My 2 Cents

The Nursing Police and Nursing Regulation

My colleague, Taralynn R. Mackay, JD, RN , a nurse attorney who represents nurses before the Board of Nursing, had a well written article published in the Nurse Grad Issue 2007 • Page 31 of Advance for Nurses. The article is titled "The Nurse Police." See http://nursing.advanceweb.com/editorial/search/aviewer.aspx?an=nw_07sep1_nngp31.html&AD=09-01-2007. See Taralynn's blog at http://www.nurseattorney.blogspot.com/.

This is a quote from the Nurse Police article:

It's important to note that the Board was not established to be the guardian and protector of nurses in their particular state. This is a surprise to many nurses, who often misinterpret the board as their advocate. The job of advocating for nurses is performed by professional organizations, such as the state or national nursing association. Boards are entrusted to protect the public, not nurses.

Think of the board as the "nurse police" or nursing regulators and a better understanding of their role emerges. The board is on the side of the public, and has the right to investigate the behavior of any nurse who may have violated the practice act.

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The article correctly notes most nurses are concerned about medical malpractice and nursing negligence although a nurse is much more likely to be reported to a State Board of Nursing than sued as an individual defendant in a professional negligence action.

What has been your experiences with your State Board of Nursing? How would you use to describe your interactions with State Board of Nursing staff?

READ Your Insurance Policies

I posted on this subject earlier this week that all professional liability insurance policies are not made equal. Well guess what?

I spoke with a nurse this week who just received notice a complaint was filed against her license with the Board of Nursing. She has professional liability insurance with an insurance company that writes a large number of policies for nurses.

She was told by the insurer that the policy only cover attorney fees and costs for a licensure defense HEARING! It does not cover attorney fees and costs during the investigative phase.  What a JOKE!

Depending on the particular State Board of Nursing and the Nurse Practice Act and Board of Nursing Regulations, cases are investigated and adjudicated differently. A case may not proceed to a hearing but this doesn't mean the nurse should not be afforded with attorney representation.

Nurses, READ your professional liability insurance policy. If you don't understand the language and conditions in the policy, consider setting up a legal consultation with a licensure defense attorney in State so that you know UP FRONT the limitations, terms, and conditions in your policy in the event you are named as defendant in a malpractice case or if the event a complaint is filed against your license with a regulatory board.

Nursing Students and Criminal Convictions

I spoke with a prospective nursing student yesterday. She completed a year of nursing school. She was charged and convicted of Domestic Violence involving a minor (the situation occurred with her teenager daughter); its a misdemeanor, but its a M1. She was told by two different criminal defense attorney that Domestic Violence, M1 could not be expunged.

She wanted to know if she should continue her nursing education or consider another healthcare profession. I asked her if she would be willing to meet with me for a legal consultation given her situation however, she is strapped for cash.

All nursing students who have criminal convictions (misdemeanors and felonies) should consult with a nurse attorney (who practices before the Board of Nursing) before enrolling in and completing your nursing training. Nursing Instructors and Professors usually are not licensed attorneys and cannot provide a nursing student with legal advice and counseling on his/her options related to criminal convictions and licensure.

My sister recently completed her massage therapy training. The Ohio Medical Board application for licensure (massage therapists are regulated by the Medical Board in Ohio) asks detailed information not only about criminal charges and convictions but also about all cases where you were a defendant, this includes civil cases. This information was presented in her  class earlier this month. I had, of course, already discussed this with her at length seeing this is what I do for living.

Why not present this type of information in these programs at the beginning so that students can make an informed decision on whether or not to complete the training? Are these schools worried that students will not continue in the program and the school will lose money? Is it the duty and obligation of the student who has criminal convictions to seek out this information?

My sister mentioned that one women in her class started crying because she has multiple felony convictions and several other students expressed concern about their criminal convictions and the ability to obtain licensure.

I see this a lot with LPN training programs in Ohio. Its unfortunate and it turns my stomach. Are these schools acting in the best interest of students by delaying the presentation of this information? Should students actively seek out this type of information on their own? What do you think?

Nurses Proceeding Without Legal Advice

I appeared with a nurse client yesterday before the Indiana Board of Nursing. What struck me after listening to the appearances for applicants for initial licensure and applicants for endorsement was not that the nurses didn't have legal counsel. That's no surprise because the majority of nurses involved in a licensure matter don't have legal representation.

What about at a minimum seeking legal counseling and advising even if you don't formally retain an attorney? What struck me was in a few cases the nurses or nursing school graduate did not even attempt to seek legal counseling or advise in regards to their particular situation whether it was disciplinary action (probation, suspension, or practice restrictions) in another state or the impact of criminal convictions. Two of the appearances (both nurses seeking licensure via endorsement) obviously didn't have a clue as to the impact of Board of Nursing action against a license in the state where you endorsing from. Several nurses had previously signed legal documents (Consent Agreements, Agreed Orders, etc.) allowing action against their license without understanding the implications of the legal documents.

Even if you decide not to formally retain an attorney to represent you, at least consider scheduling a legal consultation with an attorney to review the facts and circumstances surrounding YOUR situation. You can't obtain this type of advice from collegues or online nursing chat rooms. You want legal advice from an attorney with experience in nursing licensure matters. Have an attorney review ANY legal document that pertains to your nursing practice before you sign it whether its an employment contract, Consent Agreement, Agreed Order, etc.

As nurses we must start protecting ourselves and that includes knowing when to seek a legal consultation or assistance in a licensure matter. Your license is your livelihood and its YOUR job, role, and obligation to protect yourself. To find a nurse attorney in your area, see www.taana.org, the website for The American Association of Nurse Attorneys (TAANA).