Nursing Law & Order

Pennsylvania Nurses Charged with Theft of Drugs from Lehigh Valley Health Network

See

http://www.mcall.com/news/all-a1_5nurses.7098465nov26,0,6348807.story

Happy Thanksgiving! What are you thankful for this year?

What are you thankful for this Thanksgiving?

I am thankful for my husband, my family, my health and strength, and the man upstairs.

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Okay, let's talk about shopping. I am a die hard Black Friday shopper. I have however been very disappointed the last 5 years because I am up at 3am, running around like a chicken with my head cut off and still not able to obtain anything on my A-list. I actually cried last year because I was not able to obtain a door buster item I really wanted. (Yes, I am a drama queen and I know its over the top to cry about a Black Friday item!).

This year is different because I am starting with a B and C list. I am also enlisting the help of my sisters and we are starting at 10pm with the midnight sales. We are going hard from 10pm until 3am and then again from 10am to 2pm. Also I am not going for the hot items with only 2 per store. I am shopping for three Christmas trees, odds and ends, and a few ornaments on Black Friday.

My husband and I are buying ourselves a riding lawn mower for Christmas. I wanted a juke box or an automatic pool cleaner but those received the thumbs down from my sweetie. Maybe a juke box for Valentine's Day and a pool cleaner for our 1st wedding anniversary on July 8, 2010.

Back to Black Friday. I also have client meetings in the early evening so I can't go to bananas this year which will be better for my stress level and my wallet.

My plan was to wind things down a little during the Holidays however I am busier than ever. I will never complain about being busy especially with this economy. I will travel up north to visit clients near Akron and travel to Ashland, KY to meet with several clients in the Ironton, Ohio and Ashland, KY area. I will also be in Louisville, KY next month the KY BON meeting and I am sure that I will be in Columbus, Ohio for a meeting or two in December. I am not sure if I will attend the IN BON meeting in December.

I am thankful for my nurse clients who hire me to assist them during a very difficult time of their professional career. I am also thankful for being blessed with a career that I love. I can honestly say I can't think of one thing that I would prefer to be doing for living other than what I am doing now: helping nurses.    

Will Your State Legislature "Florida Senate Bill 1986" you in the future?

Nurses, this is why as a profession we must start supporting nursing professional associations (even if its just with dues money) because its these associations that lobby the legislature and monitor legislation affecting nurses and the profession of nursing in a particular state.

Have you heard about Florida Senate Bill 1986? See http://www.doh.state.fl.us/mqa/laws.html.

Will you be Florida Senate Bill 1986'ed by your State legislature in the future? Think of the number of students in school, licensees, and training programs which will be directly affected by this legislation. What about the folks who need to renew a license and cannot because of Senate Bill 1986? I understand the stated rationale but I am questioning how did this type of legislation get passed in the first place? I guess that's like asking who was minding the store front during a riot but golly.

Where were the lobbyists for the healthcare professional associations in Florida when this passed? Was a siren or alert sent out to all the folks, institutions, ect. directly or indirectly impacted by this legislation before it passed? Was there testimony provided by healthcare training programs and healthcare professional associations against this legislation? Schools should have bused in students by the busload to testify against this legislation and healthcare professional associations should have done the same with licensed professionals.  

Some states are trying to find ex-offenders jobs and training to succeed while others are barring them out of professions, occupations, and certain employment. Its becoming tougher in some states to find employment or obtain a license with criminal convictions.  

CNMs, CRNAs, and Nurse Practitioners and the Credentialing and Privileging process

Don't fudge your credentialing and privileging applications. I know this sounds easy and should be obvious when in fact you may think that you are just telling your story with the facts you consider important to you, the Medical Staff Committee may see this is dishonesty, falsification, and downright wrong.

Don't downplay the facts or misstate what transpired in a particular situation or incident. If you have any questions about an application, contact a health law or nurse license defense attorney in your state or jurisdiction about your application. Also you can't complete privileging and credentialing applications with selective memory and while "winking one eye" like some of us do when completing an employment application.

An application for credentialing and privileging  with a healthcare employer is NOT the same as an employment application with  a healthcare employer.

If you have blemishes and a less than a perfect employment, license, or criminal history talk to someone, a health law attorney or a license defense attorney in your area before you submit your application to a particular facility. You would be surprised how much time and aggravation this may save you beforehand. Yes, it will cost a few hundred dollars but at least you will have someone to provide you with objective advice and counseling on how to proceed. Its better to pay a few hundred dollars up front and receive advice and counseling than pay several thousand dollars to representation in a Medical Staff Hearing.

More Drug Testing for Nurses being monitored by the California Board of Nursing

See http://www.latimes.com/news/local/la-me-california-nurses20-2009nov20,0,1768450.story

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More drug testing may not be a "bad thing" but it will certainly be more expensive for nurses in the Alternative to Discipline Programs adminstered by the CA Board of Nursing and for nurses who are on probation with the CA Board of Nursing and required to undergo drug testing and monitoring.

The cost of a "urine drop" varies and may run from $35.00 to $95.00 each time you drop.

If you ever had any question about the role of a State Nursing Board, here it is and its in your face:

"The bottom line is we're in the business of protecting consumers," said Brian Stiger, director of the state Department of Consumer Affairs, which announced the rules Thursday. "We're not in the business of rehabilitation."

My question is where are the national, state, and specialty nursing associations in this very public debate in California on nursing regulation and drug addiction in nursing?

Ohio Nursing Board is slated to receive 6,000 complaints in 2009!! Me a Nurse License Defense Attorney and Me Might Can Do the Money Shake

I attended two of the three days of the Ohio Nursing Board meeting this week. I tell you, if you haven't attended a meeting of your State Nursing Board, you should. Its an eye opener to learn more about nursing regulation and see the business coming before the Board.

It was mentioned by Board Members and Staff during the meeting that the Ohio Board of Nursing will receive over 6,000 complaints this year. 6,000 complaints and we have 220,000 RNs and LPNs. If you didn't know there are two sides of me: the attorney who loves money and nurse who loves nurses and nursing. The attorney hears 6,000 complaints and does the "money shake" but the nurse in me hears 6,000 complaints and a feel a ping in my heart and wonder what can be done to lower this number.

Now you can look at this and say well its just a small percentage of nurses in the State. But last year there were over 3,500 complaints and when you start adding these complaints together over let's say a two or five year period, the number of the complaints vs. the number of licensees is significant!

Are we going to get to a point where a significant portion of nurses in the State of Ohio have been investigated or disciplined by the State Nursing Board in the next ten years? What's going on in Ohio? We are not Texas or California "large" as far as the size of the state. Why are more nurses being reported to the State Nursing Board in Ohio?

1. Are more employers just reporting to the Nursing Board? Don't get me started on at-will employment and how nurses in most healthcare facilities are flipped, turned, and terminated faster than a burning pancake.

2. Have nurses here just "gone wild" and its Nurses Gone Wild in Ohio? I haven't gone wild yet but I am thinking about it.

3. Is it because more individuals are pursuing a nursing career strictly because of the benjamins (money) and this is somehow connected to professionalism, misconduct, and State Nursing Board complaints? Is there a connection between the failure to socialize into the professional practice of nursing and State Nursing Board complaints? Is it all about the benjamins for nurses? http://en.wikipedia.org/wiki/It%27s_All_About_the_Benjamins

4. Is it because nursing schools/colleges are pushing out graduates like a Ford Motor Car Assembly line and graduates are not prepared for the realities of nursing practice?

5. Is it because more nurses are entering the profession with criminal backgrounds and this is driving State Nursing Board complaints?

6. Is it because more nurses are impaired (physical, mental, or chemical)?

7. Are nurses being blamed for mistakes in healthcare, termed, and reported to the State Nursing Board? Even when its a systems issue, I see cases where the nurse is on the chopping block.

8. What do you think?

I don't buy the argument that a small percentage of any profession will always be disciplined. That's baby boomer thinking. What can be done in the future for nurses as a profession to appreciate the professional, legal, and self-regulation components of nursing practice? I am working on one of many plans to address to this that will help the profession and satisfy the nurse and the attorney in me.

The Ohio Board of Nursing has a Board Hearing Panel: Is this a new beginning or the beginning of the end?

The Ohio Board of Nursing has a Board Hearing Panel which has been operating for a few months. The Ohio Nurses Association Deputy Executive Director Jan Lanier, RN, JD testified against the Hearing Panel on behalf of the Ohio Nurses Association. See the attached. Download OBNHearingPanel

The Board is modifying some of the rules language related to the Panel because of a few of the concerns identified at the rules hearing.

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Practicing before three State Nursing Boards gives me a different perspective for nurse license defense and Board investigations and adjudications. There isn't a perfect system for investigations and adjudications but if someone asked my opinion, I would be happy to provide it.

I think there is something to be said about appearing before actual Board members. This is an appealing part about the Ohio Board of Nursing Hearing Panel. I love this about the Indiana Board of Nursing! Yesterday, I appeared with a client before a panel at the Indiana Board of Nursing. The Indiana Board of Nursing "gets its hands dirty" and I like this. What does this mean? Meaning you appear before the Board related to initial applications, renewals, license, and disciplinary issues. There is very little contact for licensees with Board of Nursing staff because you are going before the Board, the full Board of Nursing. The Board deliberates right in front of the licensee and you know the outcome immediately. No closed sessions, no closed deliberations: its out there for you and everyone else in attendance.

Because the Indiana Board of Nursing is so active in the discipline process the Board Meetings are monthly and the meetings are jammed packed with hearings and appearances which doesn't leave alot of time for the discussion of other items. Its a nurse license defense attorney's dream:) Adjudicate me, baby!!

I would have liked to see Ohio use the Board Hearing Panel as a form of mediation with the Board Hearing Officer serving as the mediator. I should have sent this in as a comment to the Board's General Counsel and Compliance Manager months ago. This could have been an intermediate step before proceeding to a full hearing before an independent hearing officer. Actually there is still an opportunity to use the in-house Ohio State Nursing Board Hearing Officer as a mediator.

Nurses have more options for the adjudications of complaints in Ohio and more options is a step in the right direction.

At the Board meeting today it was stressed by the Board President that the number of the complaints filed against licensees is increasing (no surprise with the very vague mandatory reporting language and the push to report "everyone and their momma to the State Nursing Board" in Ohio) and the Board Hearing Panel will increase the efficiency of adjudication, allow nurses to appear before a Board of their peers rather than a hearing officer, and save money. It was mentioned during the meeting that Ohio could be another California if the number of complaints continue to rise (will be near 6,000 this year) and more licensees request hearings under the former "just an independent hearing officer" system. Its cost money to hire an independent hearing officer and it was postulated that the Board could not afford to hire an independent hearing officer to handle all of the hearings and there would be a long(er) backlog of cases, aka California.  

Just say California Board of Nursing twice and really fast and this is enough in and of itself to strike fear in the hearts and minds of any State Nursing Board Member or Staff across the country. California Board of Nursing, California Board of Nursing.  

I don't know. You know I am a lawyer and I am money hungry and really I see money for me regardless of the adjudication flow sheet utilized by the Ohio Board of Nursing: Consent Agreements, Staff Hearing Officer, Independent Hearing Officers, or Board Hearing Panel. I don't know if I can do the money dance just yet but I think I can do the money shake.  Shake it, baby!!

What a Week! Indiana Board of Nursing Appearance and Its Only Tuesday

I drove to Indianapolis, Indiana this morning for an appearance with a client before the Indiana Board of Nursing. At the meeting there were nurses who appeared related to questions about the renewal application for licensure in Indiana or questions related to an endorsement application or questions for NCLEX-Applicants related to their initial application for licensure with the Indiana Board of Nursing.

Most if not all of the nurses or NCLEX-applicants appearing before the Board did so without legal counsel. Even if you don't hire legal counsel to formally represent you before the Board, you should speak with a nursing license defense attorney about your case to prepare you for the Appearance.

Keep your Personal Life out of your Professional Life: More Drama for Your Mama

This is a busy week for me this week. I will be in Louisville, Kentucky on Tuesday at an investigative meeting with the Kentucky Board of Nursing with a client. On Wednesday, I will appear before the Indiana Board of Nursing with a client in Indianapolis, Indiana. I will be in Columbus, Ohio on Thursday and maybe Friday for the Ohio Nursing Board Meeting. If you need to reach me, I am accessible via email at ldw@nursing-esquire.com or you can call my office at 513-771-7266 or Jack Stem who works with me at 513-328-7253.

I will probably start shopping this weekend for Thanksgiving dinner. I have a large extended family and we are having dinner at our home this year. The holiday drama has started already but as a client of mine told me who doesn't have any relatives living, "having a large family is a blessing." So I am guess I am blessed to have a large extended family and a large immediate family who can "get the party started right" as I call it, with holiday drama. Why are the holidays so stressful? I knew it was coming. I could feel it starting a week or two before Halloween. I am looking forward to the holidays because this is our first Thanksgiving and Christmas together as a married couple:)

Holiday mayhem and "more drama for your mama" brings me to my post. Nurses, we have got to keep the personal drama out of our professional and worklife and we have to get our house in order. By house, I mean our personal and professional lives. Why?

1. It makes for a miserable workplace when everyone is bringing the negative to work each and everyday. I don't know about you but I have worked with nurses in hospitals and home care whose entire life is open book and they bring each and everything detail to work with them. TMI and start keeping somethings to yourself. Everyone is dealing with issues and its okay to seek support from co-workers and colleagues but don't take it to the extreme. No one wants to work in a toxic workplace as nurse. Why do you want your co-workers to know all your "business" anyway? Are you working and practicing at the nursing equivalent of Chernobyl? http://en.wikipedia.org/wiki/Chernobyl_disaster

2. Criminal crap that happens in your personal life like a DV, theft, assault, disorderly conduct, telephone harassment, stalking, menancing, public intoxication, DUI/OVI/DWI, possession of drugs, and other charges and convictions may impact your nursing career, current and future employment, and your license. If you are a hot head and you tend to explode on others, what can you do differently to keep yourself safe and stay out of trouble? If  you party, club it, or you "go hard" with the alcohol, try to anticipate what you will need to do to keep yourself safe and stay out of trouble. Who wants to get arrested? I don't because I have too many licenses to worry about what will happen if .... Its not worth it.

I will say it again (because I am repeating it to myself this holiday season), keep your hands to yourself. Remove yourself from the situation. Calm down, think of your kids, yourself, and whatever else is important to you and the reason why you went to nursing school and count to 50 slowly. Counting to 10 isn't long enough.

3. Some of us are taking a boat load of medications to function. No it doesn't make it okay that you have a cocktail of meds that you are taking morning, noon, and night just because you have scripts and the meds are "legally" prescribed. Some of us are having suicidal ideations and trying to commit suicide. We then go to work and tell everyone how many benzos, narcs, and other meds we take and how out of control our life has become and then we question or become irrate when an employer suggests EAP, a psych eval, and gets the State Nursing Board involved. The bottomline is patient safety. Honestly, are you safe to practice nursing? Are you practicing impaired? You can be practicing impaired from prescription meds. Let me say this again. Its not just about diverting and illegal drugs; you can be practicing impaired as a nurse with prescription medications. Impairment can be physical, mental, or chemical.   

You don't work as a greeter at Walmart (if you do, can I use your discount?) as a nurse. You are making critical decisions and assessments throughout your shift, documenting the care provided, and communicating with others on the healthcare team. Alot is riding on you because you are on the front lines of the battlefield baby. As nurse and you need a clear and focused mind and body to work as a nurse in today's healthcare environments. No "ifs", no "ands" and damn it no "buts."  

4. There has to be a balance. You are professionally what you are personally. You can't be a liar and thief in your personal life and away from the bedside and still be an excellent nurse professionally because at some what you do personally will like water, start to flow or trickle into your nursing practice and career. No one is perfect and this will be a work in progress. But you can't have chaos and TV-like drama in your personal life and then be surprised when your work performance slips and incidents start to happen at work.

Are you personally what you are professionally? Are you professionally what you are personally? Does your personal life mirror your nursing career and practice? Does your nursing practice and career mirror your personal life? 2010 is coming (I say 2012 this weekend and it was excellent!) and you can start with a clean slate of goals for how you want to improve your personally and professionally.

More About Birchaven: Is this the future of nursing or just an anomaly?

See http://www.thecourier.com/Issues/2009/Nov/06/ar_news_110609_story4.asp?d=110609_story4,2009,Nov,06&c=n.

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What are the lessons to be taken from this situation for nurses? This case has it all: State Nursing Board and Office of Attorney General investigation, criminal charges, and a wrongful discharge lawsuit. 

Is the future of nursing where you are termed, reported to the State Nursing Board, criminally charged, and then you have to file a wrongful discharge lawsuit?

Is this an anomaly in nursing or is this the future of nursing practice?

Nurses really need to be more independent like physicians and instead of being employees, should have some type of alternative employment situation like being an independent contractor or being an employee but having an employment contract.

Someone told me this case is why nurses should consider unions. I laughed. Some nursing unions do some good and I am by no means anti-union in nursing. But in my opinion nursing unions are not the cure for what ails nursing.  

I am seeing more cases like Birchaven but these cases don't make the news. I tell you, healthcare organizations will term a nurse who has worked at a facility 10, 15, or 20 years as fast as they will term a new grad on a 90 day probationary agreement. I had a client tell me last week she was going to PA school and transitioning out of nursing because nurses are under the microscope in healthcare facilities about everything. Then it turns into someone telling you "I can have your license for this!" "We are required to report you to the Board" "We are running this by legal counsel but we think we will have to report" and the rest of one-liners that strike fear into the heart and mind of a nurse.

Do you think the system is designed to find fault with the nurse because the nurse is the first and last line of "defense" at the bedside. 

Until nurses start sticking together and moving toward in unity (which is really hard to do in a female dominated profession) nursing will continue to see more situations like Birchaven. Would this happen like this to a teacher? police officer? fireman? college professor? hospitalist physician? hospital-based dentist? Frack no.

So why is this scenario becoming more prevelant in nursing?

The greedy lawyer in me says well its more State Nursing Board complaints and possibly more money for me so I can do the money dance. But the nurse in me says its unfair (but so is life) and ponders and postulates about solutions and systems to balance the scales.  The Sleeper Must Awaken. http://flavor8.com/index.php/2007/07/21/the-sleeper-must-awaken-dune/

Wanda Wilson, CRNA, MSN, PhD named the Executive Director of the AANA

http://www.aana.com/news.aspx?ucNavMenu_TSMenuTargetID=171&ucNavMenu_TSMenuTargetType=4&ucNavMenu_TSMenuID=6&id=23876

Wanda was with the University of Cincinnati College of Nursing Nurse Anesthesia Program for a number of years. Congrats and best wishes!

I am Waist-Deep Working with Criminal Defense Attorneys and I love it!

There used to be a time when as a nurse license defense attorney, I was ankle-deep working with criminal defense attorneys. By ankle deep, I mean I had a few cases where nurses had concurrent representation by a criminal defense attorney. I work the Nursing Board case and the criminal defense attorney of course handles the criminal case. This was maybe 6 years ago.

About three years ago, I would say my nurse license defense practice was knee-deep working with criminal defense attorneys.

I must report as of this year, I am waist-deep working with criminal defense attorneys throughout Ohio, Kentucky, and Indiana. I am also working with one or two medical malpractice defense attorneys in cases where my client is involved in a nursing malpractice case and I am representing the nurse before the Nursing Board.

I like defense attorneys whether its a criminal defense attorney or a med mal defense attorney because we tend to think alike. Tell me what you see on your side and I will tell you what I see on my side.

Why am I saying this to you? To me this shows that legal cases involving nurses are not just your "run of the mill case" anymore and as such there may be one or more different specialties of attorneys working a case or a particular avenue of the case involving a nurse. Nursing is evolving.

If you have a legal issue make sure you have the right attorney with the right skill set and the right experience working your case or a particular avenue of your case. Its your license, your livelihood, and your case.  

Nursing Professional Associations Are Struggling for Members: Nursing Associations of the Past Should not be the Nursing Associations of the Future

I supported the Licensed Practical Nurse Association of Ohio (LPNAO) in the past by purchasing a booth, donating products, or buying advertisement in program meeting brochures. LPNAO like many other nursing professional associations is struggling financial because membership is decreasing. See the President's message at http://www.lpnao.org/.

Why are nursing professional associations struggling for membership? Why don't nurses support the very professional associations which purportedly represent them and the profession? Do you feel that the nursing professional associations adequately represent the profession of nursing? Are there too many nursing professional associations? There are national, state, local, and specialty nursing associations around the country and the majority of RNs, some three million, yes 3 million, do not belong to ANY nursing professional association whether its a national, local, state, or specialty association.

I must add in fairness to nursing associations/organizations that membership in all professional associations across the spectrum are down because of the economy.

http://www.asaecenter.org/PublicationsResources/ANowDetail.cfm?ItemNumber=44103

http://www.issociate.com/issociate-101/Postings/Association-Help/How-social-networking-could-end-professional-associations/default.aspx

http://www.canadianmarketingblog.com/archives/2009/05/professional_associations_repo.html

http://www.ammr.com/PayingTheirDues.pdf

http://www.washingtonpost.com/wp-dyn/content/article/2008/12/14/AR2008121401638.html

http://meetingsnet.com/associationmeetings/mag/meetings_associations_aim_generation/

http://blogs.capella.edu/askdoctoraladvising/2009/10/07/professional-associations-do-i-have-to/

http://www.publicrelationsprincess.com/2009/10/are-professional-associations-obligated-to-help-job-seekers.html

http://www3.interscience.wiley.com/journal/114080275/abstract?CRETRY=1&SRETRY=0

http://www.dcardillo.com/articles/assoc.html

http://allnurses.com/nursing-activism-healthcare/ana-membership-388073.html

See

http://www.nursingworld.org/EspeciallyForYou/Links/SpecialtyNursing.aspx

What does that say to you as a nurse? How many nursing professional association do you belong to at this point? Are you planning to continue your membership?

I belong to the American Nurses Association, the Center for American Nurses, the Ohio Nurses Association, and the Southwestern Ohio Nurses Associations. I pay close to $36.00 a month to belong to all four of these organizations. I also belong to The American Association of Nurse Attorneys (TAANA) and I pay $170.00 a year.

I can tell you as one who has been active in nursing professional associations that those who participate in the associations, run the committees, and do the work of the association, don't understand why the majority of nurses don't join. Its almost like "oh those nurses who don't join don't know any better" and "we who do join, belong, and actively participate are doing so because other won't." I have been told that "somone must do the work of the profession even if the majority of nurses don't belong to the association."

Its easy to fall into this self-defeating train of logic and thinking but honestly after participating in several nursing professional associations on the national, state, and local levels for years, I can see why the majority of nurses don't belong to some of these organizations. I don't say this as a slap in the face to any one organization or association but I don't think the powers that be in some associations "get it" or understand what needs to be done or want to do what needs to be done to be appealing to the vast majority of nurses.

What got a small percentage of nurses to join these association twenty or thirty years ago (hell even 10 years ago) is not working. Case in point. Alot of nursing students support the National Student Nurses Association but then don't transition into membership in a nursing professional association. Why?

What do these organizations/associations need to do to get the majority of nurses in the United States to belong to an association/organization?

I look at the American Bar Association. I belong to the American Bar Association and the Ohio Bar Association. There are also a number of specialty bar association like nursing associations. A large percentage of attorneys join the American Bar Association. Don't say its because attorneys have more money because some attorneys make less than what some nurses earn in a year.

I wouldn't part with my ABA membership of the value of the products I receive from the Bar Association and the ABA is involved in everything legal and advocating for attorneys on every topic here in the US and overseas.

With Web 2.0 and online communities and training of a new and the next generation of nurses, the demands of nursing practice and balancing a life outside of your role, the nursing associations of the past should not be the nursing associations of the future.

Free Recording of Legal Issues with Professional Boundaries and Professional Sexual Misconduct

For a limited time (I love the salesman talk don't you!) I am offering a FREE CD. Legal Issues with Professional Boundaries and Professional Sexual Misconduct in Nursing. See https://m360.centerforamericannurses.org/event.aspx?eventID=7426

This offer is available to first 25 nurses who contact my law firm and request the CD.

Please call during business hours 9am to 5:30pm Eastern Time and provide my receptionist with your name, credentials, and complete mailing address. Call 1-888-571-1110 or 513-771-7266.

Act now while supplies last.

You May Need A Nurse License Defense Attorney if....Here's My Top 20

This is copied from website. See http://www.nursing-jurisprudence.com/boardinvestigations.html

Also, in response to a high demand, my law firm is now offering email consultations. See www.nursing-jurisprudence.com.

As a Nurse, you need a license defense attorney with experience in administrative law and procedure involving licensed healthcare professionals if:

1. A complaint has been filed against your license with the Nursing Board or the Office of Attorney General and you were just notified;

2. Your nursing license has been suspended and you need assistance meeting the terms and conditions for reinstatement;

3. Formal charges are filed against your license with the State Nursing Board;

4. An administration hearing is scheduled related to a complaint filed against your license;

5. You received a Potential Violation Report from the Ohio Board of Nursing or a Notice of Complaint from the Kentucky Board of Nursing; 

6. You are planning to self-report to a State Nursing Board Alternative Program for Chemical Dependency;

7. You are involved in a disciplinary investigation in State A and you  reside in a Nursing Licensure Compact State or you are licensed by endorsement in other states;

8. You are asked to sign a Consent Agreement, Consent Decree, or an Agreed Order and don't understand the terms and conditions in the legal document and you don't know how the document will impact your nursing license and your nursing career;

9. You receive a Notice of Opportunity for a Hearing from the Ohio Nursing Board;

10. You are being encouraged by your employer or colleagues to "self-report" an incident to a State Nursing Board;

11. A Nursing Board investigator or any Regulatory Board (Pharmacy Board, Adult & Protective Services, Department of Health, Attorney General, Office of Inspector General, etc.) agent, officer, or investigator contacts you and want to meet with you to discuss any complaint filed against you;

13. A Nursing Board investigator or Regulatory Board agent asks you to provide a written statement regarding the allegations in the complaint filed against you;

14. You received a temporary, summary or automatic license suspension by the State Nursing Board;

15. You were terminated from your employment and told that you are being reported to the State Nursing Board for allegedly violating the Nurse Practice Act and/or Board rules; 

16. A State Nursing Board or regulatory board investigator or agent wants to conduct an telephone interview of you regarding a complaint filed against your license;

17. You have been accussed of stealing drugs and this is reported to the State Nursing Board;

18. You have been contacted by federal, state, or local law enforcement officers and you are being "encouraged" to admit guilt or confess to criminal conduct; 

19 You are a nurse and you have been charged with a crime, felony or misdemeanor. You want to know how a possible conviction or plea to a lesser offense will impact your nursing license if at all; and last but certainly not least 

20. You answer the door at your residence and its an investigator from the Pharmacy Board who wants to speak with you about Pyxis or OmniCell discrepancies.  

Can I Be Mandated to take the H1N1 Vaccination? What happens if I refuse?

Oh, the joys of at-will employment and healthcare organizations.

See the Ohio Nurses Association website at:

http://www.ohnurses.org/AM/Template.cfm?Section=Health_Care_and_Nursing_News&CONTENTID=5042&TEMPLATE=/CM/ContentDisplay.cfm

See the American Nurses Association website at:

http://www.nursingworld.org/H1N1

Nursing Students and Criminal Convictions: He Said and She Said

The Holidays are fast approaching and I am staying busy with my law practice. I am getting into the Christmas spirit and we are planning to have our Christmas Palm tree in the living room again this year. We are putting a colored (I think red or pink) tree in our bedroom window. We are also placing a tree or something near the fireplace in the family room and downstairs in the rec room near the bar (which should be interesting for folks who have too many gin and tonics). We are also having Thanksgiving dinner at our home this year. I enjoy cooking however we have a large family so my mother, grandmother, and I will split the menu and we will have other family members bring a small side dish, a dessert, or drinks.

I received a really distressing email from a NCLEX Applicant who is having trouble obtaining a license because of criminal convictions. The applicant was crying because she stated "I would not have went to nursing school if I would have known I would have these issues getting a license." This Applicant is a single mom, recently divorced who has 18k in student loans for associate in nursing.

If you are a nursing student, considering nursing school, or you will be sitting for the NCLEX and you have criminal convictions, you need to speak with someone, preferably an attorney with experience representing nurses in licensure matters before you complete your initial application for licensure by examination. Click here and see the info on my website related to NCLEX applicants and suitability for licensure.  http://www.nursing-jurisprudence.com/legalservices.html

Now I know your nursing instructor(s) probably told you to "just complete the application and you will be fine" but I would suggest that you speak with an attorney about your situation to obtain objective counseling and advising not just about your suitability for licensure but also about any hurdles you may face with employment.  Most if not all healthcare employers are conducting criminal backgrounds checks in states around the country.

I know you may think I am saying this because I am a money hungry lawyer (well I do like money and I am usually hungry) and I just want you to contact another money hungry attorney but I say this sincerely. You need to make informed decisions and too many of us are doing things because "we were told to do this by so and so." When you are dealing with something as precious and fragile as your license, your career, and your livelihood, you should not rely on "he said and she said" to make these important decisions.

DUIs R Us: There Isn't a One Size Fit All Approach for the Implications of a DUI in Nursing

I received at least 6 emails this week from nursing students, NCLEX applicants, and nurses from around the country related to one or more DUI/OVI/DWI convictions and its impact on employment, suitability for initial licensure and renewal, and placement in clinical sites. I always respond to emails because I know there are alot of us out there who need assistance and don't know where to turn.

You should contact the following for assistance:

1. an administrative law attorney in your state or jurisdiction for assistance;

2. a nurse license defense attorney in your state or jurisdiction for assistance; or 

3. contact The American Association of Nurse Attorneys (TAANA) for a referral to the above in your state or jurisdiction.

If you live, practice, or are seeking licensure in Ohio, Kentucky, and Indiana, you can schedule a consultation with my office. I cannot answer your question(s) unless you are a client or unless you schedule a legal consultation. For additional information about legal consultations, see my website at www.nursing-jurisprudence.com and click on consultations.

The cost of a 30 minute telephone consultation is $150.00 and the cost of a 60 minute telephone consultation is $250.00. I also schedule in-person consultations at my office for nurses in the Greater Cincinnati area (my office is really easy to find off I-275 on Reed Hartman Highway) or if I am traveling to area. We can schedule telephone consultation the same day if needed depending on my schedule. On average, I have between 5-15 legal consultations with NCLEX applicants, nursing students, RNs, LPNs, and/or APRNs a month. A legal consultation is a one-time event. http://www.nursing-jurisprudence.com/consultations.html

To pay for a legal consultation, go to website and click on the online payment tab. The payment can be made via debit or credit card and it posts immediately. You will then receive a phone call and/or email from me, my assistant, or my receptionist about scheduling the consultation. http://www.nursing-jurisprudence.com/onlinepayments.html

For additional information about the difference between a legal consulation vs. legal representation, see my website at http://www.nursing-jurisprudence.com/consultations.html.

You have to pay for and schedule a legal consulation with me if you want me to provide with a legal opinion or provide you with legal advice and counseling.

I do not offer pro bono (free) license defense or nursing law services.

Why am I saying this again? I had a nurse contact my office this week at least 8 times in a 2 hour period. She told the receptionist that she was a client and she needed to reach me ASAP and it was a matter of extreme importance and urgency. My assistant returned the call initially and the nurse told my assistant that she would only speak to me. I contacted the nurse and her first response was "thank you for calling me back, I am sorry about lying to your staff about being a client, but I really need to ask you a few questions."

I politely asked the nurse to stop speaking and instructed her to pay for telephone consultation online and I would be happy to answer her questions about the impact of a recent felony conviction on her KY and OH RN license later that evening. The nurse hung up on me.  WTfrack:(

You can contact TAANA at www.taana.org for a referral to an attorney who may offer pro bono services in your state or jurisdiction. You can also contact your local or state bar association for an attorney referral. You can also search the internet to find an attorney in your area who may be able to answer your questions without charging a fee. You can contact your State Nurses Association or Specialty Nursing Association for assistance or contact the State Nursing Board.

State Nursing Board Complaints and Nurses: It Can Happen to Anyone

Even the best nurses who are expert practitioners can be reported to the State Nursing Board. Nursing Board complaints don't just happen to "bad nurses" or nurses with a drug addiction. You can go to work on Monday, a situation can arise at work, and the outcome of the situation may be your termination and the filing of a State Nursing Board complaint against you for failing to practice in accordance with one of hundreds of standards for safe nursing practice or failing to act in accordance with company policy and procedure and jeopardizing patient safety.

What do you do then? Most nurses don't have professional liability insurance which would cover attorney fees before the State Nursing Board. Also employers are mandatory reporters so alot of State Nursing Board complaints are filed by hospitals, nursing homes, home care agencies, etc. against nurses.

I will say this again. Alot of State Nursing Board complaints are filed by employers. Yes, the same employers who you are depending upon for liability insurance are the same employers who will term you and report you to the State Nursing Board faster than the speed of light, sound, and smell.  

Does your employer's or former employer's insurance provide you with attorney representation before the State Nursing Board? No, of course not. Don't make me laugh.

When a nurse tells me "I am covered by my facility's policy and that's why I didn't purchase professional liability insurance" my next question turns to the retainer fee for representation.

Most attorneys want several hundred or a few thousand dollars for a retainer. I think this is why most nurses continue to represent themselves before the State Nursing Board. I also believe that most nurses think the State Nursing Board is "their friend." I am also asked does having an attorney "anger" the State Nursing Board. I continue to hear this.

I am meeting more and more nurses who simply don't have the resources or funds to hire an attorney for representation, counseling, and advising in a State Nursing Board matter. For those nurses I say the following:

1. Can you represent yourself knowing that you don't know until you know and when you know it, its usually too late?

2. Can you borrow the money from your 401K, 403B, or a relative or family friend?

3. You can represent yourself and get the best case scenario (State Nursing Board complaint is closed) or you can represent yourself and get the worst case scenario (license revocation) or anything in between. Are you comfortable with this? If so, by all means represent, counsel, and advise yourself. Again this is what the majority of nurses do when a State Nursing Board complaint is filed against their nurse.

If so, do your research and move forward. Most of these nurses I find however only see the facts and their situation from their own perspective i.e. that "I didn't do anything wrong and there is nothing that I would have done differently."

This is one of the pitfalls with self-representation. You are wearing rose tinted sunglasses and you can't see the sun no matter how bright it shines because of your perception of the situation or incident.

What are the other pitfalls to self-representation in a State Nursing Board matter?

1. You cannot be objective when you represent yourself;

2. Okay representing yourself before the Board is one thing. But how do you counsel and advise yourself if you are not familiar with the law, legalties, and legal issues that flow from State Nursing Board complaints?

3. You may not be familiar with the State Nursing Practice Act and Nursing Board regulations;

4. You may not be familiar with the process and procedure for State Nursing Board investigations;

5. You may not be familiar with the process and procedure for State Nursing Board hearings; and

6. You may underestimate or fail to appreciate the severity or seriousness of the allegations in the Complaint and therefore the rationale of any action proposed or taken against your license.

I had a nurse ask me during a legal consultation, what would I do if I was being investigated by the State Nursing Board? I responded, I would hire an attorney. I have professional liability insurance for my nursing practice.

I will also say that in the event a complaint is filed against law license (knock on wood), I will retain an attorney. I have legal malpractice insurance which covers this as well.

More Nurses Will Look to the Internet and Web 2.0 for Solutions to Legal Issues

I am reading the End of Lawyers by Richard Susskind. http://www.susskind.com/endoflawyers.html

This is a very thought provoking book and an excellent read. I am reading this book this month as I map out for law and consulting practice goals for 2010 and beyond. What are your goals for your nursing practice? I also take the time to review my practice goals and business plans for years prior. I started writing out practice goals and business plans in 2003.

I am planning to roll out new products and services in my consulting and law firm in 2010 now that I have hired a legal assistant who works close to full-time to assist me with administrative and clerical components.

Richard Susskind says in his book that because of the proliferation of the internet and IT solutions (which is only beginning) consumers in the future will look to the internet and Web 2.0 for legal solutions to problems. My first thought was is this why nurses gravitate to online nursing chatrooms, boards, and forums and seek advice and counsel from peers on a wide variety of issues ranging from clinical practice to personal to financial to legal.

Do these online nursing chatrooms, boards, and forums provide nurses with the anonymity and asynchronous communication demanded by more net savvy professionals who are busy with their own personal and professional lives but still need the nourishment and feedback of peers?

What does this mean for a nurse attorney like myself whose law practice is limited to representing, counseling, and advising nurses? I find this intriguing and also frustrating. Its frustrating because I see everyday what happens when nurses represent, counsel, and advise themselves in the highly regulated healthcare environments whether its before the State Nursing Board and in a number of other settings. Frustrating but in the words of Kurtis Blow, "these are the brakes." http://www.youtube.com/watch?v=kegfsV7g-tM

1. Some do okay representing, counseling, and advising themselves  and never seek attorney involvement or advice.

2. Others (a growing percentage) don't want to pay for an attorney (which is understandable) but begin to doubt their abilities to represent, counsel, and advise themselves even though they have a fan club of other nurses, a significant other, and family members saying "You didn't do anything wrong", the "State Nursing Board has bigger fish to fry than this silly case" and my new favorite "don't worry about it, it will all work out for the best in the end." 

These nurses then try to "hit up" nursing license defense attorneys around the state for "informal advice." I can smell money and after speaking with you for a few minutes I will know your intentions; its obvious. After 8 years of license defense before State Nursing Boards you know the nurses who are fishing around the shark tank. These nurses have no intention of hiring an attorney but just want to obtain the opinions of several different attorneys who practice license defense on the merits of their case.

3. Other nurses will say let me talk to someone first and then I can will represent, counsel, and advise myself. Sometimes I get calls from these nurses a year or two later when things didn't turn out as planned.

4. Then other nurses will say and this percentage is also growing slowly as I think nurses are saying this is my license, my livelihood, and without it, I can't practice nursing or smell the money. More nurses are saying I need legal assistance and I need it now, let's get started. I like these nurses:)

I see online nursing forums, boards, and chatrooms as a tool when used constructively can of course be beneficial to nurses. But the real world sets in and you know I have to keep it real on this blog. The majority of nurses in State Nursing Board matters across the country represent, counsel, and advise themselves so maybe the online nursing boards, forums, and chatrooms are already serving as the "nursing law attorneys" for the next generation of nurses. Whether you call it the unauthorized practice of law or the proliferation of bootleg, watercooler lawyers, it happens everyday and all day on the net and it will continue in the forseeable future.

There has to be a balance because the information, advice, and counseling you receive from others about your legal matter may not be accurate whether this information is provided online or in-person. Maybe using the internet and web 2.0 for issue spotting and then seeking more specific legal advice and counseling on your situation and determing if there is a need for legal representation. Do you need to hire an attorney or is this something you can handle on your own?

I love this book! Is it the End of Lawyers? For some sure but not for this one. Why? I am hungry, creative, lean enough to make mistakes or misteps with developing products/services and revamp, and eager to embrace the apparent and obvious trends with web 2.0 and nurses and figure out a way to offer a product or service in my law or consulting firm. Onward and Forward!!!