Texas Nurse License Defense:

As a registered nurse in Texas, your license isn’t just a piece of paper—it’s your livelihood, your career, and potentially your life’s work. A criminal charge doesn’t just threaten your freedom; it threatens your ability to earn anywhere from $60,000 to $160,000 annually, support your family, and continue in the profession you’ve invested years of time and effort and often over $100,000 to enter.

I’m Pat Ruzzo, and I have been a criminal defense attorney based in Houston, Texas for over thirty years. Over the past few decades, I’ve helped many nurses navigate the intersection of criminal investigations, criminal charges and Board of Nursing (BON) disciplinary actions. What I’ve learned is this: most nurses don’t understand that beating a criminal charge doesn’t automatically save their license, and losing a criminal case doesn’t necessarily mean losing their license either.

The relationship between criminal law and professional licensing is complex, nuanced, and completely misunderstood by nurses who try to handle it themselves—and even by many attorneys who don’t practice in both areas.

What’s Actually at Stake When You’re Arrested

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Let’s be clear about what you stand to lose.

Registered nurses in Texas can earn between $60,000 and $160,000 per year, with some traveling nurses making even more. Over the span of a thirty-year career, that’s millions of dollars in lifetime earnings. After investing years of your time and $100,000 to $150,000 for college and nursing exam preparation, you’re looking at the potential loss of everything you’ve worked for and the fear and anxiety of an uncertain future.

It’s not just about Texas. There’s reciprocity among states when it comes to nursing licenses. A disciplinary sanction in Texas can impact your ability to work as a nurse anywhere in the country. I’ve represented nurses who had complaints filed in other states that triggered investigations here in Texas. The ripple effects are real and they’re national.

And here’s what most nurses may not consider: you have houses to pay for, student loans to service, families depending on your income, and financial obligations that don’t pause while you fight to keep your license.

The first question most nurses ask me is: “How will they even know?”

They find out in one of three ways:

Someone reports it.
This could be another nurse, your employer, or even a patient. In my experience, the most common scenario is that your employer reports you to the Board of Nursing. Many institutional employers—hospitals especially—require nurses to report any arrest to their employer within 48 hours as part of their employment contract. Once your employer knows, the BON typically knows soon after.

You self-report.
When you submit your periodic license renewal application, you’re asked whether you’ve been arrested and have a pending criminal case. Here’s where it gets tricky: you need to know exactly which types of arrests you’re required to report and which you’re not. Class C misdemeanors like traffic tickets, littering, or certain health code violations typically don’t need to be reported. But if you’re arrested for a felony, DWI, drug possession, assault, theft, or other crimes involving dishonesty, you’re required to disclose this information.

Many nurses think they can research the law themselves and figure out what to report. They can’t. As much as nurses want to believe their intelligence and education translate to understanding legal requirements, the reality is that these rules are complex and unforgiving. Many nurses have looked to me for help after they made their situation worse trying to handle it themselves.

The Board discovers it through their own processes.
The Board has access to criminal records and databases that can discover arrests even if you haven’t self-reported yet.

And here’s the critical thing: if you don’t self-report properly when required, that failure to report is itself grounds for discipline—separate from whatever criminal charge you’re facing.

Here’s the typical sequence of events when a nurse gets arrested in Texas:

Immediately After Arrest
You’re arrested for a criminal offense—let’s say a DWI. Within 48 hours, if you’re employed by a hospital or institutional employer, you’re probably contractually required to notify them. Many nurses panic at this stage and either say too much or try to explain themselves. This is your first critical mistake.

Within Days to Weeks
Your employer may report your arrest to the Texas Board of Nursing. Or you might be approaching your license renewal period and face the question about arrests and pending criminal cases on your application.

The Notice of Investigation
Eventually—and this could be weeks or months after your arrest—you receive a letter from a Board of Nursing investigator. This is typically the moment when nurses panic and contact me.

The letter usually contains:

• A summary of the complaint that’s been filed
• A request for a written response
• A deadline, typically around thirty days
• Contact information for the investigator
• Sometimes a request for a voluntary interview

Most nurses don’t understand what this letter actually means. It’s not a conviction. It’s not a professional license sanction. It’s not even a formal charge. It’s a notice that allegations have been made and the BON is reviewing them. But how you respond to this letter can determine whether you keep your license or lose everything.

Understanding the process is critical because at each stage, you have rights you must affirmatively invoke—and if you don’t invoke them properly and within the statutory deadlines, you waive them permanently.

Stage 1: Complaint Screening

When a complaint is filed, the Board screens it to determine:

• Whether they have jurisdiction
• Whether the allegation, if true, constitutes a violation of BON rules
• Whether there’s sufficient information to proceed

If the complaint lacks sufficient information, falls outside BON jurisdiction, or involves what they consider a minor incident, they may close it without further action.

Stage 2: Investigation

If they proceed, the BON assigns the case to an investigator who sends the Notice of Investigation letter. The investigator will request:

• A detailed written response to every allegation
• Names of potential witnesses
• Employment history
• Patient charts, logs, and records
• Confirmation or denial of specific patient chart entries you made (or failed to make)
• Information about any pending criminal cases

Here’s what nurses may not understand: you are not required to speak with the investigator without legal counsel. They cannot force you to talk to them. But they’re very good at making you feel like cooperation is in your best interest.

The investigator might say things like, “Just cooperate with us and we’ll help you out.” Maybe they will even give you a wink and a nod. There is no binding promise or guarantee that the information and assistance you provide will result in leniency or any benefit to you.  You should talk to an attorney before you do anything.

Stage 3: Written Response

Your written response is due within thirty days. This is not a one-page letter saying, “I deny it.” A proper response can be forty to fifty pages long, including supporting documentation. I’ve submitted responses that included:

• Detailed admissions or denials of every single factual allegation
• Supporting evidence for each denial
• Surveillance video footage
• Audio recordings
• Human resources files
• Medical records
• Treatment documentation

After the investigator receives your response, they review it and may request additional information. Then they present everything to the Board.

Stage 4: Board Decision

At this point, the BON can take one of three actions:

Close the case with no action. This is the outcome you want. It means they found no evidence of a violation or insufficient evidence to proceed. If this happens, you’re entitled to an immediate expunction of the records. An expunction is the destruction and deletion of all records related to the complaint. But if you don’t know about this rule, the BON isn’t going to automatically expunge the records, and they will be there and under some circumstances may be used against you if another allegation ever arises.

Issue non-disciplinary actions. This typically means a warning or required remedial education—professional ethics classes, pharmaceutical handling courses, or record-keeping training approved by the BON. These outcomes are usually reserved for minor, unintentional violations.

Proceed to formal charges. This is when things get serious. The BON believes you engaged in conduct that may require formal discipline.

Stage 5: Informal Settlement Conference (If Formal Charges Are Filed)

If the BON pursues formal charges, you have the option to participate in an informal settlement conference. You, your attorney, and Board representatives sit down to discuss potential outcomes.

This conference gives you valuable information about:

• How strong a position the BON is taking
• What sanctions they think are appropriate
• What evidence they believe they have
• Potential resolutions

You’re entitled to legal representation at this conference. In fact, once you have an attorney, the BON is required to communicate only through your attorney about the disciplinary matter.

Potential negotiated outcomes might include:

• Remedial education requirements
• Temporary restrictions (for example, not being permitted to administer medications for a certain period)
• Fines
• Probated suspensions

Stage 6: Formal Administrative Hearing

If you can’t reach an agreement at the informal settlement conference, or if you choose to fight the charges, the next step is a formal administrative hearing before the Board of Nursing.

I’ve had many hearings before the Board of Nursing. They’re very different from criminal trials. They’re typically held in a conference room with Board members and a court reporter present. The BON tries to make nurses feel comfortable in this environment, almost like they’re just having a conversation.

Don’t be fooled. This is a formal proceeding where your license is on the line.

The BON will decide whether you violated their rules. The burden of proof is a “preponderance of the evidence”—meaning it’s more likely than not that you violated the rules. This is a much lower standard than the “beyond a reasonable doubt” standard in criminal court.

This is critical to understand: a jury might find you not guilty in criminal court because there was reasonable doubt, but the BON can still find that it’s more likely than not that you violated their rules and take action against your license.

Potential Sanctions

If the BON finds you violated their rules, the potential sanctions are:

• Warning or reprimand (private or public)
• Fine
• Remedial education requirements
• Probated suspension (suspended for a period, but you can keep your license if you comply with conditions)
• Actual suspension (you cannot work as a nurse for a specific period)
• License revocation (your license is taken away)

Many of these sanctions can include additional requirements:

• Drug testing
• Supervised practice
• Participation in outpatient or inpatient rehabilitation programs
• Mandatory additional training

And here’s what many nurses don’t realize: even after a suspension ends, reinstatement is not automatic. You have to apply for reinstatement, sometimes after a legally required waiting period, and meet specific requirements.

Let me give you some examples from my practice that illustrate how this actually plays out.

Case 1: The Burglary That Wasn’t

Back in the early 2000s, I represented someone in a criminal case. We achieved what we considered a successful outcome under the circumstances.

Years later, that person contacted me wanting to become a registered nurse in Texas. Individuals planning to enroll in a nursing program or applying for a nursing license who suspect they may be ineligible must petition the BON through a Declaratory Order of Eligibility (DO). The BON responded that they were disqualified because of their criminal history.

Here’s what happened: My client was charged with burglary of a habitation—a serious second-degree felony. The circumstances were that he was reportedly so impaired from alcohol that when he thought he was walking into his own house, he actually walked into a house a block away. The homeowner met him with a shotgun.

While on bond for that burglary case, my client was arrested for DWI. We achieved excellent outcomes in both cases: the burglary was reduced to a misdemeanor criminal trespass, and he received deferred adjudication probation. The DWI resulted in probation with a conviction (because in Texas, you cannot get deferred adjudication for intoxication offenses).

The problem was that DWI conviction raised red flags about my client’s competency to become a nurse. So here’s what we did:

We filed petitions for non-disclosure on both the criminal trespass and the DWI probation cases. Non-disclosure is essentially sealing of the records—private background searches can’t see it, but law enforcement and licensing boards can, and you’re required to disclose it when applying for a license. This helps when you are looking for a job. 

We also obtained an expunction on the burglary case. An expunction is like waking up from a nightmare—everything is destroyed and deleted, it never existed, and with rare exception, you don’t have to report it.

But my client had tried to fill out the application without my assistance initially. It was flagged and rejected.

When I was apprised of the situation, we sealed and expunged the criminal cases, and then we also showed that my client had completed a program at an inpatient treatment facility for alcohol use disorder.

Here’s the key insight: it’s very difficult for a medical board like the Board of Nursing to reject someone who has availed themselves of medical treatment for a medical condition like alcohol use disorder, was successfully treated and recovered, and had no problems for five or six years.

We went through the process and ultimately had a hearing. That person went to nursing school, graduated, and became a registered nurse without restrictions.

WHAT IS A DECLARATORY ORDER:

A Declaratory Order of Eligibility is a formal process allowing the Texas Board of Nursing (BON) to determine whether an individual is eligible for nursing licensure before or during nursing school. It is intended for individuals who believe they may be ineligible due to criminal history, mental health conditions, or substance use issues.

WHO MUST FILE A DECLARATORY ORDER:

Individuals planning to enroll in a nursing program or applying for licensure who suspect they may be ineligible must petition the BON through a Declaratory Order.

DOCUMENTATION REQUIRED FOR A DO:

• A written personal statement explaining the potential ineligibility.
• All court documents if related to criminal history (indictments, judgments, probation records, completion of probation).
• Mental health documentation demonstrating treatment stability.
• Substance use treatment and sobriety documentation.
• A non-refundable filing fee.

WHAT HAPPENS AFTER FILING A DO:

The BON reviews all documents and may request additional evaluations, such as psychiatric, psychological, or substance-use assessments. The eligibility determination typically takes three to six months. The BON will then issue a written decision: Eligible, Eligible with Stipulations, or Ineligible. Failure to obtain timely BON clearance can delay nursing school progression or NCLEX eligibility (National Council Licensure Examination, a standardized test required for nursing licensure).

APPEAL PROCESS AFTER A DO DENIAL:

If the BON denies a Declaratory Order, the individual may begin the appeal process. Before a court appeal can be filed, a Motion for Rehearing must be submitted. This motion must be filed within twenty days of the BON’s order. If the BON does not rule on the motion within forty-five days, the decision becomes appealable. Once appealable, a Petition for Judicial Review may be filed in Travis County District Court as required by the Texas Administrative Procedure Act. 

ADDITIONAL INFORMATION ON DENIALS:

Common reasons for denial include incomplete documentation, criminal history, substance use history, mental health concerns, or inconsistent reporting. I strongly encourage you to contact me immediately when facing denial or when preparing an appeal.

Case 2: Drug Possession Case Dismissed

Recently, I represented a nurse who was arrested for possession of a controlled substance, specifically a quantity of a Penalty Group 1 Controlled Substance (which includes cocaine, methamphetamine, and heroin). At the time, this person had been a nurse for almost ten years.

The potential consequences were severe: if everything went wrong, they faced a minimum of two years and a maximum of ten years in prison, or up to ten years of probation.

We were able to keep that person’s license without any disciplinary action from the BON. The criminal possession case was dismissed without indictment in the interest of justice.

How did we do it? We implemented a comprehensive damage control strategy:

• Hair follicle drug testing from accredited, certified labs recognized by courts and institutional employers
• Documentation of individual therapy and group therapy
• Ongoing testing showing sustained sobriety

No action was taken by the BON.

Case 3: Hospital Charting Allegations

I represented a nurse whose hospital employer alleged that the nurse violated the hospital’s policy regarding charting and administration of medication. The allegation was technically correct—the nurse had not followed the hospital’s specific charting policy.

However, we prevailed because we demonstrated that the hospital’s own practice and standards were inadequate. We showed that the nurse’s charting complied with generally accepted standards and guidelines for professional nursing practice and actually exceeded the hospital’s standards, even though it didn’t follow their specific requirements.

After a hearing, the complaint was dismissed. The Board of Nursing actually commended my client for their documentation practices.

The Critical Mistakes Nurses Make

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In over thirty years of practice, I’ve never represented someone from the very beginning of the process who received a disciplinary sanction that resulted in loss of their license. Obviously, that record of success does not guarantee any particular outcome in your case.  Every case is different and unique.  If you have any questions relating to your license especially as it relates to a criminal history, investigation, or charge, contact me immediately to arrange a consultation.  My experiences and observations strongly suggest that the most important action for you to take is to immediately seek competent and experienced legal counsel.

But I have encountered countless nurses who tried to handle things themselves or waited too long to get proper representation. Here are the mistakes that hurt them:

Mistake 1: Talking to Law Enforcement or Board Investigators Without Counsel

One of the worst decisions any professional license holder can make is thinking they can handle conversations with law enforcement or BON investigators on their own.

Nurses tell themselves: “I know what I’m doing. I’ll just tell the truth. I have nothing to hide. The truth will set me free.”

Here’s the reality: you may be told you’re “not a suspect” or you are “just a witness.” But you could be what they call a “person of interest” who hasn’t been classified as a suspect yet. You have a false sense of security, start talking, and provide information that may ultimately be used against you and result in confinement in jail or prison and also impact your nursing license.

I strongly discourage my clients from speaking with investigators, and if you’re my client, I prohibit you from talking to anyone about your case—the police, the BON, your employer, anyone—without me being there and approving it.

Mistake 2: Writing Your Own Response

A lot of nurses receive the Notice of Investigation letter, see that it’s requesting a response within thirty days, and think, “I can write a letter explaining my side.”

That letter becomes evidence against you. It’s fraught with peril because:

• You don’t know what you’re legally required to admit vs. what you can deny
• You don’t understand how the administrative rules differ from criminal procedure and how they intersect
• You don’t realize that information you provide to the BON can be used in your criminal case and the impact it can have
• You don’t know what supporting documentation is actually helpful vs. harmful

I’ve had nurses come to me after they’ve already submitted a response. At that point, I have to do damage control which is more time consuming and costly than if I had been hired from the start. The nurses truly believed that the research they had done sufficiently informed them to present a proper response.  Instead, almost without exception, they made the situation more difficult for an attorney to obtain the best outcome under the circumstances.

Mistake 3: Not Understanding Due Process Rights

Your nursing license is your property. The United States Constitution says you can’t be deprived of your liberty or property without due process of law. The Texas Constitution has a similar provision called the “due course of law” provision.

This means the Board of Nursing must provide you with:

• Notice of the allegations with some specificity
• An opportunity to respond
• A process for fair review of evidence
• The right to a fair hearing

But here’s the critical part: you must take affirmative steps to invoke these rights. If you don’t invoke them using the proper procedures and within the statutory deadlines, you waive your rights permanently.

Many nurses don’t understand this. They think their rights protect them automatically. They don’t.

Mistake 4: Not Understanding Reporting Requirements

There are substantive and procedural requirements for self-reporting to the BON. Nurses often don’t understand which arrests they must report and which they don’t.

For example, the renewal application asks if you’ve been arrested. But it’s asking about specific types of arrests. Class C misdemeanors like traffic tickets generally don’t need to be reported. But nurses who aren’t sure will either:

• Report things they don’t need to report (triggering unnecessary scrutiny)
• Fail to report things they should report (which becomes its own violation)

I’ve seen nurses answer the question about pending criminal cases incorrectly because they didn’t understand what “pending” means in this context. They think they’re being truthful, but they’re actually providing false information which may lead to an independent basis for sanctions.

Mistake 5: Not Hiring an Attorney with Criminal Law Experience

Many attorneys represent professional license holders before various boards. But very few have deep criminal law experience.

This matters enormously because if your attorney doesn’t understand criminal law, they don’t understand:

• How disclosure of information in the administrative licensing case impacts your criminal case
• How criminal procedure and evidence rules differ from professional licensing and administrative rules
• How to coordinate strategy between your criminal defense and your license defense

● The relationship between criminal proceedings and licensing proceedings

The importance of having an attorney who understands both criminal law and professional licensing law cannot be overstated.

After representing nurses before the BON for decades and learned that what the BON actually cares about is often very different from what nurses may know or understand.

Nurses may think the BON cares about: Whether you’re a good person, whether the arrest was a mistake, whether you’ve learned your lesson.

The BON actually cares about: Whether you pose a risk to patients and the public going forward.

This is why showing evidence of treatment, rehabilitation, sustained sobriety, and changed behavior, presented in an appropriate and persuasive manner, is so powerful. The function of the BON isn’t necessarily to punish you for past mistakes—they’re trying to determine whether it is safe for you to work as a nurse going forward.

This is also why evidence of substance use disorder, alcohol use disorder, or another mental health diagnosis, combined with successful treatment, may often actually help your case. When properly, persuasively, and effectively presented, the BON may consider lesser sanctions for someone who has:

• Sought medical treatment for a medical condition
• Successfully completed treatment
• Demonstrated improvement and recovery for a significant period
• Exhibited commitment to ongoing stability and wellness

The BON also cares about:

Whether you respect the profession and its standards

Whether you’re honest and forthcoming

Whether you take responsibility

Whether you understand what went wrong and how to prevent it in the future

Why You Need a Criminal Defense Attorney Who Understands Licensing

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The overwhelming majority of licensed attorneys never practice criminal law. Even those who represent professional license holders often come from a civil practice background and don’t understand how criminal law intersects with administrative licensing proceedings.

Here’s why my background matters:

I understand the impact of every criminal outcome on your license. An arrest, a charge, a grand jury indictment, a conviction for a misdemeanor, a conviction for a felony, and probation—each of these outcomes has different implications for your license. An attorney who does not have extensive experience in the area of criminal defense law may not understand the distinctions.

I can coordinate strategy between both cases. Your criminal case and your licensing case are happening simultaneously. What you say or submit in one can be used against you in the other. I know how to protect you in both proceedings.

I have represented clients in over 200 criminal jury trials, trials in state court, Federal court, bankruptcy proceedings, and appeals in state and Federal courts. When I walk into a BON hearing, I’m comfortable because I am regularly in higher-pressure situations.

I know the people and the process. Over the years, I have built solid working relationships with various staff members at the Board of Nursing. I know how they like to receive information and how to get information from them. I know what makes their jobs easier. These relationships matter.

I draw on experience across multiple licensing boards. I’ve represented pharmacists, physicians, court reporters, DPS employees, inspection station operators, and other license holders from numerous professions. While each board has its own specific rules, the due process requirements and the Texas Administrative Code apply to all of them. This breadth of

What You Should Do If You’ve Been Arrested

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If you have been arrested (especially if you’re a nurse), here’s what you need to do immediately:

1. Stop talking. Do not speak to law enforcement, your employer, the Board of Nursing, or anyone else about the situation without an attorney present. If someone asks you about it, say: “I need to speak with an attorney before I can discuss this.”

2. Do not try to handle this yourself. You may be intelligent and educated, but understanding nursing and understanding the intersection of criminal law, professional licensing law, and administrative law are completely different skill sets.

3. Contact an attorney immediately. The mere passage of time can interfere with the degree of success you have in your cases. The best time to hire an attorney is right after the arrest, before you’ve said or done anything that could hurt your case, or failed to do something you are required to do.

4. Do not write a response to the BON without legal counsel. If you receive a Notice of Investigation letter from the BON, do not write your own response. Every word matters, and what you think is helping you might be limiting available strategies and eliminating possible defenses.

5. Understand that time is critical. Deadlines in these cases are strict and unforgiving. If you miss a deadline to respond, you could waive your rights to a hearing or other protections.

When prospective clients ask me how much this is going to cost, I often ask them: “what’s your license worth to you?”

Over a 30-year nursing career earning $60,000 to $160,000 per year, you’re looking at $1.8 million to $4.8 million in lifetime earnings. After you’ve already invested $100,000 or more in your education, can you afford not to protect that investment?

In a typical case involving a criminal charge and a Board of Nursing investigation, I generally charge a flat fee for the criminal defense and a minimum fee for the initial phase of BON matters with additional fees at my hourly rate. I can only determine the fees and costs after an initial consultation and review of your needs.

Competent legal representation can be expensive. But investing in an attorney to protect your license, your career, and in criminal cases your freedom, is money well spent.

Beyond attorney fees, there are potentially additional expenses that can make the difference in your case:

Hair follicle drug testing from accredited, certified laboratories that courts and institutional employers recognize. This provides objective evidence of sustained sobriety.

Treatment programs. Whether inpatient or outpatient, showing that you’ve sought treatment for substance use disorders or other underlying issues demonstrates to the BON that you’re addressing the root cause of the problem.

Rehabilitation documentation. Individual therapy, group therapy, support groups—all of this shows the BON you’re committed to recovery and reducing any risk they perceive exists.

These investments in your defense and rehabilitation aren’t just about winning your case today. They’re about developing a strategy that shows the BON you’re safe to practice nursing going forward.

Independent investigation.   I use a licensed private investigator to assist in providing strong, comprehensive representation.  The investigator is essential to obtaining records, statements, affidavits, video and audio recordings, witness statements and background checks.  There are specific procedures for accomplishing these tasks that are properly entrusted to a licensed private investigator at my direction.  

Sometimes in a consultation, I’ll present options clients haven’t thought about:

Resignation in lieu of sanctions. If you’ve decided you don’t want to be a nurse anymore—maybe you have another career path or a side business that doesn’t require a nursing license—you can resign rather than fight a lengthy battle that can be expensive.

Focus on the criminal case first. In rare circumstances where the potential criminal consequences are so severe, we might decide to focus entirely on the criminal case and minimize engagement with the BON investigation to prevent information from being used against you criminally.

Weighing the battles. Sometimes the fight isn’t worth the financial expense or emotional suffering. You need to understand all your options, the costs and benefits of each, and make an informed decision about how to proceed.

A final warning: I’ve seen an alarming trend of nurses and other professional licensees trying to use AI or internet research to figure out how to handle their BON cases.

AI cannot understand the legal framework, the specific context of your situation, or the nuanced interplay between criminal and administrative law. It hallucinates answers that could be completely wrong. The internet is full of general information that may or may not apply to your specific circumstances and current Texas law.

Professional license holders like nurses are typically intelligent, educated people with life experience. You’re used to solving problems. But this is not a problem you can solve by reading articles online or asking ChatGPT.

Whatever you think you know about this process, it’s probably dangerous for you to rely on it. And it could result in loss of your license, loss of your freedom, or both.