California Registered Nurses With Out-of-State Disciplinary Records at Risk of License Revocation

A recent newspaper exposé ofof prior discipline in another state may not be
California-licensed nurses who have been disciplinedavailable. Or the out-of-state records may not
for professional misconduct in other states hasmeet the standards of admissible evidence set
resulted in a California-wide effort to revoke all offorth in the California Evidence Code (California law
those nurses' California licenses. So committed iswill apply at the hearing.) The discipline imposed by
California's Governor to this agenda, that hethe prior state may have been based on conduct
recently fired the head administrator and replacedthat is lawful in California. Many procedural defects
all of the members of the Board of Registeredmay exist in the out-of-state disciplinary process.
Nursing. The new appointees have been givenMany more reasons exist for invalidating or
their marching orders, and more than 2,000reducing the State's claims. The out-of-state
Registered Nurses are slated for licensediscipline may have occurred a number of years
revocation on the basis of prior conduct in otherago, and the nurse may have current relevant
states. It seems clear that Licensed Vocationalwork experience that demonstrates that any
Nurses will face similar issues soon.previous performance problems have been
Obviously, some nurses should not be practicingaddressed and resolved. The nurse may have
anywhere. But California apparently assumes thatevidence of further professional training since the
all nurses with license issues in other states shouldtime of the out-of-state discipline, or the nurse
also be barred here. And nurses who are now onmay have completed rehabilitation or received
California's hit-list might assume that loss of theireffective counseling. The nurse may be able to
California licenses is inevitable. Neither of thesedemonstrate a new maturity, significant changes
assumptions is supported by logic or law.based on life experiences (parenthood, military
License Discipline and Revocation in Californiaservice, successful employment, religious
A nursing license-RN or LVN-once earned, is theenlightenment) and improvements in professional
property of the nurse. And, like any othercompetence. Any similar facts would be compelling
property, such as real estate (think foreclosure)evidence where the State's only basis to discipline
or money (think of fines imposed by courts), thethe nursing license is out-of-state prior misconduct.
nursing license cannot be taken away (revoked),These are only a few of the more obvious kinds
even for a short time (suspension), and cannot beof evidence that may be utilized to defend a
diminished or restricted in any way (probationarynursing license in an administrative hearing.
conditions) without two things: good cause andCountless others exist.
due process.The Economics of Defending Against Discipline of
There is a vast body of law as to whatthe Nursing License
constitutes good cause. But here's the take-awaySome nurses (and other professional and
you need to remember: the mere fact that in theoccupational licensees) believe that they cannot
past some other state revoked or disciplined a"afford" to invoke the fair hearing process and
nursing license issued by that state does not, bydefend their license against the State. But
itself, constitute good cause for California toconsider: what do you earn in a year from
discipline a current California nursing license.nursing? In two years? In three? A license
As for due process, that means that Californiarevocation will prohibit re-application for a new
cannot simply unilaterally revoke or discipline thelicense for at least three years and probably
license based on what State officials believe to belonger. You do the math: can you afford not to
good cause. Instead, California must first notifydefend your right to earn your living?
the nurse of the State's intention to discipline orHow to Begin to Defend Against Discipline of a
revoke the license. Then the State must offerCalifornia Nursing License
the nurse an opportunity to deny that the licenseThe one certain way to lose your California
should be disciplined, and an opportunity tonursing license on the basis of prior out-of-state
demonstrate why. The demonstration of why theprofessional discipline is to do nothing when you
license should not be disciplined takes place at anreceive a notice of proposed action from the
administrative hearing where the nurse's advocateState of California. Do not let this happen to you!
can challenge all or any of the State's reasons andRead the notice. It will give you a very short
evidence in front of an impartial administrative lawwindow of time in which to provide written notice
judge.of denial of the charges and your demand for
Also at the hearing, the nurse's advocate willhearing. Do not let this deadline pass! It is critical to
introduce evidence that the nurse is competentsubmit your denial/demand before the time
and that there presently exists no reason to denyexpires. Then, get a lawyer.
the right to practice nursing in California. The judgeAs the State will tell you, you are not required to
will give due consideration to the evidence puthave an attorney to defend against discipline of
before him or her and issue (1) findings of factan occupational license, or to obtain one after the
that explain what evidence the judge findsState has denied the application. But you should.
credible, (2) conclusions of law that explain whatThe State will be represented by an experienced
laws the judge thinks apply to the case, and (3) aand specialized attorney. Because the coming R.N.
proposed decision. The proposed decision is thencases will feature out-of-state records that may
forwarded to the Board for action, and the nursebe subject to challenge on the basis of California
and the nurse's advocate can appear before theevidentiary standards, these are not the kind of
Board to argue in favor of or in opposition to thecases where it will be okay if the only party
Administrative Law Judge's proposed decision.without an attorney is the nurse with everything
Opportunities to Defeat Discipline at theto lose.
Administrative HearingYour nursing license is your asset. It has value:
Anyone who is not familiar with the hearingreal, quantifiable, actual value. Protect it by
process might not realize that the hearing offersexercising of all of the legal rights it carries.
many opportunities to the nurse to avoid orCalifornia may be at war with its dual- and
reduce the discipline against the license that ismulti-state licensed nurses, but you need not be
proposed by the State. For example, the recordsone of the casualties.