Nursing Law & Order

Drug Stealing Nurses: An Epidemic- Watch the Video

See this video at http://www.kdvr.com/videobeta/watch/?watch=47936018-e07a-4609-bda7-6b5c0fcfc95c&cat=b22125c7-493e-446c-8ae4-453443bd82c4&src=front&title=Drug-stealing%20nurses:%20an%20epidemic?

See also http://associationdatabase.com/aws/NADDI/pt/sd/news_article/21390/_PARENT/layout_details/false.

CRNAs, the State Nursing Board, and Addiction: the Pedal to the Metal

I don't know where to start with this post so I will  begin and end by saying if you are a CRNA and you are stealing medications, self-administering medications, abusing alcohol, or diverting medications:

1. You may have a chemical dependency and you should be evaluated ASAP;

2. You may need a criminal defense attorney if you are stealing medications; theft of drugs is usually a felony in most states and jurisdictions; and

3. You may need a nursing license defense attorney to assist you with the State Nursing Board. Talk to your license defense attorney about your State's Alternative to Discipline Program for Chemical Dependency.

If you are a CRNA and you are stealing drugs or impaired at work, then the State Nursing Board will be involved at some point because of patient safety issues and public protection. This is a no brainer.

Local law enforcement and the State Nursing Board really go through these types of cases with a fine tooth comb for public protection and safety.  Some states and counties really "go hard and play hard" when licensed healthcare professionals (whether its a nurse, physician, or pharmacist) steal medication. The disease of addiction takes a back seat or gets placed in the trunk of a fast moving Chevy and protecting the health, safety, and welfare of patients and the public is in the driver's seat with the pedal to the metal. I watched the Fast and Furious last night on DVD!  

CRNAs, addiction, and the State Nursing Board. These cases can be much more complicated than your typical (if there is a such thing as a typical case before the State Nursing Board) nurse dependency case because CRNAs have much more autonomy and prescriptive authority than RNs and other advanced practice nurses. With CRNAs more autonomy means more money (CRNAs can do the money dance because most are making the big bucks) AND also more responsibility, accountability, and the potential for more liability.

Take the bricks out of your shoes and do one of more of the following:

1. Contact your Anethetists in Recovery (AIR) or state peer advisors for AANA. See http://www.aana.com/Resources.aspx?ucNavMenu_TSMenuTargetID=154&ucNavMenu_TSMenuTargetType=4&ucNavMenu_TSMenuID=6&id=191

 Call the Peer Assistance Hotline at (800) 654-5167

2. Get yourself evaluated by an CD evaluator or an addictionologist and get treatment ASAP;

3. Talk to a criminal defense attorney in your state or jurisdiction and confess your soul because whatever you say is confidential;

4. Talk to a nursing license defense attorney in your state or jurisdiction and confess your soul because whatever you say is confidential; and/or

5. Call Jack at 513-328-7253 and confess your soul. Jack loves to talk and he will listen. Jack is former CRNA who is in recovery and works with me as a Recovery Assistant. Whatever you say to Jack is confidential because he is working at the direction of an attorney. Jack is not an attorney and cannot provide you with legal advice but he will listen and provide alot of hand holding and referrals.

Call someone or do something but get the help you need now. Today can be the first day of the rest of your life and the best day for your nursing career, license, and livelihood.  

It is possible and in some jurisidictions probable: Being sentenced to Actual Jail Time for theft of drugs or drug diversion!

See http://www.roanoke.com/news/roanoke/wb/217557

Here is the cut and paste from the Roanoke Times (I get scared just saying Roanoke after watching the Stephen King's Storm of Century):

Nurse anesthetist gets 6 months in hospital drug theft

Alvin Earl Parkes had pleaded guilty to stealing the drugs at Pulaski Community Hospital.

By Mike Gangloff
  981-3336

A nurse anesthetist whose career in the New River Valley spanned decades will serve a six-month prison sentence for taking drugs meant for patients.

Alvin Earl Parkes, 62, had pleaded guilty in June to two counts of possessing a controlled substance tied to his theft of fentanyl citrate, a synthetic opiod used to treat pain. In U.S. District Court in Roanoke on Wednesday, he was given the longest prison term recommended by federal sentencing guidelines and fined $3,000.

An emotional Parkes apologized for what he described as an ill-considered bid to ease the strain of long shifts and tough hospital conditions. He said his working life had begun as a child and he had just wanted to stay at his current job long enough to pay down the debt on his farm in Draper.

"All I know is work," Parkes said.

Trained in the U.S. Air Force in the 1970s, Parkes said in June that he came to Pulaski in 1979 and worked most of the time since then at the town's hospital.

The charges against Parkes resulted from his stealing drugs at Pulaski Community Hospital between July and September 2008. A document filed by the prosecution stated that two years earlier, Parkes similarly took fentanyl while working at Carilion New River Valley Medical Center.

Parkes said Wednesday that the amount of painkiller to be administered to each patient was determined on a moment-to-moment basis by a nurse anesthetist and a supervising anesthesiologist, a medical doctor who would oversee several patients' surgeries or other treatments simultaneously. Various monitoring equipment also tracked bodily functions that would be interpreted as signs of increased pain, Parkes said.

He said he kept the fentanyl not needed by patients, administering it to himself by an injection in his wrist, where his watchband would cover it.

He said he never felt impaired by the drug but admitted that once he found himself signing a hospital form in an unusually tiny, precise script and realized he was more affected than he had anticipated.

Assistant U.S. Attorney Charlene Day said there was no evidence that patients suffered because of not receiving sufficient drugs.

Parkes said he sometimes filled vials with distilled water to help conceal his actions but kept track of which vials were water and which were fentanyl.

Day said in June that hospital staff became aware of Parkes' activities because he began reporting a much higher rate of broken vials to explain the missing drugs.

Several witnesses, including Parkes' daughter, testified Monday that stealing and using drugs was out of character for him.

A longtime co-worker, Judy Dalton, praised his manner with patients, saying he had been part of her own medical team when she underwent two procedures.

"Patients still come through and ask for him," Dalton said.

Judge Samuel Wilson said he recognized that Parkes had led "an otherwise exemplary life" but said the problem of drug diversion within the health care industry is a serious one. He opted for the upper end of sentencing guidelines that ranged from no incarceration to six months behind bars. Wilson said that Parkes will be supervised by the federal probation office for a year after his release.

Parkes has given up his license to practice medicine.

State Nursing Board Alternative to Discipline Programs for Dependency: 3 to 5 years or 5 to 10 years

If you are in an alternative program for dependency with a State Nursing Board, congrats on getting help and moving forward with your recovery.

I am being contacted by more and more nurses in Ohio, Kentucky, and Indiana as well as other states where I don't practice law about State Nursing Board Alternative Program for Chemical Dependency compliance issues and monitoring.

Here is something quick to consider:

1. An alternative to discipline program is wonderful because it allows you to be monitored and for the Nursing Board not to propose disciplinary action against your license for your violation of the Nurse Practice Act;

2. Read the agreement or contract and then read it again;

3. You MUST strictly comply with the Alternative Program contract or agreement. Partial or substantial compliance isn't enough;

4. Failure to complete the program may result in a suspension of your license or your case being referred for a disciplinary investigation;

5. These programs are not "quick fixes" and require long-term compliance and monitoring of 3years to 5 years;

6. Consider having attorney representation, counseling, and advising while you are in the program. You will have questions and concerns and these are things you can discuss with your attorney. Hire an attorney with experience in State Nursing Board cases and familiarity with addiction and nursing practice; and

7. If you relapse, report your relapse in accordance with the contract or agreement you signed. Don't look for avenues, ways and excuses not to self-report your relapse. I have been contacted by more than one nurse seeking to "get around" not self-reporting a relapse and trying to "knit pick" the definition of a relapse.  Addiction is a disease and relapse isn't uncommon. Report your relapse as required by the agreement or contract you signed. Failing to report a relapse can result in your termination from the program;

8. Before you enter into a State Nursing Board Alternative to Discipline Program for Addiction, speak with a nurse license defense attorney in your state or jurisdiction. Even if you don't retain the attorney, at least have a consultation with the attorney to review the terms and conditions in the agreement/contract with you before you sign the agreement/contract;

9. If you are in an alternative program in State A and State B and you want to apply for a license in State C and also apply to State C's alternative program, contact a nursing license defense attorney in State C before you start this process. Each State Nursing Board alternative to discipine program for addiction is different and all states don't have an "open admission" process; and

10. Don't despair because its a process and you will get through this also. Continue to work your recovery plan. Don't be afraid to ask for assistance from family, friends, and colleagues. Don't be to frugal to pay an attorney for a consultation or legal representation if you are hitting a brick wall and need counseling and advising on navigating the system. Yes, it costs money to hire an attorney and you may have to borrow the money or tap a retirement account. But this may be money that it well spent.

I am speaking with more and more nurses navigating a combination of the State Nursing Board alternative program enrollment, termination, and/or license suspension phases (depending on where you are in the program and how long you have been enrolled before the termination) for 3-5 years which may then be referred to the State Nursing Board for the discipline, reinstatement, and monitoring process which may be another 5-10 years (if you count the alternative program time or sometimes in addition to the alternative program time) without much success. Hire a nursing license defense attorney to work with you.  

CRNA facing 8 years of prison in a federal criminal drug diversion case in Virginia

See

http://www.usdoj.gov/usao/vaw/press_releases/parkes_11jun2009.html

 

 

Alternative Program for Chemical Dependency in California in the hot seat now!

http://www.propublica.org/feature/loose-reins-on-california-nurses-in-drug-abuse-program-725.

Does your State Board of Nursing have an Alternative to Discipline Program for Chemical Dependency?

Jack is Back! I am pleased to have Jack Stem, a colleague and a friend assisting me

I love Jack. He is such a good guy and we have worked over the last year on several projects.

I am referring to Jack Stem, of course. See http://www.peeradvocacyforimpairednurses.com/. See also http://www.selfgrowth.com/experts/jack_stem.html.

I have planned for more than a year or so to bring a nurse on board in some capacity to assist me with my law practice because I have more and more cases involving DUI/OVI/DWI, alcohol abuse, addiction, criminal convictions where drugs and/or alcohol is involved, controlled substances, dual diagnosis, prescription falsification, etc. 

I just needed to find the right person and I have found the right person to assist me in my law practice.

Chemical dependency and addiction cases with nurses are complicated and the licensure aspects can take years to resolve. These cases are not cut and dry; but maybe that's just my law practice....

Jack is in recovery as a former CRNA in Ohio. He works with the Ohio Association of Nurse Anesthetists Peer Assistance program and is "all over and on top of" addiction and dependency issues in nursing especially in the Ohio, Kentucky, and Indiana tristate area.

Jack is a recovery coach and provides services to nurses in his companies as well. Jack and I are co-presenting a series of CE events for nurses also this year.

Jack is coming on board as an independent contractor to assist me in my law practice starting in July. He will be assisting me with my clients who are in recovery as we wind through the disciplinary investigation, adjudication or settlement, post-discipline monitoring, reinstatement/monitoring, and/or State Nursing Board alternative program process.

Thank you again, Jack for all that you do and I am looking forward to working with you yet again and welcome aboard.

Jack Stem, CEO 

Peer Advocacy for Impaired Nurses, LLC

http://www.peeradvocacyforimpairednurses.com

Cincinnati, Ohio 45230

513-833-4584

jack@jackstem.com 

Bootleg Attorneys: Chemical Dependency Counselors, Therapists, and Evaluators Giving Legal Advice to Nurses

I spoke with a nurse this week who was ordered to evaluated for chemical dependency evaluation by the State Nursing Board in response to the complaint involving allegations of impairment and suspected drug diversion.

The chemical dependency evaluator told the nurse, "if you are guilty, you don't need an attorney, but if you are really innocent, then you should hire an attorney."

What the frack does that mean? I think this evaluator has watched too many episodes of Law & Order or CSI. Guilt and being innocent are terms more relevant in a criminal case, not a State Nursing Board matter.

I hear this all the time from nurses who then rely on this "I am not an attorney but...." type advice.

I really wish chemical dependency counselors, therapists, and other folks without a law degree and a state law license would stick to their scope of practice, do what they were trained to do, and stop giving legal advice to nurses and stop trying to counsel and advise nurses on their legal options in these types of cases.

Also nurses, stop asking for and soliticing this type of advice from evaluators, counselors, and therapists because most of it is not accurate anyway in my opinion.

Yes, I am a little hot under the collar because these therapists, counselors, and evaluators wouldn't pull this crap with a physician or dentist. They would stay in their place and provide the services they were asked to provide.

What is it about nurses and a nursing license that makes everyone and their mother qualified to be a bootleg attorney and ready and willing to provide legal advice and counseling on something so important as the life, livelihood, and career of a nurse? http://en.wikipedia.org/wiki/Bootleg

Although working in some healthcare facilities may feel like jail, nurses you are not in a prison environment where you need to rely on the advice of a bootleg attorney. Talk to a license defense attorney about a State Nursing Board matter.

State Nursing Board Alternative Program for Chemical Dependency

These are voluntary programs and are an alternative to discipline where a nurse with a chemical dependency enters into a program for monitoring (3-5 years) in lieu of formal action being proposed or taken against the nursing license related to addiction issues (diversion, theft of drugs, impairment in the workplace, etc.).

These are wonderful programs! However you should make sure that you understand the terms and conditions in the program Contracts and Agreements before you sign on the dotted line. Why? You have to comply strictly with the terms and conditions in the contract, not substantial or partial compliance but strict compliance as these are legal documents and there are consequences for non-compliance.

Although Nursing Board or Nursing Association (depending on who administers the program) staff review the contracts with nurses prior to entering into the program, I would suggest that you meet with a license defense attorney to review the Agreement with you. Don't just sign on the dotted lines and date without understanding the terms and conditions in these contracts.

I have spoke with several nurses this year in State Nursing Board Alternative to Discipline programs who are struggling with complying with the contracts for a variety of reasons. It helps to talk to someone before you sign the Agreement so that you know what your options are before you sign and who can walk you through the Agreement. It may also help to have attorney representation throughout your monitoring so that you have someone to counsel and advise you on the employment, workplace, and licensure issues presented with monitoring.

If you need a licensure defense attorney, see www.taana.org. Call the Nurse Attorney Referral Hotline for a nurse attorney or licensure defense attorney in your jurisdiction.

Two Caretakers Indicted for Allegedly Stealing Drugs in a Warren County, Ohio Nursing Home

The caretakers ere charged with theft of drugs, illegal processing of drug documents, and aggravated possession of drugs, which are all felonies. The Enquirer refers to the former nursing home employees as caretakers and although I could not verify the Ohio Nursing Board license of both of the accused (I did for one online), I am assuming both of these women are nurses because of information recounted in the story.

http://news.cincinnati.com/article/20090512/NEWS0107/305120013/1163/Caretakers+accused+of+stealing+drugs

This is your fourth DUI; Are You an Alcoholic?

I was contacted yesterday by a APRN who received her fourth DUI over the weekend. I also had a family member (remember I have a large family) who received a DUI over the weekend, but that's another post.

The APRN is of course concerned about her nursing license and the impact that the fourth DUI, which is a felony will have on her nursing career, employment, and liberty, as she may be facing jail time. She is also concerned about her children, her husband, and her elderly parents and how this will impact her family.

What is your opinion? Does one DUI charge/conviction mean you an alcoholic or do you see it as a form of alcohol abuse but not alcoholism?

What about the 2nd DUI? What about the 3rd DUI? What about the 4th DUI?

Should I Smoke Marijuana and What Would LaTonia Do?

You were hanging out last week with a group of friends all of whom are successful and educated professionals ranging from nurses to teachers to lawyers to accountants. Someone pulls out a marijuana cigarette and its being passed around the group. You are a nurse and you work in a facility that recently implemented random drug screens.

You ask yourself, what should I do when you are handed the marijuana cigarette? You think to yourself, the chances of you being tested in the next 20-35 days is possible but not very probable and you decide to smoke the marijuana.

Two weeks later you are work at a hospital and there are large amount of missing controlled substances in the Omni Cell. Hospital security, nursing management, and HR are present and request that all staff with access to the Omni Cell proceed immediately (as coverage is lined up for patients) to Employee Health for a mandatory drug screen.

You panic, although you have nothing to do with the missing controlled drugs, you realize you smoked marijuana a few weeks ago and you will probably test positive.

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You don't know when you may have to provide a sample in the workplace related to a random drug screen, for cause drug screen, and reasonable suspicion. Do you feel lucky? Are you willing and able to roll the dice on your employment, nursing career, and license?

I know alot of folks smoke marijuana. I also know there are some of us using cocaine, heroin, crack, or other illegal drugs. Then there are the issues with prescription medication and medication use and abuse by nurses which impact patient safety and the care provided in the workplace. There are also a few of us who are doctor shopping to obtaining medications from several different providers and this is "okay" because you have prescriptions.

If you can't stop using drugs, talk to someone and seek treatment. If you can stop using, then stop before you are busted and when licensed healthcare professionals get busted, we really get busted, and the consequences are long-term, far reaching, and may appear extreme in comparision to what happens to other professionals and paraprofessionals in other occupations.

If I $19.95 for each and every time I have been told, "I know a ________ (your choice of profession or occupation) who was in the same situation and nothing happened with her license or job, I could have a manicure and pedicure at Mitchell's Spa and Salon every Friday for the remainder of the year.

If you are in situation, where you are about to do something you know or suspect is wrong, illegal, unethical, immoral, or unprofessional and you know the situation could have untoward implications and consequences for your employment, license, and career, just think of me, this blog, and ask what would LaTonia do?

FL and OH Licensed Nurse charged with DUI and Felony Child Neglect; Allegedly Abandoned a Disabled Child in the Home

See this article

http://www.tampabay.com/news/publicsafety/crime/article985508.ece

Addiction in Nursing: Where are we now and where are we going in the future?

Kudos to my buddy Jack Stem who was interviewed for this article appearing in RN Magazine.

Drug addiction among nurses: Confronting a quiet epidemicMany RNs fall prey to this hidden, potentially deadly disease.

See http://rn.modernmedicine.com/rnweb/Modern+Medicine+Now/Drug-addiction-among-nurses-Confronting-a-quiet-ep/ArticleStandard/Article/detail/592623?contextCategoryId=47338

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Jack and I are working together on chemical dependency and legal issues in nursing topics for nurses in the Greater Cincinnati, Ohio area.

I see alot of addiction and drug abuse cases in my tri-state law practice and it is troubling to see the road that one travels and the stigma associated with being a nurse and having a chemical dependency.

Sometimes it starts with a single DUI and morphs into something else. Other times it starts with prescription pain medication and gradually erodes into something else. For others its obtaining controlled substances from physician colleagues and prescribers in the workplace and a number of treating physicians and this spirals out of control. For a few it starts out with medicating depression or other issues and leads to a dual-diagnosis.

Criminal charges and convictions, DUI/DWI/OVI, reasonable suspicion drug testing, randon drug testing, criminal defense attorney, license defense attorney, Nursing Board investigations, Alternative Programs, Consent Agreements, Agreed Orders, Recovery Monitoring Agreements, Return to Work Agreements, suitability for licensure, diversion programs for criminal charges, law enforcement, drug diversion task force investigators, pharmacy board investigators, Nursing Board probation and monitoring, Daily Call-Ins for Drug & Alcohol testing, CD evals, psych evals, NA/AA support meetings, criminal probation, criminal parole, license suspension, Nursing Board investigator, Nursing Board attorney, license revocation, limited license, practice restrictions, diversion, permanent practice restrictions, narcotic restrictions, temporary practice restrictions, probation officer, monitoring agent, action against a license, employability, appearance before the Nursing Board, Nursing Board hearing, and others terms that you don't associate with nurses and nursing become common place for those struggling with and fighting drug and alcohol addiction.

For those of us who don't have a chemical dependency, please show some compassion for our colleagues who have a chemical dependency and are actively dealing with it AND prary for our colleagues who have a dependency or abuse issues and who are in denial.

National Organization of Alternative Programs (NOAP) Annual Meeting

I booked my flight, paid the registration fee, and reserved my hotel room in Austin, Texas for this 3 day conference. I am looking forward to the content as I am seeing more alcohol abuse and abuse and chemical dependency and addiction cases in my law practice.

If you are attending this conference in Austin, Texas, let me know.

http://www.alternativeprograms.org/2009_Conference_Brochure.pdf

Alternative to Discipline Programs for Chemical Dependency in Nursing

I have budgeted to attend two to three conferences this year. I am frugal and I have to feel it is worth my hard earned money when I pay several hundred dollars to attend a conference and then fly in and pay hundreds of dollars for hotel room.

I am registered for the Center's LEAD Summit in Orlando in June 2009. The content on conflict management, patient safety, and nursing fatigue is relevant to my law and consulting practices.

I think I found my second conference. Its the National Organization of Alternative Programs 2009 Annual Meeting in Austin, Texas, April 1-3, 2009. I am going to think about it this weekend and decide. The content is interesting and relevant to my law practice.

See http://www.alternativeprograms.org/2009_Conference_Brochure.pdf

TAANAs  (The American Association of Nurse Attorneys) annual meeting this year is October 1st-3rd. October is a busy month for me and I have only attended one TAANA annual meeting, in Chicago, which is driving distance for a road warrior like myself.

I don't think I am attending the TAANA Annual Meeting this year; it depends on the program. Who am I kidding, I won't attend but each year I keep hoping there will be such a eye dropping program that I will write the check from my personal money market account without a grimace.

Now next year, TAANAs annual meeting is in Lexington, Kentucky (I can drive to Lexington, KY with my eyes closed) so I will probably attend.

See the 2009 Call for Presentations for the 2009 TAANA Annual Meeting at http://associationdatabase.com/aws/TAANA/pt/sd/news_article/7094/_parent/layout_details/false

Legal Issues with Chemically Dependent and Chemically Impaired Nurses

Do you want to know more about the legal issues associated with chemical dependency and impairment in nursing? Do you want to learn more about the professional practice and workplace issues involved with chemical dependency and nursing? What are some of the most common signals and signs that a nurse may be impaired or have a chemical dependency? What are your ethical responsbilities if you suspect that a co-worker has a chemical dependency? What is an State Nursing Board Alternative Program for Chemical Dependency?

The Center for American Nurses is sponsoring a legal webinar for nurses titled Legal Issues with Chemically Dependent and Chemically Impaired Nurses on Wednesday, February 18, 2009 from 7pm to 8:15pm ET.

The presenter is Cynthia Mikos, BSN, MBA, JD who is a Florida licensed attorney with years of experience in nursing licensure defense and health care law.

For additional information or to register online see www.centerforamericannurses.org.

CAPTASA Conference in Lexington, Kentucky focuses on Chemical Dependency and Addiction

I am registered to attend this conference in Lexington, Kentucky. Its a highly rated chemical dependency conference.

Although its a two day conference, I am only attending on Friday as I scheduled appts on Saturday forgetting it was a two day conference.

See the conference website at http://www.captasa.org/

Convicted of a DUI and a Licensed Nurse in 2 states. What do I do?

Last year there were plenty of posts on this blog about DUI. I am attending a two day seminar in Lexington, Kentucky on chemical dependency this month because I see alot of these issues in my cases.

I saw this post on allnurses.com which was immediately closed by the administrator. The nurse is seeking legal advice related to a DUI and the impact on his/her license in Ohio and Virginia.

Just a thought, I know we live in an age where online communication is the norm with Web 2.0, linked in, facebook, my space, list serves, forums, chatrooms, emails, blogs, websites, etc. These mediums serve a real purpose. However a word of caution.

Don't plead your legal case in an online chatroom or listserve. This year I have started asking new clients to provide me with copies of internet and web discussions posted regarding their case. You will be surprised at the information that one is willing to post online because of the anonymity. What's posted online usually differs from what I have been told, imagine that?  

http://allnurses.com/general-nursing-discussion/need-advise-359894.html

Butler County, Ohio Nurse Convicted of Drug Theft and other crimes

http://news.cincinnati.com/article/20081118/NEWS0107/311180044

Here is the cut and paste:

LEBANON – A nurse at The Otterbein Home pleaded guilty today to five drug-related charges.

Roxie Luff, 22, was stealing Hydrocodone and Oxycodone from the retirement facility, 585 N. State Route 741. She would manipulate her patients’ charts to indicate that they had been given the drugs, and then take them for herself, said Warren County Prosecutor Rachel Hutzel.

Tests of her patients revealed that they had not received the drugs that their charts indicated, Hutzel said.

Luff pleaded guilty to three counts of theft of drugs, one count of aggravated possession of drugs, and one count of illegal processing of a drug document, or altering the patient’s charts.

Her sentencing has been scheduled for Jan. 6 in Warren County Common Pleas Court.