Nursing Law & Order

I Can Feel It! Living, Sweating, Breathing, and Bleeding Nurse License Defense for $995.95?

My law practice keeps me very busy. I love what I do for a living and it is my passion. Nurse license defense is still and has always been my dream job. Being on the frontlines in nurse license defense has shown me there is a need for additional services for nurses and nursing students related to the law, legalities, and legal issues. This is phase II for my practice and I am sooooooo excited that I am finally able to move forward with consulting practice while continuing with my bread and butter, nurse license defense in the context of my law practice.

Nurses just a few pointers however, attorneys provide a service to the public just like nurses provide a service to the public. The difference being that nurses are typically paid an hourly wage or salary by an employer for the services provided while most attorneys quote the fee or the amount for the service being provided to the public.

Why is this important and what am I saying? After 11 years of nurse license defense NOTHING surprises me anywmore in the context of my law practice; I am seen the worst in the profession and the arguably some of the best in the nursing profession also. I am not surprised but just puzzled by the number of nurses who need legal representation before the State Nursing Board but decide for "cost" not to retain ANY attorney.

You spend anywhere from $15,000 to $60,000.00 on undergraduate and graduate school nursing education for an ASN, BSN, MSN, or PhD. LPN or LVN programs cost $10,000-$20,000 now.

After spending tens of thousands of dollars on a nursing education, the majority of nursing students and NCLEX Applicants with affirmative responses on a State Nursing Board application will roll the dice and apply for a license without consulting with an attorney on the responses to the application questions. "My nursing instructor said this isn't a disqualification so I should just apply", "I am a different person than I was 5 years ago when I committed those 4 felonies and 3 misdemeanors and the Nursing Board will see this." You don't say?

A LPN, RN, RN-BSN, RN-MSN, or RN-PhD has an income potential of several hundreds of thousands of dollars or several million over the course of a lifetime of nursing practice. That's money. Nurses, as LPNs, general RNs, or APRNs don't earn server wages plus tips. Yet this is the disregard I see with respect to the severity and seriousness of a State Nursing Board complaint and the possible implications on licensure, employability, and the nursing career. You don't say?

I hear all the time "I don't have that kind of money for a lawyer", which is usually anywhere from $3,500 to $9,500.00 with most cases being at the $3,500 to $5,500 range (excluding probation and monitoring with the State Nursing Board) and the most complex cases ranging from $7,500 to $9,500.00. Even APRNs, with advanced education and who certainly earn more and have more scope of practice and more autonomy than LPNs or general RNs will frown at representation and proceed pro se. I quote a few cases over $10,000.00 but usually not because how I can structure my flat fees on case milestones. I don't quote low ball fees; I don't have to do this and it isn't a sound business practice. I quote a fee based on me working your case and we have to work license defense cases, in my law practice anyway. We go hard in my practice, just ask my paralegal.

I am even seeing cases where APRNs and RNs start their own businesses providing nursing services and maybe billing the government for services and fail to consult with and work with a nursing law attorney on the business basics before opening the doors. This is a recipe for disaster. Just look at the number of Independent Providers who have their license suspended and are indicated for fraudulently billing the State of Ohio for home care services. Why don't these IPs, both RNs and LPNs consult with a nursing law attorney? How can you bill for services and also practice in your business as a nurse with advice and counsel of a nursing law attorney? Not the corporate or general practice attorney who did your LLC, but an attorney who can assist you with the nitty gritty practice and operational issues like job descriptions, scope of practice, etc.  

Most nurses spend thousands of dollars on a vacation or two in a year, a bathroom remodel, or some other expense or luxury but will frown at the investment into representation, counseling, and advising in a State Nursing Board complaint which can silence, stop, end, terminate, or unfashionably cramp, crop, and crimp a lifestyle with its career and employability consequences. 

I can't represent you for $995.95 in ANY case and certainly not one where the Board has issued a Compulsory Psychiatric Evaluation (these cases are akin to doing that old school dance "the fight", Cabbage Patch, the Snake, and the Humpty Hump to slow music if you get involved late in the game. See http://www.youtube.com/watch?v=3suw_vb6-fY) and you are licensed as a APRN in Ohio, Kentucky, Indiana, West Virginia, Michigan, and Illinois. Sorry.

Nursing malpractice and nursing negligence don't end careers baby; State Nursing Board complaints and discipline of the license are the career enders pumpkin pie. Don't believe what you were told in nursing school or what you were lead to believe by colleagues. The issues isn't malpractice or negligence it is State Nursing Board discipline. This is why I am so excited about Phase II to my business, it only took me 10 years to get here but I am ready finally to offer additional services and products for nurses and nursing students on understanding the law and the practical implications for nursing practice. Better late than never applies to me and maybe you.

I am also planning to start volunteering as a nurse later this year to get my hands back in nursing practice. If you know where I can volunteer as a nurse here in Cincinnati, email me or call my office. Just a few hours a month.

Do yourself a favor and retain an attorney if a complaint is filed against you with the State Nursing Board and not necessarily the least expensive or cheapest attorney. Do your homework and retain an attorney who practices primarily before the State Nursing Board, there are usually several in any given state. I get calls from nurses who go with an attorney just because the initial fee was so cheap only to find the representation, counseling, and advising isn't that great. Retain an attorney who lives, breathes, sweats, and bleeds license defense and has represented  a lot of nurses. License defense is a cross between criminal defense and family law because the stakes are high and the emotions run even higher. Criminal law, family law, and license defense are intense but guess what Hot Mama (that's me) is intense also.

Also, I can't spend an hour in-person or by phone with a prospective client; unless you are paying me for my time. I offer legal consultations.

Nurses, you don't work for free as a nurse so don't expect me or any other attorney to review a shitload of documents (35-45 minutes plus any research time) and tell you your options and next steps on how to proceed and what to expect over 45-60 minutes "at no cost" as an attorney. Just the facts: this isn't a solid business model for a solo attorney and although I have found my passion, I am in business to make money (I have to pay bills too) and provide needed and necessary services to nurses.

I receive on average 35-60 calls and emails from nurses in Ohio, Kentucky, and/or Indiana who have pending issues with the State Nursing Board MONTHLY. If I (or my paralegal) spent 1 hour with each prospective client (who may or may not retain me) how could I work for my clients who actually pay me to provide them services? Just between Ohio, Kentucky, and Indiana, there are over 11,000+ complaints filed in a fiscal year, every year. Nursing malpractice and negligence complaints "go to your room" and take a nap because State Nursing Boards complaints are "in the house."  

We have free will and if you decide to proceed pro se in a State Nursing Board complaint, I sincerely hope and pray things turn out all right and okay for you. I pray for myself, my clients, and all of us as nurses.

Sometimes it turns out okay for nurses who represent themselves in State Nursing Board cases; others are not so lucky. The landscape is changing before State Nursing Boards in Ohio, Kentucky, and Indiana; I can feel it like DMX.    http://www.youtube.com/watch?v=I0nAjxPV-E8      

I see it and I am living, breathing, bleeding, sweating and practicing it daily; you can't say the same when you represent, counsel, and advise yourself in a matter which can/may break your nursing career.

 

Workplace Incident to State Nursing Board Complaint to Career Standstill to Professional Suicide and No Lawyer

The headline above is a worst case scenario but it is a growing reality for a number of nurses who represent, counsel, and advise themselves in legal matters involving their license. I cannot tell you how important it is for nurses, whether you are a LPN, RN, or APRN to seek advise and counseling from a private nursing law attorney when a patient care or other significant issues arises in the nursing workplace. No one, whether it is your nurse manager, nurse supervisor, union rep, risk manager, etc. is going to say to you "You need to consult with your own attorney about this situation." I haven't heard it in my 11 years of solo practice in nurse license defense. Not once. Most of the time, a nurse contacts a nurse license defense attorney or nursing law attorney ONLY AFTER the defecation hits the ventilation: the complaint is filed with the State Nursing Board, your union rep tells you "you may need to resign instead of being fired", your employer terminates you and says "we are required to report this to the State Nursing Board", you receive a letter of Complaint from the State Nursing Board, you are told you are being named as a defendant in a nursing malpractice case, you are contacted by local law enforcement about the "incident three weeks ago", etc.

I often hear nurses say "I didn't know there were nursing practice attorneys or nursing law attorneys that help nurses." Yes, there are nursing practice attorneys and nursing law attorneys whose primary role is to assist nurses and/or other licensed healthcare professionals. See www.taana.org.

It is not the role of your nursing manager, nursing supervisor, nursing union representative, risk manager, or anyone else to counsel and advise you objectively about the seriousness of an incident from a licensure, career, employment, or credentialing perspective. This is the role of a private attorney who has experience in nurse license defense, nursing law, and professional nursing practice matters. And guess what? You can't find an attorney with this type of expertise and experience in the yellow pages usually.

Yes, you can call the attorney who handled your divorce, you call the attorney who has helped your extended family in a number of cases, you can put on a blind fold and open the yellow pages and pick an attorney and call for a "free consultation" about your specific issues which is usually a combination of nursing law, professional nursing practice, employment law, labor law, credentialing, criminal law, nursing negligence, etc. Guess what? That attorney will not PROBABLY NOT give you the answer you need because the attorney does not have experience in the area.

Also I am pleasantly surprised yet again by the number of attorneys who represent nurses before the State Nursing Board just to take a case and make a few bucks and who know little or nothing about what it takes to adequately and effectively defend a nurse before the Board and counsel and advise the nurse on attending matters. Is a nurse a nurse a nurse? Of course not. Therefore an attorney is not an attorney is not an attorney. Why do you want an attorney who practices primarily wills and trust representing you before the State Nursing Board? Is it better to have any attorney (regardless of whether or not the attorney has ever practiced before the Board or has experience advising nurses) as opposed to an attorney who can competently handle your case and assist you?

It is your case, your license, and your livelihood and this is a question you as the nurse should answer and consider when retaining counsel. I only practice in the areas of nurse license defense, nursing practice, and nursing law; no wills, no personal injury, no workers comp, etc. You don't have to retain me in Ohio, Kentucky or Indiana; just retain an attorney who can effectively represent you and who has experience representing nurses. Nurses as licensed healthcare professionals have different legal needs than your average consumer and this is significant in the context of representation. These cases are time intensive and you don't want an attorney to take your case and not work it like it should be worked.

What am I saying? I don't say much on the blog these days because my law practice is keeping me busy but I am getting fired up again because I am seeing where nurses are being TOO TRUSTING and not looking after and protecting THEIR LICENSE, CAREER, CREDENTIALS, and hard earned EDUCATION.

Sorry to say this but I am a nurse first also. Nurses are fungible; just look at how nursing employers terminated and discipline nurses: at the drop of a hat. A healthcare organization will fire a nurse with 25 years of experience and loyalty to the organization just as fast as it will terminate a new employee. If you pass gas (and you are not a CRNA :) on a patient care unit, you will be terminated and reported to the State Nursing Board because it "looks better" from a liability, public relations, and accreditation perspective.

But guess what, more facilities are throwing nurse supervisors, nurse managers, and nurse executives to the wolves and under the bus also. This does make me feel better and it shouldn't please you either because it typifies the harsh reality & environment of nursing practice now. More nurse managers and nurse executives are being terminated and I am receiving more and more of these calls and these nurse managers and nurse executives are also being reported to the State Nursing Board.

What am I saying?

1. You know your practice area, don't you? If something happens and its triggers an investigation in the workplace and you are involved, get your own attorney involved to review the situation with you and give you OBJECTIVE legal advice and counseling. You need to have your own Nursing Practice and Nursing Law counsel you can consult with about situations which happen in the workplace. If you are a nurse supervisor, nurse manager, and nurse executive, are you aware of your exposure?

2. Stop listening to the advice and counseling of everyone and their momma about the seriousness of an incident. It is human nature to underestimate the seriousness of an incident to a friend, colleague, or relative because you don't want the worry the person and you want the best for the person.

If I call one of my grandmother's right now and say "mom, I slapped someone and I may be charged criminally", the response will be "it is going to be okay. You are a good person. Who did you slap?  and "I know you type a lot, did you hurt your hand when you slapped this person?"

This may help me feel better emotionally but it certainly doesn't help me deal with the criminal, licensure, legal, and career implications of pimp slapping someone.

By the way, my little sister's 1 y/o son, open hand slapped me so hard (yes, he pimp slapped me) he knocked my glasses off. My sister says he picked this up this behavior in daycare and/or watching cartoons. Really? This was last month and I still smile about it daily. Thank you Baby Chris for putting a smile on Auntie's face whenever I think of you!!!

3. Nurses don't have the income and prestige of dentists or physicians but nurses certainly have similiar liability just a different context. http://www.nso.com/. Take a look at the report, Understanding Nurse Liability from 2006-2010 from Nursing Service Organization.

The public is more aware than ever that you can be sued and you can be reported to a licensing board. Nurses are not self-employed like most dentists and physicians and therefore USUALLY do not have a personal and private attorney for practice, workplace, and career issues. This should not prevent you from consulting with an attorney even if it is one a time basis.

Most nurse attorneys or license defense attorneys may offer a legal consultation. Pay the money and consult with an attorney. It is only your License, Livelihood, and Career on the line. I receive at least 10-35 calls or emails a month from nurses who need legal services but do not want to pay for a legal consultation or legal services. Attorneys like nurses don't work from free (this one doesn't anyway) and it is worth the money to consult with an attorney for a few hundred dollars rather than gamble with your career, isn't it?

I never represent myself. Why would I because I am biased and I would see the facts as I want to see the facts. This is human nature and this is why now more than ever it is important for nurses, a front-line providers who work as at-will employed nurses or who are part of bargaining unit, to consult with a private nursing law or nursing practice attorney about situations in the workplace. Gone are the days when you could say a hospital, nursing home, or healthcare organizations acted in the best interest of its employees; an organization asks what is in the best interest of the organization, right? It is the role of YOUR ATTORNEY to ask what is in the best interest of YOU, as a licensed nurse.

4. If you can, try to negotiate an individual employment contract with a healthcare organization which afford you the same rights physicians have in the medical staff bylaws. Individuals employment contracts hold power for nurses; it is not at-will employment or even collective bargaining. The future of nursing should be Nursing Staff Bylaws and Individual Employment Contracts for All Nurses.

Yes, I said it and I stand by it. I am on the front lines of representation because my clients are front line and bedside providers. The future of nursing lies in securing power and negotiating a seat at the table in healthcare and in the nursing workplace; this power can be obtained in Nursing Staff Bylaws and Individual Employment Contracts not Collective Bargaining Agreements and certainly not At-Will Employment, which is for the birds. This is my opinion and you should have your own opinion. You can email me until the cows come home baby and I will not change my opinion which has been solidified from years of nurse license defense practice and actual nursing practice in a variety of healthcare settings. I seriously doubt I will see cows in my backyard at my home or my office; maybe deer at my home but certainly not cows. Also I don't eat meat, but I may start again, if I see a cow in my backyard.

 

State Nursing Board Non-Compliance: If It Ain't Rough, It Ain't Right!

Thank you again to a client who had to remind me three times, yes three times to change the picture on my blog and facebook pages. I have lost a lot of weight (almost 60 pounds) and I am wearing my hair differently, so here is my new picture. 

The law practice has been extremely busy this year and thank you again to those of you who retained my services. I am noticing over the last few months, the Board cases are becoming increasingly more complex with personal, mental health, impairment, practice, or criminal aspects. 

I reviewed and revised my Legal Services Agreement to reflect the changes I am seeing in my law practice. 

1. I fire clients more readily now than in the past for not providing us with the requested information in a timely manner because this slows down the processing and reviewing of information and can lead to me being unprepared for a hearing, investigative meeting, appearance, etc. If you want a lawyer who will forget you were supposed to send in your performance evals, update your prescription meds, etc., then don't retain me. I will remember, there is a task in my project management software, AND it is in my hand-written and barely legible notes. 

2. I have a paralegal who works with me part-time and her role is exclusively Client Service, Management, and Scheduling. This has been wonderful! Thanks, Dani. 

3. I like what I do and I like who I am. Therefore I am announcing: I am a workaholic and I am proud of it. No excuses anymore like "oh, it is the nature of the beast" or "I really don't work that hard." I do work hard and I enjoy it. Therefore I am looking for another part-time paralegal to work Monday, Friday, Saturday, and Sunday in the afternoons. Also my boss is nuts and she keeps giving me work at all times of the day. 

4. Non-compliance, non-compliance, and more non-compliance. Are you non-compliant? Hell, I am non-compliant with my personal monitoring.  

If you are struggling with State Nursing Board probation and monitoring or compliance with an alternative to discipline program, get some help. Retain a lawyer to assist you. I receive more and more calls related to compliance issues than I used to because non-compliance with a contract results in breach of the contract, i.e. the suspension of a license or the inability to practice nursing. 

Why would you hire a lawyer after you have resolved your State Nursing Board case on your own? Because you need help, because you don't really understand why or what you signed and initialed fifty times, or because you have a few extra thousand dollars in your night stand. 

Life happens when you are being monitored by the State Nursing Board. Things will come up and down during a 1 to 5 year period you are being watched by the Board. Who are you going to call for assistance? Your State Nurses Association, Your Union, Your Employer, or Your Cute Lawyer. Look at my current picture and tell me who do you want to call? Call me. 

I revised my legal services agreement because in the future, I am executing another flat fee agreement when patterns of non-compliance emerge. My best friend says "if it ain't rough for some, it ain't right." This should NOT be your Motto during State Nursing Board Monitoring; maybe in other contexts but certainly not in the healthcare licensing setting.  

5. Nurses, Self-Employment, and Private Practice

I am being contacted by more APRNs in Ohio, Kentucky, and Indiana who own their own business or are planning to provide primary health services. Please keep in mind when you open a business providing healthcare services, you will need a general business attorney AND an attorney like cute lawyer to help you with nursing law, regulatory compliance, and risk management. 

I am seeing more self-employed nurses who open shop and just practice. You do so at your own peril because healthcare is highly regulated and you are assuming too much unnecessary risk, exposure, and potential liability. Yes, it costs money for specialized legal services but it is a cost of doing business in healthcare. I see this with Independent Providers, RNs and LPNs in Ohio also as well as CNS and RNs who own businesses. You cannot practice in your business and run your business without some type of risk management and regulatory compliance plan. You can but the consequences for nurses are swift and cold.

 

 

Ready or Not: the $2,500.00 State Nursing Board case

http://www.youtube.com/watch?v=W7MUKF2uE6k&feature=related

http://www.youtube.com/watch?v=0GfUPXfw5Mg&feature=related

Lauryn Hill says it best: Ready or Not.....

Ready or not and (regardless of) whether you realize it or not:

1. The State Nursing Board is investigating you if you receive a Notice of Complaint from the Kentucky Nursing Board or Indiana Board of Nursing or if you receive a Potential Violation Report, telephone call, email, or official correspondence from a Compliance Agent (investigator) or Adjudication Coordinator (Juris Doctor (law degree) prepared Staff) from the Ohio Nursing Board.  

a. It is not the role, responsibility, job, or function of the State Nursing Board or anyone who works for the Board to explain to you what this means to you, for you, and what you shoulda, coulda, maybe, or mighta do or do not. The Board's role is pubic protection: no ifs, no ands, and certainly not buts.

b. You are representing yourself anytime you are not represented by an attorney in legal proceeding. YES, Board of Nursing investigations and complaints are legal proceedings. Therefore anything you do or don't do and how you proceed in the legal proceeding before the State Nursing Board, you are representing yourself.

c. Self-Representation in a legal proceeding is a right just like deciding whether or not you want to retain legal counsel (private or have one appointed  in a criminal matter) in a legal proceeding. No, sorry, attorneys are not provided by the State to represent healthcare professionals in licensure matters.

d. You are an educated and licensed healthcare professional i.e. you have something to lose: your employability, your career, your license, your....... Therefore ANYTIME you as a licensed nurse are involved in a legal proceeding, you MUST ask yourself, do I need a lawyer?

No one is going to hold up a sign and walk a picket line in front of your home saying "Retain a Lawyer."

No one is going to tell you "you are required to hire a lawyer."

No one is going to tell you "you are nuts if you attempt to work through this on your own."

Everyone will tell you:

1. Just tell your side of the story and it will be okay (this is my grandmother's favorite that I figured out to disregard at age 9);

2. This is not a big deal as I am sure the Board of Nursing has bigger fish to fry. I love this one because not only do I like to fish for sport but I also like to eat fish: the bigger the better.

3. It is going to be okay. When anyone tells me this, I immediately think "how and why would you know how it is really doing to be or be not for me?"

4. This is just a misunderstanding, just be honest and it will work itself out. Like what, a knot?

Lawyers can be expensive for corporate litigation and other matters but license defense is actually affordable because the fees are quoted to an individual healthcare professional. Most license defense attorneys will quote you a flat fee or a retainer and hourly fee based on your case and the complexities which is actually affordable when you consider your monthly, annual, or lifetime income as a LPN, RN, or APRN.

If you are NOT willing to spend $2,500 to $__________ to defend your license in a Complaint filed against you for whatever reason, what does this mean to you and for you?

This is why I have legal malpractice insurance that covers malpractice and Bar disciplinary investigations of my license. This is why I still maintain my nursing liability insurance. This is why I just purchased media insurance for my blog and online projects. Because I am a professional, I am licensed, and there is always always a chance I can be sued or reported because of legal, professional,and personal accountability, responsibility, duties, and obligations.

I know this isn't explained in school or discussed in the workplace this way but that's a fact Jack and if you are not comfortable or PREPARED for this, get prepared or surrender your license (as a teacher, nurse, lawyer, dentist, physician, PT, etc.) and work in a field that does not require a State issued license and does not have the regulatory complexities of healthcare.

A Notice of Complaint is a Notice of Complaint and a PVR is a PVR from the Nursing Board regardless of whether or not you appreciate the significance, complexities, or law, legalities, and legal issues therein: it is what is it.

The cases I am seeing in 2010/2011 vs. 2003/2004 before the State Nursing Boards are like day and night. http://www.youtube.com/watch?v=hlbQhD2sxz8

The cases now are much more complex than the $2500 fee from yesteryear. $2500 was the standard fee I quoted years ago but very rarely do I quote a $2500 fee anymore because of the issues involved. That's why I do my own initial phone calls to nurses who contact my office because I need to listen, listen, and ask a question or two before I can quote a flat fee for representation because the $2500 standard State Nursing Board case only comes around once every blue moon and every other purple sun. I also need to review a few documents for myself to get a feel for your case because although I understand what you are telling me, I need to see the paper: black and white.

Also do you want an attorney to quote you a fee of $1,110.56 for Nursing Board representation? Do you know how long these cases take to be worked up and eventually resolved? What type of representation do you honestly think the attorney will provide to you for $1,110.56? Does this $1,110.56 include any research or prep work? What is included for $1,110.56?

This is your State Nursing Board LICENSE, not a muni court case or a will. I do not quote low ball fees just to get a case or bring someone on board and then not work up the case or answer client calls. If you want an extremely low fee, I am probably (99.99% of the time) not that nurse license defense lawyer.  

So even when you say, I called Lawyer A and he told me $2500. I called Lawyer B and she told me $5000, don't expect for me to yell out "BINGO, I can represent you for $3,750.53 and a pack of Apple Now Laters."   

I represent my clients how I would want a lawyer to represent me if: my license, my career, my livelihood and my essence was at stake because I am my license. Sorry. I know others will say you are more than what you do for a living and "your job" but not me.  I am RNBSNJD and LDW Law.  I haven't decided which I want to have on my vanity license plates, what do you think? 

I am committed to my law practice, my nursing career, and the nurses I represent. http://solopracticeuniversity.com/2011/07/12/back-to-the-root-of-things-the-role-of-servant-lawyers/.

Also think about this: are you providing the service each and everyday you practice as a nurse that you expect other service providers to provide to you and your family? If not, Houston, we have a problem.....

NO LICENSE or RESTRICTED LICENSE means a lot to you as a LPN, RN, APRN who is LICENSED or a nursing student, NCLEX-PN or NCLEX-RN on the road to licensure. Your license is always at stake in a State Nursing Board case and ready or not, regardless of whether you realize it or not, it is what it is and what it is usually just the beginning because the Nursing Board investigation is a starting point on a dim and winding path and you may not see the forest because of the trees.

Take a look at these articles.

Download BillofRightsforNursespdf

Download Nurselicensedefenseattorney

 

It is Going Down like Charlie Brown: Nursing Students will Sue!

I attended nursing school "back in the day" when nursing students viewed their instructors and professors with admiration, respect, and "awe." This was in the early 90s for me. I received my ASN in 1993 and my BSN in 1994.

Things have changed in the almost 20 years and nursing students are willing to file complaints against instructors and professors with the State Nursing Board, file complaints against their schools of nursing with the Board of Nursing, and sue! That's right baby, litigate!

I tell you there is nothing like a civil law suit and the discovery process.  I tell you a Complaint for Damages smells like a warm strawberry PopTart with sprinkles to a defense attorney. Sometimes I miss med and dental malpractice defense work (only for 3 seconds).

Former Viriginia Western nursing students were awarded damages. http://www.roanoke.com/news/roanoke/wb/291572

I expect more of these lawsuits especially from nursing students are crim-ed out, attend nursing school and spend $30k+, only to find a restricted nursing license and little to "zip" employability because of the restricted license and being crim-ed out.

What is crim-ed out? I picked this up over the weekend while out and about. You know I am a single now and I am out and about and on the loose, 60 to 90 minutes every week now. It is start. But anyway.

It is crim like brim. So crim-ed out. Crim-ed out means multiple criminal convictions, either Misters or Fellows. I picked this up to this weekend also. And no, I did not visit anyone in jail or prison and pick this up and no, I didn't pick this up at a Bar association event.

Personally I think nursing students should be more proactive as adult learners. You are seeing this now with law students who take on 100k to 150k in debt from law school to realize most attorney positions start at 35k to 55k.

http://www.nytimes.com/2011/07/17/business/law-school-economics-job-market-weakens-tuition-rises.html?_r=1

http://www.nytimes.com/2011/01/09/business/09law.html?pagewanted=all

If you are a nursing student or NCLEX-Applicant and you have felonies or misdemeanors, you need to speak with a nursing law attorney before you submit your application for licensure to the State Nursing Board. Anytime you are REQUIRED to make affirmative disclosures on a renewal or initial application for licensure, you should talk to a nursing law, nurse license defense, or administrative law attorney in your state.

Like Yesterday, Nursing Board Compulsory Examinations and the definition of Routine, Ordinary, Common, or Mundane

If you look up the words ordinary, common, routine, or mundane in any dictionary, you WILL NOT see "State Nursing Board Compulsory Order for Examination" as an example.

Why? There is nothing ordinary, common, routine, or mundate about a Compulsory Order for an Examination.

It is usually written in the Nurse Practice Act that a State Nursing Board can order a licensee or applicant for licensure by examination for a compulsory examination or order, at the expense of the licensee or applicant being investigated by the Nursing Board may have a physical or mental impairment that MAY affect the ability to practice nursing safely.

In Ohio, see ORC 4728.28(G).

Therefore let's say today you open your mail and you find a Compulsory Examination Order from the State Nursing Board ordering you to submit to:

1. Forensic Psychiatric examination;

2. Medical Examination;

3. Behavorial Examination;

4. Substance Use and Abuse vs. Dependency examination;

5. Neuro-Psychiatric examination; or

6. Psychological examination like a Fitness for Duty

then you need to:

1. Review the document carefully;

a. Sit down and take a cold shot of H20 on the rocks to clear your head;

b. Re-read the document again because I know you didn't read it carefully.

2. If you are represented by an attorney, contact your attorney and discuss; or

3. If you are not represented by an attorney in the Board investigation, you need to speak with an attorney like yesterday.

These Orders for Examination are the real deal. Yes, I know you are a nurse and maybe in one of your nursing roles you were involved in administering, observing, or reviewing these types of examinations for patients, but.....

Ask yourself, what would a reasonable and prudent nurse do at this point in a disciplinary investigation when you receive this type of Order for an Examination/Evaluation?

Do you continue to rep yourself? There is nothing wrong (or wright) about repping yourself before the State Nursing Board. It saves a dollar or two and you can then spend this dollar or two at Walmart, Target, or Lowes. I am all for repping yourself and I advocate repping:

a. Your hood (you can do this with a block party or garage sale. Invite me, please!);

b. Your block (you can do this with a swim party, block party (with a permit), or yard sale); and

c. Your City (next time you are at a professional function, wear a t-shirt saying "I love Columbus, Ohio" or the "Cincinnati Bengals  Superbowl 2020).

But repping yourself in any legal matters can be a train wreck waiting to happen.

You only have one RN or LPN (with State Nursing Board A) and when this license is investigated and you receive an Order for a Compulsory Examination/Evaluation, is saving a dollar or two in the best interest of your nursing career, future employability, future plans for nursing education, and your sanity.

For example, I received three certified letters from the IRS that were not delivered yesterday because of my two horse like dogs which roam the yard stalking birds, bees, and anything that moves. I went into overdrive and contacted the IRS about my estimated taxes for 2011 and whether or not full payment was received for my 2010 tax liability. But I thought about the worse case scenario: Oh frack, I am being audited for 2011! My first thought was will I use my acountant or retain a tax attorney now: like yesterday.  Certified letters from the IRS means "hear ye hear ye" for me as small business owner and attorney just like a Notice of Complaint, Potential Violation Report, or Compulsory Exam Order from the State Nursing Board means "hear ye hear ye" for a RN, LPN, APRN, or RN or PN NCLEX Applicant.

You have to be able to appreciate the best and worst case scenario for any workplace, licensure, legal, or State Nursing Board issue and sometime this requires the assistance of legal counsel for informed decision-making: like yesterday.  I appreciated the best/worst and WTF scenarios from my certified letters from the IRS; the letters are related to my 2010 tax liability and estimated tax payments from 2011.  

When you receive certain items, documents, or information by mail that impact you as a professional and your livelihood as a licensed professional, your natural instincts should flare up and you should go into hyperdrive like the Death Start from Star Wars in less than 10 seconds and start critically thinking about your next steps.

For nurses: it is a medical mal complaint naming you individually as defendant (because you probably do not have your own liability insurance policy), criminal indictments, certified letter from your employer after you have been suspended from work pending an investigation, letters from the State Attorney General's or Department of Health related to a workplace incident, and State Nursing Board Complaints and Compulsory Examinations/Orders.

You have critical thinking skills (if you don't email me and I will send you an invoice to pay me to help you develop those skills) so use those skills to critically think and be objective about your situation. There is nothing routine, ordinary, common, or mundane about receiving a Compulsory Examination Order from your State Nursing Board and the fact that this is "lost" of most nurses and NCLEX Applicants is troubling and speaks volumes to where we are as profession with knowledge and education of the intersection of the nursing law and professional standards of practice and the practical applications in the workplace.

 

 

Legal Consultations: One Ring to Rule them ALL and Ketchup vs. Mustard

I have from 5 to 40 legal consultations in a month usually by phone with nurses throughout Ohio, Kentucky, and Indiana. 

The benefits of a legal consultation for a nurse are:

1. You have an objective attorney reviewing your case;

2. You are able to ask questions and receive solid advice and counseling about your situation; and

3. The cost is $150-$250.00 in my law firm. Some license defense attorneys charge $500-$1,000.00 for legal consultations. For example, there is an attorney who charges $750.00 for a 2 1/2 hour consultation and this is the minimum and includes all his preparation time reviewing your materials and performing research on the issues therein.

What I am a finding however is that I have a lot of nurses who become quite hostile and argumentative with me during legal consulations because I am not telling them what they want to hear, I am not agreeing with them, or I am being "too direct and too blunt."

I think this is why we lawyers get a bad rep because it is our role to "tell it how it is." If you are paying a professional and the professional is telling you exactly what you want to hear about yourself and your situation, then you are wasting your money. 

Objective advise and counseling: this is what an attorney does. However, most nurses involved in a State Nursing Board case are proceeding pro se, most nurses being monitored by the State Board are pro se, and most nurses who are in a Board Alternative to Discipline program are pro se.

Pro se meaning you are representing, counseling, and advising yourself in the matter. It is difficult to be objective and critically review and analyze your own situation from a legal, clinical, and professional practice standpoint. When you are representing yourself it becomes a epic battle for mankind and the fate of the world rests in your hands.

I had a nurse tell me the following in reference to a State Nursing Board investigation and an employment termination, "I now know how Jesus Christ felt when he was prosecuted." No comment.

It emotionally becomes One Little Nurse vs. the Big Bad State Nursing Board (not the Big & Bad, just Big Bad) which is huffing and puffing to blow down everything you  accomplished: your licensure, your career, your family, and your life. 

It is portrayed to colleagues, family, friends, and "anyone who will listen" as serious as the epic battle for Middle Earth and the "Rings of Power" akin to good vs. evil, the Jedi vs. the Sith, and Ketchup vs. Mustard.  

If you are representing yourself before the State Nursing Board consider a legal consultation with a nurse license defense attorney in your state; it may be the reality check you need to place the case in the proper prospective.  

Hello, my name is LaTonia, I am Your Legal Therapist. My office hours are 11:30pm to 11:45pm every 3rd Tuesday of any month ending with the letter "r" or "y"

I terminated my legal representation of a nurse in the past because this nurse was just too difficult to deal work with in a professional relationship. Also the nurse refused to accept any responsibility or accountability for the actions or even acknowledge the obvious.  

We remained professional with the nurse at all times but I should have terminated the representation  earlier. I shook my head when I received the correspondence requesting the client file from the new attorney of the nurse because I would not wish that client on any lawyer.

 The nurse developed a case theory the nurse just knew would work.

I told the nurse in a nutshell even if we pretend, this ain't CSI; it is Nursing Law & Order.

Anything is possible, Neo but let's discuss the probabilities because this ties into the burden of proof and persuasion.

The spouse of the nurse berated me for not "trusting in and believing in" the nurse. FTW, you are kidding me, right?

I trust and believe Jesus died for my sins.

The spouse told me the nurse would be CLEARED of all charges at a Nursing Board hearing with a new attorney who trusted and believed.

I thought to myself: maybe an imaginary hearing with the Snow White as a hearing officer but certainly not a formal adjudication in an administrative law matter.

The nurse was nasty. This nurse was my nastiest client. By the way, I fired my first, second, and third nastiest clients. Life it too short to deal with nasty clients because I love what I do. I don't want to start calling off at work, taking extended FMLA leaves, or start smoking and then disappearing for 2 hour smoke breaks before and after my lunch smoke as a coping mechanism. 

By nasty here I am referring to a aggressive disposition, a disruptive personality, condescending tone with everyone,  emotional and uncontrollable outbursts ranging from excitement to panic to sadness to rage in 15 minutes, etc. I don't know whether to continue to take notes or  make a run to an exit but not before closing the door to lock Jack in the room.

I am a counselor; a counselor at law that is  pumpkin, not a therapist unless you need legal therapy. I guess I am a Legal Therapist. LOL. My office hours are 11:30pm to 11:45pm every 3rd Tuesday of any month ending with the letter "r" or "y" if you need assistance. I see clients, return calls and answer emails or texts and conduct business only during the stated office hours.

Back to Nasty.

Angry Nasty;

Nasty Nasty; and now

Disciplined Nasty. I mean Disciplined Hard.  I had to read and then re-read the discipline. No hearing by the way: settled.

Just a word of practical advice:

1. Allow your license defense attorney to assist you in developing your legal strategy;

2. Be honest with your lawyer; why pay your a lawyer and then lie to your lawyer? 

That's like going to a weight loss clinic and saying you don't want pills; you just came in to be weighed. It makes no damn sense; 

3. Don't watch CSI and try to develop conclusions of law and findings of fact  for your case based on a CSI episode. It is Nursing Law & Order; and

4. I zealously represent my clients and I counsel and advise my clients. But remember I critically think for a living. I make my money critically thinking about nursing and the law. All day. Remember this when you retain me and start to shovel the ......

5. Life is too short to be nasty to anyone trying to help you help yourself.

Even though you were Super Nasty, I wish you the best with:

a. Securing employment during the years your nursing license is suspended;

b. Meeting the terms/conditions for the reinstatement of your nursing license;

c. Securing nursing employment during your Nursing Board probationary period;

d. Meeting the terms and conditions of your Nursing Board probation; 

e. Having the terms/conditions of your Nursing Board probation lifted; and

f. Your nursing career.  

RN and LPN Independent Providers in the State of Ohio: Stop, Look and Listen!

More and more nurses both LPNs and RNs are having billing, nursing practice, and other issues practicing as an Independent Provider.

Home care isn't for everyone and self-employment isn't for everyone. The combination of the two can ring disaster for nurses who just jump into being an Independent Provider without any preparation.

You are a licensed healthcare professional and you are a small business owner as an IP. You cannot just jump and then figure things out as you go. This is recipe for an ODJFS Notice of Deficiency, Plan of Correction, Ohio Nursing Board Complaint, and/or a certified letter from ODJFS saying "you owe us ten million dollars because you failed to...."

What is an Ohio Independent Provider?

 http://ohioip.net/

http://www.ohiohcp.org/provider.html#php1

If you are going to be an Ohio Independent Provider you need to learn the basics of home care before you just jump.

For example, consider taking a home care course to learn about the Ohio Home Care Program. See 

http://ochch.org/associations/11629/files/MarchHC101brochure.pdf

I am actually thinking about registering for this program as a refresher.

Also why not attend a coding and billing CE for home health to increase your knowledge?

See http://ochch.org/associations/11629/files/JuneAdvancedCodingBrochure.pdf. Oh, let me guess, you just have someone "do" your coding? Bullshit. That's like me saying as an attorney "oh, I just have someone do my billing, I don't have to know anything about it."

Nurses as a group do not support and join professional associations for a number of reasons. But guess what? As a Independent Provider, you need the support. You will probably not find it in a general national or state nurses association but you should at least attending CE and training offered by ODJFS and the Ohio Home Care Organizations. Its Risk Management, baby!!!!!!!

https://m360.ochch.org/frontend/portal/viewcalendar.aspx

http://www.ohpco.org/aws/MCA/pt/sp/education_homecare

Also as Ohio IP you should have the following professionals on your team:

1. Accountant;

2. Business Lawyer;

3. More experienced IP in your County; and

4. Nursing Law Attorney (that would be me).

Things are going to come up because you are a self-employed and you want to evaluate the situations as a licensed nurses and a business owner. Also for heaven's sake, BUY Professional Liability Insurance with a License Defense Protection Benefit!!!!!!

As an IP, you can pay it on the front end with risk management, paying for consultative services, etc. or you will pay it on the back end when mistakes (practice, billing, etc.) are made. and you have to retain a lawyer to represent you before the State Nursing Board and/or in an ODJFS matter proposing the termination of your provider agreement.  

Remember this isn't Disney World: you are billing the State for skilled nursing services and you are essentially your own agency: billing for services, scheduling visits, and providing care.

 

 

The Liquor Store: Unemployment Compensation, Nursing Schools, and the Saturation of the Employment Market in Nursing

This is not legal advice because no one paid me to say this but:

 1. If you are a LPN, RN, or APRN and you were terminated from your employment with a healthcare organization, consult with a nursing law attorney BEFORE you apply for unemployment compensation benefits. 

2. By a consult, I mean pay for 30 minutes to 60 minutes of the nursing law attorney’s time and provide the attorney with your documentation to review. This is not the sixty second call you have with a nursing law attorney and the attorney is typing, eating, and listening to a podcast while taking your frantic call.  

3. Why? If you were terminated from your job and you are awarded benefits, your former employer may contest the award. I think someone in HR screams “1, 2, 3, 4, I Declare War” then the healthcare organization receives notice of a former nurse employee request for unemployment compensation benefits. http://boardgamegeek.com/thread/65396/i-declare-war. I loved this game as a kid. I grew up in a very competitive household and this game along with monopoly always resulted in a shouting match, fist fight, profanity (I learned early), or a promise for a rematch for the “title.” 

4. Why? If you terminated from your job, you may or may not be reported to the State Nursing Board if you are in a mandatory reporting state. You won’t know you are reported until you open the mail and “claim your prize” or you receive a phone call from the State Nursing Board.  

5. I had to calm a nurse down by phone yesterday who opened her mail and “claimed her prize.” I opened my own mail two weeks ago and “claimed my own prize.” I am 0.75 CLE short on my Ohio law license renewal. I have to pay $110.00 and take a one hour CLE class by April 31, 2011. This blog is Nursing Law & Order, not Nursing & Law Disorder, so I plan to take my CLE online this evening and mail the check and my CLE transcript in the morning. Yes, I know its horrible and that’s why my walkie talkie handle is the Nursing Law Bandit. http://en.wikipedia.org/wiki/Walkie-talkie. 

6. The interplay of unemployment compensation benefit appeals and procedures and State Nursing Board complaints is something I am seeing in my law practice over the last 2 years. I used to handle unemployment comp. cases (years and years and years ago) and this is where I “cut my teeth” (learned the ropes) with telephonic hearings. 

7. It is a tough job market out here for nurses in certain areas and the proliferation of nursing schools and colleges does not help. Nursing Schools are the new pills mills like law schools. http://thirdtierreality.blogspot.com. 

8. Let’s see there are LPN, RN, RN to BSN, LPN to RN, BSN, MSN, post-MSN, and doctoral programs, schools, and colleges in nursing. Just in the Greater Cincinnati area, there are maybe 20+ programs. You can open a nursing school faster than you can open a liquor store in some states IMO. Nursing Schools are on every corner in some cities like a Pony Keg selling cigarettes, beer, and lottery tickets. Come here and get your nursing education; it is on sale for $35,000.00. http://www.ehow.com/how_4549219_open-drive-through-pony-keg.html.

9. The proliferation of nursing schools and programs across the states result in more and more new grads, new nurses, and not so new nurses competing for the same jobs. This IMO prompts more nurses who are termed from a HCO to apply for unemployment compensation benefits because you don’t know if you are going to get a job. It is not like it used to be when you could get fired today and start working somewhere else on Monday. The nursing employment market (in some areas) is more saturated than my 2 y/o niece’s Pull-Up at 7am.  

10. I attended a nursing function a few months ago and I was asked “where do you practice?” I replied “in a law firm, I am a nurse license defense attorney.” The nurse, who happened to be a “nurse educator” said “Oh, you represent those nurses in the Momentum.” The Momentum is the Ohio Nursing Board newsletter. I replied where you do you practice? She said “Proprietary XYZ Nursing School, Nail Tech, and Plumbing Program.” I said “Oh, you are educating those nurses in the Momentum.”

 11. Most nurses are repping themselves in the investigation of the State Nursing Board complaint as well as the unemployment benefits compensation process. This is a NO-NO.  Guess what? You may be excited and ready to fight the first 5 weeks but guess what you will move on after 2 months and this is the point where your former employer, the HCO has declared war and is ready to fight you to hell and back for those benes, baby. 6 months to 9 months later you are going to say WTF was I thinking? I don’t have the time and energy for this shit. Also you cannot be objective when you represent yourself. You just cannot.  Find an attorney who handles admin. law cases like workers comp and SSDI to represent you in an unemployment comp. matter. I am not taking unemployment comp. cases now because my nurse license defense practice is busy; but I may have to hire a Virtual Paralegal and start taking these cases again. Unemployment comp, workers comp and license defense are all administrative law practices. 

12. Don’t have your unemployment comp. lawyer rep you before the State Nursing Board unless the attorney has experience with this niche. Yes it is all admin law but guess what? I am a nurse license defense attorney and I can take an unemployment comp case but I would not take a SSDI or workers comp. case because I don’t have experience or even an interests in these areas. 

13. If you want to play around and represent yourself, do so in traffic court. You can follow behind me when I am driving to Columbus, Indy, Lexington, or Louisville and I am sure you will get a ticket. The State Patrol are out this month!!!! You can appear and represent yourself there. But don’t do the monkey in an unemployment compensation case and a Nursing Board complaint investigation case.

Ohio Medical Board's Resolution Regarding Prescription Drug Abuse: And So It Begins!

Thanks, Jack "The Smack" Stem at http://www.peeradvocacyforimpairednurses.com/why.html for emailing this to me yesterday.

Everything that has a beginning has an end, Neo. http://www.youtube.com/watch?v=orXDu3Stb-c

The Ohio Medical Board issued a resolution regarding prescription drug abuse last week.

See http://www.med.ohio.gov/pdf/PrescriptionDrug%20Abuse.pdf.

See also http://www.zanesvilletimesrecorder.com/article/20110311/NEWS01/103110309/DeWine-Ohio-medical-board-must-fight-prescription-drug-abuse-harder for an idea of what's coming for licensed healthcare professionals with prescriptive authority like MDs and APRNs.

Why is this important for nurses?

* Nurses who are prescribed controlled substances by their physicians or APRNs and practice nursing. Its a balancing act yet I don't think there is an appreciation of the risks and liabilities for nurses who take "prescribed" controlled substances and then report to work or who take meds while at work; and

* APRNs in private practice or who work for/with docs in private practice and have prescriptive authority. The State Medical Boards and State Nursing Boards go hard in these cases and unfortunately the majority of docs and nurses will represent themselves with the "I didn't do anything wrong" defense.

More about the "I didn't do anything wrong defense" and how it applies to me this week.

Guess what? I saw this coming two years ago and put together a webinar sponsored by the Center for American Nurses titled:

A Balancing Act in the Workplace, Managing the Risks When a Nurse Takes Prescribed Medication

This is one of my fav. Center webinars and I provide this CD to clients.

See http://www.can.affiniscape.com/storelistitem.cfm?itemnumber=13

What are you saying LaTonia? Just give it to me straight without the legal mumbo jumbo.

If you are a nurse (RN, LPN, and APRN) and you are prescribed controlled substances for chronic pain, a nurses back, etc.; is this affecting your nursing practice? What are the risks and potential liabilities for you and your nursing practice? Remember you are your own risk manager on Nursing Law & Order; this isn't Nursing Law & Disorder, not yet anyway.http://advocatefornurses.typepad.com/my2cents/2011/03/the-plan-do-you-need-assistance-with-revising-reviewing-or-developing-the-plan-we-can-help.html

If you are APRN with prescriptive authority, what does this mean for your nursing practice? How can you develop strategies to protect your nursing practice and your nursing license with the "heat" being placed on prescriptive drug abuse?  http://advocatefornurses.typepad.com/my2cents/2011/03/the-plan-do-you-need-assistance-with-revising-reviewing-or-developing-the-plan-we-can-help.html

Allegations involving the inappropriate prescribing of controlled substances are complex because multiple state, federal, and/or national agencies or groups are involved on various levels. The implications for MDs and APRNs who prescribe and for LPNs, RNs, and APRNS who use controlled substances and practice are really starting to take shape in the last 3 years. Get ahead of this issue if this applies to you and your nursing practice, its risk management, baby!

This isn't an issue where you want to be caught with your pants down with the pics on FB and the video U-Tube. Be proactive and manage the risk and if you need assistance managing the risks, seek assistance. This is just how licensed healthcare professionals should roll!

 

 

 

Charlotte's Web and Drug & Alcohol Use, Abuse, and Dependency in Nursing

Are you weaving a web so thick that not even Charlotte could manage to migrate it? http://en.wikipedia.org/wiki/Charlotte's_Web.

I am writing an e-book, the New Charlotte's Web: Deceit, Deception, and Dishonesty, Drugs/Alcohol, and Nursing's Social Policy Statement.

Deceit, Deception, and Dishonesty is part of addiction and use. I get it.

Drug and Alcohol Use, Abuse, Dependency, and Impairment is no doubt an issue in nursing. I get it.

There are alot of nurses who are abusing prescription medication but think its "okay" because I have script. There is a thin line between using prescription medication as prescribed vs. using prescription medication prior to and while at work vs. impairment regardless of whether you are working 4, 8, 12, or 16 hour shift.

However, there are competing forces with drug and alcohol use, abuse, dependency, and impairment in nursing. Yes, there is a recognition that this is disease on one end of the spectrum and on the other end of the spectrum is the public and the State Nursing Board and Law Enforcement.

Guess what's in the middle? IMO, its Personal and Professional Responsibility & Accountability.

http://www.nursingcenter.com/Library/JournalArticle.asp?Article_ID=492769

http://www.nursingtimes.net/nursing-practice-clinical-research/part-51-accountability-autonomy-and-standards/200972.article

http://ajcc.aacnjournals.org/content/19/3/296.full.pdf+html

http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2648.2006.03684.x/full

http://www.aspan.org/AboutUs/PresidentsPage/ArchivedPresidentsPage/PresArchive_102010/tabid/7404/Default.aspx

http://faculty.ksu.edu.sa/hisham/Documents/Medical%20Education/English/Nursing%20Education/90.pdf

How does this apply in the workplace? Examples.

http://www.slhn-lehighvalley.org/docs/pdf/final%20professional%20practice%20model%20nov%2007%20_2_.pdf

So you know what this means? Yes, Alcohol & Drug Use, Abuse, Dependency, and Impairment are medical issues but as a state licensed nurse, you are personally and professionally accountable and responsible for your actions and inactions in accordance with American Nurses Association professional standards of practice and your State Nurse Practice Act and Board of Nursing Regulations.  

So guess what? You are a nurse and you are diverting drugs; you have a medical condition but you are accountable. You are nurse and you are showing up to work drunk; you have a medical condition but you are accountable.

You cannot be a state licensed nurse and NOT be accountable and responsible for your actions or inactions or conduct. This isn't Burger King and you can't have it your way. It works this way for most licensed professionals especially in healthcare, which is HIGHLY regulated.

The accountability and responsibility piece and the foundations for the legal, professional, and self-regulation of nursing practice is lost. This is what frustrates me is this connection is lost somewhere in the transition from nursing student to professional nurse to professional nurse and expert clinician.

Nursing schools are the new puppy and pill mills, teaching to pass the NCLEX and producing graduates who don't understand the role of personal and professional accountability and responsibility in nursing practice and the importance of legal, professional, and self-regulation of nursing practice. (Oh, snap, I guess I won't be invited to present on nursing law and rules for nursing faculty. Tear.)

This isn't picked up in the workplace of course and most nurses don't belong to a nursing professional or specialty nursing associations. So in my opinion the majority of us are showing up to work and just practicing until something happens and we are doing this without a plan for our nursing practice and without a healthy appreciation & understanding of JUST how important the legal, professional, and self-regulation of nursing practice is to our nursing practice and "the plan." 

Sections of the Nursing's Social Policy Statement: The Essence of the Profession (2010) will be required reading for ALL of my law office clients going forward.  http://www.nursesbooks.org/Main-Menu/Foundation/Nursings-Social-Policy-Statement.aspx.

If you are a law office client, take a guess what you will receive on your birthday, my birthday or around the holidays this year!!!

What's your point, LaTonia? Weave it, baby, Weave it! You can weave a web and weave it as thick, as sticky, as murky, and for as long as you can. Regardless of whether you weaved the web because of a medical condition, mental condition, etc. the "why" is a mitigating factor: you are responsible and accountable due to the professional regulation, legal regulation, and self-regulation of nursing practice.

Alcohol Use vs. Alcohol Abuse vs. Alcohol Dependency: State Nursing Board Renewals and DUI, OVI, or DWI. DEATH by Evaluation!

Nurses if you have been charged or convicted of a DUI, OVI, or DWI and you have to renew your Ohio RN license, Indiana RN license, and/or Kentucky nursing license (RN or LPN) this year, consult with an attorney.

Schedule an appt. with a nurse license defense attorney to discuss your situation before you self-report to the Ohio, Kentucky, and/or Indiana State Nursing Boards. This isn't legal advice because you didn't pay me to say this its just plain common sense.

Why would you self-report "anything" to the State Nursing Board without speaking with a nurse license defense attorney? Okay, I know I am biased but really? Would you walk into a police station and "confess" and admit to committing a crime verbally and in writing? Probably not, so why do nurses self-report to the State Nursing Board when anyone and everyone including but not limited to Direct TV  Service Technician to their friends tells them its the right thing to do. Its the good thing to do.

WTH, does that mean anyway? Save right vs. wrong for the 8 hour graduate level symposium on Ethics and Morality and Nursing's Social Policy Statement. Save good vs. evil for Sundays and you are welcome to join me at 8am service at a Baptist church.

You are not Luke Skywalker (actually Luke is here with me. My dog's name is Luke Skywalker and he uses the force on mommy) and the State Nursing Board or Alternative to Discipline Program in Ohio, ISNAP, or KARE does not represent the Dark Side of the Force. Let's turn it down a notch and focus on the issues.

1. You are a licensed nurse.

2. You were charged and/or convicted of a DUI, OVI, or DWI.

3. You may have been charged with other crimes along with the DUI, OVI, or DWI.

4. You are practicing as a nurse.

5. You are receiving more "helpful" advice from family, friends, foes, and strangers than a politician caught in a whorehouse.

Speak with a nurse license defense attorney about your situation. There are license defense attorneys in every state, see www.taana.org.

Don't fire off the 25 page handwritten letter to the Board (that you don't keep a copy of for your records) disclosing everything you have done right vs. wrong and good vs. evil since the 6th grade. 

You need advice and counseling and maybe representation. This is the role of a state licensed attorney just like its the role of state licensed nurse to provide nursing care. Don't bootleg it! 

I offer 40 minute legal consultations for nurses with licensure renewal issues. You can pay for and schedule the legal consultation online. This is for nurses licensed in Ohio, Kentucky and Indiana. I am licensed to practice law in these states only.

Also, a nurse emailed me this weekend and inquired whether I could obtain a license in State C and represent the nurse. The State Nursing Board applications for licensure pale in comparison to the Attorney Licensing Applications and the Character & Fitness Interviews. The Bar Applications make you cry like you are running a 10 mile marathon in a size 5 pump and you wear a size 10, in gym shoes. Yes, we have to interview!!!!

I have NO plans to sit for another bar examination or regurgitate every speeding ticket since age 16, discuss my credit report and score and why I was late 30 days late paying my Spiegel's charge 20 years ago (I loved Spiegels), and disclose every civil, criminal, administrative matter, case, issue, or thought or anything remotely legal (this includes purchasing a hotdog at the food stand next to the court house) and not to mention mental health issues on a State Bar Application for Licensure as an Attorney. 

When I say NO plans, I mean never ever neverland Peter Pan. Three Bar Exams, Three Bar Apps, Three Bar Charter & Fitness interviews, and Three times passing the Bar on the first try. I am stopping while I am ahead.

I am sure you have heard of Death by Meeting? Okay, I am writing an e-book titled DEATH by Evaluation and self-reporting is Chapter 1.  

Why? Hell just from my posts on this blog, I am sure the Bar Examiners if I wanted to apply for a law license in another state would want a psychiatric evaluation (forensic nonetheless) and maybe a fitness for duty  (I am sure my employer would not object:) not to mention maybe a chemical dependency evaluation because of my references to Long Island Iced Tea, Moscato, Bartles & James wine coolers (traditional, berry, or strawberry), Miller Lite and Miller Genuine Draft vs. Bud Light vs. Keystone Light (hint: only if your money "ain't" right this week) and my fav, Martini & Ross Asti Spumante over the years.  Also I have lost 35 pounds since November 2010 so they may want a medical evaluation or a return-to-work evaluation (before I can step foot in my home office or my traditional office) as well. After speaking with one or more of my clients, they may also want a behavioral examination.

Okay, I am just kidding here but you get my point about self-reporting without obtaining objective advice and counseling, right?

Oh, snap, the link for the License Renewal Application consultations:

http://www.bookfresh.com/profile/157503739

The cost of a 45 minute legal consultation (conference call) for 2011 nursing license renewals in Ohio, Kentucky, or Indiana is $225.00.

 

The Good, The Bad, The Ugly, and the Unrepresentable vs. Unforgiven and Unrepresentatble

The Good, The Bad, and The Ugly with Clint Eastwood and Unforgiven are two of my favorite movies.

What is unrepresentable? Well, first it is not an acceptable word but that has never stopped me before....

Nurses when you represent yourself for so long in:

1.  a State Nursing Board investigation, adjudication, or post-disciplinary monitoring;

2. You are involved in a med mal or nursing malpractice cases that transitions to a Board of Nursing investigation, adjudication, or post-disciplinary monitoring;

3. A criminal case that transitions into a Board Alternative Program monitoring and/or Board Disciplinary Action and post-disciplinary monitoring

you may become UNREPRESENTABLE. I can actually see this as nice legal drama and cowboy movie.

Unrepresentable means attorney representation, counseling and/or advising is of no benefit to you because of YOU; its usually not the case because all cases can be worked through, it may take time, but.... You are unwilling to see anything in the case but your own point of view. Most of the time it involves taking a victim approach and that you are being picked on for whatever reason by whomever and "this" is the result.

There is also a tendency to see everything as "Me against the State Nursing Board." Sorry, but you are no Tupac and "Me against the World" has no place or meaning when defending your license in a disciplinary investigation, hearing, or post-monitoring period. http://en.wikipedia.org/wiki/Me_Against_the_World

I am seeing this with nursing students, NCLEX Applicants, LPNs, RNs, and APRNs who have represented themselves over a period of months or years in State Nursing Board cases and who really would have been benefited from legal representation and counseling and advising earlier: days, weeks, months, or years earlier.

I don't think a nurse can appreciate just how much impact these types of cases can have on you until it happens to you. You of course take it personal but its not personal; its a complaint against you in your professional capacity and therefore it should be handled professionally. This is why you don't represent yourself and you have someone helping you.

However, the benefits of representation, counseling, or advising are lost in the present and the "now" as well as in the future because of the past. We all have crap in our closet that we don't want to come out (you are not perfect) but if the crap in your closet is directly or indirectly related to the State Nursing Board complaint, guess what? The closet has to be cleaned up somewhat. I like to use a cleaning combination of bleach, holy water, and baking soda.

I don't have a "S" on my chest. But I do have a pair of red boots and you certainly won't catch me in a Red Cape (at this time of the year anyway in the Midwest) for SUPER Nurse Defense Lawyer. But I will probably wear my red blood red cape to see this movie. http://www.imdb.com/title/tt1486185/.

Sorry, but I cannot fly (I can barely walk in my Red Hot Red Knee Boots) around the State Nursing Board Office at the speed of light and turn back time to the exact point in time where if you knew then what you know now, you would have proceeded differently before the State Nursing Board.

Some nurses do just fine representing themselves in State Nursing Board cases. But how do you know if this will be you? How do you know depending on the allegations in your case if you can adequately represent, counsel, and advise yourself before the State Nursing Board?

You don't know what you don't know until you find out you didn't know.

If you are trying to save a few dollars and you are representing yourself, read up and arm yourself with the knowledge and information you need. But, when you get to that point, where your gut and instinct says:

1. I don't know what the hell I am doing here!;

2. Your license is suspended and you don't know why?;

3. You are signing legal documents from the State Nursing Board faster than you sign and cash your income tax refund check;

4. You feel as if you are backing yourself in a corner;

5. You are unsure of what you need to do next; or

6. You are becoming overwhelmed with the process

Its time to contact an attorney now instead of waiting until you are unrepresentable. Some nurse license defense attorney won't tell you this and hell depending on how the legal fees are structured some will take your case on a hourly basis at $200.00 or $250 an hour with a 5k evergreen retainer and "go as hard as" you can afford to pay if those are your wishes. Go Johnny, Go! http://www.youtube.com/watch?v=uMY5VGYh2Go

If you are struggling in a complaint investigation pending against your licnese, obtain an objective opinion or advise from a license defense attorney about the past, present, and future of your nursing license. Just my two cents!!

You received a Compulsory Order for an Examination from the Nursing Board: Retain a Lawyer, Now!!!

I don't like to beg, but in these cases I will make an exception. Please retain legal counsel ASAP. It does not have to be me but hire a nurse license defense attorney to represent you if you receive:

1. An Order from the Kentucky Nursing Board requiring a Chemical Dependency Evaluation; or

2. An Examination Order from the Ohio Nursing Board.

A.   Schedule an appt. with a nurse license defense attorney immediately after you receive the Order to review the Examination Order and your case from Day 1 until today;

B.   Seriously consider whether or not really should be representing yourself before the Board in this case. Of course you can represent yourself and you have represented yourself up to this point BUT is it in your best interest to represent yourself going forward; and

C. I don't need a lawyer because:

1. Its too expensive.

Call around and obtain a few quotes from license defense attorneys about the cost of representation. If you need to borrow the cash, take a loan from the 401K or 403B, borrow money from your in-laws or parents, etc. just do it!

2. Hiring a lawyer make me look guilty.

Really. I am a nurse and a lawyer and if I am sued, charged, or being investigated for ANYTHING, my lawyer is involved.

Don't ask if you need a lawyer in these cases start with asking yourself why would you not have a lawyer here.

These cases are some of the most serious and priority cases before the Board because the case may suggest impairment, an inability to practice nursing safely, and other issues and you are representing yourself without  a sense of urgency.  

Hell just writing this blog post and the mention of an Examination Order from the State Nursing Board makes me nervous. I always take a deep breath and breathe slowly when I review an Examination Order from the State Nursing Board. Those docs are never nice.

You say hiring a lawyer makes you look guilty well I am honest (unless I am lying) and continuing to represent yourself in some complaints before the Board especially when Compulsory Orders have been issued is mind boggling.

How in the hell can you maintain the objectivity needed to represent yourself when an Order for a Chemical Dependency, Mental Examination, Behavioral Examination, Physical Examination, or Psychiatric Examination has been issued by the State Nursing Board?

In this cases and I am a seeing more and more and more, when I quote a fee I am going to do the following:

1. Take my usual flat fee range and multiple it by 3;

3. Substract $556.55 because the fee looks a little heavy;

4. Add the cost for extra Pepsi and Mountain Dew for 2-5 years; and

5. Divide by 1.5 which is the number of vacation days I have for 2011.  

Verified Response to a Kentucky Board of Nursing Complaint: Why is this a big deal and the real deal?

The Kentucky Nursing Board isn't playing with nurses involved in disciplinary investigation before the Board.

When you open the mail and receive the Notice of Complaint, you won't here a violin in the background and you certainly shouldn't have a picture of you and the Kentucky Nursing Board investigators meeting for afternoon tea if your investigative meeting is schedule after 12noon or chatting about the details of the complaint over coffee if your investigative meeting is scheduled in the morning.

I love it because it out there and in your face. It says Notice of Complaint and it required a Verified Response. The Board requires a Verified Response to a Complaint filed against a license within 30 days of receipt of the Notice of Complaint.

Why is this a big deal?

Well let's see. The rationale for a Verified Response to a Complaint is simply:

1. You have to verify what you are saying to the Board in response to the Complaint is accurate. No more just saying whatever to the Board.

2. The Verified Response must be notarized. This is significant because you are legally attesting to what is stated in the Verified Complaint on the date the response is notarized.

3. If you don't respond or respond with false or inaccurate information, this can lead to other alleged violations of the nursing law and rules.

Why is this a big deal?

1. This tells me as a license defense attorney that some nurses (certainly not all but enough) have been submitting statements to the Kentucky Nursing Board which are not accurate; and

2. This tell me as a license defense attorney that some nurses (certainly not all but enough) have been dishonest, deceitful, and deceptive with the Board in complaint investigations.

Dishonesty, Deceitful, and Deceptive= Dumb, Dumber, and Dumbest IMHO in licensing Board cases. This is why one should really consider having legal representation instead of representing yourself before a State Nursing Board.

Just saying anything and just putting anything in writing doesn't cut with a Verified Response to the Notice of Complaint.

Pardon my french, this is strictly my opinion, and if asked (unless I am asked in a Verified Response to a Notice of Complaint) I will lie about it; a 30 day Verified Response to a Kentucky Nursing Board Complaint, is the first step when differientating the sh*t from the shinola. http://en.wiktionary.org/wiki/you_don%27t_know_shit_from_Shinola

Its my job as a license defense attorney to do the same.

A Verified Response to the Notice of Complaint is fairly new and this isn't something the Kentucky Nursing Board has always done for years or decades prior. As a nurse license defense attorney,

I am actually glad to see the Board take this approach. Why?

a.  It impresses upon the nurse the seriousness of the Verified Response and that you can't just say anything to the licensing Board governing your nursing practice in response to a complaint filed again you with the licensing board;

b. You must respond and the failure to respond can be lead to more problems. This is common with attorney disciplinary investigations; as attorneys we just can't respond to a Bar investigation because the failure to respond is an issue in and of itself.

c. You must respond within a required period of time and the failure to respond within this period of time can lead to more problems. This is the consistent with Bar investigations of attorneys and some other licensing Board investigations.

d. The majority of nurses represent themselves in State Nursing Board complaints and having to respond with a Verified Response may cause a nurse to pause and consider the complaint and what is alleged and before drafting a 29 page handwritten response to the Complaint, seriously consider one's response and whether or not legal counsel would be beneficial; and

e. I like it because its, IMHO, the Kentucky Nursing Board's Miranda Warning who receive a Notice of Complaint. Please tell me you know Miranda. http://en.wikipedia.org/wiki/Miranda_warning.

The Board is saying "here's the complaint, here's what is required, and here's what can happen if you don't do what's required." Its out there and in your face.

Please tell me that you knew these cases, investigations, and adjudications were adversarial?

http://en.wikipedia.org/wiki/Adversarial_system

I love it because this is what a Nursing Board should do when a complaint is filed against nurse. The Board's role should be stated and again "out there and in the face" of the nurse who is being investigated. . 

I however would suggest one minor change to the Notice fo Complaint. It would be nice if the Kentucky Nursing Board ended the Notice of Complaint with "Do you feel lucky?" http://en.wikipedia.org/wiki/Dirty_Harry

Although I am just kidding of course with the Dirty Harry quote and I am adding a little humor, the Notice of Complaint is a big deal and the Verified Response required by the Kentucky Nursing Board is the real deal.

We live in Serious Times and so of course there are Serious State Nursing Board cases

The State Nursing Board cases and the allegations are becoming more complex.

1. Med Mal/Nursing Negligence and the State Nursing Board

If you are or will be named a defendant in med mal case listen up. Hopefully you have your own professional liability insurance to provide for your defense and for your own defense attorney to work with your employer or former employer's defense attorney.

Find an attorney you trust, who you like (somewhat), and you can work with over a period of months or years. If you need to meet with several attorneys then do so.

Also, imagine this. If you are named as defendant in a med mal case or your conduct, actions, or inactions are one of the focuses in a med mal case, chances are you are going to be reported to the State Nursing Board. Talk to a nurse license defense attorney initially.

I am seeing a trend where nurses blame their attorneys for the outcomes of the representation, counseling, and advising.

2. My Attorney Fracked Up My Case!

#1. If you call my office and you start blasting another attorney, red flags, bells, whistles, and fireworks go off in my mind. Why?

You probably won't be working with me because I am not going to be the next target. Also I am pretty good with reading clients and the issues and I know in a few minutes if this is someone I want to work with or refer out to other license defense attorneys , in Columbus. LOL.

#2. If you are not satisfied with the representation then talk to your current attorney, don't call me. I don't like that I will tell you so.

#3. Talk to your attorney and work it out and terminate your attorney and retain another lawyer. I usually don't represent nurses who have been represented by more than one license defense attorneys because this in and of itself tells me alot.

#4. Do your research and find the right nurse license defense attorney for your case. Ask questions and if necessary speak with several attorneys before you retain a lawyer. Ask for referrals from other nurses, your State Nurses Association, and conduct your own research about the attorney and the law firm. Its your license and its just that important.

#5. Just a hint. Don't call my office or any attorneys office and say to an attorney "I don't like, trust, or respect lawyers."

I am a nurse and I am also a lawyer. I was offended another nurse would call my office and be that damn rude. I wasn't surprised because nothing surprises me anymore in a nurse license defense practice. But don't call my office and tell me you don't like lawyers and then ask for my assistance. Why?

I am going to put you on speaker phone, give the phone the middle finger (I know; its so passive aggressive but I am a nurse also), and start reviewing emails. Then after five minutes, I am going to thank you for calling, tell you I cannot assist you, and refer you to the State Bar Association of What-Chu-Ma-Call-It.

This was nurse whose self-representation before the State Nursing Board was a disaster and the nurse was angry, very angry.

3. Criminal Convictions, the State Nursing Board, and Dual Diagnosis, Substance Use/Abuse, or Cognitive Impairments

When I meet with clients who have a combination of the above, I bring a pillow, cover, and Pepsi to the meeting because its going to be a long one and justly so.

You need to have attorney representation in these cases, period. There are just too many issues to consider and too many short and long-term implications for self-representation here.

4. Patient Injury or Death and a State Nursing Board Complaint

Retain a nurse license defense attorney.

5. This is your 2nd, 3rd, or 4th State Nursing Board Complaint

Retain a nurse license defense attorney. Bring your check book and a credit card.

6. APRNs and State Nursing Board Complaint

Don't represent yourself in these cases. Unfortunately I am seeing this more frequently and the consequences of not making informed decisions and thinking about the long-term and the short-term can shorten or kill your nursing career. Retain a nurse license defense attorney.

7. Nursing Students and NCLEX Applicants & Criminal Convictions

a. You don't know what you don't know.

b. Talk to a nurse license defense attorney before you submit your State Nursing Board application, please. I charge a fee for consultations; you may find someone who does not.

c. Don't rely on the advice given to you by nursing instructors, professors, and others which essentially "just submit your application, it will be okay, as you are a different person now." WTH and who in hell says this? You are NOT applying for a job at Diary Queen when you submit a State Nursing Board Application for Licensure by Examination. 

d. NCLEX-Applicants may benefit from attorney representation as well. I know your nursing program or nursing instructors didn't tell you this but I am telling you this. If you have ANY affirmative responses on your Application for Licensure you need to speak with a lawyer and schedule a consultation. Pay a few hundred dollars to find out what you are facing here instead of blindly submitting your App. Last but not least

8. Criminal Convictions and State Nursing Board Renewals

a. Schedule an appt. with a license defense attorney to discuss the renewal application.

b. Consider attorney representation in these cases.

Yes, they are just that serious.

Also if you have falsified your renewal applications with a State Nursing Board, bring your checkbook and 2 credit cards to the meeting with the attorney you retain. Don't represent yourself in these cases; its a recipe for disaster.

The Ohio Nursing Board renewal is fast approaching. We should receive our renewal applications here soon and when I do, I will post the language in the questions.

 

Client Meetings and + 1, 2, 3, or 4 friends or family members present. Where is Waldo and the dirty dirty?

Can I bring someone with me to a legal consultation?

Of course. Who you bring in to the appointment is up to you, ultimately. However, please know that there may be a point during the consultation when the attorney asks your friend or family member to wait separately during part of the consultation because their presence could jeopardize the Attorney-Client Privilege. I retained Ms. Wright. Can I can bring someone with me to my in-person meeting with her? Of course. Who you bring in to the appointment is up to you, ultimately. However, please know that there may be a point during the meeting when the attorney asks your friend or family member to wait separately during part of the consultation because their presence could jeopardize the Attorney-Client Privilege. What is the rationale? The presence of a friend, family member, colleague, partner, or spouse during initial meetings, I have found in general is helpful because these individuals can contribute significant information and details. Also these individuals are just as concerned as you are about your license, the next steps, and how long is this going to take? However, I am finding that its difficult to say "I relapsed LaTonia" to me and of course this is extremely important information in a license defense case when you have a spouse or parent present and the spouse or parent is not aware of the relapse. Its even tougher for a nurse client to say "I started an intimate relationship with Patient B immediately after discharge" and the spouse of my client who is also a RN and works at the same facility in middle management is also present. So for this reason and others (I care not to mention) its my law firm policy (I think this is only my second or third law firm policy; I have to ask Jack) effective NOW that a friend, family member, or spouse will be asked to leave the meeting at some point so that attorney can speak with her client privately. The nurse is my Client regardless of who paid or is paying my flat fee true retainer. I am representing, counseling, and advising the nurse and I don't want my client concerned about his/her responses to me or unwilling to answer my very pointed questions to the best of their ability because +1, 2, 3, or 4 are present. Its not personal but I know when I am being spoon-fed water droplets through a dirty sock during a consultation or client meeting when there is the nurse + one, two, three, or four in the room. For me its not some much of a concern with a one-time legal consultation but with the traditional attorney-client relationship and ongoing representation cases, its unacceptable. I completely understand because the details in some of the State Nursing Board cases are too hot for even cable TV at 3am. But its a waste of your time and my time if you are providing with me fluff and buff because + one, two, three, or four are also in the conference room or my office with us. State Nursing Board complaints are the real deal. The Boards mean business in these cases and I need information, facts, documents, and "the dirty dirty" from my clients so I can provide the best legal representation, counseling, and advising available under the circumstances. I also need to know the "dirty dirty" so we can formulate a plan to become "fresh and clean" or at a min. "dingy but wearable." I have to go to the laundromat and wash our comforters, the bulkier bed linens, rugs, and our dogs linen (I know) this weekend, can you tell?  Seriously Waldo couldn't find the "dirty dirty" through the layers of fluff, buff, and just plain bullsh*t I am sometimes attempted to be fed on a small spoon like its Stage 1 baby food. If you are meeting with me and I: 1. Put my head down on the table; its not because I am tired; or 2. I excuse myself, thank you for meeting with me, and ask Jack to wrap up the meeting; its not good. It takes Jack 15 to 20 minutes to even wind down the meeting, 5 minutes to summarize, 7 minutes to conclude, and another 10 minutes to walk you down or out to the lobby and then resummarize and conclude because he forgot something.  If I want fluff and buff, I go to my stylist. I have an appt. in the morning at 11am. I just revised my medical, substance use/abuse and/or mental health Intake Form for  clients, and legal consultations. This is used in certain cases in additional to a general Client Intake Form. Oh, you didn't know? Although I may not check your blood pressure and do a head to toe physical assessment, I am a nurse and I am performing others assessments in license defense cases because its a necessity.

Do I stand a chance if I represent myself? The Price is WRIGHT

I need help. I am getting screwed over royally by the State Nursing Board. I can't afford to hire an attorney. One attorney wanted 1500+.

Do I stand a chance if I represent myself??

------------------------------------------------------------------------------------

Thank you for your comment on my blog. As you can see, I edited your comment as you disclosed alot of information in your original comment.

Guess what?

 You are representing yourself.

You are representing yourself whenever you have a legal matter with a licensing board and you don't have an attorney. You may not realize it, but you are already representing yourself.

You are representing yourself now, you have represented yourself in the past with your dealing with the State Nursing Board, and your representation of yourself had lead to you this point. The here and the now.

Therefore I think you have enough information to answer your question which is: do I stand a chance if I represent myself?

I don't mean to be harsh but I don't think many nurses realize that you are representing yourself before the State Nursing Board anytime you don't have an attorney and you are involved in a disciplinary investigation, complaint, hearing, or application for endorsement or initial licensure and there are affirmative responses which trigger an investigation.

But I asked the Board investigator do I need an attorney and I was told no?

Really? You are not required to have an attorney for ANYTHING because there is a RIGHT to self-representation in this country. So therefore when you ask a Board investigator, do I need an attorney, the answer is no.

But ask yourself this, if you have to ask a Board investigator do I need an attorney, do you need an attorney? Probably so. 

But I didn't do anything wrong?  

This isn't Sundary, you are not at church and we are not talking about moral right and wrong. Nursing Board investigations are about alleged violations of the State Nursing Practice Act and Board of Nursing regulations. If you want to speak of and deal with right and wrong, speak with your spirtual advisor. 

If you want to know whether or not your alleged conduct, actions, or inactions violated the State Nurse Practice Act and/or Board of Nursing regulations, then come on down, you are the first contestant on the Price is WRIGHT. Call me, text me, email me, fax me, or send me a smoke signal.   

Did your actions or inactions violate the Nurse Practice Act and/or Board of Nursing Regulations? Oh, damn, I didn't look at it like that.

There are pros and cons to representing yourself.

The best thing about repping yourself is you save money and who doesn't want to save money.

The worst thing about repping yourself is you fail to be objective, you are biased, you don't see any issues with anything, you see this as a matter of right or wrong, good nurse vs. evil State Nursing Board, east coast vs. west coast rappers, Pepsi vs. Coke (let's not even go there, pumpkin with the Cola Wars today), you rationalize your actions or inactions, you minimize your actions or inactions (what about those nurses who steal drugs?) and /or frankly you can't "see me" i.e. yourself when you represent yourself. Are you Tupac?  

That's why attorneys are told to never represent themselves. An attorney who represents themselves has a fool for a lawyer and a client. We were told this in law school.

I don't have money to hire an attorney?

This is income tax refund season and you can ride through certain neighborhoods (like where I grew up) and see all the new "30 day" temporary tags on vehicles. Why? Tax refund checks. I smile when I hear I am getting "4k", "8k", or "3k" back.

But honestly I love watching the Income Tax Refund Mania from January to April of every year. Your average person goes "willy nilly" with a refund check and buys flat screens, designer clothes, etc.

Are you pimping your ride, your home, or your kids out with your tax refund this year? I have a better idea.

Why not use your income tax refund to hire a nurse license defense attorney? As a bonus, this also helps to stimulate the economy because I am going to Walmart, Big Lots, Bob Evans, and Kenwood Mall for clothes and shoes. I may also gamble a little and help the ecomony in Indiana as well. I may also get a manicure; I can't do tips or any artificial nails because I type alot and hard.

Do you know I type so hard the letters are missing from my most used keys on my external keyboard? I know. I can't wait until Spring so I can start walking outdoors again, kicking trees, breaking sticks and branches, and throwing rocks at passing cars until I am tired again.

No seriously, if I am talking to a client and typing at the same time, I will hear, "oh my God, that's not you typing is it?" I will say no, that's just me eating a ear of corn.

Okay back to my point, you can't afford NOT to hire an attorney at this point. Your attorney can't change the past but the attorney can counsel and advise you going forward on your options so that you are making informed decisions.

If you are going to rep yourself, put your options (oh, you may not know your options because you are repping yourself) in a magic hat and pick one. Or flip a coin, "heads" I met with the State Nursing Board investigator without an attorney "because its just an investigation" or "tails" I bring my best friend who is studying to be a legal assistant with me to the meeting.

This way with the magic hat or flipping a coin, you can blame "everything that happens thereafter" on "chance" and not your decision to retain legal counsel at the beginning or initial stages of the State Nursing Board matter.

In all seriousness, the slightest discipline against the license can have long lasting implications and consequences on a nursing license. Hire an attorney to work with you throughout the process and to be on your team throughout your nursing career. Consider having Nursing Practice Counsel.

We are getting to the point with the legal, regulatory, clinical practice, employment, and other issues in nursing where I think RNs especially APRNS should have their own personal legal counsel for practice issues like physicians. But that's another post.

Boundaries in the Attorney-Client Relationship: Betrayed Trust. Today & Tomorrow

The attorney-client relationship is built on mutual trust. The seeds for trust start either by phone or with an in-person meeting and then develop and mature over time.

I have a client who has been lying to me. Not just white lies, little lies, or your average lie, but lying to the extent that the person doesn't know where the truth stops and the lies start. 

I always establish and maintain boundaries with my law firm clients because being friends with a client is a NO NO because its harder to provide objective advice, unbiased counseling, and give someone the "cold hard facts" and the "low & lovely legal" when you are friends.

Nurse license defense is intense; well it is in my law firm. We work closely with our clients and over the weeks, months, or years (yes, pumpkin, years in some cases) the seeds of a friendly attorney-client relationship are planted. Some of my cases, we are working together just a few weeks or months with phone calls, several meetings, and that's it while others are weekly calls, monthly meetings, emails, and text messages. It just depends.

Also this isn't a law firm factory where we have 500 cases pending at one time and a swarm of lawyers, paralegals, and secretaries servicing a case. You call the office, you speak with the receptionists. Then there is Jack and there is LaTonia. I get to know my clients and their cases.

There are clients with nicknames like Big Lot Betty, and The Jam Lady (who is paying for her legal defense with jars of homemade strawberry jam) and others. I had a client send me a wedding present and the gift sits right next to our wedding certificate in our entryway. I receive Christmas and birthdays cards from the clients. I had one client send cookies (and this person knew I was dieting) on our 1st wedding anniversary last summer. I am a nurse and I represent nurses so it can get a little emotional or personal at times. Its the nature of the beast.  

My husband asked me last week, why don't we have a pool party for your clients here this summer?  I told him by the time, I had everyone sign the appropriate disclosures, waivers, disclaimers, and I had everyone essentially sign a document essentially saying "we are not here and this didn't happen" that it wouldn't be a very fun pool party. I can't imagine a pool party without alcohol and I certainly couldn't serve alcohol at a pool party with nurse license clients. 

Why? Alot of my clients are in Board of Nursing Alternative Programs or have Agreements, Orders, or Contracts which require UDS and prohibit the consumption of alcohol.  

Imagine, a Notice of Opportunity for a Hearing from the Ohio Nursing Board suspending the license of Nancy Nurse for violating her Consent Agreement:

NANCY NURSE in her statement to the Board indicated she attended a party given by her attorney on May 31, 2011. She consumed several fruity colorful and extremely well made beverages shaken, stirred, and/or blended by attorney. NANCY NURSE as she backed out of the driveway of attorney's home at 4am was pulled over by a police officer on a bicycle and was arrested, charged, and convicted of felony OVI in just 3 days.

Also in violation of her Consent Agreement, NANCY NURSE submitted to a UDS on June 1, 2011 and tested positive for alcohol and Tramadol. NANCY NURSE has a history of alcohol dependency. She does not have a legally valid prescription for Tramadol. NANCY NURSE states that someone at the pool party gave her a pill for a headache and NANCY took pill because in the direct sun it resembled "Ibuprofen when wet." 

This is just a hypo folks. But you can see why entertaining clients sounds nice but no, pool party at LaTonia's.

Betrayed Trust.

I was angry. I was upset. However I was angry and upset because I was hurt. But I realized today its more than just hurt feelings or a bruised ego; its betrayed trust. This nurse betrayed my trust and it hurts.

Actually I expect lying, deception, deceit, and dishonestly in PERSONAL relationships with friends, relatives, and others because its human nature. But I guess this is where I struggle to connect human nature with the essence of nurse legal defense and counseling and advising because I do not expect my clients to lie to me; I expect this behavior in personal relationships but not professional service relationships. Yes, it happens but I don't expect it.

Why? I assume my clients want to provide me with helpful information for their defense. 

You tell me but what a##wipe would:

*Intentionally lie, deceive, and/or provide inaccurate, incomplete, or otherwise untruthful;

*Materials, documents, statement, or verbal representations;

* To the nurse license defense attorney;

* Providing legal representation before a State Nursing Board;

* Counseling and advising the nurse on the implications of a complaint and the implications and consequences of The "D" (discipline); 

*When the Advice, Counseling, & Representation provided by said attorney is oh so DEPENDENT on the instructions of the client?

Bottom line:

Attorneys exist to serve the public and provide a service. The case belongs to the client. I tell my clients, its your case and its your license and I explain my role.

An attorney represents, counsels, and advises you based partyly or primarily (it depends of course) on the information you provide. You are paying the attorney for this service. Therefore, why would you lie to the person you are paying thousands of dollars for a service? Are you nuts?

If I did nurse license defense just to pay the bills then I might feel differently. But nurse license defense is more than a job to me just like practicing law in a law firm limited to nursing and nursing law issues is more than a niche to me.

I have a client who betrayed my trust and it hurts. Like anything else, this too will pass but it is what it is today. Today, my feelings are hurt and I feel a pinch in my chest today.

 But because it hurts today, this lets me know that I care about my clients and their case and their license, today and tomorrow.