standards established by the board for a nurse practitioner unless meeting the standards established by the board pursuant to Article 8 (commencing with Section 2834) or holding oneself out to the public as being certified by the board as a nurse anesthetist, nurse midwife, clinical nurse specialist, or public health nurse unless the person is at the time so certified by the board. (k) Except for good cause, the knowing failure to protect patients by failing to follow infection control guidelines of the board, thereby risking transmission of blood-borne infectious diseases from licensed or certified nurse to patient, from patient to patient, and from patient to licensed or certified nurse. In administering this subdivision, the board shall consider referencing the standards, regulations, and guidelines of the State Department of Health Services developed pursuant to Section 1250.11 of the Health and Safety Code and the standards, guidelines, and regulations pursuant to the California Occupational Safety and Health Act of 1973 (Part 1 (commencing with Section 6300), Division 5, Labor Code) for preventing the transmission of HIV, hepatitis B, and other blood-borne pathogens in health care settings. As necessary, the board shall consult with the Medical Board of California, the Board of Podiatric Medicine, the Dental Board of California, and the Board of Vocational Nursing and Psychiatric Technicians, to encourage appropriate consistency in the implementation of this subdivision. The board shall seek to ensure that licentiates and others regulated by the board are informed of the responsibility of licentiates to minimize the risk of transmission of blood-borne infectious diseases from health care provider to patient, from patient to patient, and from patient to health care provider, and of the most recent scientifically recognized safeguards for minimizing the risks of transmission."
5California Business and Professions Code Section 2762 provides: "In addition to other acts constituting unprofessional conduct within the meaning of this chapter it is unprofessional conduct for a person licensed under this chapter to do any of the following: (a) Obtain or possess in violation of law, or prescribe, or except as directed by a licensed physician and surgeon, dentist, or podiatrist administer to himself or herself, or furnish or administer to another, any controlled substance as defined in Division 10 (commencing with Section 11000) of the Health and Safety Code or any dangerous drug or dangerous device as defined in Section 4022. (b) Use any controlled substance as defined in Division 10 (commencing with Section 11000) of the Health and Safety Code, or any dangerous drug or dangerous device as defined in Section 4022, or alcoholic beverages, to an extent or in a manner dangerous or injurious to himself or herself, any other person, or the public or to the extent that such use impairs his or her ability to conduct with safety to the public the practice authorized by his or her license. (c) Be convicted of a criminal offense involving the prescription, consumption, or self-administration of any of the substances described in subdivisions (a) and (b) of this section, or the possession of, or falsification of a record pertaining to, the substances described in subdivision (a) of this section, in which event the record of the conviction is conclusive evidence thereof. (d) Be committed or confined by a court of competent jurisdiction for intemperate use of or addiction to the use of any of the substances described in subdivisions (a) and (b) of this section, in which event the court order of commitment or confinement is prima facie evidence of such commitment or confinement. (e) Falsify, or make grossly incorrect, grossly inconsistent, or unintelligible entries in any hospital, patient, or other record pertaining to the substances described in subdivision (a) of this section."
6California Government Code Section 11503 provides: "A hearing to determine whether a right, authority, license or privilege should be revoked, suspended, limited or conditioned shall be initiated by filing an accusation. The accusation shall be a written statement of charges which shall set forth in ordinary and concise language the acts or omissions with which the respondent is charged, to the end that the respondent will be able to prepare his defense. It shall specify the statutes and rules which the respondent is alleged to have violated, but shall not consist merely of charges phrased in the language of such statutes and rules. The accusation shall be verified unless made by a public officer acting in his official capacity or by an employee of the agency before which the proceeding is to be held. The verification may be on information and belief."
7California Government Code Section 11506 provides: "(a) Within 15 days after service of the accusation the respondent may file with the agency a notice of defense in which the respondent may: (1) Request a hearing. (2) Object to the accusation upon the ground that it does not state acts or omissions upon which the agency may proceed. (3) Object to the form of the accusation on the ground that it is so indefinite or uncertain that the respondent cannot identify the transaction or prepare a defense. (4) Admit the accusation in whole or in part. (5) Present new matter by way of defense. (6) Object to the accusation upon the ground that, under the circumstances, compliance with the requirements of a regulation would result in a material violation of another regulation enacted by another department affecting substantive rights. (b) Within the time specified respondent may file one or more notices of defense upon any or all of these grounds but all of these notices shall be filed within that period unless the agency in its discretion authorizes the filing of a later notice. (c) The respondent shall be entitled to a hearing on the merits if the respondent files a notice of defense, and the notice shall be deemed a specific denial of all parts of the accusation not expressly admitted. Failure to file a notice of defense shall constitute a waiver of respondent's right to a hearing, but the agency in its discretion may nevertheless grant a hearing. Unless objection is taken as provided in paragraph (3) of subdivision (a), all objections to the form of the accusation shall be deemed waived. (d) The notice of defense shall be in writing signed by or on behalf of the respondent and shall state the respondent's mailing address. It need not be verified or follow any particular form. (e) As used in this section, "file," "files," "filed," or "filing" means "delivered or mailed" to the agency as provided in Section 11505."
8California Code of Regulations, Title 16, Div. 14, Art. 4 �1444 provides: "A conviction or act shall be considered to be substantially related to the qualifications, functions or duties of a registered nurse if to a substantial degree it evidences the present or potential unfitness of a registered nurse to practice in a manner consistent with the public health, safety, or welfare. Such convictions or acts shall include but not be limited to the following: (a) Assaultive or abusive conduct including, but not limited to, those violations listed in subdivision (d) of Penal Code Section 11160. (b) Failure to comply with any mandatory reporting requirements. (c) Theft, dishonesty, fraud, or deceit. (d) Any conviction or act subject to an order of registration pursuant to Section 290 of the Penal Code."
9California Business and Professions Code Section 2765 provides: "A plea or verdict of guilty or a conviction following a plea of nolo contendere made to a charge substantially related to the qualifications, functions and duties of a registered nurse is deemed to be a conviction within the meaning of this article. The board may order the license or certificate suspended or revoked, or may decline to issue a license or certificate, when the time for appeal has elapsed, or the judgment of conviction has been affirmed on appeal or when an order granting probation is made suspending the imposition of sentence, irrespective of a subsequent order under the provisions of Section 1203.4 of the Penal Code allowing such person to withdraw his or her plea of guilty and to enter a plea of not guilty, or setting aside the verdict of guilty, or dismissing the accusation, information or indictment." See also Notice to Registered Nurses by the Board of Registered Nursing regarding Disclosure of Convictions and Discipline and New Fingerprint Requirement (undated).
10See BRN license renewal form, page 2. See also California Penal Code Section 19.8 ("The following offenses are subject to subdivision (d) of Section 17: Sections 193.8, 330, 415, 485, 490.7, 555, 652, and 853.7 of this code; subdivision (n) of Section 602 of this code; subdivision (b) of Section 25658 and Sections 21672, 25658.5, 25661, and 25662 of the Business and Professions Code; Section 27204 of the Government Code; subdivision (c) of Section 23109 and Sections 12500, 14601.1, 27150.1, 40508, and 42005 of the Vehicle Code, and any other offense which the Legislature makes subject to subdivision (d) of Section 17. Except where a lesser maximum fine is expressly provided for a violation of any of those sections, any violation which is an infraction is punishable by a fine not exceeding two hundred fifty dollars ($250). Except for the violations enumerated in subdivision (d) of Section 13202.5 of the Vehicle Code, and Section 14601.1 of the Vehicle Code based upon failure to appear, a conviction for any offense made an infraction under subdivision (d) of Section 17 is not grounds for the suspension, revocation, or denial of any license, or for the revocation of probation or parole of the person convicted.")
11See also California Business and Professions Code Section 490.5 ("A board may suspend a license pursuant to Section 11350.6 of the Welfare and Institutions Code if a licensee is not in compliance with a child support order or judgment.")
12California Business and Professions Code Section 2759: "The board shall discipline the holder of any license, whose default has been entered or who has been heard by the board and found guilty, by any of the following methods: (a) Suspending judgment. (b) Placing him upon probation. (c) Suspending his right to practice nursing for a period not exceeding one year. (d) Revoking his license. (e) Taking such other action in relation to disciplining him as the board in its discretion may deem proper."