My 2 Cents

Nurse Charged with Interference with Medical Services & Exploitation of an Endangered Adult

This is a press release issued by the Indiana Attorney General's office:

FOR IMMEDIATE RELEASE

November 28, 2007

Nurse Arrested and Charged in New Albany following Investigation by the Indiana Attorney General’s Medicaid Fraud Control Unit

(INDIANAPOLIS, IN) – A Louisville, Kentucky woman working in Indiana has been arrested and charged for coercing one of her patients to save her prescribed medications for the nurse’s personal use.  Licensed Practical Nurse (LPN) Kathy Stinson has been charged in Floyd Superior Court with one count of Interference with Medical Services and one count of Exploitation of an Endangered Adult.

“A patient suffered needlessly because of the greed of this nurse who was in a position of power,” Indiana Attorney General Steve Carter said.  “We appreciate the assistance of local law enforcement in working with the state’s investigators to arrest and file charges against this individual.”

Stinson was arrested Monday, November 26, 2007 in Indiana.  She is alleged to have asked a patient not to take her prescribed medications and to save them for her.  The patient complied and over several weeks stashed her medication away for Stinson, even though she was suffering considerable pain without the medicine.  Stinson would visit the room and take the medication that had been hoarded.

Stinson is being held on $50,000 bond.  The case is in the Floyd Superior Court in Indiana; cause number 22D01-0711-FC-772.

See  http://www.in.gov/attorneygeneral/press/Release.StinsonLPN.html.

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In the American criminal justice system, you are innocent until proven guilty. This nurse will not only have to defend herself in the criminal case; she may be facing disciplinary investigations before the Kentucky and Indiana Boards of Nursing if she is licensed to practice nursing in both states.

Sometimes in criminal cases, if the prosecutor knows the defendant is a licensed nurse, the prosecutor may forward the criminal complaint to the State Board of Nursing, which initiates a state board of nursing disciplinary investigation. 

What does the future hold for Nursing Unions and Professional Associations?

According to an employment law newsletter published by an Ohio law firm in February 2007, 1.2 million RNs do not belong to a nursing union. The majority of nurses do not belong to a nursing union. See http://www.bricker.com/publications/articles/1053.pdf. I am one of the 1.2 million RNs who don't belong to a nursing union.

What's your opinion? Will we see more RNs attempting to organize in the future? Do you think the interest in unions for RNs will wax and wane in the future?

What does the future hold for the nursing unions and national, state, and specialty nursing professional associations?

Do you belong to a nursing union? Do you belong to a nursing professional association?

NNOC wins an election in Nevada

The National Nurses Organizing Committee (NNOC), which is affiliated with the California Nurses Association won its first election in Nevada. Registered nurses at Saint Mary’s Regional Medical Center in Reno voted by over 64 percent to join the California Nurses Association/National Nurses Organizing Committee (CNA/NNOC). According to the press release link Nevada becomes the fourth state, joining California, Illinois, and Maine, where CNA/NNOC represents RNs in collective bargaining. See the following link for additional information:

http://www.calnurses.org/media-center/press-releases/2007/december/saint-mary-s-reno-rns-choose-cna-nnoc-in-landslide-64-percent-vote-for-500-rns-nevada-breakthrough-for-fastest-growing-union.html

With the departure of Ohio, New York, Oregon, and Washington State Nursing Associations from the ANA-affiliated, United American Nurses (UAN); it remains to be seen which national union represents the largest numbers of RNs for collective bargaining.

Is it the UAN, CNA/NNOC, or the SEIU?

The Big Four Disaffiliate from the United American Nurses

The Ohio Nurses Association, New York Nurses Association, Washington State Nurses Association, and the Oregon Nurses Association have all opted to disaffiliate from the United American Nurses (UAN). See http://www.uannurse.org/media/hot_issues.html?view=press_release&press_id=302. See also

http://www.ohnurses.org/displaycommon.cfm?an=1&subarticlenbr=258.

The UAN was the largest RN union in the country. I seriously doubt the UAN will be able to make that claim now that over 50,000 of its membership has disaffiliated.  These collective bargaining agreements were serviced at the state nursing association (called constituent members associations or CMAs now) level so there shouldn't be any interruption in services provided to RN union members.

2007 has been a year of surprises in nursing. Onward and Forward....What will 2008 hold for the profession of nursing?

Do you think national nursing unions are a thing of the past? Is there a need for national nursing unions?

Texas Medical Board Being Sued

The Association of American Physicians & Surgeons (AAPS) is suing the Texas Medical Board and alleges that the Texas Medical Board engages in the manipulation of anonymous complaints, has conflicts of interest, violates the due process of physicians, engages in breaches of privacy, and engages in retaliation against those who speak out. See the attached complaint. Download tmb-12-20-2007.pdf

Do you think healthcare licensing boards, including Medical, Pharmacy, and Nursing Boards, need a major overhaul? If so, what changes would you recommend?

Do you think national and state nursing professional associations will respond to the lawsuit filed by the AAPS against the Texas Medical Board? Do you think national or state nursing associations should file law suits against state nursing boards on behalf of nurses? In your opinion when should a nursing professional association sue a state board of nursing? What's your opinion?

Don't Sign a Document You Don't Understand

My law practice used to slow down around Thanksgiving and pick up again around Valentine's Day or March. I am really busy, so much in fact that I am planning to bring an assistant on board next to help me with administrative issues (invoices, scheduling face-to-face meetings and phone consultations, marketing, etc.)

One of the most common themes I have observed this year from my law practice is a trend of signing documents and not understanding or taking the time to understand the implications of your signing said document.

For example, Barry self-reports a chemical dependency to a state board of nursing and is accepted in the Board's Alternative Program for Chemical Dependency. Barry signs a 8 page Monitoring Agreement. Barry knows that he is supposed to strictly comply with the Agreement but he doesn't for whatever reason.

Another example, Sherry is a nurse and she signs a Consent Agreement that imposes temporary and permanent practice restrictions on her license and other conditions on her license. Its a 7 page document that lists the conditions. Sherry fails to comply with the Consent Agreement.

Do not under any circumstances sign a document unless you understand each and every condition, provision, and term in the document and the practical applications for your nursing license. 

An Unrestricted Golden Ticket

I was interviewed several months ago by the Center for American Nurses, see www.centerforamericannurses.org about board of nursing disciplinary investigations and whether or not nurses need legal representation. Attached is the article. Download centerarticleBOARDofNursinginvestigations.pdf .

Please answer the following:

1. If you were charged with a felony in the criminal justice system; would you retain an attorney? Of course you would.

2. If you were named as defendant in a nursing negligence case; would you retain an attorney? Of course you would.

3. If you were being sued for defamation or libel by a coworker related to a workplace incident; would you retain an attorney? Of course you.

Why is it then that we as nurses question whether or not we need legal representation, counseling, and advising when your "golden ticket" (this is the term used by an Assistant Ohio Attorney General at an Administrative Law Seminar last week to describe a healthcare professional's license) is being investigated by the state board of nursing or attorney general's office? 

I traveled to Indianapolis this weekend to meet with a prospective client, who was concerned about "making the Board mad" if he retained an attorney to represent him before the Board. If I had $39.95 for each time I was asked this, I could.... Oh, I discussed this in a previous post, so I won't go there. See http://advocatefornurses.typepad.com/my2cents/2007/11/angry-nurses-an.html

The general lack of education, training, appreciation, and awareness that we as a profession have regarding professional associations standards of practice, state nursing law and regulations, and employer-specific workplace policies and procedures which ALL impact the ability and suitability of a nurse to carry an unrestricted golden ticket is unacceptable.

Are you concerned about your golden ticket?

What's your mission?

I plan to blog for the remainder of the week regarding my observations from the Ohio Attorney General Administrative Law Seminar. This seminar and the underlying tones and messages from the seminar gave me something to think about driving from Columbus to Cincinnati this evening.

I have also decided that 2008 is the year for me to move forward with starting my non-profit; the focus of the non-profit will be nursing law and regulation, and assisting nurses with legal issues. I have wanted to do this for several years and I hesitated because I assumed that one day one or more of the many national or state nurses association would start to fill in the gaps in this area.  I am volunteering for job!!!! 

I love practicing law and will continue my law practice. However my goal in practicing law and consulting has always been to connect with individual nurses about the law, legalities, and legal issues in nursing. To a certain extent, I am able to accomplish some of this as a licensure defense attorney. This is my mission and I am passionate about representing, counseling, and advising nurses.  Just like a nurse, I know, always in rescue mode, don't remind me?

What do you think about the concept of a non-profit focusing on nursing regulation and legal issues?

I am also pleased to announce that next year, I will be presenting with Cross Country Education and conducting a 6 hour legal seminar for nurses. The seminar will begin in March 2008 in Illinois and Wisconsin. I want to reach out to more of us about the law, legalities, and legal issues in nursing and presenting with a national company provides me with this opportunity on a larger scale.

What's your mission? What are your professional goals for 2008? 

Ohio Board of Nursing Disciplinary Investigations: Can it Happen to You?

RWS Education, LLC. is a company owned by Wynne Simpkins, MS, RN. Wynne was employed with the Ohio Board of Nursing for a number of years and later worked as the Executive Director of the Licensed Practical Nurse Association of Ohio. See www.lpnao.org.

Wynne's company which offers CE for nurses is sponsoring a three hour CE event for nurses in Cincinnati, Ohio. The title is Ohio Board of Nursing Disciplinary Investigations: Can It Happen to You?

Both Wynne and I are the presenters. The date is April 23, 2008 from 1pm to 4pm at the conference center at Drake Hospital. The Drake Center is located at 151 W. Galbraith Road. The application for CE is pending with the Ohio Nurses Association. The registration deadline is April 4, 2008.

The cost is:

$50.00 for RNs or LPNs

$40.00 for members of LPNAO or ONA

$25.00 for students

$35.00 for early bird registration (received by March 1, 2008).

The content includes a discussion of the investigation and discipline of a nursing license in Ohio and the legal rights and responsibilities of nurses in disciplinary investigation.

Registration is limited to 75 attendees. For additional information about the seminar contact Wynne at 937-620-2861 or bartkinswr@aol.com.

I will post additional information about the seminar as it becomes available on my website at www.nursing-jurisprudence.com and on this blog.

Fairness is in the Eye of the Beholder

I attended the first Annual Administrative Law Seminar sponsored by the Ohio Attorney General Mark Dann's office today. It was really a very nice and informative seminar. Healthcare licensing boards were a focus of the seminar and the presenters.

One speaker remarked that Board disciplinary investigations, proceedings, and adjudications are handled in a fair manner for the most part. I would caution however that fairness, like beauty and ugliness is in the eye of the beholder.

Its easy for defense attorneys, judges, hearing officers, assistant attorney generals, and in-house regulatory board attorneys who are trained in the law to conclude that investigations, proceedings, and adjudications are "fair" in the sense of substantive and procedural due process rights afforded by federal and state constitutions, stautory law, regulations, and case law.

Fairness for me as a practicing Ohio registered nurse is more than notice and the opportunity to be heard in sense its expressed in  Ohio Revised Code 119 and Ohio case law. This concept and plea for action was expressed and implied by a few at the seminar; let's hope that the plea is heard and acted upon.

In administrative law, respondent licensees are not afforded the "rights" afforded to litigants in the civil justice system (depositions, discovery, statute of limitations, etc.) and to defendants in the criminal justice system (depositions, discovery,  statute of limitations, etc.). A licensee doesn't know this until he or she becomes involved in a licensure matter and 9 times out of 10 still doesn't know this because he or she is not represented by counsel before a licensing board. Is this fair to licensees?

The definition and practical application of fairness in nursing board disciplinary investigations, proceedings, and adjudications is in the eye of the beholder. The beholder can be a nurse, nurse regulator, board staff, defense attorney, patient, HCO administrator, state nursing association staff, etc.

What's your opinion? Do you think nursing board disciplinary investigations, proceedings, and adjudications are fair? How do you define fair?

Are You Engaging in the Unauthorized Practice of Law?

This article appears in the Fall 2007 Momentum, a publication of the Ohio Board of Nursing, on page 6. The question is directed to nurse educators and faculty and notes "faculty members or administators may encounter situations in which a nursing student seeks help in addressing questions on the licensure applications that could be construed as legal in nature." See http://www.nursing.ohio.gov/publications.htm.

What's the bottom line? A nurse unless you are a licensed attorney in your state, you should NEVER give another nurse or nursing student any legal advice or counseling about a professional practice matter which includes the completion of Board of Nursing Applications for Initial Licensure and Endorsement.

I blogged about this issue a few months ago as I am finding that more and more nursing students and nurses receive "legal advice" from non-attorneys about disciplinary investigations and professional practice matters. If you want to practice law, graduate from law school and pass a state bar exam. No exceptions.   

Are you a Nurse?

My grandmother had surgery on Friday and will be hospitalized for 7-10 days. I spend most of my days at the hospital with her. My 6 y/o nephew, who was diagnosed with pulmonary hypertension and ASD is scheduled for a cardiac cath on Friday and will be hospitalized for 3-4 days. I will spend this entire week and two or three days of the following week at Cincinnati Children's Hospital and University Hospital.

When a family member is hospitalized, how do you respond when you are asked, are you a nurse? Maybe I should using legal terms like negligence, licensure defense, liability, and assumption of the risk; do you think someone will ask, are you an attorney?