My 2 Cents

The USA is changing; Will Nursing Embrace Change?

We will have our 1st African-American President of the United States next year, President-Elect Barack Obama.

We have our 1st four star army general, who is a women. See http://www.cnn.com/2008/POLITICS/11/14/campbell.brown.general/index.html?iref=mpstoryview#cnnSTCText

What changes do you envision for nurses and the profession of nursing in this new era where anything is not only possible, but maybe probable?

Will Nursing Embrace Change? Is change coming to nursing? What are some of the changes needed in nursing?

DUI, Nurse, and Nursing Board

Do you want to know one of the most common google searches where this blog appears?

"Nursing Board and DUI"

"Nurse and DUI"

"Nurse, DUI, and license"

"DUI and nursing license"

"Report DUI to Nursing Board"

What does this say to you?

Also take a look at the informal poll on my blog. Look at the number of the nurses with an active and unencumbered license vs. the number of nurses currently being investigated by a Nursing Board.

Its says alot of things to me, but what's your opinion.

Does Your Employer Have Your Best Interest at Heart?

What is your initial response to this question?

I think this is shock for most nurses. Most of us are good people and I like to think we are in this profession to help others. There is also an assumption of fairness in how your employer handles disputes and issues in the workplace. We as a profession assume "someone else" always has our best interest at heart. Why?

I am getting married!!!!!!!

My fiance proposed and we are getting married on 07/08/09 in Las Vegas, Nevada. I am so excited.

Are Non-Union State Nursing Associations going to bolt from ANA?

This is just my opinion.

Labor oriented state nursing associations are leaving the American Nurses Association. Look at California, Michigan, Minnesota, Hawaii, Mass., Maine, and the others. See www.mnnurses.org.  

I am curious to see which workforce advocacy (non-union affiliated) state nurses association will break from ANA first. Its a possibility because there isn't enough members to support a federated model of national, state, and district nurses associations on the dues paid. Proposes in dues increases are met with huge resistance at most conventions.

Which state nursing association that is not heavily by collective members and affiliated with ANA will bolt first (at the advice of outside legal counsel of course) and escrow the dues money paid by its members? 

When you are pushed up against the wall and there is a need for income and cash flow, you question old ties, you survey the landscape, and you seek more cost effective means of association and affiliation, and there is no limit on what you will do to survive....... http://www.youtube.com/watch?v=Xv6lHwWwO3w

ANA and State Nursing Association dues: Paying One Month at A Time Because Next Week I may say "no more"

I attended a meeting this month and a discussion turned to the hostility and turmoil between ANA, State Nursing Associations, and other organizations once affiliated with ANA.

I listened because I love nursing and nurses however I am a liberal (if you didn't guess already) and I support change. Change is needed on a grand scale level in nursing professional associations if the associations want to really speak for nurses and have the support of the majority of nurses.

This person is a long-term member of the Ohio Nurses Association and ANA and she indicated she could no longer write a check and paying her dues in full once a year. Therefore she opted to have her dues removed from her checking account once a month because she may decide next week she doesn't want to belong to the Ohio Nurses Association and the American Nurses Association anymore. She also remarked how alot where she works are no longer ONA and ANA members.

This is scary because she is a nurse educator. If nurse educators and those with credentials such as LaTonia Denise Wright, RN, BSN, JD, PHD, MPH, MBA, CNE, BC, APRN, MSN, MEd don't support ANA, membership will surely drop and more of those Newsweek "articles" will be needed.

Her words were, I may wake up one morning and decide this is it.

For me personally, I have always paid my ANA dues monthly and I don't know if I plan to remain a member of the Ohio Nurses Association and the American Nurses Association. Although I must admit the $35.00 a month I pay is worth it just for the blogging material alone so I will remain a member.

See how fast I flipped about membership in ANA and ONA; like a pancake on a hot griddle.  

What's Up with the Ohio Nurses?

I was asked this by a RN-JD (who is not from Ohio) but who was remarking about the large number of nurses with legal issues. Now of course this wasn't a scientific poll by any means; it was an observation.

I told there are alot of Ohio nurses discussing licensure, discipline, employment, criminal, and other issues in internet chat rooms, listserves, etc.

If you are an Ohio nurse, I will ask you, what's up with the nurses in Ohio? Are we "off the chain" or out of control here?

Or is it that the internet has made it easier to express your frustrations with other nurses from around the country?

In your opinion are things worse here in Ohio than in other States for nurses?

Road Warrior for a Week

I attended the Ohio Board of Nursing meeting in Columbus, Ohio on Friday and met with a client who lives near Columbus. I attended part of the Indiana Board meeting on Thursday.

I meet with 7 clients in Streetsboro, Ohio on Sunday from 8am to 6pm. We drove up to Streetsboro on Saturday evening. Streetsboro is a central location to meet with clients who live in Cleveland, Youngstown, and Akron, Ohio. We returned to Cincinnati late Sunday evening. On Tuesday, I drove to Louisville, Kentucky for a KBN meeting and to meet with two clients.

We rented a car for the week because I didn't want to gas up my boat. We are turning the rental car in today and I know we drove it over 1,300 miles in a week. It was a Saturn and I am considering buying a midsize vehicle next year. Actually, I am really enjoying not having a car payment and I tell myself I am buying a new car just to say it.

This was my second trip to the Streetsboro, Ohio area to meet with clients. I don't mind traveling and I travel extensively in Ohio and Kentucky. I typically have meetings in Indianapolis, Indiana in Indiana which is a two hour drive (and that's driving at 70mph) from Cincinnati.

Next week, on Monday, I am meeting a client a Lexington, Kentucky. Lexington is a easy drive from Cincinnati, only about 75 minutes.

Are you Stressing About Finances?

The economy is ugly and although the experts will not not say the "R" word, we are all concerned about a recession.

See this newsletter from WISER about Less Stress in a Stressed Economy: http://www.wiserwomen.org/pdf_files/WiserNewsSpring08.pdf

I overheard one of my family members last week saying their retirement strategy is "to work until I die." This isn't a strategy. Are you planning to work until you die as a retirement strategy?

There is no time better than tight times to start trimming some of the fat or phat and look towards building a more financially sound and stable future.

Are you doing anything differently in this tight economic times? I am trimming some of the phat in my household.

I removed my acrylic nails (please don't laugh) this spring and I am sporting my natural nails again. It hard cramming two hours for nails and a pedicure every two weeks into a crowded calendar anyway.

I am grooming my dogs myself. This will change. Actually, I don't like doing this and may delegate this to my son or fiance.

I don't go to the hair salon once a week anymore. Try once every 6 weeks for a relaxer. This will probably change, as I can't keep up on my old neighborhood gossip anymore without visiting the salon. Maybe I will go every two weeks.

We didn't have as many pool parties this year as we did last summer. I have been extremely busy and I didn't really want to entertain my family or my fiance's family anyway.

I work every weekend on law and consulting firm cases and projects. I would typically sip Martini & Rossi Asti Spumante champagne on Saturday and Sunday while I worked. I cut back to Bartles & James coolers. (This will change this weekend).

If You Take the Time, Effort, and Money to Hire An Attorney, Be Honest & Forthright!

How do you effectively represent, counsel, and advise a nurse in a licensure defense matter if he/she is providing with you false, inaccurate, or untruthful assertions?

I would ask you nurse to nurse that if you take the time, effort, and money (because attorney representation costs money) to hire an attorney to represent you in a legal matter, be honest, even if it hurts with your attorney.

Your attorney cannot adequately represent, counsel, and advise you based on false, inaccurate, untruthful assertions and information.

I have several clients who are not/have not been honest and forthright with me. This directly impacts the legal representation, counseling, and advising that I am providing to these nurses.

I feel a sense of disappointment initially; actually it hurts because being a nurse and representing nurses in licensure matters, I take my cases personally to a certain extent. However I have step back and remember:

1. The cases belongs to the clients not the attorney. Its their case, their license, and their livelihood on the line; and

2. Recall my 1993 nursing school ethics class discussion on personal vs. professional responsibility, accountability, and liability.  

I am back

I'm back; this is my first full day of work since Sunday when we experienced major weather issues here in Cincinnati.

Our power went out on Sunday and I started practicing law out of Kinkos on Tuesday.

Monday was a wash as we were moving food from the freezers to my brother-in-law's home and cleaning up yard debris. I watched the Closer at my brother in law's home on Monday. (No, I am still not married but we are getting there).

Tuesday, I ran down the car battery speaking with clients on my cell phone.

Wednesday, I attended the KY Law Updated sponsored by the Kentucky Bar Association in Northern Kentucky.

The gable vent blew off on our rental property on Sunday. Our deck hot tub cover was damaged when it flew off. Nothing major when you consider a tree fell on my next door neighbor's home and another neighbor had a tree fall into their swimming pool.

This storm reinforced three points:

1. If you live in a tree-lined community and we do, you have to trim and cut your trees at some point. Yes, it is expensive but its necessary. Thankfully we removed four large trees last month from around our home.

2. Practicing from Kinkos is expensive. Its cost $.49 per page for laser prints and $12.00 an hour to use the computer. Its cheaper if you bring your own laptop and then print documents.

3. I have a "thing" for coffee and I become irritable and unstable if I don't have hot coffee by 11am. I won't say addiction because I don't anyone reporting me to Ohio Nursing Board.

RN-JD Risk Management position: Going Once, Going Twice....

If you are a RN-JD and looking for a change in your practice, consider this position.

I am sure it pays very well. I am guessing of course but I would say at least low to mid six figures depending on experience, credentials and qualifications, with a generous relocation package, and an average to above average medical, dental, and retirement package. What do you think?

I must admit, I reviewed this position description twice. If I were on the market....

Download program_director_of_risk_management_job_spec1.doc

Professional Boundaries Post Request for an Ohio Nurse and her Colleagues

I received the following email from a nurse yesterday:

Can you tell me about professional boundaries regarding RNs and behavioral health clients?  I am seeking direction in 'timelines' of appropriateness in establishing social relationships with prior clients. 

For example, is it 'ok' to have lunch with a former client?  (i.e. not a sexual boundary issue)  If so, what is considerate appropriate time-wise? 

As my peers & I discussed this, the next question was 'what about dating' a former client?  How much time needs to lapse for this kind of relationship to not be considered a boundary violation?

We've had no success in finding any real answers on the OBN website.  Maybe you have a blog about this -- if so, would you direct me where to find it. 

Thank you -- your website/blog is great!  If you don't have any current blogs on this topic, maybe you could take into consideration for future blogs. 

I appreciate any information you can share -- & I'll gladly share with my peers.

Thanks for your consideration!

******************************************************

Thank you Ohio nurse for contacting me and suggesting a post for my blog. I smiled when I read your email because I love it when nurses research the Nurse Practice Act and Board regulations then analyze and discuss how it applies to daily nursing practice. Now that's what I am talking about!!!

I actually have an article appearing in the next Kentucky Nurse, the newsletter of the Kentucky Nurses Association about professional boundaries and professional sexual misconduct.

I have published several peer reviewed articles on professional boundaries in nursing and professional boundaries and professional sexual misconduct is one of my favorite presentation topics. As a home care nurse, I have also encountered a number of boundary issues.  

I will link the KNA article to this blog post when its published in September 2008. Although I cannot provide you with legal advice and counseling and answers to your specific questions on this blog, I think you will find the article very informative.

 

Update: My Nephew is Recovering

My nephew is doing well. Thank you for the emails and notes of prayer I received.

His surgery was successful. His ASD was closed and he is recovering.

My Nephew is Having Surgery Today

My 7 y/o nephew is having open heart surgery today at Cincinnati Children's Hospital to repair his Atrial Septal Defect. He also has pulmonary hypertension.

Please keep us in your prayers.

Why Do We Like to Play the Victim?

This has been a long week or it seems long anyway.

I spoke with a nurse this week who is having licensure issues with a nursing board. The nurse is upset because of the proposed discipline against her license offered by the state nursing board to resolve a pending complaint.

1. The nurse insisted that she was tricked by the State Nursing Board and never told she could retain an attorney during the investigation. She didn't know there were attorneys who represent nurses before the Nursing Board. She feels victimized and cheated.

Comment: Nurses are educated professionals. As a professional don't depend on anyone to inform you of what your rights are in a particular investigation whether its internally in the workplace, criminal, licensure, etc.

Its your license, do some initial research into your options. Trust your instincts; if your gut is saying "hey I am not comfortable" or "I need to speak with someone" get online, contact your state nurses association, or contact an attorney.

You worked hard for your education and license; work just as hard to keep it! We have to stop playing the victim role, meaning here that we blindly assume and trust that "everyone" whether its nursing management, human resources, law enforcement, regulatory agent, Board investigator, etc. has our "best interest" at heart. Its your job to have your own best interests at heart at all times. Then when things don't go as planned we can say "I didn't know" "no one told me" "how would I know".

Why do we as nurses like to play the victim role? 

Will I remain a member of the ANA and the Ohio Nurses Association?

I had someone email me yesterday asking this question. The ANA House of Delegates ended Friday. I was not able to the attend the ANA HOD (gosh darn!).

Therefore I need to review what was adopted, adopted as amended, and rejected before I make a decision.

Several Ohio Nurses Association members (who I respect and adore) commented to me that any decision made now will be in the heat of moment and I should give it at least one year.  

I need to "get the skinny" on what happened at the ANA House of Delegates. Its trickling in slowly.  

Will I remain a member of ANA and ONA? I will for a period of time. I am a delegate for the Center for American Nurses from the Ohio Nurses Association and I would lose this status if I terminated my membership with ANA/ONA.

Will I remain a member of the ANA Congress on Nursing Practice & Economics? No.

Will I remain a member of the Center for American Nurses? Yes

Baptist, Democrat, and Thirty-Six

A neighbor asked me my age. Before I could reply his wife told him you don't ask folks their age, religion, or political affiliation.

Do you agree?

I replied I was born July 2, 1971, I am a Baptist, and I am a Democrat.

Go OBAMA!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

What Do Physicians Really Want?

See this link and what's being proposed at the American Medical Association of House of Delegates.

AMA Resolutions Involving Other Health Professions

The American Medical Association's (AMA) resolutions for its upcoming House
of Delegates meeting (occurring June 14-18, 2008) have begun to be posted
online The following are links to two resolutions of particular interest
that will be considered at the meeting. Should you choose to submit
comments on these resolutions, the deadline and contact information are
posted at the end of this communication.


Resolution 303 Protection of the Titles "Doctor," "Resident" and
"Residency"


http://www.ama-assn.org/ama1/pub/upload/mm/471/303.doc


The "Resolved" clauses in Resolution 303 state that:


"RESOLVED, That our American Medical Association adopt that the title
“Doctor,” in a medical setting, apply only to physicians licensed to
practice medicine in all its branches, dentists and podiatrists (New HOD
Policy); and be it further


RESOLVED, That our AMA adopt policy that the title “Resident” apply only to
individuals enrolled in physician, dentist or podiatrist training programs
(New HOD Policy); and be it further


RESOLVED, That our AMA adopt policy that the title “Residency” apply only
to physician, dentist or podiatrist training programs (New HOD Policy); and
be it further


RESOLVED, That our AMA serve to protect, through legislation, the titles
“Doctor,” “Resident” and “Residency.” (Directive to Take Action)"


Resolution 214 Doctor of Nursing Practice


http://www.ama-assn.org/ama1/pub/upload/mm/471/214.doc


The "Resolved" clauses in Resolution 214 state that:


"RESOLVED, That our American Medical Association oppose the National Board
of Medical Examiners participating in any credentialing procedures for
Doctors of Nursing Practitioners (DrNP) and refrain from producing test
questions to certify these DrNP candidates (New HOD Policy); and be it
further


RESOLVED, That our AMA make it a legislative priority to urge Congress to
increase funding for residency slots, particularly primary care physicians
(Directive to Take Action); and be it further


RESOLVED, That our AMA adopt a policy that those nurses who are Doctors of
Nursing Practice must only be able to practice under the supervision of a
physician and as part of a medical team with the final authority and
responsibility for the patient under the supervision of a licensed
physician. (New HOD Policy)"


Comments on these resolutions for consideration by the AMA reference
committee must be submitted by June11, 2008 to roger.brown@ama-assn.org.

***************************************************************************************

What do you think?

What is Your Impression of Attorneys?

I spoke with two nurses this week who both mentioned how badly they were treated by attorneys.

One nurse who allegedly diverted narcotics is seeking representation before the Nursing Board. She contacted two different attorneys. One attorney told her "what she did was stupid" but he would represent her. The nurse said she got the impression that the attorney didn't want to be bothered with her or her case because he was so condescending.

Another nurse is being investigated by the Nursing Board and is seeking attorney representation. She contacted at least 5 different attorneys. Two of the attorneys rushed her off the phone after quoting her a price for representation, one attorney was very crude and rude, and another attorney told her "I know some people on the Board and who work for the Board" and this may help her case.

What has been your experience with attorneys and law firms? What is your impression of attorneys and the services provided by attorneys?

Be honest, I can take it.

I enjoy practicing law. I am happy and I enjoy what I do for a living. Don't get me wrong, of course I have bad days like everyone else, but I am happy. 

I don't consider my law practice "a job" or "a position"; its my life, my livelihood, and its who I am. Its me from my bright business cards to my colorful letterhead. I am a RN and an attorney and I represent nurses.

I have worked in positions as an attorney just for the experience or the money and I wasn't miserable (okay actually I was in one position) but I always yearned for more. I was working in the position but planning and plotting my escape. Are you planning your escape? Have you recently escaped?

Nurses and Attorneys are service providers. Personally, I think how you feel about yourself and if you enjoy what you do for a living impacts how you treat, manage, and interact with clients, patients, or customers as a service professional. What do you think?