Mary was started working in December 2004 as a Certified Nursing Assistant (CNA) at a 232 bed rehabilitation/long term care facility. Mary enrolled in nursing school in January 2005 and continued to work as a CNA.

July 2006 Mary contacted the Staff Development Coordinator (SDC) and asked if she could start orientation while she waited to write the licensure exam. Mary thought that while she waited she would be working with a licensed staff nurse, just the way she did with the instructors in nursing school. The facility agreed and hired Mary as a new graduate with at starting salary of $21.32/hr.

Mary arrived to orientation on 8/7/06, with another new graduate, Charlie, who told Mary he had taken his licensure exam already. Mary and Charlie went through the paperwork, including a math test. The SDC took Mary and Charlie on a tour and introduced them as new nurses and entered their names into the pharmacy computer. Mary and Charlie also received their identification badges which indicated they were licensed nurses.

Mary arrived to work on 8/14/06 and was assigned to 5West, where the Nurse Manager gave her an assignment to perform finger sticks for blood glucose. Later that morning, Mary was taught how to do medications, treatments, narcotic counts, and how to avoid medication errors.

On 8/23/06 Mary was preparing medications when the SDC walked by and told the Nurse Manager that Mary could not administer medications because she had not obtained a nursing license. Mary was instructed to meet with the Director of Nursing who told she could not function as a nurse until she obtained a current and valid license.

Discussion Points:

  • 244 CMR 8.00 Licensure Requirements
  • Application for Initial Licensure as a Nurse by Examination (page 3, Attestation)
  • Board of Registration in Nursing: Alert: No Graduate Nurse Status in Massachusetts

Based on an investigation by the Department of Public Health-Health Care Quality, a compliant was filed with the Board of Registration in Nursing (Board). During the Board's investigation it was found the licensee had signed Medication Administration Records, Controlled Substance Count Verification sheets, and written nurses notes prior to have having obtained a nursing license. The nurse did obtain her Massachusetts nurse license by exam, which was reprimanded by the Board.


This information is provided by the Division of Health Professions Licensure within the Department of Public Health.