Professional credential fraud in nursing manifests primarily in two distinct forms. The first involves identity theft and impersonation, in which a criminal steals the personal and professional dataincluding the nurse's license numberof a real, legitimate nurse. The thief then uses this stolen identity to gain employment, which may result in disciplinary actions or criminal charges being filed against the unknowing, legitimate nurse whose identity was compromised.
The second, and currently more widespread form, is credential fraud or diploma mill schemes. In this scenario, individuals purchase fraudulent degrees, transcripts, and licenses without ever completing the education or clinical hours.
Why Does Nurse License Theft Happen?
Many factors lead to people committing identity theft and fraud. Understanding the factors driving the rise in nurse license fraud is necessary to develop effective preventive measures.
High Demand and Staffing Shortages
The healthcare industry has been battling staffing shortages for several years. The shortage creates a desperate hiring environment that fraudsters can exploit. When facilities operate with constant staffing gaps, pressure increases on human resources and recruitment teams to fill roles rapidly. Background checks and credential verification steps, which require time and detailed investigation, may be rushed or given less priority than they require.
Financial Incentives
A career as a registered nurse offers good earning potential, professional stability, and benefits. Legitimate nursing education, including tuition and associated costs, often requires a significant investment of time and money.
Criminal networks, or "diploma mills," capitalize on this by offering a fraudulent shortcut. These organizations charge large sums to issue fake diplomas, transcripts, and completion certificates.
Public Accessibility of Professional Data
To ensure transparency, the boards of nursing (BONs) maintain a public database where a nurse's license status can be verified. This function, intended to allow employers and the public to confirm a license's validity, creates a vulnerability. Publicly available information includes the nurse's full name, license number, license type, and expiration date.
Criminals can utilize automated scraping tools to gather this data in bulk. Once a nurse's information is obtained, it can be used to forge documents that appear to be tied to a real person for credential fraud or to open new financial accounts.
Red Flags in the Hiring Process
For healthcare organizations, effective defense against license fraud relies on implementing multi-layered verification protocols. Due diligence should extend beyond simple resume review into mandatory, real-time electronic checks.
Mandatory License Verification
The single most critical step an employer must take is to verify every nursing license directly.
Recruiters must utilize the Nursys database, the official system of record for nursing licensure maintained by the National Council of State Boards of Nursing (NCSBN). This system allows employers to confirm that the applicant holds a current, valid license and, critically, to verify that the license is unencumbered. An unencumbered license has no current disciplinary actions, restrictions, or sanctions imposed by any regulatory board.
The Nursys e-Notify system service provides automated, real-time alerts directly to the employer when a license status changes, disciplinary action is taken, or a nurse reports a change of residence to another state.
Comprehensive Screening of Education and Background
Verifying the license is only half the battle; employers must also validate the authenticity of the applicant's educational path.
Before accepting any educational credential, the hiring institution must confirm two essential facts:
- First, the program is fully accredited by a recognized national body (such as the Commission on Collegiate Nursing Education, CCNE, or the Accreditation Commission for Education in Nursing, ACEN).
- Second, the program was approved by the state's nursing regulatory board (NRB) in the state where the school is physically located.
If a schools accreditation status cannot be easily confirmed, the application should be flagged for rejection. Recruiters should be trained to recognize signs of possible diploma-mill education.
Fraudulent schools often use names that are intentionally very similar to those of reputable institutions, such as established universities, hoping to trick reviewers into performing a quick scan.
Legitimate nursing school graduates can typically describe their clinical rotations, specific patient populations, and coursework in detail. Vague or generic descriptions of clinical placements or practicum experiences are a strong indicator that the experience may not have been completed.
Interview and Onboarding Red Flags
The interview phase is a key opportunity to detect fraud through behavioral and knowledge assessment. Some things to check for include:
- Inconsistent Clinical Knowledge- Interviewers should ask scenario-based questions that test fundamental clinical judgment and knowledge commensurate with the degree claimed. A candidate who holds a Bachelor of Science in Nursing (BSN) credential but consistently performs poorly on basic clinical knowledge assessments, or who cannot coherently articulate their past clinical experiences, should raise a red flag.
- Document Originals- Recruiters should insist on inspecting original, high-quality diplomas, transcripts, and professional certifications. Poorly formatted or inconsistent photocopies should be viewed with skepticism.
- Background Discrepancies- A thorough background check will perform a Social Security Number (SSN) trace, employment history verification, and criminal records check. Any discrepancies between the information provided on the job application and that revealed by these third-party checks should be thoroughly investigated.
Maintaining the Integrity of Nursing
The threat of nurse license theft and credential fraud requires a collaborative approach to ensure the continued safety of patients and the integrity of the nursing profession. For healthcare employers, this means a non-negotiable commitment to robust, electronic verification systems like Nursys and meticulous scrutiny of educational histories. The speed of hiring must never compromise the thoroughness of vetting.
The fight against license theft is a collective responsibility. By adhering to professional security measures and advocating the highest standards of credential verification, the healthcare community can uphold public trust and ensure that every individual providing care is a truly qualified and licensed professional.
About the Author:
Breann Kakacek, BSN, RN, has been a registered nurse since 2015 and a CNA prior to that for two years while going through the nursing program. Most of her nursing years included working in the medical ICU, cardiovascular ICU, and the OR as a circulating nurse. She has always had a passion for writing and enjoys using her nursing knowledge to create unique online content. You can learn more about her writing career and services at ghostnursewriter.com
Breann is an independent contributor to CEUfast's Nursing Blog Program. Please note that the views, thoughts, and opinions expressed in this blog post are solely of the independent contributor and do not necessarily represent those of CEUfast. This blog post is not medical advice. Always consult with your personal healthcare provider for any health-related questions or concerns.
If you want to learn more about CEUfast's Nursing Blog Program or would like to submit a blog post for consideration, please visit https://ceufast.com/blog/submissions.
