Clearing up misunderstandings about professional regulation and nursing licensure

FigureMany years ago, I was appointed to the Board of Nursing (BON) by the governor of my state and served for 5 years. During my second term, I was elected BON president. Like most nurses, I went in knowing that BONs were keepers of the Nurse Practice Act and issued disciplinary action. However, the years of BON meetings, committee work, and disciplinary hearings imparted new perspectives on professional regulation and the widespread misunderstandings about it in the nursing community. As I prepare to give a lecture on this subject to a senior nursing class, let me set the record straight on a few key points. The BON is not a professional nursing organization like the American Nurses Association that can be joined by paying membership dues. The BON is a state government–based regulatory agency with statutory authority over nursing practice in a given state or jurisdiction. The BON's primary purpose is to protect the public, whereas a professional nursing organization supports and advocates for nurses. The implications of this difference are vital to understand. The laws and regulations that govern nursing practice vary by state or jurisdiction. Nurses need to know the information contained in these rulings as applicable to their practice or be at risk of violating them. For example, the tasks nurses can delegate vary by state; inappropriate delegation may lead to disciplinary action. Employers can narrow a nurse's scope of practice, but are not authorized to expand it beyond what the Nurse Practice Act or regulations permit. Under the law, nurses are nurses 24 hours a day. If a nurse engages in an activity that meets the definition of unprofessional conduct or is criminally charged—even if the offense occurs outside of the workplace—action can be taken on the nurse's license. A criminal conviction for driving while intoxicated or tax fraud, for instance, can lead to BON disciplinary action. These types of actions violate public trust in the nurse. Disciplinary hearings are formal legal proceedings and may include lawyers from the state attorney general's office, along with legal counsel for the BON. Nurses facing disciplinary action are given the choice to obtain legal counsel or represent themselves. Some nurses are surprised by the formality of the proceeding and may not initially appreciate the value of legal counsel. However, these proceedings can become adversarial. Lack of representation by a nurse attorney or licensure defense attorney can negatively impact the hearing outcome for the nurse. Your nursing license is your livelihood. Do all that you can to protect it. Until next time, LINDA LASKOWSKI-JONES, MS, APRN, ACNS-BC, CEN, NEA-BC, FAWM, FAEN, FAAN EDITOR-IN-CHIEF, NURSING2025