My 2 Cents

Ohio Board of Nursing FY 2007 Draft Report

If you practice nursing in Ohio, hold an active Ohio license, or plan to practice nursing in Ohio in the future, you should review the draft of the Ohio Board of Nrusing FY 2007 Report. Its available online at http://www.nursing.ohio.gov/PDFS/NextMeeting/M1/2.3DrftAnnualreport.pdf.

Depending on where you practice nursing, you should make it a point to review the FY Report's submitted by the Nursing Board. This information is usually available online and you can print it and review it about your leisure.

Why? To stay abreast of possible issues that may impact your nursing license and the professional practice of nursing in your state. I do the same for states where I hold a law license and I always find something interesting in the Reports.

Will It Anger to Board if I have an Attorney?

I am always puzzled when a nurse asks this particular question. A RN contacted me this week. She knows that a Board of Nursing complaint is forthcoming and she wanted to know her rights and responsibilities in the investigation. She asked if it will anger the Board of Nursing if she retains her own attorney to represent her before the Board.

I have a standard response to this question because I have been asked this question countless times since starting my own law practice in 2001. Board of Nursing disciplinary investigations are adverserial. When the Board of Nursing contacts you related to a complaint filed against you; its not a social call. The Board of Nursing has its attorneys (whether in-house legal staff or through the Attorney General's Office)to do the "business" of the Board, this may include prosecuting complaints.

Representation before the Board of Nursing is an important part of what your attorney will do. A larger part of the scope of representation should include counseling and advising you on the disciplinary investigation and process and the implications for your nursing career if action is proposed against your license.

At what point will the profession of nursing start educating its own about the law, legalities, and legal process involved in the professional practice of nursing? Disciplinary investigations are not a game and this isn't preschool where you should be concerned if "someone" is mad at you. You retain counsel because you need an experienced legal professional to guide you through the maze and discuss your options.

This question really underscores the lack of knowledge that most of us have as nurses regarding the legal regulation of nursing practice. I must admit I am a nurse, first and foremost, so please don't be mad at me if this post offends you. I am apologizing in advance and I am truly sorry. I sincerely hope I haven't angered you in anyway. 

Increase in Board of Nursing Action Against Nurses

A fellow Nurse Attorney, Connie Morrison http://www.camorrison.com/ has the following posted on the front page of her website:

Did you know:
An alarming trend is that the numbers of state board of nursing actions against nurses has been steadily increasing since the 0.2-0.3 percent of all United States registered nurses who were annually disciplined at the turn of the twenty-first century (Benner et al., 2002). At the same time, the numbers of nurses who have had increased responsibility and accountability in their scope of practice have also faced intensified scrutiny by these same boards of nursing. With the national trend of increased litigation, increased malpractice premiums, and increased civil, criminal, and board of nursing action, Continuing Legal Education Programming (CLEP) is vital.

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This is an alarming trend especially considering there is a documented need for more nurses across the country to practice in a variety of settings. Maybe Congress and the state legislatures when considering studies and funding for nursing schools/colleges, centers of nursing, and the lack of nursing faculty should also consider the following: Are we recruiting potential nurses only to have these nurses disciplined at some point in their career by a state Board of Nursing?

This does not even take into account criminal convictions (misdemeanor and/or felony) and the legal headaches faced by nursing students who have criminal convictions and then apply for initial licensure in a particular state. Or licensed nurses who face disciplinary investigations for a criminal conviction (misdemeanor or felony) even if unrelated to nursing practice in some states.

I had a family member of mine inquire about nursing school last week. She has several misdemeanor convictions from several years ago but no felony convictions. I advised her if she does enroll in nursing school and complete her education that depending on the state where she seeks initial RN or LPN licensure, she may need legal representation, counseling, and advising. I don't think she plans to apply now and if she does I will counsel her to seek initial nursing licensure in an appropriate state.

Should a new graduate and newly minted nurses start his/her career on probation with a Board of Nursing (depending on the Board of Nursing, this is akin to being "on criminal probation" or "on criminal parole") or with "action" against his/her license prior to the first day at work?

What a way to welcome new nurses to the practice of professional nursing!

RN Renewal in Ohio

Ohio licensed RNs should receive their renewal application in the mail soon. I received my renewal application last week. It is important that you renew your RN and COA (if applicable). There are several questions on the back side of the Ohio RN Renewal Application that must be answered.

My law office offers legal consultations for nurses if you don't know whether or not you need to check yes or no to a particular question. The cost of a 30 minute phone consultation is $150.00 and the fee can be paid online. In the context of the consultation, I will review court documents and other correspondence if needed.

It is important that you respond accurately and truthfully to the questions on the Renewal Application, although responding in the affirmative may trigger a disciplinary investigation. The Board considers it "fraud" to respond inaccurately and untruthfully on a nursing renewal application. 

If you have questions about the 2007 Ohio RN Renewal Application, you can email me at ldw@nursing-jurisprudence.com to schedule a legal consultation or call my office at 513-771-7266.

How to Stay Out of Legal Hot Water

The January 2007, Vol. 70, No. 1 edition of the RN Magazine, the professional journal with a personal touch, has several members of The American Association of Nurse Attorneys (TAANA) www.taana.org on the front cover. These nurse attorneys were interviewed for the article, How to Stay Out of Legal Hot Water. See www.rnweb.com.

Congratulations to Rebecca Cady, RN, JD, Barbara Ryan RN, JD, Taralynn Mackay, RN, JD, and Gayle Sullivan, RN, JD!

Disciplinary Investigations

What a way to bring in the New Year! However, if you are being investigated by your state board of nursing, state board of pharmacy, department of health, or office of attorney general, you should consider scheduling a legal consultation with an administrative lawyer in your state.

You should consult with an attorney prior to being interviewed by a state investigator in person or via phone or providing a written statement. You are a licensed professional, so act like it! You must always consider what is in your best interest. If you don't consider what's in your best interest, what makes you think others will?

Alternative Program for Chemical Dependency

If you have a chemical dependency or legal problems (DUIs, drug theft, Board of Nursing or Board of Pharmacy investigations) directly or indirectly related to a chemical dependency, consult with a licensed attorney in your state regarding your options.

KY ARNP & Controlled Substances

I attended the Kentucky Coalition of NP & NM seminar in Bowling Green, Kentucky on Friday. The topic was prescribing controlled substances. There were over 200 nurses present at the conference. The speakers included staff from the Kentucky Board of Nursing, Office of Inspector General, Louisville Drug Diversion Squad, and more.

The conference was okay. It was a three and half hour drive to and from from the Cincinnati area. It was a long drive however I am glad that I attended. Not because it was an excellent seminar but because the seminar confirmed a point I see everyday in my law practice.

As an attorney who represents, counsels, and advises individual nurses I thought it was unbalanced presentation from regulatory and law enforcement officials. The seminar focused on the responsibilities of ARNPs related to controlled substance prescriptions but not the rights of ARNPs in regulatory and law enforcement investigations. Why not include a session on managing the risks associated with controlled substance prescriptions and ARNP practice?

Professional associations like the KCNPNM advocate for the profession which includes individual members. I think its "nice" when members from regulatory and law enforcement agencies speak at these seminars however there should be limits so attendees can view these presentations in the proper perspective.

Is this one of the reasons why nurses in general represent themselves in regulatory investigations if contacted by the board of nursing, office of inspector general, or office of attorney general? Is this one of the reasons why nurses do not invoke the right to counsel when questioned by law enforcement agents in workplace investigations related to suspected criminal conduct?

The role of a regulatory agency like the board of nursing and office of inspector general is to protect the public, the role of law enforcement agency is to enforce laws and regulations, and the role of the attorney general is to investigate and prosecute violations of the law. Please contrast this with the role of a nursing professional association which is to advocate for the best interests of the profession and its membership. Conference planners need to keep this in mind when developing seminars for ARNPs across the country.

Maybe its just me.....

Scope of Practice

I spoke today at the Greater Cincinnati Chapter of the American Association of Critical Care Nurses spring meeting at the Cintas Center (Xavier University). There were over 170 attendees registered for the conference and I had over 60 nurses attend my presentation on the RN Scope of Practice in Ohio.

After the session, I fielded questions pertaining to nursing delegation, professional liability insurance, and the RN and LPN scope of practice in the workplace. Scope of practice is a big deal and as a starting point, download and review a copy of your State Nurse Practice Act and State Board of Nursing Regulations.

What is the difference in the scope of practice of RNs and LPNS in your state? You tell me.

Board of Nursing Meeting

I attended the Ohio Board of Nursing meeting today in Columbus, Ohio. Nurses, if you have never attended a meeting of your state Board, I would suggest that you do to review the Board agenda and see how your state Board conducts its business. Its quite refreshing. The Board Task Force on the Ohio Center for Nursing met today. There was a discussion on the pilot program for Medication Technicians and Community Health Worker training yesterday.

There were graduate students from Wright State University in Dayton, Ohio present today. Did you attend a Board of Nursing meeting as a student? Was it a requirement for a class?

During my ASN (1993) and BSN (1994) studies, I wasn't required to attend an Ohio Board of Nursing meeting as part of a course requirement. Should it be a requirement as part of a professionalism or ethics nursing course? In your opinion would this help socialize student nurses in the practice of professional nursing?

American Journal of Nursing articles

Have you reviewed the two articles discussing board of nursing disciplinary investigations in July 2005 Vol. 105 No. 7 of the American Journal of Nursing (AJN)? One article advocating for a Bill of Rights for Nurses in investigations is written by Sharon LaDuke, who directs a med-surg unit at Lakeview Hospital in Utah. The second article written by Vickie Sheets provides the viewpoint of the board of nursing. Sheets is a nurse attorney and director of practice and regulation for the National Council of State Boards of Nursing.