My 2 Cents

RN Renewal in Ohio

I am a RN in Ohio and I have to renew my license this year. I have the required continuing education for renewal. The RN Renewal Application in Ohio asks a series of questions that may trigger a disciplinary investigation:

1. Have you been convicted of a felony?

2. Have you been convicted of a misdemeanor in the course of nursing practice?

3. Have you received intervention in lieu of conviction (treatment in lieu of conviction for a chemical dependency where a nurse has stolen medication)?

4. Have you been been convicted of any crime that involves moral turpitude or reckless conduct? This is not the exact wording however its close. Moral turpitude is interpreted very broadly under Ohio case law.

5. Have you had any action taken against a professional license in any other state or jurisdiction?

Nurses if you are not sure on whether or not you should respond in the affirmative seek assistance. You can contact the Ohio Board of Nursing for clarification. Or you can seek legal advice and counseling in the form of a legal consultation from an administrative law attorney who practices in this area.

Don't guess if you have questions related to an incident, occurrence, conviction, etc. Make sure you are responding truthfully and accurately to the Ohio RN Renewal Application. 

You Could Lose Your License for This!

I had a legal consultation with a nurse this week and her employer told her in the course of investigation of a workplace incident, you know "you could lose your license for this" and "we could have your license." Excuse me?

Employers have control and make business decisions related to the workplace. That includes whether to hire or fire employees, policies and procedures, purchasing equipment and supplies, in-servicing of employees, etc.

A nursing license is privilege granted to you by a state regulatory agency based upon you meeting the conditions for licensure. In general (unless the nurse poses a immediate risk of harm to the public and swift action is warranted based on the facts) the state must afford you with due process (investigation of the allegations in a complaint filed against your license, being informed of the allegations in the complaint, attorney representation if you choose to represented, etc.) before any action (reprimand, suspension, probation, revocation, etc.) is taken against your license.

Your employer does not control your nursing license. You control your nursing practice, as you decide where you decide to practice, if you want to continue to practice with a certain employer, if you want to resign from your employment with Employer A and seek employment with Employer B, Employer C, Employer D, or Employer E. You can always find employment with Employer Z also. 

Your nursing license is what is important and you take your license with you when you resign or you are discharged from your employment with Employer T. You can always find another position with Employer X around the corner with medical, dental, and other benefits that you need for you and your family. This is one reason why all nurses should consider starting and maintaining retirement funds, accounts, and medical benefits that are not connected with any specific employer, such as Employer U.

If Employer S threatens with "you can lose your license" or "we are reporting this to the Board",  consider obtaining a legal consultation so that you can obtain counseling and advising on what your options are at that point. You always have options.

Institutional licensure for nurses does not exist, thankfully. Can you imagine the power (employers have enough power already over nurses) that institutional licensure for nurses would give hospitals, the long-term care industry, etc? 

Its your nursing license, not Employer Vs. Don't allow yourself to be intimidated by idle threats and the silly techniques used by some nursing employers to intimidate and belittle nurses. 

Know Your Rights in a Disciplinary Investigation!

Here is a scenario I hear at least once a WEEK from a nurse who contacts my office:

The nurse receives a letter or a phone call from a Board of Nursing investigator. The investigator tells the nurse, that he/she would like to meet with the nurse to discuss an allegation(s) made against the nurse. The investigation is routine and should only take an hour or so. The nurse meets with the investigator. The nurse is interrogated about an incident that may have occurred months or even years ago. The nurse can't quite recall everything with the particular incident and is nervous of course. The nurse suspects that this may be more than a routine interview however he/she wants to cooperate. Also once the nurse tells his/her side of what actually transpired this entire thing will just go away, right? The nurse submits a handwritten statement after the interview and is not provided with a copy of the statement. Now, fast forward six to thirteen months later and the nurse receives a large mailing the Board. He/She opens the mailing to find a Consent Agreement that will resolve the Complaint filed against the nurse's license.

What would you do? What is a Consent Agreement? How will this Consent Agreement impact my nursing license, career, and future nursing-related goals? Do you contact Board staff to discuss your concerns with the legal document? Do you contact an attorney to discuss your concerns? Do you allow a nurse co-worker who was previously disciplined by the Board to review the legal document? Will I appear in the Board's newsletter?

Hindsight is always 20/20. Seek a legal consultation as soon as you learn that a complaint has been filed against your license and prior to taking ANY action, such as being interviewed, submitting documentation, etc.

Be Your Own Advocate because its YOUR license and YOUR license is your livelihood! 

Going Bare: Is it Ethical?

The majority of nurses (RNs and LPNs) don't carry their own professional liability insurance policy. I have professional liability insurance to cover my consulting firm and my practice as a home health RN and I also have a separate policy for my law firm.

Why? The same reason why I purchase medical, dental, and other insurance. I want the coverage to protect my myself.

I had a meeting with a prospective client last week, who later retained me to represent her before a state board of nursing. She cancelled her policy two years ago after being told by hospital risk management staff that the policy was unnecessary because nurses are covered by the hospital's policies.

Going bare in this post refers to a nurse not having his or her own professional liability insurance policy. In this post, relying on your employer's policy is not considered "insurance" unless you are provided with a copy of the policy(ies), you are provided with updates on the status of the policy(ies) whenever renewed, modified, etc., and your name and your title with your employer is specifically mentioned in the policy.

Is is ethical not to have your own professional liability insurance policy? Or would you say that it has nothing to do with ethics and it is strictly a business decision whether or not a nurse purchases his/her own professional liability insurance? What do you think?

Legal CE for Nurses

I was going through my old files this week and discovered legal CE programs that I offered in 2002 and 2003 for nurses. I am applying for reapproval this month on at least 12 out of 15 of the CE programs.

What type of legal content would interest you? Let me know.

How to Stay Out of Legal Hot Water

The January 2007, Vol. 70, No. 1 edition of the RN Magazine, the professional journal with a personal touch, has several members of The American Association of Nurse Attorneys (TAANA) www.taana.org on the front cover. These nurse attorneys were interviewed for the article, How to Stay Out of Legal Hot Water. See www.rnweb.com.

Congratulations to Rebecca Cady, RN, JD, Barbara Ryan RN, JD, Taralynn Mackay, RN, JD, and Gayle Sullivan, RN, JD!

Avoiding Malpractice Lawsuits

The American Nurse Today, which is the official publication of the American Nurses Association (ANA), in the Feb. 07 edition, Vol. 2, No. 2 has an article titled Avoiding Malpractice Lawsuits.

What steps have you incorporated into your nursing practice to avoid being named in a medical malpractice or nursing negligence lawsuit?

Also what steps have you incorporated into your nursing practice to avoid being reported to the state board of nursing for an alleged violation of the state nurse practice act and/or board of nursing regulations?

What is Competency?

I am flying to Silver Springs, Maryland the American Nurses Association Congress on Nursing Practice & Economics (CNPE) meeting on Friday and Saturday. There will be over 60 nurses who practice in variety of settings (hospital, nursing education, public health, home care, nursing management, etc.) across the U.S. at this meeting.

I was elected to the Congress at the ANA House of Delegates in 2006. I am part of a subcommittee working on a definition of Competency.

How do you define competency? Are you competent? How do you measure competency in your nursing practice?

Traffic Violations

My 17 year old (soon to be 18 and the age of majority) had his drivers license suspended for 90 days. He was allegedly speeding in a school zone and was ticketed and later that week he rear-ended a vehicle. His has driving privileges to and from work and school. My son is a senior in high school and graduates in May 2007. He doesn't understand why his driving license was suspended. Its unfair in his eyes because in both instances he can rationalize his behavior.

What does this have to do with nursing? Healthcare is a highly regulated environment and the care provided by nurses more than ever is being reviewed, scrutinzed, and evaluated by the public, employers, government agencies, and accreditation agencies.

I don't think that we as nurses fully understand and appreciate our position in the hierarchy and scheme of the provision of healthcare services until something happens....