Advanced Practice Registered Nurses have an expanded scope of practice, more responsibility, more accountability, and potentially more liability for a general RN or LPN.
Also APRNs have the same issues for general RNs and LPNs and also prescriptive authority, credentialing, certification, and other issues generally not associated with RNs and LPNs.
If you are a APRN and you are representing yourself before the State Nursing Board in a complaint filed against your license, listen up. Here is my Top 10 like Letterman:
1. Everyone thinks a PERM; that's permanent revocation. Let me tell you there is "discipline" where you don't get a perm but it damn sure feels like it for APRNs; a public reprimand IS NEVER just a public reprimand for a APRN. Trust me on this one pumpkin;
2. Discipline, ranging from a public reprimand and up to a suspension can be the kiss of death for a APRN if you just sign on the dotted line (and have notarized in some cases) without considering the short-term and the long-term implications. Remember its never JUST a public reprimand. Also I want to know what SOBunny started saying "its just a public reprimand" because I am sure it wasn't a nurse license defense attorney;
3. Things are never just the way you see it; so that's why you need an bitter but objective attorney (like myself) to work with you;
4. Retain an attorney who practices before your State Nursing Board and who has handled more than one or two cases before your State Nursing Board.
Its nice the attorney practices is a pharmacist and practices before the Pharmacy Board and takes Nursing Board cases or practices primarily before the Medical Board (big dollar cases for physician representation) and will take on your case. Do your research and find an attorney, it can be a non-nurse but an attorney who practices before your State Nursing Board.
Why? Cases proceed differently before different licensing boards and while its all administrative law, you want someone who is going to take your case and work it not just take your case, take your money, and settle it without considering the short and long-term implications of any proposed discipline.
In a State Nursing Board case, you always want the best case scenario. In some cases the best case scenario is discipline, just a matter of how much. In others it may be resolving the case without discipline.
That's why I quote a flat fee for representation because I know this time next year if I am alive, guess what I will be doing. Two years from now; Five years from now. You guessed it and I work with my clients even after resolving a case throughout their nursing career.
5. APRN cases are complex. I charge more for APRN cases because APRN cases are complex. No ifs, No ands, and certainly no butts.
I was told by a APRN who is involved in a State Nursing Board complaint that the APRN spoke with several other APRNs who stated the care provided was consistent with the collaborating agreement and therefore the APRN would respond to the complaint without attorney assistance.
That's great, but you contacted me; I don't just call nurses around the state and say "hey this is LaTonia from CVG. I know what you did last summer? Have you received a complaint from the Board yet? No, your kidding me?"
I have been doing this for a long-time and if you can have a nurse license defense lawyer to review your statement, provide legal advice and counseling to you, and spend 25-40 minutes on the phone or in-person with you, then hop on that train. With APRNs, there are just too many documents I need to review and you can't just tell me "my SCA or collaborating documents are okay", I need to review those myself. Sorry.
This brings me to my next point with APRNs.
6. APRNs in general can and do make more money than general RNs and LPNs. I said in general okay. APRNs especially CRNAs have the means to pay for legal advice, counseling, or representation however most don't see a benefit to legal representation because "I didn't do anything wrong."
I think everytime I hear this on the phone, I willl place my speakerphone on mute and pimp slap myself in the face.
I think everytime I hear this during an in-person meeting, I will excuse myself and go to the men's restroom and just sit on the floor and smoke a cigar (I don't smoke), chug a tall boy of Colt 45 (I sip slow so I may need 4-6 hours to finish a tall boy without background music), and pop a Perc (I have a legally valid script for Perky from dental work in 1989).
7. APRNs this ain't legal advice but don't go to an investigative meeting (that's where you meet with a State Nursing Board investigator(s) without legal counsel). Be unNike and just don't do it! If you want to do it and you plan to do it; don't do it! You can thank me later.
8. APRNs if the complaint involves the State Nursing Board, State Pharmacy Board, or the State Office of Inspector General or Law Enforcement, call a nurse license defense attorney and don't say do I need representation just say "oh frack, we just paid property taxes, how much is this going to cost me?"
I immediately perk up when I hear someone else complaint about property taxes. I will say "really we did too! I hate paying property taxes, SOBunnies, but I don't mind paying federal, state or local income taxes. I like you and I will work with you on payment."
Hint, Hint. I am a solo and its my law firm. I don't have a laminated fee chart covered with dried ketchup from eating Chick-fil-A waffle potato fries and mouth watering droppings from an extra chicken Chipotle burrito in my law firm. No sir re, Bobby Junior, I threw it out yesterday. I am hungry now!
I set the prices quoted for legal representation and I pull the number out of my magic hat. I can say that will cost you "one dollar, sir." No seriously, I quote "blue light special" and "bottom basement" type fees if I am drinking Pepsi and chewing Extra sugarless gum and you make me smile or laugh.
9. APRNs if you are abusing your prescriptive authority and its reported (writing scripts for friends, family members, other nurses, etc.) to the State Nursing Board, you need legal representation. Oh, you didn't now that may be construed as abusing your prescriptive authority? Snap, you need a consult. Complaint involving your prescriptive authority? You need to be repped.
10. Last but not least, scope of practice and/or unsafe practice complaints or allegations of drug diversion. Long and complex cases. You need to be repped.
This is what an APRN needs. Assistance with the licensure matter and also an attorney who can essentially serve as "outhouse" counsel for the APRN when issues arise and issues do arise.
If you are a APRN regardless of whether you are self-employed, employed by a hospital, employed by a physician, or employed by a pharmacy chain, you need to have your own Nursing Practice Legal Counsel.