California Board of Registered Nursing Guide: What Nurses Need to Know

California Board of Registered Nursing

What Is the Purpose of the BRN (Board of Registered Nursing)?

In the state of California, the licensing and regulation of registered nurses is overseen by the California Board of Registered Nursing (BRN). The BRN is responsible for determining and maintaining high standards for practicing nurses to ensure public safety.

The BRN’s practices are informed by legal statutes known as the Nursing Practice Act, which gives the agency the authority to field and investigate complaints against nurses and take disciplinary action against nurses whose actions put the public at risk. The BRN also possesses the authority to deny nursing licenses and take legal action against RNs if it is warranted.

While no nurse wants to have issues with the BRN, license denials and patient complaints commonly put nurses face to face with an agency that has significant power over their license, their reputation, and their future careers.

Understanding some of the most common legal issues nurses face and being prepared to respond appropriately is essential for all nurses, no matter how well they do their jobs. In many BRN cases, it is crucial to work with an experienced and knowledgeable Board of Registered Nursing defense attorney to protect your license and your future.

Scott J Harris is committed to helping nurses understand their rights while fighting to ensure they receive their licenses and keep their licenses when issues arise. 

California Nursing Licensing Requirements

Getting Licensed 

To practice as an RN in the state of California, a nurse must be legally licensed. To receive a license, the application process must go smoothly. 

For many applicants, the process is straightforward: they complete their educational requirements, pass the National Council Licensing Examination, pass a criminal background check, and receive their license.

Disclosure of Convictions

Sometimes, however, the application process can be complicated, especially if the applicant was previously convicted of a crime. California law requires all nursing license applicants to disclose criminal convictions on the application, including out of state convictions. 

Expunged or dismissed convictions must be disclosed, and in cases where the applicant received a deferred entry of judgment or criminal court diversion, may also be disclosed.

Unfortunately, many nurses fail to make the proper disclosures, only to have their crimes discovered by the BRN and result in a license denial. In some cases, an applicant who provides false information in an application could be referred for criminal prosecution for perjury.

Other applicants run into trouble because they disclose a conviction but fail to provide evidence that they have rehabilitated themselves since the conviction. In both cases, hiring a Board of Registered Nursing defense lawyer can make the difference between the end of your career and successfully acquiring your license.

Will a Conviction Disqualify Me from Licensure?

It is important to remember that a criminal conviction does not automatically disqualify an applicant from licensure. 

To deny a license, the BRN must find that the crime was “substantially related” to the duties, functions, or qualifications of an RN.

To determine whether the crime is “substantially related,” the Board will consider the nature, severity, and recency of the offense, as well as whether or not the applicant has taken steps to rehabilitate themselves, thus proving that they are capable of practicing their profession safely.

According to Title 16, California Code of Regulations, section 1444, a conviction is considered substantially related to the duties of an RN if it demonstrates that the nurse is significantly unfit to practice while protecting public health, safety, or welfare. 

Assault or abuse, failure to comply with mandatory reporting requirements, sex offenses, theft, fraud, dishonesty, and deceit are a few examples of behaviors that are considered inconsistent with public welfare and safety. 

Any of these actions could result in the denial of your license, as well as the revocation of an existing license. 

The conviction does not have to be committed in the course of one’s healthcare practice, and convictions from one’s past, including alcohol and drug-related cases, can provide the basis for a denial.

How Can a Lawyer Help?

If you are considering applying for your RN license, but have received a criminal conviction, it is in your best interest to seek the assistance of a lawyer as soon as possible. 

A lawyer can help you create a meaningful disclosure statement and help you gather and provide proper evidence and documentation that you have worked to rehabilitate yourself since the crime occurred. 

An experienced lawyer can often help applicants with criminal convictions earn a license with restrictions, and in best-case scenarios, help applicants successfully earn their license without stipulations.

Filing an Appeal After a Nursing License Denial

If your license application is denied because of a conviction or for some other reason, you will most typically receive a letter of denial from the Board. 

At that point, you have sixty (60) days to appeal the denial. If you appeal, or if the Board chooses to skip the denial letter altogether, you will receive a “Statement of Issues” from the BRN detailing the Board’s rationale for its decision. 

Why Does the Statement of Issues Matter?

A “Statement of Issues” is the legal filing that starts the full legal appeal. If you do not respond to the denial letter or the “Statement of Issues,” your application will be denied, and you will be forced to wait one year from the date on your denial notice to reapply.

If you wish to appeal a license denial, a knowledgeable lawyer can help you understand your rights, meet deadlines, and gather proper documentation to support your appeal. They can also help you create a strong written statement to improve your chances of a successful appeal. 

Common Complaints Investigated by the BRN

If a patient complains about the care they received from a licensed nurse, it can cause serious difficulties and even jeopardize an RN’s license. 

A complaint is considered any information the BRN receives that alleges that a registered nurse, or nursing license applicant, has acted in violation of the Nursing Practice Act.

The BRN handles many types of complaints. Among the most common complaints that lead to investigations are those regarding patient care, where the complainant alleges that the nurse acted unsafely or inappropriately. Some examples include medication errors, failure to document, abuse of patients, or failure to provide care.

Another very common complaint against nurses is the allegation of chemical dependency, where the complainant believes the nurse is abusing drugs or alcohol.

Other types of complaints within the BRN’s jurisdiction include:

  • Violation of patient confidentiality
  • Sexual contact with a patient
  • Seeking a social relationship with a patient
  • Provision of services the RN is untrained or licensed to perform
  • Fraud or deceit
  • DUI
  • Failure to keep proper records of drug administration
  • Improperly following procedures when dispensing drugs
  • Unprofessional conduct
  • General negligence

Complaints Outside BRN Jurisdiction 

Some complaints fall outside of BRN jurisdiction and are important to note. 

These include problematic relations between employers and employees, billing or fee disputes, labor issues, rude behavior, complaints against health care providers who are not RNs (i.e., physicians, nursing assistants, and other healthcare providers), and complaints against the healthcare facility itself.

If any of these complaints are submitted, the case will be closed or referred to the appropriate agency.

What Happens During the Investigation?

Once the BRN receives a nursing complaint, the Board thoroughly reviews it to determine whether the complaint is valid or invalid, whether additional information is needed to determine the validity of the complaint, or if the complaint should be redirected to a different agency. 

If a nurse is accused of substance abuse or of having a mental health issue, the Board will decide whether the RN qualifies for the BRN’s Diversion program.

Depending on the details of the allegations, investigations can be lengthy and in-depth processes. During the investigation, investigators conduct interviews with all involved parties, including the nurse and the complainant, as they gather evidence and reports to determine the validity and severity of the offense.

Once the investigation concludes, the investigator submits a written report to the BRN that states their findings. If no violation is found, the case will be closed. 

If, at the end of the investigation process, it is determined that the nurse committed a crime or a serious violation of the Nursing Practices Act, the case will get referred to the Attorney General’s Office.

Even if the complaint against a nurse is minor, it is typically in the accused party’s best interest to work with a lawyer rather than attempt to defend themselves against the allegations. 

Interviews are often recorded, and a nurse can be held legally responsible for actions taken during the process. It is always advisable to wait until you have legal counsel in place before attending any meeting or investigation activity.

Minor Vs. Serious Complaints

There is a wide range of potential responses the BRN may have to complaints. 

Sometimes a complaint is closed because it is unsubstantiated, not within the BRN’s jurisdiction, or considered a minor case that is not serious enough to warrant punishment. 

In some cases, involving minor violations of the Nursing Practice Act, the BRN will simply deal with the issue in-house through the BRN Citation and Fine System by issuing a citation, fine, or private reprimand. Nurses may contest any citation or fine by way of an informal or formal appeal.

If a complaint is deemed serious by the BRN, such as an allegation of drug abuse, gross negligence of standard of care, or sexual contact with a patient, the allegation will be immediately referred to the BRN’s own internal investigation unit. 

If the complaint involves a violation of the Nursing Practice Act, it may be referred to the Department of Consumer Affairs’ Division of Investigation (DOI).

Understanding Nursing Accusations

If the allegations at hand are found to be valid, and the nurse’s alleged behavior violates the law, the BRN may file a Formal Accusation against their nursing license. Accusations typically result in disciplinary action, revocation, or suspension of a nursing license.

With a formal Accusation, the licensed nurse will receive a list of actions they took and the specific laws or regulations they violated. It will include a request that disciplinary action is taken against their license along with the reasoning. 

Once the Accusation is filed, the nurse has 15 days to file a Notice of Defense, which entitles them to an Administrative Hearing. If the nurse fails to respond, their license will be revoked.

Types of Accusations

There are many types of accusations, including standards of practice issues. The most common allegation involving the standard of practice is Gross Negligence. 

According to the BRN, “Gross Negligence is an extreme departure from the standard of practice for RNs.” 

It is reserved for cases where a nurse repeatedly failed to provide proper care or did not exercise proper precautions in a situation where they knew they could harm the patient. 

Gross Negligence Accusations can also be filed for patient chart errors, medications that were not properly accounted for, or for wrongly administered medication.

In general, any serious documentation, medication, or drug or alcohol issues may fall under gross negligence.

If you receive an Accusation, you must work with a Board of Registered Nursing defense attorney as soon as possible. They can help you get a clear sense of your legal rights and fight to help you keep your license.

Defending Your Nursing License Against an Accusation 

If you receive an Accusation, you will have the right to a hearing at the Office of Administrative Hearings. While these hearings are often described as informal, in reality, they take place in a courtroom with an Administrative Law Judge, evidence is presented, and an experienced attorney from the BRN will be present. A nurse facing an accusation must have a lawyer as well.

After the nurse’s lawyer and the BRN lawyer have presented evidence and stated their case, the judge has 30 days to write a decision. The decision will then be submitted to the BRN, which has 100 days to decide whether to adopt, reject, or make changes to the decision. 

They may choose to accept or reject the decision in whole or in part. The BRN will then impose a specific disciplinary action, which could include penalties, fines, probation, suspension or revocation of the nurse’s license, or other outcomes.

After a decision is rendered, you have a short period to file a Petition for Reconsideration or an appeal. You should consult an attorney about all appeal rights, knowing that once the Board’s decision becomes effective, it is binding in most cases.

Petitions for Reinstatement

If a nurse has lost their license and wants to have it reinstated, they can file a petition of reinstatement. In the state of California, it is very rare to have a license permanently revoked, but the nurse must wait one year before petitioning for reinstatement. 

Several eligibility requirements must be met before a nurse can petition for reinstatement. 

First, they cannot petition if they are on probation or parole. In addition to the application submission, they must submit evidence of rehabilitation, showing that they have taken steps to improve themselves in relevant ways, such as attending drug rehabilitation or therapy.

Successful petitions are often accompanied by letters from colleagues attesting to the nurse’s ability to successfully do their job. While some licenses are reinstated in full without restriction, others are reinstated provisionally or on probation with the record of discipline featured on the nurse’s license record, which can create difficulties when looking for employment.

Some licenses are reinstated after a single attempt, while others may require several attempts. Sometimes the amount of time for which you have demonstrated personal change is among the most critical factors in the decision.

During the reinstatement process, working with a Board of Registered Nursing defense attorney is a powerful strategy. An attorney can help you prove personal improvement and demonstrate your readiness to work with the public again safely. 

If your history of discipline is particularly sensitive, having a lawyer on your side can help you present this in the best light possible. In the case that your license is reinstated with restrictions, an attorney can sometimes get these restrictions reduced, or have negative information removed from your record, which can help you as you seek employment.

Substance Abuse and Nursing

Because healthcare is a high-stress profession, substance abuse and mental illness are not uncommon among nurses. In California, both of these situations may qualify you for a Diversion program in lieu of disciplinary action. 

Participating in a Diversion program can help you get sober, regain your mental health, and become rehabilitated. Diversion is typically offered before a serious incident occurs to intervene and protect the public. If the damage has already been done, you may not be eligible.

Enrolling in a Nurse Diversion

Depending on your situation, Diversion may or may not be right for you at a given time. If you are not ready for Diversion and fail in your rehabilitation efforts, the consequences can be harsh and may include a referral for discipline against your license.

If, however, you qualify for Diversion, you will often be able to continue practicing under strict monitoring. Successful completion of Diversion may help you avoid disciplinary action.

How a Qualified Board of Registered Nursing Defense Attorney Can Help You

If you are facing issues with license denial, a forthcoming investigation, an Accusation, or are aware of a complaint that has been made against you, it is essential to seek legal help quickly. 

Statutes of limitations for these cases are notoriously brief, and a qualified and experienced lawyer will ensure that you submit proper documentation and meet strict deadlines. They can also help you understand your rights and potential outcomes for your case.

Scott J Harris is an experienced Board of Registered Nursing defense attorney. He and his team believe that a nurse should never feel guilt or shame because they have made a mistake. Nursing is a stressful profession, and all professionals make errors. Regardless of the severity of your case, we will treat you with respect and consideration and fight to help you acquire or keep your license. 

Scott J Harris has a strong understanding of BRN regulations and criminal laws in the state of California. He can help lessen restrictions on your license, negotiate punishments, and help you get back to work again. 

He is committed to helping you build the strongest case possible and acquiring the best possible outcome for your reputation, your career, and your future.

Our firm has helped many nurses with BRN issues, and we may be able to help you as well. Contact us today for a free 30-minute consultation on your case.

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This blog is meant to be informational. It is not meant to be all-encompassing legal advice. If you are facing a situation involving your professional license, seek counsel from a licensed attorney.