Nursing Law & Order

Nursing Students and Criminal Convictions: He Said and She Said

The Holidays are fast approaching and I am staying busy with my law practice. I am getting into the Christmas spirit and we are planning to have our Christmas Palm tree in the living room again this year. We are putting a colored (I think red or pink) tree in our bedroom window. We are also placing a tree or something near the fireplace in the family room and downstairs in the rec room near the bar (which should be interesting for folks who have too many gin and tonics). We are also having Thanksgiving dinner at our home this year. I enjoy cooking however we have a large family so my mother, grandmother, and I will split the menu and we will have other family members bring a small side dish, a dessert, or drinks.

I received a really distressing email from a NCLEX Applicant who is having trouble obtaining a license because of criminal convictions. The applicant was crying because she stated "I would not have went to nursing school if I would have known I would have these issues getting a license." This Applicant is a single mom, recently divorced who has 18k in student loans for associate in nursing.

If you are a nursing student, considering nursing school, or you will be sitting for the NCLEX and you have criminal convictions, you need to speak with someone, preferably an attorney with experience representing nurses in licensure matters before you complete your initial application for licensure by examination. Click here and see the info on my website related to NCLEX applicants and suitability for licensure.  http://www.nursing-jurisprudence.com/legalservices.html

Now I know your nursing instructor(s) probably told you to "just complete the application and you will be fine" but I would suggest that you speak with an attorney about your situation to obtain objective counseling and advising not just about your suitability for licensure but also about any hurdles you may face with employment.  Most if not all healthcare employers are conducting criminal backgrounds checks in states around the country.

I know you may think I am saying this because I am a money hungry lawyer (well I do like money and I am usually hungry) and I just want you to contact another money hungry attorney but I say this sincerely. You need to make informed decisions and too many of us are doing things because "we were told to do this by so and so." When you are dealing with something as precious and fragile as your license, your career, and your livelihood, you should not rely on "he said and she said" to make these important decisions.

DUIs R Us: There Isn't a One Size Fit All Approach for the Implications of a DUI in Nursing

I received at least 6 emails this week from nursing students, NCLEX applicants, and nurses from around the country related to one or more DUI/OVI/DWI convictions and its impact on employment, suitability for initial licensure and renewal, and placement in clinical sites. I always respond to emails because I know there are alot of us out there who need assistance and don't know where to turn.

You should contact the following for assistance:

1. an administrative law attorney in your state or jurisdiction for assistance;

2. a nurse license defense attorney in your state or jurisdiction for assistance; or 

3. contact The American Association of Nurse Attorneys (TAANA) for a referral to the above in your state or jurisdiction.

If you live, practice, or are seeking licensure in Ohio, Kentucky, and Indiana, you can schedule a consultation with my office. I cannot answer your question(s) unless you are a client or unless you schedule a legal consultation. For additional information about legal consultations, see my website at www.nursing-jurisprudence.com and click on consultations.

The cost of a 30 minute telephone consultation is $150.00 and the cost of a 60 minute telephone consultation is $250.00. I also schedule in-person consultations at my office for nurses in the Greater Cincinnati area (my office is really easy to find off I-275 on Reed Hartman Highway) or if I am traveling to area. We can schedule telephone consultation the same day if needed depending on my schedule. On average, I have between 5-15 legal consultations with NCLEX applicants, nursing students, RNs, LPNs, and/or APRNs a month. A legal consultation is a one-time event. http://www.nursing-jurisprudence.com/consultations.html

To pay for a legal consultation, go to website and click on the online payment tab. The payment can be made via debit or credit card and it posts immediately. You will then receive a phone call and/or email from me, my assistant, or my receptionist about scheduling the consultation. http://www.nursing-jurisprudence.com/onlinepayments.html

For additional information about the difference between a legal consulation vs. legal representation, see my website at http://www.nursing-jurisprudence.com/consultations.html.

You have to pay for and schedule a legal consulation with me if you want me to provide with a legal opinion or provide you with legal advice and counseling.

I do not offer pro bono (free) license defense or nursing law services.

Why am I saying this again? I had a nurse contact my office this week at least 8 times in a 2 hour period. She told the receptionist that she was a client and she needed to reach me ASAP and it was a matter of extreme importance and urgency. My assistant returned the call initially and the nurse told my assistant that she would only speak to me. I contacted the nurse and her first response was "thank you for calling me back, I am sorry about lying to your staff about being a client, but I really need to ask you a few questions."

I politely asked the nurse to stop speaking and instructed her to pay for telephone consultation online and I would be happy to answer her questions about the impact of a recent felony conviction on her KY and OH RN license later that evening. The nurse hung up on me.  WTfrack:(

You can contact TAANA at www.taana.org for a referral to an attorney who may offer pro bono services in your state or jurisdiction. You can also contact your local or state bar association for an attorney referral. You can also search the internet to find an attorney in your area who may be able to answer your questions without charging a fee. You can contact your State Nurses Association or Specialty Nursing Association for assistance or contact the State Nursing Board.

I Appeared before the Board without counsel and signed a Nursing Board Agreement without counsel: What Can I Do Now?

I spoke with a nurse today who was upset that she wasn't told that she could have had attorney representation before the Board.

1. Why didn't the State Nursing Board tell me I could have an attorney to represent me before the State Nursing Board?

ANSWER: You can hire an attorney to represent you in any legal proceeding. As a professional, you need to be informed of what your rights and obligations are in any matter involving your license, career, and professional nursing practice. Some State Nursing Boards will indicate in correspondence to a licensee in a pending investigation or matter "You have a right to retain an Attorney." Some State Nursing Board don't indicate this in correspondence to a licensee. Therefore as professional you need to have an awareness of what your rights, obligations, duties, and responsibilities are in any investigation, appearance, complaint, or other formal/informal matter related to your nursing practice.

2. Why didn't the Board tell me that I could have an attorney to represent me when I appeared before the State Nursing Board?

ANSWER: SEE ABOVE.

3. Why didn't the Board or/and Board Staff tell me that I could have an attorney counsel and advise me before I signed a State Nursing Board Agreement, Agreed Order, Consent Agreement, or Board Contract?

ANSWER: SEE ABOVE.  

Would You Surrender Your Nursing License? RN to the End

Would you surrender your nursing license? Have you surrendered your nursing license? If so, why?

My motto is "RN to the end" but I am questioning under what circumstances would I be willing to surrender my nursing license. I worked hard for my nursing license and even harder my law licenses but I question under what circumstances if any that I would be willing to walk away.

Would I surrender my license if its suggested or would I be the one nurse who is screaming "if you want my license you will have to take it" or "give me liberty, give me death, but I am keeping my nursing license" at a State Nursing Board hearing?  

My recovery assistant, Jack "Jackie" Stem, is a former CRNA who surrendered his nursing license and privilege to practice as a CRNA in Ohio. He will tell you that if didn't surrender his nursing license, he probably would not be alive because of his battle a decade or so ago with addiction. He is proudly clean and sober and active in the CRNA recovery community. He will tell you, you can call him and he loves to talk:) that "life doesn't stop because you no longer have a state nursing license." Call Jack at 513-328-7253. He has turned his struggle into a career assisting nurses with recovery issues. See www.jackstem.com and www.peeradvocacyforimpairednurses.com.  

RN, LPN, and the APRN titles are protected by law so if you don't have a license you can't call yourself a "nurse" but even without a title, you have the education, experience, and training. Are you still a nurse at heart even if you don't have the State Nursing Board sanctioned title of RN, LPN, CRNA, NP, CNS, or CNM?

More and more of us are voluntarily surrendering our nursing licenses, most of the time it is because of a pending State Nursing Board complaint. Would you "go out swinging and fighting" in the event of a possible revocation of your nursing license or would you surrender your license?

For those of us who did surrender, what are you doing now?

In some states, a voluntary surrender is like a suspension and at some point you can apply for reinstatement of your license. You may have to sit for the NCLEX Exam again. Its more like a non-permanent revocation.

However in some states if you surrender, you surrender your privilege to practice as a nurse in that particular state permanently. Its a permanent revocation and surrender of your privilege to practice nursing forever and always.

What are your thoughts?

Nursing Documentation Disasters: My Top 10 for the Funky Stuff

I am hearing about some pretty wild things going on related to nurses and documentation. So here it is, my top ten documentation disasters for the funky stuff (this is a legal term):

1. Charting ahead. Oh you know what I mean. Its only 8pm and you have charted up until 5am the next day for your 7pm-7am shift.

2. Addendums. Making addendums or changes in a medical record or on patient care documentation in violation of your facility policy.

3. Submission of false billing documentation for skilled nursing services provided and you are paid for those services. Why are you submitting notes for services you didn't provide anyway? Have you ever heard of fraud or theft?

4. Signing off documentation, charts, or flowsheets using someone else's signature. WTF, why are you intializing or signing "anything" for someone else anyway?

5. Destroying, concealing, creating, or alterating any type of medical record, flowsheet, competency, etc. after an incident to paint a prettier picture of the incident. What is your intent here?

6. Charting you peformed a task or skill on a flow sheet or in the medical record and you didn't perform the skill or task.

7. Sneaking a peek at the electronic medical records of your neighbors, family, and friends who are admitted to your hospital and you are not assigned to provide care for these individuals.

8. Getting sloppy with your administration, handling, and documentation of controlled substances in a hospital. Its your career and your license on the line. The Pharmacy Board and the police may get involved so don't be surprised.

9. Getting sloppy with your administration, handling, and documentation and counting of controlled substances in a nursing home or assisted living facility. Its your career and your license on the line. The Pharmacy Board and the police may get involved so don't be surprised.

10. The cover-up or a conspiracy (two or more nurses) to cover-up is always worse.

Have you ever heard of monkey see, monkey do?

If a nurse colleague jumped off a bridge, would you do the same just because your colleague did it?

My grandmother would say this to us all of the time growing up. LaTonia, if you saw one of your friends jump off a bridge, would you jump off the bridge? I would always so "no" of course but peer pressure is a "mother" also. Get it, now that's funny.

Trying to cover-up and conceal 1-9 and using deceit, deception, and dishonesty to rationalize your behaviors, actions or inaction when 1-9 occurs or you know that 1-9 is happening on your unit or floor and you do nothing. Remember, there is a Code of Ethics for Nurses and nursing laws and rules governing your practice.

If the funky stuff is happening on your unit, contact your State Nurses Association or a nursing law attorney in your state or jurisdiction to determine what are your reporting obligations.

Firing A Client is Never Easy: What if we lived in a perfect world?

I fired a client yesterday. It wasn't an easy thing to do but it was necessary. I wish that I could make everything all right in these cases for my clients but this is real life, real issues, real drama, and therefore I "keep it real" with all my clients.  

If you are looking for an attorney to just tell you what you want to hear, then don't call LaTonia Denise Wright, RN, BSN, JD. For some of us that's hard. I must admit when I have legal issues (yes attorneys have legal issues that arise) it hard for me to absorb the legal advice provided to me by own legal counsel. Years ago I planned to fight a fine "all the way to the Supreme Court" because I knew I was right. I called my personal attorney. She laughed at me. We are friends so she laughed at me a little more over the phone. She took me out to dinner, laughed at me some more, listened to me, and then gave me legal advice. I paid the fine.

What I have found in 12 years of law practice and 8 years in nurse license defense is its even harder to absorb for some nurses who have been representing themselves over an extended period of time in a State Nursing Board matter(s). I am going to add these types of cases to my red flag list going forward because as I was driving home from Louisville (I also attended part of the Kentucky Nursing Board meeting) yesterday, I kept thinking you should have seen this one coming. Actually I only recently started representing the nurse this month so damn, I guess I did see it coming. But that's what 12 years of law practice and 8 of those years on the legal battlefield performing triage teaches you, baby!

A nurse with a long standing State Nursing Board case may say I know my case, the facts, and the issues better than some attorney who I just retained, right?

I wish we lived in a perfect world. In a perfect world, I wouldn't have a law practice representing nurses before the State Nursing Board because in a perfect world, nurses would not be reported to the State Nursing Board. In a perfect world, all nurses would also be perfect and there would not be a need for mandatory reporting to the State Nursing Board.

Pre-Licensure Issues evolve into Post-Licensure Issues for Nursing Students and NCLEX-Applicants

This has been a very interesting year. I am being contacted by more nursing students and NCLEX-Applicants with a variety of legal issues pre-licensure which carry over into post-licensure issues.

I remember being in nursing school. Most nursing students don't have the funds to retain legal counsel. I know I didn't have that kind of money (okay I did in a rainy day fund) to spend on attorney fees. But I was initially licensed in 1993 as a RN and licensure for nurses has changed alot since then.

Pre-licensure issues for nursing students and NCLEX-Appplicants are turning into post-licensure issues for newly licensed RNs and LPNS, which may then carry on and forward into their nursing career, workplace, and may restrict employment opportunities.

I know they don't tell you this in nursing school but I guess its not their "job" to tell you these things. I hear

*  Why didn't my nursing instructors tell me this?

*  I can't find a job with all these restrictions on my license!

*  I didn't know I could contact an attorney!

*  Why wasn't an attorney appointed to represent me?

* What am I going to do now?

Then it gets even more difficult when you want to move out of state and obtain a license somewhere else. If you have pre-licensure issues, retain an attorney. If you don't have the money, talk to relatives or immediate family members. I am seeing nurses who are investing $20-60k in a nursing education (for a diploma, ASN, or BSN) only to find out at the end of the road that there is a licensure dance.

Do you dance by yourself? Or do you retain legal counsel and dance with a partner? The decision is yours of course and economic realities may dictate that you dance alone.

Board Contract, an Addendum to the Board Contract, and another Board contract or an Adjudication Order

What does this mean?

1. You have a Consent Agreement, Agreed Order, or Contract to resolve a complaint with the Nursing Board. This varies from State to State so we will call it a Board Contract.

Okay let's say you had 3 years of probation and monitoring. During the 1st year of probation and monitoring you were going through a nasty divorce and your spouse hits you, the police were called, and you both were arrested. You have to report the arrest to the Nursing Board because of the terms and conditions in your Board Contract that you signed.

2. You have an Addendum to the Board contract based on the DV (domestic violence) charge which was reduced to a simple assault. You agree with the Board to extend your probation by another year.

Okay now let's say you are continuing to practice at the Hospital and you are in your 3rd year of probation with the Board. You are getting excited because you may be able to apply for release from probation next year. You are now divorced and things are going well at work until you have a series of medication errors during one shift. One of the errors result in a patient death. The errors are related to you working 60-75 hours a week to pay your child support and support your new family; you are remarried.

3. Your license is automatically suspended because you failed to practice in accordance with safe standards of nursing practice. You will either take your case to a hearing, resolve the case with another contract with the Board, or apply for reinstatement pursuant to the terms previously agreed upon.

If you don't have legal counsel, you need it at this point. I am seeing Consent Agreements, Addendums, Agreed Orders, and Adjudication Orders with hearing transcripts that are the size of a phone book. I have to drink two cans of Pepsi to keep myself focused because there are so many documents cross-referenced. Okay, I am a drama queen and of course I am being dramatic, but you get my point!

___________________________________________

Does this seem unlikely? Actually its not and it can happen to anyone who practices as nurse. I am not saying its common because I think the majority of nurses have unrestriced and unencumbered licenses but a growing percentage have "action" against the license and a few of these nurses have multiple Agreed Orders, Consent Agreements, Settlement Agreements, Adjudication Orders, and Nursing Board contracts.

I am seeing this in my law practice in Ohio, Kentucky, and Indiana.

These cases are complicated because after a while the nurse becomes upset with the process and "being on probation", "jumping through hoops for reinstatement" for years and may give up. If this is you:

1. Stay on course;

2. Stay compliant with your Consent Agreement, Adjudication Order, Settlement Order, or Agreed Order; and

3. Stay healthy.   

Nursing Students and Nurses in Florida with Criminal Convictions: Beware of SB 1986

Here is the cut and paste and the link from the Florida Nurses Association website regarding SB 1986.

See http://www.floridanurse.org/legislative/index.asp

Here is the cut and paste of the information available on the Florida Nurses Association website:

LEGISLATIVE ALERT: (posted 8/11/09)
It is important for nurses and those considering entering nursing school to be aware of the implementation of SB 1986 which is a 160 page Medicaid Fraud bill which was passed in the last moments of session. It contains provisions which got past everyone concerning the licensure of healthcare providers convicted of certain felonies. If a provider or applicant has a history of a conviction for any felony relating to medical fraud, non-medical fraud or controlled substances, they may not be issued a license for 15 years after their probation has ended. The new law also requires that providers who have these convictions may not be issued a renewal license. This law is going to present serious problems for a number of providers and those who want to be providers. For example, a recent graduate of a nursing program was denied a license because as a freshman in college she had an issue with possession of marijuana. She has been through drug treatment and has successfully completed nursing school. Now she cannot get a Florida license due to this new law. There were a number of cases like this during the last Board of Nursing meeting.

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It is becoming more and more difficult to obtain and remain licensed in some states as LPN, RN, or APRN. Don't shoot the messenger but nursing is not necessarily the best career choice anymore for persons with criminal convictions regardless of whether expunged or diverted.

If you are a Florida nursing student or a Florida nurse who will have issues because of SB 1986, all hope is not lost. You may have to seek licensure in another state. Talk to a license defense attorney in a State where you are considering licensure before you just apply for a license however.

To the legal nurse consultant acting as a bootleg attorney in KY and advising nurses in licensure matters

You know who you are and I have been contacted again by one of your "clients" who you provided inaccurate legal advice. Why are you providing legal advice to nurses in State Nursing Board matters, assisting nurses with responding to State Nursing Board complaints, and counseling nurses on how to handle State Nursing Board matters when you are not a licensed attorney in KY?

From my understanding you are a RN, you took a LNC course, and you have a LNC business. There is a big difference and an entirely different scope of practice and level of oversight between being a legal nurse consultant and a state licensed attorney. 

What you are doing is legally, ethically, and morally inappropriate? You actually tell nurses, you can do what an attorney does for cheaper. You brag about your success in getting Kentucky Board of Nursing complaints and cases closed on behalf of nurses. That's cute, real cute.

You are putting yourself and the nurses you "represent" as a bootleg attorney at risk. If you didn't know, I will tell you the first thing these nurses do is contact a real attorney (you know one who has attended law school, passed a Bar exam, and is a sworn officer of the court) to complain about your services when things don't go their way.

Did you know fraud and misrepresentation are criminal charges and grounds for discipline under the State Nurse Practice Act? I guess not.

You are not a state licensed attorney and you cannot charge for the advice you to provide to nurses involved in State Nursing Board matters. This is the practice of law.

My suggestion for you is to go to law school, graduate from the law school, and pass a State Bar exam. Only then can you legally and ethically provide the services you are providing now as a RN and LNC to nurses involved in State Nursing Board matters.

I have been contacted by several of your clients in the past year. From my understanding you have "represented" lots of nurses and do everything short of actually appearing before the Board. Any investigation of your conduct will involve the nurses who sought out your services also.

Just a few things for you to think about:

1. Did you know a complaint can be filed against you with the State Nursing Board and the Kentucky Bar Association Unauthorized Practice of Law Committee and local authorities?

2. Did you know know that your actions may be criminal?

3. Have you considered what would happen if a disgruntled nurse-client decides to go to the police, the Kentucky Bar Association, or the Kentucky Nursing Board?

4. Have you considered that you can be sued in civil court for negligence, fraud, misrepresentation, etc. by one of your nurse clients?

5. Did you know the KY Supreme Court and the Kentucky Bar Association don't look very kindly at non-attorneys practicing law in the Commonwealth of Kentucky? 

6. Do you know anything about an injunction or injunction relief?  

Marital Mayhem: a Marriage, a Nurse, and a License. Keep Your Hands to Yourself

I am married now so I will post on this subject as I am receiving more inquiries, consultations, and cases involving a marriage, a nurse, and a license. I have more nurses contacting me regarding domestic disputes with a spouse or partner that go postal for whatever reason and reports start being made to the State Nursing Board or criminal charges and convictions pop up that will utimately be reported to the State Nursing Board. This is in addition to the divorce and custody battles that the nurse is dealing with on a daily basis. 

You don't want to be in criminal court, family court, and before the State Nursing Board at the same time, do you?

My husband has a state issued license also. Maybe I am still in my honeymoon bliss stage but I can't imagine us getting to the point where we are filing complaints against each other licenses and taking our relationship to the dark side of the force with criminal charges, battling in court over who gets the dogs (our kids are adults), etc.

I am a counselor at law, not a clinical counselor but if things are getting to that point, you need to talk to someone or consider exiting the relationship. Get some help and move forward.

Domestic violence (DV) charges and convictions can really put a damper on your employment options and impact your nursing license. I am seeing convictions involving assault, stalking, menacing, tampering with evidence, restraining orders and restraining order violations, domestic violence, telephone harassment, destruction of personal property, theft of personal property, etc.

All of these convictions can have a impact on your nursing license, depending on the State(s) where you practice.

Keep in mind these three things if you are a nurse and you are in a situation that escalates:

1. I learned this in preschool and I know it can be a hard rule to follow but keep your hands to yourself. Put your hands in your pockets or keep your arms crossed if needed.

2. You always have options; you may not like your options, but you have options with any and every situation; and

3. Criminal convictions involving violence against person or property can impact your nursing career, employment, and your license.

Kentucky Board of Nursing Complaint and You Have 15 days to Respond: Don't Go Willy Nilly

I received a phone call from a nurse this week who received notice of a complaint from the Kentucky Board of Nursing. Its on and popping in Commonwealth of Kentucky (and not just because of the possibility of casino gambling) because I have received several phone inquiries in the last two weeks from nurses in Kentucky with pending complaints.

The nurse wrote out a 36 page response (I am not kidding and this was the first red flag) to the Complaint and asked me if I would review the response. I informed the nurse that she/he could schedule a legal consultation with me and I could review the response and provide suggestions on the response after reviewing the complaint. I also informed the nurse that I was available to represent him/her before the Nursing Board.

Most nurses even in these tight economic times refuse to purchase professional liability insurance with a license defense benefit. Therefore whenever a complaint is filed with the State Nursing Board, if you want attorney involvement, you have to pay out of pocket for legal fees.

The nurse became upset because she/he was told to hire me by another nurse (thank you for referral) however the nurse has money to pay for my services, but wants to negotiate my fee or if I am willing to barter my services because the spouse of the nurse does website/blog design. Second red flag.

I am sorry that I cannot handle pro bono cases because we have a mortgage (actually two mortgage including our rental property) and bills just like everyone else. I really feel bad for some of the nurses who contact my office and who need legal assistance because as a license defense attorney, I know what is involved.

Maybe you can borrow the money, tap into your 401K or 403B. I had someone tell me jokingly several weeks ago in another matter that she was going to retain me even if she had to rob a bank. She then said she was just kidding and I am glad she did because I was going to have to contact State Bar Association ethics hotline to determine how to handle a prospective client who is threatening to commit an illegal act to retain my services. You can't tell an attorney you are planning to commit an illegal or criminal act in the future; we are officers of the court and we have codes of professional conduct and ethical canons, you know.

Okay now what? If a complaint is filed against your license with the Kentucky Nursing Board and you have 15 days to respond you can:

1. Retain a license defense attorney;

2. Seek assistance from a colleague to formulate your response, which is what I am told lots of nurses do anyway. I think this is a scope of practice issues but that's just me.

I was actually contacted by a nurse in Kentucky who was issue spotting for another another nurse involved in a Nursing Board complaint. WTF, do you think as a license defense attorney I am going to assist you in the unauthorized practice of law and practicing outside of the nursing scope of practice. This nurse also told me that she is very successful in drafting these responses and has had several cases closed.

Damn, I guess I didn't need my law degree to do this type of work after all;

3. You can draft your own response and submit all 36 pages of your response to the Board;

4. You can not respond;  or

5. You can consult with an attorney before submitting your response and seek limited legal counseling.

See www.nursing-jurisprudence.com for information about my law practice if you are involved in a matter before the Kentucky Nursing Board.

You are a professional and you can do anything of the above.

I can't tell you what to do however I would not advise you to contact a license defense attorney and/or the Board, swear and curse at the Board staff and/or the attorney about the complaint being filed, state you are going to sue everyone and their momma in the Nursing Board office including Board members for defamation and libel, and/or how you are NOT going take this anymore. http://www.youtube.com/watch?v=wJX1fEINRvs 

Don't do this to a license defense attorney; the attorney may not want to work with you. Imagine that? Third red flag, the nurse started yelling at me.

I just calmed the person down  and said I am unavailable and referred the nurse to the State Bar Association. I woudn't dare refer this type of prospective client to another license defense attorney.

If you don't know how to talk to me or my staff, then don't call my office or have someone else call for you. I am here to help you. Years of experience however has taught me to avoid some cases and prospective clients like a bride trying to avoid sweets and Pepsi days before her wedding. Yes, that's me baby!!!! 

Can you tell a nurse contacted my office really out of control this week?

Sometime I feel as if I am a criminal defense attorney or a family law attorney because emotions run high also in license defense cases; you are walking a tight rope without a net sometimes in these cases.

The Nursing Board deals with all types and personalities with nurses being investigated and the Boards are extremely cautious and rightfully so in these matters. You don't want to go there with the Nursing Board by losing your cool, making threats or what could be perceived to be threats, and going all willy nilly.

Again, if you cannot maintain your composure or objectivity in a Nursing Board matter, hire an attorney. If you cannot maintain your composure long enough for the Law Office of LaTonia Denise Wright, LLC to assist you, please do the following:

A. Move on to the next license defense attorney on your list; 

B. Don't contact the Law Office of LaTonia Denise Wright, LLC ever again in your natural life; and 

C. Take a chill pill; you are going to stroke out before the Nursing Board investigative process unfolds at the rate you are going.

My Nursing License was Suspended! What do I do now? How do I make a living? Where do I start?

I am receiving more phone calls and emails from nurses who have had their license suspended. Don't walk away from your nursing license!

I know its tough but don't just say "frack it, I don't want to ever deal with a Nursing Board again." The key is finding someone like me, who loves to deal with the Nursing Board to assist you.

I don't know your situation of course, but I know that there is help out there for you if you want to avail yourself to the resources and services out there for nurses in your situation. Yes, its going to cost money, especially to retain an attorney, but what is your license worth to you as nurse?

1. If your license is suspended there may be terms and conditions for the reinstatement of your license. You should receive a copy of this terms and conditions from the Board. If you don't have a copy or can't find your copy, then request another. It is very important that you review the terms and conditions for reinstatement of your license.

2. Consider contacting a license defense attorney in your state or jurisdiction to discuss your options. See www.taana.org. Attorney representation, counseling, and advising is important here also.

Attorney representation is not just for the disciplinary investigation and hearing process because if you license is suspended, there will be terms/conditions for reinstatement, and most likely some type of probation and monitoring by the Nursing Board.

Nursing Board probation is no joking matter and it requires strict compliance with the terms and conditions for probation; you don't get to pick which terms you want to abide by when on probation. I see sooooo many cases where nurses are non-compliant with Nursing Board probation and this leads to additional issues.

I spend alot of my time working with my clients who are currently on Nursing Board probation (which can range from 6 months to 5 years depending on the State Nursing Board and the allegations in the complaint(s).

I am also being retained by more nurses who are suspended, seeing reinstatement, or being monitored and who need assistance with not only the Nursing Board process and procedure but also the professional, employment, ethical, workplace, and sometimes criminal issues that arise.

Remember, the Nursing Board staff works for the Board and are not there to hold your hand or provide you with legal advice or counseling. That is not their role.

Some of the Nursing Board staff are nurses but they are there to protect the public. Don't take it personal as they are doing their job and you need to do your job. Its not a friendship; it is a professional relationship.

They are not their to be your friend and this should not be an expectation that you have anyway in your dealings with Nursing Board staff related to your nursing license.

Also being angry with Nursing Board staff doesn't help. Cursing and swearing at Nursing Board staff is counterproductive. Again if you can't maintain your composure because of everthing that has transpired, retain an attorney, who is an objective third party, to represent you.

3. You cannot practice nursing but that does not mean you cannot work especially in this tough economic times. This is where a license defense attorney, your State Nursing Association, peer support group, or nurse colleagues come in handy. Talk to other nurses about employment options which utilize your nursing background but don't require a nursing license. You cannot work in a position requiring a nursing license and you cannot practice nursing.  

If you are reading this post and your license is suspended or you know a suspension is forthcoming, start preparing yourself now! You can dig yourself out of this hole but you have to take the first step. Start climbing!

Is Your Address and Telephone Number Current with the State Nursing Board? If not, how will you receive notice of a pending investigation, complaint, or renew your license!

There is a reason why you are probably required by your State Nurse Practice Act to keep your mailing address current with the Board. In the event that a complaint is filed against your license, the notice of the complaint is mailed to your address on file with the State Nursing Board. The Board is required to "serve" you with the complaint and this service is perfected via your current mailing on file with the Nursing Board.  

If the Board is contacting you related to a complaint and you are not responding, the Board can move forward with proposing action against your license because it has afforded you with due process (notice of the complaint, an opportunity to respond to the complaint, right to legal counsel of your choice, opportunity for a hearing to dispute the accusations in the complaint, and fundamental fairness in the investigative and adjudicative proceedings).

Make sure you keep your CORRECT mailing address and telephone numbers current with the State Nursing Board. This is important for the license renewal application process also in some states.

If I say just say I have an addiction and I stole drugs, the Nursing Board will go easy on me? This is Common Knowledge!

I was asked this question this week. A nurse was told this by several colleagues that with State Nursing Board investigations the Nursing Board will "go easier on you" if you say you have an addiction and you stole drugs; this is "common knowledge."

Its just that simple, right? You admit to having a drug addiction, you stole drugs, and everything is in an instant made better, right? 

A few of things I can say are "common knowledge" in my 12 years of law practice and 8 years of license defense:

1. Nurses in general proceed pro se for the most part and represent themselves before the State Nursing Board in complaint investigations;

2. Nurses in general proceed pro se for the most part and receive "legal" counseling and advising on license, criminal, professional practice, workplace, and employment related issues from other nurses, family, friends, and co-workers. This includes the online chat rooms, message boards, and other online forums;

3. Nurses are very trusting professionals and in general assume that "everyone" has their best interest at heart; and

4. Nurses for the most part do not purchase their own individual professional liability insurance policy based on misconceptions and myths.

Impairment and addiction may have physical, mental, social, financial, criminal, license, employment, civil, workplace, regulatory, and career implications for LPNs, RNs, and APRNs and navigating through this maze and haze is anything but "common knowledge."   

Lexington GYN loses his medical license in Kentucky

See this post:

http://nky.cincinnati.com/apps/pbcs.dll/article?AID=/AB/20090514/NEWS0103/305140020

If you are an Advanced Practice Nurse in Ohio, Take Your Time with the Renewal Applications

Don't wait until the last minute and don't rush; take your time if you are an Advanced Practice Nurse in Ohio as you might have to review one or more of the following:

1. Your RN license;

2. Your COA (certificate of authority); and/or

3. Your CTP (certificate to prescribe).

Starting this year, we will no longer receive a wallet renewal card in Ohio therefore it is important now more than ever to make sure everything is renewed because practicing after August 31, 2009 in Ohio when your RN license, COA, and/or CTP has not been renewed is a violation of the Ohio Nurse Practice Act and can subject you to an investigation and discipline by the Board.

I am going to miss my card! My 2007-2009 card was stolen when some bastard stole my purse, which is why you cannot verify my RN license status online in Ohio.

I am receiving calls from RN in Kentucky who failed to renew their license in the Fall of 2008. Yeah, your employer should check to make sure you are not but its not your employer's license, so save yourself the frustration, extra cash, and legal headaches and renew your license and certifications (APRNs make sure your state required certifications are valid if needed for licensure) in a timely manner and before the deadlines.

Ohio Independent Providers and Medicaid Billing

Dear Ohio Nurses,

If you are working as an independent provider as a RN or LPN in home care where you directly bill the State of Ohio for the care provided in the Ohio Home Care Waiver Program, listen up. You must, there are no exceptions, submit accurate and correct billing for the care and services ACTUALLY provided.

Do not inflate your billings because at some point you will be audited and contacted by the Ohio Attorney General's office. These are very serious accusations!!!!

Allegations of overbilling the State may have criminal, license, regulatory, employment, and career implications for nurses. Also there are ethical, legal, and professional guidelines imposed by the Ohio Dept. of Jobs & Family Services in addition to the Ohio Nurse Practice Act and Nursing Board regulations (regulating conduct for all nurses) for indepenent providers and those exist for a reason.

I am seeing more cases in the last 4 years with RN and LPN Independent Providers in the State of Ohio and allegations of fraudulent billing and theft related to medicaid billing. These cases can get very complicated quickly and evolve into a legal nightmare for the nurses involved. 

If you are being investigated by the Ohio Attorney General's office for these allegations, you need to speak with an attorney ASAP.

Nurse License Defense: Its the Cradle to the Grave Approach for Me

When someone retains me in a license defense case, I am involved from the beginning to the end. Period. No exceptions unless you fire me as your attorney or I term you as a client.

But that's me because I like the extremes of an absolute. There is a thin line between love and hate for me, it is typically all or nothing with me, and a do or die mentality for me related to business and finances (http://en.wikipedia.org/wiki/Do_or_Die_(album); although I don't think in terms of black or white.

Can you tell my zodiac sign is Cancer? TMI.

I spoke with a nurse last week who hired an attorney to represent her before the Nursing Board. The attorney charged a large retainer ($7,500) and billed hourly ($175.00). The case involved a license suspension of several years. The nurse contacted the attorney and the attorney in order to represent the nurse in the reinstatement process requires another large retainer ($10,000) along with an hourly fee ($215.00). This is why nurses should have professional liability insurance with a license defense benefit, but that's another post.

Each attorneys establishes their fees differently and you want to understand what those fees are initially and what is included in the fee prior to initiating an attorney-client relationship.

In license defense cases, I charge a flat fee and I don't bill hourly unless the nurse or healthcare professional has professional liability insurance. I have been doing this long enough where I am comfortable quoting a flat fee for representation. I still track my time on flat fee cases to document the work peformed in my files however I am not bound by the ball and chain of hourly fees.

If I wanted to live in increments of six minutes or dream about time sheets I would have stayed and continued to practice in a large law firm environment. But that's just me. There are cases, typically where I am working for a healthcare organization on a limited basis or I am engaged as a consultant, where I am do bill hourly however it is not the norm for my practice.

What am I saying? Talk to an attorney about his or her fees for representation and obtain an understanding of what is included in the representation. Ask for a legal services agreement to memoralize the arrangement. And lastly if you are not comfortable with a particular attorney, speak with another attorney about your situation until you find an attorney who you are comfortable retaining.

Remember you are the client and it is your case, your license, and your money.

Representing Yourself Before the Nursing Board: It Sounds Good Until Things Don't Go as You Plan

I received a phone call from a nurse who is representing herself before a State Nursing Board. The nurse submitted a statement and met with Nursing Board staff for an investigative meeting and submitted additional information to the Nursing Board.

The Nursing Board is proposing action against the license and the nurse is very upset and is considering attorney representation.

If you are going to retain an attorney to represent you in any matter, do it at the beginning if at all possible. You are not necessarily saving yourself money by retaining an attorney later in the case.

It is difficult to be objective when you are representing yourself in a Nursing Board matter. Your emotions start flowing and you assume a "I didn't do anything wrong, I am a good nurse" posture. That may to true to a certain extent but the complaint and the investigation are still pending and must be resolved.

I asked this nurse, did you consider having attorney representation when you received correspondence from the Board? The answer was, why would I need representation at that point, I thought I could handle it.

And handle it the nurse has as the Board is proposing action against the license and the nurse has not had any representation, counseling, or advising on the process and procedure and the attending issues in these cases.

I know money is tight but your license is your livelihood and if you are involved in a State Nursing Board investigation, you should consider having attorney representation.

What is a few thousand dollars in legal fees compared to your lifetime earnings as a RN, LPN, or APRN?

Self representation is a right in country and you can call my office or the office of another license defense attorney and yell "Give me Liberty or Give me Death" into the phone.

The question is not can you represent yourself because of course you can represent yourself in any civil, criminal, or administrative matter. Is it in your best interest to represent yourself?