Nursing Board License Defense

A nursing license lawyer should be your first phone call if you’ve received a letter that the Colorado Board of Nursing is taking disciplinary action against your professional license as a licensed practical nurse, registered nurse, or an advanced practice nurse such as a nurse practitioner or nurse anesthetist.  If the nursing board is investigating you, you are likely concerned about your job, your professional license, your entire career as a nurse and ability to provide for yourself or your family.  You may be concerned about the confidentiality of the discipline and your reputation among your peers.  If the disciplinary action is based on criminal charges, the stakes includes all of that and the risk of criminal punishment, such as jail or prison, as well.

Do not panic, but get ready for a fight.  These disciplinary action letters require a response within 30 days, but do not wait even that long.  The best outcomes come from a thorough, coordinated defense, which takes time to prepare.

The first step is to hire an attorney who practices in front of the Colorado State Board of Nursing and Office of Administrative Courts– there are numerous legal and practice pitfalls for attorneys who are not well versed in this area. If the disciplinary action is connected to criminal charges, then find an attorney who is also an experienced criminal defense lawyer.  Until your attorney is involved, it is important to not make any statements about the situation to police, investigators, on social media, or to friends.  If the police or investigators contact you, politely get their contact information and let them know your attorney will reach out to them.  You may have to cooperate with an internal investigation at work, but we can discuss that.   If your disciplinary action or criminal charge relates to alcohol or drug abuse, it is critical to get and stay sober, one way or another.  You may wish to discuss treatment options with your attorney.

Be ready to email the PDF of your 30-day letter to an attorney who can begin advising and defending you throughout this process.

Matt Hand is an experienced Denver lawyer focused on criminal defense and medical and nursing license defense.  To schedule a free consultation, email a copy of your 30-day letter (or a brief description of your situation) to matt@handlaw.com — you may also call (303) 900-8480, but emails get quicker responses than voicemails.  All consultation with me is strictly confidential, whether or not we ultimately work together.

Nursing Licenses—Causes of Discipline

The Colorado Board of Nursing is empowered by law to discipline nursing licensees for a range of unprofessional conduct.   Most incidents giving rise to discipline can be characterized as triggering multiple grounds for discipline.  Sometimes it is possible to defend each and every claimed ground for discipline– Matt Hand regularly wins dismissals of complaints, though every case is different.  Sometimes it is necessary to admit the unprofessional conduct as part of an agreement to receive tolerable disciplinary sanctions.   Sometimes it is possible to contest certain claimed unprofessional conduct, while admitting other conduct, to obtain more proportionate, reasonable discipline.  A nursing license defense lawyer can guide you through this minefield.  What follows is a list of some common grounds for nursing license discipline.

• Fraud or deception, whether by lie or omission, in regards to license applications or renewals
• Certain criminal convictions, including felonies, and any crime that relates to the person’s employment as a nurse, or that indicates an alcohol or drug use disorder
• Willful or negligent conduct inconsistent with the health or safety of persons under the nurse’s care
• Nursing license suspensions or revocations in another jurisdiction
• Violation of a range of particular nursing-related laws, rules, or orders of the nursing board
• Practicing nursing in a manner that fails to meet generally accepted standards for the nursing practice
• Falsifying or negligently making incorrect entries, or failing to make essential entries, on patient records
• Excessive use or abuse of alcohol or drugs, or diverting controlled substances from work
• Distributing to family or self any controlled substance
• Dispensing or injecting an anabolic steroid except under narrow circumstances
• Having a physical or mental disability that renders the person unable to practice nursing with reasonable skill and safety to patients
• Violating laws regarding patient confidentiality
• Health insurance abuse, insurance fraud, or willful and repeated ordering of demonstrably unnecessary laboratory tests or studies, or other unnecessary treatment, failure to obtain consultations or perform referrals, etc.
• Administering, dispensing, or prescribing any habit-forming drug or any controlled substance, other than in the course of legitimate professional practice.
• Willfully failing to respond in a materially factual and timely manner to a disciplinary complaint
• Misrepresenting to the public one’s credentials, or practicing on a license that is suspended, revoked, or inactive.
• Failure to report to the nursing board, within 45 days after a final conviction, that the person has been convicted of a crime.
• Failure to maintain professional liability insurance

Nursing Licenses—Disciplinary Sanctions

When grounds for discipline against a licensee exist, the Colorado Board of Nursing may impose a wide range of possible disciplinary sanctions.   In narrow circumstances, the nursing board may determine that no formal action is necessary, and may only send the nurse a confidential letter of concern. At the other extreme, the nursing board may revoke a nursing license completely.  Between those two extremes are a range of increasing intermediate sanctions, from a letter of admonition (essentially a public reprimand), to a probationary license with practice restrictions, education and treatment requirements, to temporary suspensions of a nursing license.

These different levels of sanctions can be, from the perspective of the nurse, the difference between a manageable speed bump and a catastrophic head-on collision.  An aggressive nursing license defense lawyer will fight to improve and manage the potentially severe consequences of a disciplinary action, so that you can maintain your career, your reputation, and your sense of self.

The Board of Nursing has an immense amount of discretion in choosing disciplinary sanctions, as long as it is following the law and acting in what it believes is the public interest.  Though possible, it is difficult to challenge their final determination of one sanction versus another, once they have proven that some discipline was warranted.  Generally, courts will uphold the Board’s choice of sanctions unless the sanctions bear no relation to the conduct, are manifestly excessive in relation to the needs of the public, or constitute a gross abuse of its discretion.  Those are high bars to overcome, and so it is important for a lawyer to try to influence the nursing board’s decision up front, through negotiation, or through litigation in the administrative courts, where complaints that have not been settled are first developed and challenged by the two sides.

For both negotiation and litigation, the key is to credibly and persuasively deny what can be effectively denied, to contextualize and mitigate any unprofessional conduct that did occur, and to persuade the Nursing Board that severe discipline is not necessary to protect the public.  These efforts take a variety of forms, from interviewing fact witnesses, to retaining experts to opine on standards of care, to getting the nurse treatment for drug or alcohol use disorders, to obtaining character and reference letters, to using unique procedural statutes and regulations to the nurse’s advantage, and much more.  At all points, a nursing license lawyer will be fighting to ensure that the nurse’s rights are not violated, that the Board of Nursing is held to its burden of proof, that the Board of Nursing does not exceed its legal authority, and that the most persuasive arguments in favor of the nurse are presented in every forum, from initial negotiations with the Board, all the way to appeals, if necessary.

Criminal Charges and Nursing Licenses

Criminal charges against a nurse can give rise to disciplinary action against the nurse’s professional license, even when the criminal allegations had nothing to do with the workplace, and sometimes even when the criminal charges are beaten by the nurse (this is complex).  Occasionally, criminal charges can be filed for ordinary mistakes in the course of nursing. Criminal charges against a nurse require a coordinated defense, by an experienced lawyer, of both the criminal case and the Board of Nursing license action. Most criminal convictions must be reported to the nursing board within 30 days of conviction, and any nursing renewal application will inquire about such cases.  But the law specifies that only certain crimes constitute unprofessional conduct warranting license discipline: felonies, crimes that relate to one’s work as a nurse, crimes that endanger someone under the nurse’s care, crimes that indicate excessive use or abuse of alcohol or drugs, and crimes that implicate any of the various other triggers for discipline.  Sometimes the Board will ignore the formal result of the criminal case, and attempt to discipline a nurse based simply on concerns raised by the underlying conduct in a criminal case, whether they are behavioral concerns or drug/alcohol concerns.

Because of potentially severe professional license consequences, it is typically necessary for a nurse or doctor to be more aggressive, than the average person, in defending against criminal accusations.  Even when the criminal consequences may seem mild (say, merely a fine or probation), the act of pleading guilty can trigger serious consequences for a nursing license. So if you’ve been charged with a crime, slow down, and get help.  I am a former prosecutor with an extensive criminal defense practice.  I have fought for doctors, nurses and allied health professionals charged with felony assault, domestic violence, DUIs, child abuse, hit and run, theft, and more. Though every case is different, in many appropriate cases I have obtained dismissals or acquittals of serious charges, thereby avoiding or limiting disciplinary action against their licenses.  In other cases, we have been able to present mitigation and structure a favorable plea in the criminal case, while limiting the impact to the person’s professional license.

Email or call Denver attorney Matt Hand directly to discuss your criminal defense and nursing license:  matt@handlaw.com (preferred) or (303) 900-8480.

Alcohol & Drug Abuse and Nursing Licenses

A nursing license is always in danger when a nurse has a problem with excessive alcohol use or drug abuse, but in many cases there are ways to preserve the nursing license without too many restrictions.  In some cases, the matter can even be kept confidential, which is normally a challenge with nursing license discipline.   Ideally a nurse would self-identify a problem and get professional help before the nursing board takes action.  But even after the board has initiated action, a coordinated legal defense and serious efforts at achieving sobriety will create a manageable path forward.  Do not despair, just begin to get help.

Note that there are a number of ways that a nurse’s problems with alcohol or drugs may come to light and trigger discipline.  The law states that discipline is authorized when a nurse “excessively uses or abuses alcohol, habit-forming drugs, controlled substances,” or diverts controlled substance from a place of employment, and related situations.  Sometimes these issues come to light when a nurse is charged with a DUI, drug possession, or is charged with theft or diversion of controlled substances.  Sometimes these issues come to light in a criminal case that on its face may have nothing to do drugs or alcohol.  For example, a domestic violence case where alcohol played a role in the conduct may independently trigger board action based on the alcohol concerns, after the nurse discloses that case to the board.  Or separately, if a nurse is reporting to work under the influence, and thereby endangering the patients under his or her care, that will become a separate basis for serious board discipline against a nursing license.   However the board takes notice, whatever prompts the board action, treatment, sobriety, and a coordinated legal defense of your license are critical to creating a positive path forward.

One of the keys to any of these cases, or to preventing a case in the first place, is Peer Assistance Services, a non-profit with a contract to administer and oversee treatment of nurses in Colorado. It is the vendor Colorado uses both as an alternative to discipline, and as a means of overseeing treatment as a rehabilitative element of license discipline.  However, unlike traditional therapy, there are critical limitations to the confidentiality of what you discuss with Peer Assistance– they work closely with the Board of Nursing.  Discuss with an attorney before you choose to self-report anything to the Board of Nursing or Peer Assistance.

The Board of Nursing has empowered its program director to authorize non-public participation in treatment via Peer Assistance under certain circumstances, even after a complaint has been made against the nurse for having a problem with drugs or alcohol.  Nothing requires the program director to offer this favorable resolution to anybody, but for license holders without disciplinary history, it is sometimes possible to close a matter administratively, and without public discipline, upon the nurse licensee signing an agreement to obtain treatment with Peer Assistance.   In rare circumstances it may be possible for a person with disciplinary history to obtain such an agreement.  In all cases, this possibility should be discussed with your attorney to see if you have a shot at it.

Contact Denver Nursing Board lawyer Matt Hand to discuss these and other issues related to your nursing license or criminal charges: matt@handlaw.com (preferred, for fastest response), or (303) 900-8480.

Nursing License Links

Colorado Board of Nursing

National Council of State Boards of Nursing

Colorado Department of Law– Business & Licensing

Peer Assistance

A Nurse’s Guide to Substance Use Disorder in Nursing

Get Help Defending Your Colorado Nursing License

For a free, confidential consultation regarding criminal charges or disciplinary action against your nursing license, call Denver attorney Matt Hand at (303) 900-8480, or email me at matt@handlaw.com.