My 2 Cents

I See Why Nurses Represent Themselves

This was a busy week for me with inquires about representation.

I had a nurse say to me after I quoted him a flat fee for representation "I've spoke with three attorneys about representing me before the Board. The fees are too high and I see why nurses represent themselves in these cases." See this article/CE. http://www.wildirismedicaleducation.com/courses/147/index_nceu.html

My response was that is your choice. You as a professional have to decide whether to represent yourself or retain an attorney to represent you in a Nursing Board investigation.

Flip a coin, heads you represent yourself and tails you retain a licensure defense attorney. Maybe that is the better way to decide.

If I Hear "I only signed the Nursing Board Agreement because I didn't have a choice" Again

In a democratic society, you always have a choice. You may not like your options and choices but you have a choice. Wars have been fought and blood has been shed so that we as Americans have a choice in deciding how we live, work, raise our children, vote, etc.

If I had $19.99 for every time a nurse told me this I could afford to send my five dogs to therapy with a expensive shrink.

"I only signed the Nursing Board Agreement because I didn't have a choice"

Last time I checked, State Boards of Nursing are regulatory agencies of a State and are required to afford licensees with procedural due process before "taking action" against a license. You have choices in a Board of Nursing investigation whether or not you know you have rights, choices, and options. You have options although depending how far along in the process you are, you may not like your options and choices. But you still have a choice, rights, and options.

You also have a choice to determine whether or not you want to be informed of what your options are before you sign a document that impacts the remainder of your nursing career. Its your decision whether you decide to contact a licensure defense attorney or sign an agreement offered by the Board of Nursing to resolve your complaint. Its your choice whether or not you proceed to a hearing. Its your choice whether or not you speak with a Board of Nursing investigator. Its your choice whether or not you submit a formal response to the Complaint. Its your choice whether or not you agree to an investigative meeting to further discuss the complaint with an investigator.

Do you know what your rights, options, and choices are in a Nursing Board investigation?

Should you know what your rights, options, and choices are in a Nursing Board investigation?

What do you do if you don't know what your rights, options, and choices are in a Nursing Board investigation?

What Happens After "Board of Nursing Action" Against Your License?

This has been a very stressful week for me with my nephew being hospitalized for his ASD Repair. His ASD Repair is complicated by his pulmonary hypertension. We were really concerned that he may have to go on Flolan after his surgery. However no Flolan just his usual regimen of Digoxin, Lasix, Vasotec, Viagra, and Tracleer for now. His pulmonary pressure prehospitalization was just as high as his systemic blood pressure. Post-surgery his pulmonary pressure is still running higher than normal but lower than it ever has. We were praying that his pulmonary hypertension was secondary to his ASD and other cardiac defects.....but we are so happy the surgery was successful and that he is recovering.

I had a nurse practitioner contact me this week. She agreed to action against her license and now she can't find a job. I have a consultation scheduled with her this week to discuss her options.

1. Before you "agree" to action against your license, consult with a licensure defense attorney. You want to know what are chances for employment if you agree to action against your license and you want to know what your options are in the licensure matter before you sign a legal document. Talk to a nurse attorney who repesents nurses before the Nursing Board. You want someone who can give you the "skinny" fairly quickly. An attorney who represents nurses should be able to review your Agreement and have a discussion with you about what happens after Board of Nursing action against your license.  

2. Contact your state nurses association or the local chapter of the specialty nurses association. Lots of professional associations offer workplace consultations and counseling services.

Is Nursing for Everyone who wants to be a nurse?

I spoke on Monday at the Southwestern Ohio Nurses Association (SONA) annual meeting. I presented on Ohio Nursing law and rules; it was a one hour CE program offered by my consulting firm.

I had a ball! I had a chance to see old friends and colleagues at the Meeting.

This was a very interactive audience with excellent comments and questions about nursing licensure, criminal convictions, and student nurses.

I posed the question of whether we as a profession as socializing new nurses in the professional nursing practice. Comments varied.

There were lots of questions and comments about nursing students and criminal convictions and why are we seeing so many nursing students with criminal convictions.

I even had someone approach me after this meeting who works as a RN with incarcerated women. She mentioned that alot of these women (who are currently incarcerated in a women's penitentiary) were former nursing students or worked in the healthcare field and want to pursue a nursing education upon release. She wanted to know if these women (not individual cases but the women as a whole) had a chance for nursing licensure because of their criminal convictions and prison terms.

I was at a professional association meeting a few months ago and someone mentioned that a good percentage of the nursing students of today were the Taco Bell and McDonald workers ten and fifteen years ago and this is the reason why there has been a shift i the "mind set" of nursing students and more nursing students with criminal convictions.

A comment was made at this meeting that nursing schools shouldn't take a nursing students money if the school knows this individual will not be able to obtain a nursing license or will obtain a license with restrictions that will impact employability and career satisfaction. Wow!!

Don't flame me, this is just my two cents and a few observations:

1. Nursing is a female dominated profession and this attracts women of course.

2. Nursing has multiple entry levels to practice and this is very appealing especially in these tight economic times.

3. Nursing is seen as end to a means or a means to an end depending on who you are and where you are because of the multiple entries (LPN (one year), RN (two year), RN (four year), RN accelerated if you have a Bachelor's degree in another field, etc.)

4. Criminal convictions and criminal issue happen; there are lots of folks with criminal convictions. 

5. Individuals with criminal convictions like everyone else seek professional training and employment and healthcare and especially nursing is seen as a very viable option.

6. Nursing is considered one of the most trusted professions.

7. A career in nursing is not a right or entitlement. Nursing is not for everyone. Individuals with criminal convictions need to do some research and speak with a licensure defense attorney before applying to a nursing school to make informed decisions. A licensure defense attorney won't embellish your "chances of licensure" unlike some others.

8. State Nursing Boards, Nursing Schools/College, and Nursing Clinical Sites will continue to look into criminal convictions unless parameters and boundaries are imposed by the state or federal legislatures.

9. Proprietary nursing schools.

Ohio Attorney General Newsletter-Spring 2008

Here is a Spring Newsletter received from the Ohio Attorney General's Office. There are cases related to licensure discipline of physicians that may be of interest to nurses in the Newsletter.

Download admin_law2008041.pdf

Ohio Litigation involving a Nurse turns a Private Issue into a Public Forum

I receive a publication from the Ohio State Bar Association listing a summary of Ohio appellate cases each week. I receive the "Green Book" for attorney discipline cases because I want to make sure I am not doing what those attorneys did and for case law involving nurses and nursing.

I found a very interesting case which in my opinion illustrates why you there are some things that just shouldn't be litigated. A very private matter involving a nurse and her husband and her lover is a public record and was published in the Ohio State Bar Association Report.

The case involves criminal charge, civil complaint, marital  infidelity, and illegal wiretaps. Not the kind of thing you want published and made public when you are a licensed professional. 

See Hodges v. Hodges, 175 Ohio Ap..3d 121, 2008-Ohio-601 at  http://www.sconet.state.oh.us/rod/docs/pdf/6/2008/2008-ohio-601.pdf.

Ohio Peer Support Programs for Chemically Dependency

What is the status of Peer Support Programs in Ohio for chemically impaired and dependent nurses?

See this memo from the President of the Ohio Board of Nursing to the President of the Ohio Nurses Association. http://www.nursing.ohio.gov/PDFS/NextMeeting/M2/6.3ONALetter.pdf.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   

Identification Theft of Nursing Home Residents in Northern Kentucky

I had my purse stolen two weeks ago, which included my driver's license, debit cards, credit cards, and professional licenses. This occurred the day before I was flying to Washington, D.C. for a Center for American Nurses Meeting. I was hysterical.

So you can imagine the feeling of these nursing home residents who had their identity stolen by nursing home employees. The thieves applied for credit cards and purchased hundreds of thousand of dollars in merchandise.

The article did not indicate if any of the employees were nurses. See http://news.enquirer.com/apps/pbcs.dll/article?AID=/20080430/NEWS01/804300343.

The nursing home is of course embarrased and saying one employee used a fake identity to obtain employment. Hmm? What about fingerprinting and obtaining a national background check? Fingerprints don't lie. Most nursing homes have high turnover with direct care staff and I can imagine a scenario where a nursing home cuts a few corners to bring a "body" on board for staffing purposes.

What has been your experience with practicing in a nursing home? What's the good, the bad, and the ugly about practicing as a nurse in a nursing home?

I must be honest; yes, attorneys can be honest. I worked in a nursing for almost a year after I graduated from my ASN program and was working on my BSN. I did not enjoy it although I worked only two shifts a week. It could have been that I was a new nurse and I really wanted to work in a hospital and saw the nursing home as just a "job" until something else opened up. This was in 1993 and Hospitals here in Cincinnati were not hiring new grad nurses at the time.   

This is a cut and paste of part of the article below: 

Kathy McCameron, executive director of Atria Highland Crossing, said Bounds' background check showed no criminal history.

That was because Bounds wasn't the name she gave the nursing home when she applied. She used another identity that had no criminal history, McCameron said.

Bounds worked just one shift at Atria before McCameron told her to leave "because of some other incidents" that McCameron refused to specify.

The identity thefts started coming to light last summer when nursing home residents received bills for credit cards that they didn't know they had.

Those credit cards paid for pricey electronics as well as bills for cell phones and cable television.

The U.S. Secret Service, U.S. Postal Inspectors and police departments began investigating.

Disciplinary Investigations & Adjudications in Indiana

In Indiana, the Medical Licensing Section of the Office of the Attorney
General (OAG) investigates complaints against licensed health professionals including nurses to to determine whether a violation
of a licensing statute or regulation has occurred.

For additional information about the process, see page 12 of the March 2008 Nursing Focus, the Indiana BON's newsletter. See http://www.in.gov/pla/files/March2008.pdf.

The disciplinary investigation and adjudicative process and procedures vary from state to state. However there are several constants:

1. Its an adverserial process;

2. The role of the State is always public protection;

3. The role of the State is not to advocate for the best interest of its licensees; and

4. State employees (investigators, analysts, attorneys, reviewers, etc.) cannot provide you with legal representation or give you legal advice;

5. You have a right to due process in the investigative and adjudicative proceedings which includes the right to retain an attorney to defend you, notification of the allegations against you, and to a fair hearing.

Indiana State Nurses Assistance Program (ISNAP)

An article about ISNAP, the alternative program for nurses with chemical dependency issues in Indiana appears in the March 2008, Nursing Focus. Nursing Focus is the IN BON's newsletter. See page 6. http://www.in.gov/pla/files/March2008.pdf.