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Nursing licenses: What happens off-duty may not stay off-duty

Lots of people can clock out at work and not worry too much that what happens in their personal lives will be relevant at work. Of course, this is not the case for nurses and other professionals who provide medical care. Behavior both on- or off-the-job that raises questions about a nurse’s integrity, competence, honesty, substance use or judgment has the potential to negatively impact their nursing license.

Society’s expectation of nurses is that they are upstanding, trustworthy members of the community who consistently adhere to ethical standards of behavior. We believe we can trust them to care safely for us and our loved ones when we are impaired or vulnerable.

Complaints against nursing licenses

But when someone believes a nurse may have failed to live up to the high standards required of them, that person can (or must, in some cases) file a complaint with their state nursing board (SNB or SBON), such as the Kentucky Board of Nursing (KBN), the South Carolina Board of Nursing (SCBN) or the South Carolina Department of Labor Licensing Regulation (LLR). The agency will assess the complaint to determine if the nurse should face an investigation.

Depending on the outcome, the SNB could take disciplinary action like warnings, required training or education, treatment for addiction, fines, conditions placed on the license or probation, license suspension or in the most severe cases even revocation. The SNB reports adverse actions against a nurse’s license to a national database, so licenses in other states or a multistate license through the Nurse Licensure Compact (NLC) could also be at risk.

(We focus here on state nursing board action against licenses, but negative repercussions could be broader, including those involving employment, reputation or criminal liability.)

Off-duty actions that put licenses at risk

Less than 1% of all nursing licenses in the country had disciplinary action taken against them in 2021, according to NurseJournal, citing data from the National Practitioner Data Bank (NPDB). So, while the chances are low, the individual nurse who does face possible adverse consequences against their license could be 100% at risk.

Problematic behaviors in their private lives outside of work that can result in complaints against nurses include:

  • Risky alcohol or drug use
  • Fraud
  • Criminal behavior, charges or convictions, especially involving dishonesty, violence, illegal drug use or possession, driving under the influence or sexual misconduct
  • Ingestion of alcohol, illegal drugs or prescription drugs that causes failure of work-administered drug and alcohol tests
  • Off-work behavior that makes the nurse too tired on the job to provide safe patient care
  • Inappropriate posting on social media about patients.
  • Other generally unprofessional behavior

Of course, in addition to problematic behavior outside the work setting, even more common are on-duty lapses, errors or missteps concerning medication administration, charting and documentation, privacy, patient treatment, standards of care, ethics, medication theft, prescription forgery, patient abuse or neglect, and others.


At the earliest time possible, a nurse who suspects someone may file a complaint about them, who is wondering about self-reporting requirements or who has already received notice of a complaint to their SNB should seek legal counsel to learn about their options. An attorney with administrative law or professional licensure defense experience can assist with negotiating a resolution with the SNB that may better protect the license than an uncertain outcome should the complaint be substantiated.

A lawyer can also represent a nurse throughout the investigation and in interviews, hearings or appeals. Every situation is different, but a nurse’s license is imperative to their livelihood and professional standing, so its protection and defense is of the utmost importance.