My 2 Cents

Ohio Board of Nursing and Ohio Legislative Issues of Importance for Nurses

See http://www.ohnurses.org/AM/Template.cfm?Section=Legislative_Advocacy&Template=/TaggedPage/TaggedPageDisplay.cfm&TPLID=8&ContentID=1501.

This is from the Ohio Nurses Association Legislative Action Center.

Clinical Nurse Specialist Competencies

Urgent - Your feedback is requested on Core Competencies for Clinical Nurse Specialists

In May 2006 representatives from Clinical Nurse Specialist stakeholder groups were convened to participate in a National Consensus Initiative for Core CNS Competencies with the goal of identifying and reaching consensus on core CNS competencies relevant to the entry-level CNS, regardless of specialty, population, or setting.

Draft competencies and related specific behaviors have been identified. This is your opportunity to provide feedback about these core competencies, which reflect CNS practice and will guide future educational preparation. Let us know how these competency statements reflect your current practice and you academic preparation for the CNS role. We ask you to use the survey link below to provide your feedback.

Survey participants will be asked to rate competency statements and the related specific behavior statements for relevance and specificity.

You have until May 24, 2008 to complete. 

The survey can be accessed at the following link:

http://www.surveymonkey.com/s.aspx?sm=nsURtU6cmiMgQKNp0WyFXQ_3d_3d

Thank you in advance for your feedback on this important initiative.

Turmoil Once Again in the ANA Enterprise

This is a long post.

Are you a member of a nursing professional association? If not, I am not surprised. If you follow this blog, you know I am a member of the American Nurses Association and Ohio Nurses Association however this may change after the ANA House of Delegates in June 2008.

The ANA House of Delegates provides direction to the ANA Board of Directors (or is it the other way around?) on the priorities and issues of the Association and the profession.

For the first time in my nursing career, I am considering whether or not to keep my membership in the American Nurses Association, Ohio Nurses Association, and the Southwestern Ohio Nurses Association. Its not about the dues for me, its the current and underlying turmoil with the American Nurses Association, Center for American Nurses, the United American Nurses, and State Nursing Associations.

I support the American Bar Association, not because I personally agree with all of its positions and statement. I support the ABA because it advocates for lawyers, the provision of legal services, and the rule of law. I also really like the ABA section membership publications for law practice management and solo practitioners.

I don't know if I can continue to support the American Nurses Association and the Ohio Nurses Association because of the infighting between the ANA, State Nurses Associations, the United American Nurses, and the Center for American Nurses.

I am a former Board member of the Center for American Nurses. I support and stand by the work of the Center because its relevant and needed for not only non-union nurses but it can also help union nurses. As a nurse attorney who represents individual nurses, I receive phone calls and emails from nurses, the majority of which are non-union, who need workplace support and assistance. Even with union nurses, the union assists with issues relative only to the collective bargaining agreement and these nurses need assistance.

Also my disgust with the ANA Enterprise issues involves the lack of workplace advocacy support in the Ohio Nurses Association for 2,000+ non-union nurses who support ONA but are not being serviced with state-based workplace advocacy services and products. I am one of those 2,000+ nurses non-union nurses who continue to belong and support the Ohio Nurses Association, although the majority of ONA's membership is collective bargaining and its the collective bargaining arm that uses the majority, if not nearly all of ONA's resources. There has to be a balance and as of today, in my opinion there isn't a balance.

Workplace Advocacy (non-union), Collective Bargaining (union), employment contracts, etc. are all tools for surviving and thriving in today's highly regulated workplace. Why are we still fighting? One tool isn't better than the other tool; multiple tools are needed, not just one tool.

The majority of nurses in the United States work in non-union and workplace advocacy settings. There are more than 3 million nurses (RNs, LPN, LVNs) in the United States and the majority of these nurses work in non-union environments; this is a fact.

In my opinion, I don't see these number shifting dramatically. It cost lots of money to organize a facility and most state nurses associations including the Ohio Nurses Association are not flush with cash to organize the masses and persuade nurses to join a union. A nursing strike in a state nurses association literally pushes the association to point of bankruptcy and financial ruin.  http://www.kentucky-nurses.org/. Review the article that discusses how the Kentucky Nurses Association and its union are parting ways.

Also union membership for nurses is typically tied to an organization. Gone are the days when the majority of nurses would start and finish their nursing career in one facility. You can be employed as a nurse in a union facility today and change positions next week and work in a non-union facility. Portability of licensure is the key.

Workplace advocacy support is needed and so is collective bargaining support. Non-union and workplace advocacy and collective bargaining can co-exist however I am not sure if it should be in the same association.

What do you think? Should State Nursing Associations exist purely as professional associations? Should State Nursing Associations exists as "blended" organizations, i.e. a professional association and a union? Should state nursing associations with the heavy or the majority of union membership convert to a union only status and focus only on the union activities?

There are 200,000 nurses (LPNs and RNs) in Ohio and in my opinion, the majority (50% or more) of these nurses will never be organized. Yes, I said it. The majority of Ohio's nurses will never be organized in a union. Its just not going to happen; look at the statistics, information, and the literature. ONA, which is a union and a professional association represents 6,000 via a union and 2,000 non-union. Also here, Ohio is a hotbed of union activity. We have the SEIU, NNOC, and Ohio Nurses Association here among others.

Also another thing that turns my stomach is how easy it is for nurses in one group/association/union (ANA enterprise) to say "we don't like those nurses" in this group/association/union (SEIU or CNA/NNOC) and vice versa. That's silly. We are all nurses and I don't say that I dislike a nurse because she supports the CNA/NNOC or the SEIU. 

Depending on the outcome of the ANA House of Delegates in June 2008, I will drop my membership in the American Nurses Association, Ohio Nurses Association, and Southwestern Ohio Nurses Association. I will also resign from the ANA Congress for Nursing Practice & Economics also.

I will remain a member of the Center for American Nurses and join as an individual member. I will continue my membership in TAANA, The American Association of Nurse Attorneys. I may consider joining the Kentucky Nurses Association. Why?

This is my blog and this is my opinion. I think the KNA Board made a choice that most State Nursing Association Boards don't want to consider or make. I applaud the KNA Board for making a choice. The KNA is splitting the professional association and the union. Some state nursing association executive directors and board members are happy and content to ride the fence although fence riding may not be in the best interest of the professional association, the union, and nurses in the state. Are some marriages just unhealthy?

Most executive and management level nursing professional association staff and the elected Boards are baby boomers. I have nothing against baby boomers (of course; the majority of my law firm clients are baby boomers) however in 15-20 years, I think and I am hoping the antiquated business and goverance models seen in some nursing professional associations today will be a thing of the past when Generation X and Y nurses manage and sit on the Board's of nursing professional associations. I am a Gen Xer if you haven't already guessed. 

The union vs. non-union debate is "played out" just like the entry level to practice in nursing debacle and the RN vs. LPN issue. Why are we still infighting about the same issues considering the state of healthcare and the nursing workplace? 

Most professional association staff and board members when asked "why don't nurses support your organization" have a multitude of answers and convoluted rationale for explaining the extremely low numbers. HINT. The problem is the professional association itself not the nurses who don't join professional associations.

Legal CE Track at National and State Nursing Association Seminars

I spoke this week in three cities in Illinois on legal issues in nursing. I am exhausted. I did however meet several wonderful nurses during these presentations.

One nurse asked, why aren't legal presentations scheduled more at conferences and seminars. That is a good question.

I would even propose that national and state nursing associations schedule a legal track at conferences, where nurses have the opportunity to learn about the most current legal issues impacting nursing practice.

I attend several conferences a year and there may be a legal topic here and there, but I have never attended a conference where a track is devoted to legal issues in nursing. In Ohio, Board of Nursing licensees are required to have one hour of CE on Ohio Nursing Law (Practice Act) and Rules (Board regulations) for licensure renewal. Therefore at most conferences for Ohio nurses you tend to see at least one hour of nursing law-related CE.

You might see a clinical track, educational track, pharmacological track, or a management track at a conference; what about a legal track? Do you think this is a good idea? What topics would you like to see covered?

Nursing Administration: Scope & Standards of Practice

This is from the American Nurses Association website:

The draft Nursing Administration: Scope and Standards of Practice document is available for public comment until February 20, 2008. The workgroup is interested in your comments about clarity and completeness of content. What gaps need to be addressed? Any other recommendations for improvement? Don't worry about grammatical errors. Those will be addressed in during later reviews and editing activities. Please use the online comment form to submit your comments. (See below.) If necessary, please contact ANA staff members Carol J. Bickford, PhD, RN-BC, at carol.bickford@ana.org [301-628-5060] or Yvonne Humes, Senior Administrative Assistant, at yvonne.humes@ana.org [301-628-5070] for questions or other information.

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I don't think the majority of us as nurses appreciate the legal, ethical, and professional importance of the ANA Scope and Standards of Practice.

Are you familiar with the ANA Scope and Standards of Practice applicable to your practice area? To purchase see www.nursesbooks.org.

Legal Regulations & Professional Standards for Ohio Nurses

The Ohio Nurses Association updated this guide and its for sale. I ordered a copy for my reference library today. See www.ohnurses.org. for additional information.

American Association of Nurse Executives

ANNEX is a professional organization dedicated to supporting nurse executives in long-term care and its members include DONs, Staff Development Coordinators, ADONs, Nurse Administrators, Nurse Executives, and Corporate and Clinical Consultants. See http://www.aanex.org for additional information.

2007 Ohio Nurses Association Election

Please welcome the 2007-2009 ONA Board of Directors and Officers:

President Barbara Nash, Mid-Ohio District
First Vice President Diane Winfrey, Greater Cleveland District
Second Vice President Daniel Kirkpatrick, District 10
Secretary Linda Riazi-Kermani, Summit and Portage District
Treasurer Georgetta Prystash, Northwest Ohio District

Board of Directors Unstructured
Tracy Ruegg, Mid-Ohio District
Dorcas Fitzgerald, District 3

Board of Directors/Member of E&GW Commission
Paula Anderson, Mid-Ohio District
Joyce Powell, Summit and Portage District
Kelly Howard, Southwestern Ohio District

Local Unit Member, E&GW Commission
Jacinta Tucker (4-year term), East-Central District
Rose Marie Martin (2-year term), Mid-Ohio District

Nominating Committee
Karen Budd (Chair), Summit and Portage District
Mary Ellen Seiter, District 3
Annette Lavender, Southwestern Ohio District
Sally Morgan, Mid-Ohio District
Yvonne Smith, Stark-Carroll District
Julie Senita, Ashtabula District
Barbara Conn, Southern Ohio District

ANA Delegate at Large
Barbara Nash, Mid-Ohio District
Gingy Harshey-Meade, ONA CEO
Shirley Fields-McCoy, Mid-Ohio District

ANA Delegate, Unspecified
Linda Warino, District 3
LaTonia Denise Wright, Southwestern Ohio District

ANA Delegate, Nursing Service Administration
Diane Winfrey, Greater Cleveland
Susan Yoder, District 3

ANA Delegate, Nursing Education
Mary Beth Matthews
Dorcas Fitzgerald, District 3
Karen Budd, Summit and Portage District

ANA Delegate, Nursing Practice
Paula Anderson, Mid-Ohio District
Linda Riazi-Kermani, Summit and Portage District
Johanna Edwards, Summit and Portage District
Brennon Giles, Southern Ohio
Rose Marie Martin, Mid-Ohio District
Eric Williams, District 3
Joyce Powell, District 3
Jean Ansley, West Central District
Joyce Cox, Mid-Ohio District
Jennifer Cook, Southwestern Ohio District
Joylynn Daniels, Southwestern Ohio District
Sally Morgan, Mid-Ohio District
Ferlinda Powers, Mid-Ohio District
Joyce Shaffer, District 3
Kelly Christian, Southwestern Ohio District
Holly Klein, Summit and Portage District
Deborah Martz, Mid-Ohio District
Lynette Roush, Mid-Ohio District

UAN Delegates
Linda Warino, District 3
Rose Marie Martin, Mid-Ohio District
Eric Williams, District 3
Linda Riazi-Kermani, Summit and Portage District
Paula Anderson, Mid-Ohio District
Joyce Shaffer, District 3
Jean Ansley, West Central District
Jennifer Cook, Southwestern Ohio District

Center for American Nurses Delegates
Kathleen Montgomery, Greater Cleveland District
LaTonia Denise Wright, Southwestern Ohio District

For information about the Ohio Nurses Association, see its website at www.ohnurses.org.

Dues Increase Passed by ONA House of Delegates!!

I attended the ONA Convention this weekend. A dues increase was passed by the House of Delegates today. The Association will be able to hire additional staff and "do the work" of the profession with the increase in dues revenue.

I was elected by my colleagues as a delegate to the American Nurses Association House of Delegates and Center for American Nurses Membership Council both which meet in June 2007 in Washington, D.C.

If you have never attended a state nurses association convention, I would encourage you to attend. The energy throughout the convention is dynamic and there are lively discussions and debates of current nursing issues. A group of us talked to 1am this morning about current nursing issues. 

Nursing Standard of Care during Disasters

The ANA Quadrennial Policy Conference will take place June 20-22, 2007 in Atlanta, Georgia and will discuss the altered standards of nursing care during disasters.

In your opinion, what is the nursing standard of care during a disaster? Remember the nursing standard of care focuses on patient outcomes.

What are the standards of professional performance for nurses during disasters? Remember standards of professional performance focus on the nurse's clinical performance.

This is important because nursing standards of care and standards of professional performance provide a basis for determing the legal standard of care in malpractice and nursing negligence cases and may be utilized by a board of nursing to determine if a licensee practiced in a safe and competent manner in a given situation. This type of information could also be utilized in a criminal proceeding against a nurse depending on the allegations.

I am making plans to attend this conference and I hope to see you there.

For additional information see Legal Aspects of Standards and Guidelines for Clinical Nursing Practice published by the ANA in 1998.   

ANA Congress

I attended the ANA Congress on Nursing Practice & Economics meeting Sunday, September 17-Tuesday, September 19th in Silver Springs, Maryland at ANA Headquarters. I was elected to the Congress this summer at the ANA House of Delegates.

This is an exciting time for the Congress as we have over 60 elected nurse members from all over the country in different speciality areas and with varying degrees of education. I am looking forward to serving as a member for the next four years.

If you have an issue that you would like for me to bring to the Congress for discussion, please email me at ldw@nursing-jurisprudence.com. For additional information about the ANA Congress please see www.nursingworld.org.

ANA House of Delegates

Becky Patton, an RN and member of the Ohio Nurses Association was elected President of the American Nurses Association this weekend at the ANA House of Delegates in Washington, D.C.

Three members of the Ohio Nurses Association were elected to the Congress on Nursing Practice & Economics. I am happy to report that I am one of the individuals.

Debbie Hatmaker from the Georgia Nurses Association was elected First Vice-President. Kathy Player from the Arizona Nurses Association was elected Second Vice-President. Susan Foley Pierce from the North Carolina Nurses Association was elected Secretary. Anne McNamara from the Arizona Nurses Association was elected Treasurer.

For a complete list of results see the American Nurses Association website at www.nursingworld.org.

ANA House of Delegates

I am attending the ANA House of Delegates next week in Washington, D.C. It promises to be a very interesting weekend as the delegates will elect the next ANA president, consider ANA bylaw changes, and other important work. I am also running for office in the ANA Congress on Nursing Practice & Economics.

The Center for American Nurses Membership Council Meeting follows the ANA House of Delegates this year. I am completing my two year term as a Director at Large on the Center's Board. I am not running for reelection at this time however I still plan to remain active in the Center.

This month was busier than expected however I will blog from the ANA House of Delegates and post the elections results.

What's Your Rationale?

I am involved in several nursing professional associations. I am a member of the American Nurses Association (ANA), Ohio Nurses Association (ONA), and the Southwestern Ohio Nurses Association (SONA). I am member of the The American Association of Nurse Attorneys (TAANA) and the Ohio League for Nursing (OLN).

I am running for national office in the ANA as a member of the Congress on Nursing Practice & Economics, co-chairing TAANAs Publication Committee, on the Board of Directors of the Center for American Nurses, and a member of ONAs Council on Practice. I also belong to the American Bar Association and the Ohio State Bar Association.

And yes, I can think of other ways to spend the money I pay in association dues, as you may be saying....however I choose to support associations that speak and advocate on my behalf (even if I may not always agree with the chosen course of action).

Why do I belong and participate in nursing professional associations? Professional associations advocate for the best interests of its membership and define the aspirational goals of the profession. The majority of nurses do not belong to ANY professional association.

If you a reading this post you may or may not belong to a nursing professional association. Do you belong to any nursing professional associations? If not, what is your rationale for not joining? If you do belong, are you active? If not what is your rationale?

EVERYONE is busy and has to make time for work and family however consider supporting a nursing professional association by joining as a full member. Being active in nursing professional associations has been a positive and rewarding experience for me as a RN and an attorney.

When you need someone to advocate on your behalf or on behalf of the nursing profession or on behalf of your nursing specialty, who will you turn to if nursing professional associations no longer exist because of declining membership?

American Nurses Association    www.nursingworld.org

American Association of Nurse Attorneys www.taana.org

Center for American Nurses   www.centerforamericannurses.org

Physician Monitoring

There is an interesting January 2006 article on problem physicians.The article "Problem Doctors: Is There a System Solution?" appears in the January 17, 2006 issue of The Annals of Internal Medicine. According to the authors' estimate, with all factors considered "at least one third of all physicians will experience, at some time in their career, a period during which they have a condition that impairs their ability to practice medicine safely."

See "Monitoring System Needed To Prevent Safety Hazard Of Problem Physicians" at http://www.medicalnewstoday.com/medicalnews.php?newsid=36354

What do you think? Are nurses more closely scrutinized and monitored by regulatory boards and employers than physicians?

Nolo Contendre

A nurse contacted me yesterday. She pled nolo contendre to a criminal charge several years ago. She is applying for licensure via endorsement in another state and wanted to know if her plea to nolo contrendre was a "conviction" for purposes of a licensure endorsement application. She contacted the board and was told to complete her endorsement application to the best of her ability and accurately. What would you do?

This nurse is doing exactly what she needs to do, seeking professional advice to clarify the question before proceeding with the endorsement application. Why? Because not responding truthfully on an endorsement application is grounds for revocation of licensure and may be construed as fraud. Moreover since the nurse is already licensed in State A, any action taken against a nursing license in State B (endorsement state) will eventually be made known to State A through either a reporting databank or licensure renewal in State A.

I referred the nurse to a nurse attorney licensed in the state where she is seeking licensure via endorsement to obtain a professional opinion that she can rely on as legal advice and counseling when completing her endorsement application in State B.

What is Nolo Contendre? It is Latin for "I will not defend it." A statement in a criminal trial where the defendant declines to refute the evidence presented but agrees to the charges presented in the complaint. It cannot be used as an admission in other proceedings. http://www.legal-dictionary.org/legal-dictionary-n/Nolo-Contendre.asp

Elective Offices in ANA

How many times have you said "If I could change this in nursing I ....." Get involved in your profession and make a difference.

Are you a member of the American Nurses Association? If so, why not consider running for one of the following elective offices in 2006: President, First Vice President, Second Vice President, Secretary, Treasurer, three directors-at-large and two directors-at-large (staff nurse designated). Three seats on the ANA Nominating Committee will be open as well as 35 seats on the Congress on Nursing Practice and Economics. The deadline for submission of all nomination packets is January 4, 2006. For additional information see www.nursingworld.org.

State Nurses Convention

I was elected in my district nurses association, Southwestern Ohio Nurses Association (SONA), as a delegate for the Ohio Nurses Association (ONA) Convention, which is next week in Perrysburg, Ohio from Friday, October 7th through Sunday, October 9th.

I am excited because conventions are jammed with CE, the business of the association, and networking with nurses from all parts of the state. This will be my 3rd ONA convention and 3rd Convention as a delegate representing my local district.

I am speaking this year at the Tennessee Nurses Association convention, Oct. 22-23rd in Memphis, Tennessee. Last year, I spoke at an event sponsored by the Alaska Nurses Association in Anchorage, Alaska. Its interesting to observe the different state nurses association process and procedures for convention. Anyway.....

Have you ever attended a state nurses association convention? If so, what are your thoughts? What would you improve or change? 

Legal Nurse Consultants

The American Nurses Association is seeking comments on the draft Legal Nurse Consultant Scope & Standards of Practice which were posted on July 25, 2005 on ANAs website. Are you working as a legal nurse consultant? Are you considering legal nurse consulting? If so, review the guidelines and provide ANA with your input. See the ANA website at www.nursingworld.org. Also see the website of the American Association of Legal Nurse Consultants at www.aalnc.org. The Legal Nurse Consultant Scope & Standards of Practice recognize and confirm legal nurse consulting as a nursing specialty. What is your opinion?