Let’s set the scene. It’s a chilly November evening in Connecticut, 2008. You’ve just gone to a dinner celebrating one of your colleagues being named "Nurse of the Year."
Are you on your guard for nurse misconduct?
Probably not.
Somewhere in between the entrées and dessert, someone should have spotted it, though. The dinner, the award, the nurse herself—fake, fake, fake.
Only 2 years after throwing herself a celebration for her imaginary award, Betty Lichtenstein was imprisoned for practicing without a license.
Would you have been taken in, too?
Knowing how to spot an imposter nurse is more than just entertainment. It could be the key to protecting your professional integrity, so you don’t get swept up in a scandal.
High-profile nursing fraud
The "Nurse of the Year" wasn’t the only jaw-dropping imposter crime committed in the States. These nursing fraud cases give her a run for her money:
Operation Nightingale & 7000+ fake diplomas
In 2023, more than 20 individuals in Florida were charged for selling over 7,600 fraudulent nursing diplomas and transcripts through 3 nursing schools.
These fake credentials enabled purchasers to sit the national nursing board exams and obtain actual nursing jobs if they passed.
By bypassing the educational requirements, these individuals could have posed a significant risk to patient safety.
This case underscores 2 critical points: the necessity for rigorous, continuous oversight of nursing credentials and the individual nurse's responsibility to remain vigilant against fraudulent certification schemes.
Fake nurse treating 4000+ patients
In 2025, a woman posing as a registered nurse (RN) was arrested, accused of practicing without a license and fraudulent use of personal identification.
Autumn Bardisa had provided medical services to over 4000 patients over the course of 2 years before being discovered and fired.
This case highlights the importance of repeated verification of nursing licenses as an important safeguard.
How impostors exploit the system
The question isn't whether people will try to practice with fraudulent nursing licenses, but how they manage to slip through the system and work alongside you.
This isn't about sophisticated forgeries a peer nurse has to scrutinize; it’s about a perfect storm of human error, outdated processes, and a lack of real-time data.
A nurse practicing with a fraudulent or revoked license gets on the floor in these common ways:
The busy HR manager’s mistake
During peak hiring waves, HR staff may rely on outdated methods, requesting only a paper license copy or checking a state board website once at the point of hire.
On a busy day, a simple identity mix-up—a nurse with a similar name in another state—can lead to an unlicensed person getting a badge.
Outdated data checks
Nurses are licensed by a state board of nursing (BON), which then updates national databases, such as Nursys.
There can be delays in this data flow due to administrative backlogs or data entry errors.
This creates an opportunity for a nurse with a recently revoked or suspended license to be hired in another state or to be missed in an agency nurse credentialing before the system catches up.
The peer who doesn’t see
On a hectic unit, you see a co-worker’s badge and their scrubs, and you trust they’ve been vetted. No one asks to see their license renewal certificate or runs a background check on the fly.
The fraud survives not through an elaborate cover-up, but through the normal operational trust of a busy, understaffed unit.
In short, when verification is a one-and-done, manual process, a revoked or fraudulent license can go undetected for months or years.
The professional risks to colleagues
When we discuss unlicensed practitioners, the focus is often on patient safety. While that is critical, the personal, career-ending risk to you, the licensed professional, is often overlooked.
Working alongside an imposter or an individual with a fraudulent license can have a catastrophic effect on your professional integrity.
The contagion effect
Imagine this scenario: you and a co-worker—who, unknown to you, is unlicensed—are assigned to the same critical patient.
A critical error occurs.
When the state board, lawyers, and facility investigators descend on the unit, they won’t just look at the imposter. Your work will also be scrutinized:
Your documentation is under the microscope
Investigators will dissect every single note, vital sign, and intervention you documented.
They will be looking to see if you relied on the imposter, if you signed off on their work, or if your professional judgment should have alerted you to their lack of skill.
Your judgment is questioned
The board may ask why you didn’t notice this person was clinically incompetent, or why their documentation was incomplete or illogical.
Nurse license suspension
If your documentation or actions are found to be deficient in any way, you can face your own nursing board discipline.
An imposter’s misconduct can drag your clean license into the chaos, resulting in costly legal fees, disciplinary hearings, and the potential for suspension or revocation.
Your professional career is on the line
Beyond the contagion effect, your license is a highly regulated contract. A suspension can quickly escalate into a permanent revocation, instantly ending your professional career.
In many jurisdictions, practicing without a license—even if you simply forgot to renew it—is a criminal offense that results in fines and jail time.
Protect your license fiercely; it is your single most valuable asset as a nurse.
Beyond fraud: Other "license killers"
Unprofessional conduct by nurses isn't limited to fraud.
For licensed nurses, it is defined as any act that violates the ethical or legal standards of the profession and constitutes noncompliance with established regulations.
Failure to uphold these principles often results in permanent career damage, as seen in the Nurses Service Organization (NSO) case study of an RN who faced disciplinary action for pre-charting vital signs and assessment findings.
When records fail to reflect the actual care, the nurse, the patient, and the facility are put at risk.
Watch for signs of professional misconduct in your own practice and in your environment:
- Practicing with an invalid license: This includes a license that is expired, suspended, or revoked; remember, even a clerical error on your end can cause this.
- Falsifying nurse documentation: This involves charting care you did not provide or altering records to cover up an error.
- Reporting for duty while impaired: This includes illegal use of controlled substances, drug diversion, or coming to work impaired by alcohol or drugs.
- Breaching patient privacy: This often happens by sharing a patient’s confidential information on social networking sites or discussing their care in a public setting.
Navigating the blurry lines of patient & family relationships
This refers to any act that crosses professional boundaries in nursing with a patient, their family, or their significant other. This includes any personal, financial, or sexual relationship.
The American Nurses Association (ANA) Code of Ethics for Nurses is your primary guide here.
A nurse’s toolkit for proactive defense
Protecting your career starts with taking full ownership of your license status, not waiting for an HR notice or a disciplinary letter.
The best defense is being the first to know.
Using Nursys for authoritative verification
The Nursys verification system, managed by the National Council of State Boards of Nursing (NCSBN), is the fastest and most authoritative method of license verification.
You can and should use it proactively:
- Sign up for e-Notify services: E-Notify provides instant, automated email alerts regarding any changes to your license status, including an upcoming expiration or a board disciplinary action. You get the notification before anyone else.
- QuickConfirm: For verification, the fastest method is through the Nursys QuickConfirm tool. It provides an instant license verification for both nurses and employers.
- Meticulous tracking: Maintain your own digital or physical file of all continuing education credits, renewal receipts, and correspondence with your board of nursing.
- Keep your records current: Notify the board of nursing immediately if you move or change your name so you never miss a legal notice that could affect your license.
The red flag checklist for peers
Your professional integrity also involves knowing when to speak up to protect your patients and your own reputation.
An imposter or a struggling colleague may exhibit subtle "red flags."
What do you do if your license is at risk?
If you notice any problem with your license status, you must immediately cease any practice.
Getting your license reinstated should be your priority before you continue practicing.
Trying to resolve a licensing issue while continuing to practice would constitute intentional noncompliance with state boards.
Contact your BON and legal representation familiar with employment licensure matters, and be upfront about your education, background, and any required remediation.
Common questions related to nurse misconduct
Here are some of the most frequently asked questions:
Can I work if my license renewal is pending?
No, you must have your status confirmed as active by the board before performing nursing duties.
What is the quickest method of nursing license verification?
For verification, the fastest method is through the Nursys database managed by the NCSBN. It offers QuickConfirm, an instant license verification tool.
What could happen if a nurse practices with an expired license?
The nurse may face fines and suspension, and disciplinary action could result in permanent revocation.
Does malpractice insurance remain valid in case of suspension of the license?
In general, policies do not cover acts committed while a license is suspended or revoked.
Can a nurse date a patient?
No, dating a current patient is ethically discouraged and may result in disciplinary action due to professional boundary violations.
These professional boundaries aren't just physical; they extend into your digital life as well. Whether you are navigating patient relationships or your own online presence, maintaining these standards is vital for nurse misconduct prevention.
Protect your practice today. Read our guide on using social media responsibly to keep your license safe.
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