EMILY BEST v. ARKANSAS STATE BOARD OF NURSING
No. CV-24-536
ARKANSAS COURT OF APPEALS DIVISION IV
January 14, 2026
2026 Ark. App. 9
APPEAL FROM THE BOONE COUNTY CIRCUIT COURT [NO. 05CV-23-366], HONORABLE ANDREW S. BAILEY, JUDGE, AFFIRMED
Appellee Arkansas State Board of Nursing issued a letter of reprimand (“LOR“) to appellant Emily Best for violating the Arkansas Nurse Practice Act, codified at
On September 12, 2022, an information was filed charging Best with aggravated assault on a family or household member; third-degree domestic battering; and first-degree criminal mischief. The first two charges were later nolle prossed. As for the third charge, the prosecuting attorney alleged that on or about August 20, 2022, Best had driven her car into her mother‘s car, causing property damage. On December 13, Best pleaded guilty to first-degree criminal mischief, a Class A misdemeanor, and she was placed on probation for a period of one year and ordered to pay fines and costs.
On June 8, 2023, the Board issued a LOR stating that Best had violated
The Arkansas State Board of Nursing shall have sole authority to deny, suspend, revoke, or limit any license or privilege to practice nursing or certificate of prescriptive authority issued by the board or applied for in accordance with the provisions of this chapter or to otherwise discipline a licensee upon proof that the person . . . [i]s guilty of a crime or gross immorality[.]
Best requested a hearing before the Board. Udell Ward, the Board‘s investigator, testified that Best received her LPN license in 2017 and that her only disciplinary history is the June 8 LOR. Ward testified that, when Best‘s license was up for renewal in May, she self-reported that she had pleaded guilty to a crime. Ward stated that it is consistent with Board policy as of 2022 to issue a LOR to licensees convicted of Class A misdemeanors.
Charlotte Best, Emily Best‘s mother, testified that Best lives with her because Best‘s medical needs had become “very, very, very extreme” and that she “had to get them under control.” She described Best as a high-functioning autistic individual and said that she needs
Best testified that she has never been employed as a nurse because, shortly after graduating from college, her health deteriorated. She stated that she has complex medical issues, including degenerative disc disease of the lumbar and cervical spine, scoliosis, cervical spine bone spur, chronic lower-back and neck pain, May-Thurner syndrome, chronic hypothermia of the entire body, redundant colon, irritable bowel syndrome, chronic allergies, chronic abdominal pain, a chronic liver disorder, anxiety, two genetic issues of unknown variants, and chronic eczema. Best stated that one of her doctors had prescribed Robaxin for muscle spasms following a pain procedure shortly before the August 20 incident. Best said that the incident was “solely the result of an unforeseeable adverse medication reaction.” Best claimed to have no memory of the event and insisted that she did not act intentionally. Best said that, when considering whether to accept a plea bargain, she had to
Several exhibits were introduced. In an undated letter, Dr. Kenton Hagan wrote that Best had been in his care since November 2021 concerning widespread pain, with the most severe pain in her lumbar and cervical spine. There was a work note dated February 20, 2023, in which Dr. Hagan wrote,
Ms. Best has been under my care for various orthopedic issues. We have been managing her injuries with medications and injection procedures. Recently[,] she has been taking Robaxin (methocarbamol) for back and neck pain. There have been case reports and current Phase 4 studies of Robaxin causing somnambulism[,] and while this side effect is rare[,] Ms. Best is a medically complex individual[,] and the side effect is a reported issue.
In a letter dated August 19, 2023, Dr. Patrick Travis, an oncologist, wrote,
Ms. Best shared with me the problems she experienced after starting Methocarbamol. Methocarbamol is a skeletal muscle relaxant. [Its] primary side effects it [sic] can cause sleep disorders and exacerbate the effects of other medications. This as likely as not [led] to her Parasomnias. Ms. Best is dedicated to nursing. She has an innate ability to speak out for those who don‘t often have voice and as such is an [excellent] patient advocate. It would be a loss to alter her course from a strong [career] in nursing.
In a letter dated September 13, 2022, Joshua Pursifull, a licensed practicing counselor with Ozark Guidance in Harrison, Arkansas, provided an update on Best‘s treatment. Pursifull stated that Best started therapy with him on September 7, 2022, and that they had
The Board ultimately upheld the LOR, and the Boone County Circuit Court affirmed the Board‘s decision.
II. Standard of Review
Judicial review of decisions of the Arkansas State Board of Nursing is governed by the Arkansas Administrative Procedure Act (“APA“), codified at Arkansas Code Annotated sections 25-15-201 to -221 (Repl. 2024). Tarr v. Ark. State Bd. of Nursing, 2025 Ark. App. 195, 711 S.W.3d 799. Judicial review of administrative-agency decisions under the APA is limited in scope. Id. An agency decision may be reversed if the substantial rights of the petitioner have been prejudiced because the administrative findings, inferences, conclusions, or decisions are (1) in violation of constitutional or statutory provisions; (2) in excess of the agency‘s statutory authority; (3) made upon unlawful procedure; (4) affected by other error or law; (5) not supported by substantial evidence of record; or (6) arbitrary, capricious, or characterized by abuse of discretion.
Our review is directed not toward the circuit court but toward the decision of the agency and is limited to determining whether any substantial evidence supports the agency decision or whether the agency decision runs afoul of one of the other criteria in section 25-15-212. Sex Offender Assessment Comm. v. Sera, 2023 Ark. App. 239, 666 S.W.3d 862. We give
III. Discussion
A. The LOR Exceeds the Board‘s Authority
1. Criminal mischief is not a “crime”
Best argues that section 17-87-309(a)(2) does not specify what constitutes a “crime” that warrants discipline. She states, however, that
We do not address Best‘s argument because she failed to raise it below. It is the appellant‘s obligation to raise an issue first to the administrative agency and obtain a ruling thereon in order to preserve an argument for appeal. Mountain Pure, LLC v. Little Rock Wastewater Util., 2011 Ark. 258, 383 S.W.3d 347.
2. The LOR relies on the vague term “gross immorality”
Best asserts that the Board appears to have relied on the term “gross immorality” in disciplining her given that the LOR included this definition.1 Best argues that section 17-3-102(d)(1) does not allow vague or generic terms, such as “moral turpitude,” to be used as a basis to deny a nurse a license. Best argues that “gross immorality” is the equivalent of “moral turpitude.” Buhr v. Ark. State Bd. of Chiropractic Exam‘rs, 261 Ark. 319, 547 S.W.2d 762 (1977). According to Best, the Board should not be permitted to discipline a nurse who is “guilty of a crime or gross immorality” if section 17-3-102(d) prohibits licensing entities from using vague terms to grant or deny a license.
3. Nolle prossed charges were illegally considered
Best argues that section 17-3-102(d)(2) provides that a licensing entity shall not, as a basis on which a license may be granted or denied, consider arrests without a subsequent conviction. Best contends that both the LOR and the Board‘s final order make clear that her nolle prossed charges were considered by the Board. Best asserts that, had they not been considered, the charges would not have been emphasized, detailed, listed, and referenced multiple times. Best asserts that at no point did the Board take the position that the charges were not considered.
Best‘s argument suggests that this was an ongoing improper consideration by the Board, yet she did not object at the first opportunity. Without an objection and a ruling by the Board, we cannot review the merits of this argument. It is well settled that appellate
B. The LOR Was Unduly Harsh
Best argues that, even assuming that the Board had the authority to issue the LOR, it was unduly harsh to publicly and permanently reprimand her with the LOR, which tarnished her license. Best points out that she had no previous disciplinary action, has already been properly punished, and is now deemed rehabilitated by the circuit court. She asserts that the evidence she submitted to the Board demonstrates that she is an outstanding nurse despite this isolated incident, which was related to the unintended result of medication prescribed to her. Best points to testimony and exhibits in her favor. She also cites and relies on Collie v. Arkansas State Medical Board, 370 Ark. 180, 258 S.W.3d 367 (2007).
In Collie, the Board revoked the license of a doctor who had prescribed controlled substances to a person with whom he had a romantic relationship. On appeal, the Arkansas Supreme Court modified the revocation of Collie‘s license to a one-year suspension because, even though there was substantial evidence of a rule violation, the court held that the punishment was too harsh in light of the doctor‘s “practicing medicine for thirty-four years without a prior blemish on his professional record.” Id. at 189, 258 S.W.3d at 374. Best argues that she, too, has an unblemished nursing record, and on the advice of her former defense counsel and a warning from her doctor regarding undue stress, she pleaded guilty to an offense that resulted from an adverse medical event. Best argues that the Board‘s
We disagree. Collie is distinguishable despite the absence of any disciplinary history on the part of Best. In Collie, a practicing doctor‘s license was revoked after thirty-four years. Best is a nurse who has never been employed in that capacity, and she was issued the most lenient sanction after being convicted of a crime. Moreover, Best chose to plead guilty to a crime, which she should have known subjected her to discipline under section 17-87-309(a)(2). Even assuming that Best‘s conviction for criminal mischief resulted from an adverse reaction to prescribed medication, the Board‘s counsel aptly pointed out that the time to have made that argument was during the criminal proceedings. While Best claims that she chose not to go to trial because of health concerns and bad legal advice, we note that Best‘s attorney admitted at the hearing before the Board that no doctor would go on record to say that Best had suffered a sleepwalking event brought on by Robaxin because no doctor had examined her at the time of the event.
Best pleaded guilty to a crime, and the Board has authority to sanction licensees who are guilty of a crime. After learning of Best‘s conviction, the Board issued the most lenient punishment available to it. We hold that the LOR was not unduly harsh and that the Board did not abuse its discretion in issuing the LOR.
Affirmed.
BARRETT and THYER, JJ., agree.
Appellate Solutions, PLLC, by: Deborah Truby Riordan, for appellant.
David Dawson and Jennifer Ivory, for appellees.