10 Ways to Avoid Losing Your Nurse Practitioner License: Part 3

By Healthcare Law Attorney Alex Scarbrough Fisher

This is the third article in a series designed to inform nurse practitioners and other healthcare providers about proactive steps that can be taken to avoid licensure discipline by the Department of Health.

7. Maintain proper medical records.

A nurse practitioner should ensure that he/she has records of a patient visit or interaction including a healthcare provider evaluation every time he/she writes a prescription for a patient, particularly if the prescription is for a controlled substance. If a nurse practitioner’s office has not done so already, they should consider implementing an electronic health records system. Electronic records cannot be lost or misplaced like paper documentation. Additionally, electronic records are time stamped with the exact day and time the information about a patient was entered into the record, which prevents discrepancies in record keeping or confusion over when a visit or prescription was recorded.

8. Complete your continuing medical education courses in a timely manner. 

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State Boards of Medicine or Boards of Nursing may mandate that nurse practitioners complete a certain amount of continuing medical education, particularly in the area of controlled substances. New Tennessee guidelines, for example, require that nurse practitioners complete two hours of continuing education in the area of prescribing controlled substances each year.  If a nurse practitioner fails to complete required CME hours, he/she would be subject to disciplinary action. Although the action would be minimal, such as a reprimand, the action would remain on the NP’s record forever and could be used against him/her in any future disciplinary action or proceeding.

9. Maintain appropriate surgery centers.

State Boards of Medical Examiners have very specific rules about what resources and protocols are required in an office based surgery center. Additionally, the rules dictate what kinds of surgery may be performed and on whom. They also dictate what sort of relationship is required with a licensed hospital within a “reasonable proximity” of the surgery center. If an office based surgery does not meet these standards, the Board of Medical Examiners has the authority to suspend an NP’s license until the surgery center is in compliance, which can result in a significant financial loss, as well as loss of the credibility in one’s practice by patients and the public. Each state has their own promulgated guidelines for office based surgery, so an NP should review the applicable state rules when ensuring that one’s office based surgery meets the proper requirements.

10. Think like a patient. 

“Would you want the NP treating you to be in your current physical, mental, or emotional state of mind?” Occasionally asking yourself this question will help you maintain proper self-awareness. This self-awareness may lead you as a nurse practitioner to better understand and maintain proper mental and physical health, which in turn sets a strong precedent for the cultivation of health patients. A self-aware nurse practitioner is more likely to comply with healthcare regulations personally and professionally leading to better results for patients not to mention an exponentially decreased likelihood of licensure or legal issues in the future.


Alex Scarbrough Fisher is an associate attorney at Frost Brown Todd, LLC. Her practice area focuses on litigation and administrative law. Alex’s administrative law practice’s emphasis is in health care related boards, including the Tennessee Board of Medical Examiners and the Tennessee Board of Nursing.

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