Seven Common Mistakes That Can Cost You Your Nursing License in Tennessee

Nurses in Tennessee work under intense pressure, often balancing heavy workloads with complex clinical decisions. In that environment, it can be easy to overlook how certain actions or omissions may appear to the Tennessee Board of Nursing. While every case is fact‑specific, certain patterns show up again and again in disciplinary actions. Understanding those patterns can help nurses recognize risk areas in their daily practice.

1. Medication Errors and Poor Medication Handling
Repeated, serious, or high-risk medication mistakes such as the wrong patient, wrong drug, wrong dose, wrong route, or wrong time, are a leading source of complaints. Errors involving controlled substances draw even closer scrutiny, especially when documentation is inconsistent or narcotic counts don’t match. Even when unintentional, a pattern of medication errors can be viewed as a threat to patient safety.

2. Inadequate Assessment, Monitoring, or Reporting
The Board expects nurses to recognize changes in patient condition, respond promptly, and escalate concerns when needed. Failing to assess, missing significant vital sign changes, or not reporting deterioration to a provider can all be characterized as negligence or unsafe practice. Documentation that does not reflect appropriate monitoring can become a focal point in an investigation.

3. Charting and Documentation Problems
Incomplete, inaccurate, late, or unreadable documentation is a frequent issue. Allegations of falsifying records such as charting care that was never provided, backdating entries, or altering notes without proper notation are taken especially seriously and may be grounds for discipline, including suspension or revocation in serious cases. Inconsistent documentation can also undermine a nurse’s credibility if an adverse event occurs.

4. Boundary Violations and Unprofessional Conduct
Crossing professional boundaries with patients or families through inappropriate personal relationships, social media contacts, or sharing overly personal information can lead to complaints. So can disrespectful communication, threats, or behavior perceived as harassment or bullying in the workplace. The Board views professionalism as part of safe nursing practice, not an optional add‑on.

5. Substance Use, Diversion, and Impairment Concerns
Suspected diversion of medications, working while impaired, or failing a drug or alcohol screen are common triggers for Board action. Even off‑duty issues such as DUI or drug‑related criminal charges may trigger an investigation into fitness to practice. When substance use is alleged, the focus often extends beyond a single incident to whether there may be an underlying impairment that could affect patient care.

6. Practicing Outside Scope or Without Proper Authorization
Performing procedures without adequate training, practicing beyond one’s license level, or working without a current Tennessee license can all lead to discipline. This includes situations such as an RN functioning as if they have prescriptive authority when they do not, or a nurse continuing to work after a license has lapsed or been restricted.

7. Failure to Cooperate with Rules, Policies, or Reporting Requirements
Ignoring employer policies tied to patient safety, refusing required drug testing, or failing to report required criminal convictions or disciplinary actions to the Board as required can all compound an underlying issue. The Board may view non‑cooperation or lack of transparency as evidence of unprofessional conduct in its own right.

This overview is for general informational purposes only and does not constitute legal advice for any particular situation.

If you are a nurse in Tennessee facing a complaint or Board inquiry, early guidance can make a difference in protecting your license. Contact Hagar & Phillips at 615‑784‑4588 today to schedule a confidential consultation.