My 2 Cents

Your Nursing Board Monitoring Agent is Not Your Friend; Its a Professional Relationship

I spoke with a nurse this weekend. She is on probation with a Nursing Board for practice issues. The nurse was upset because she didn't understand why the Nursing Board staff were so "cut and dry" and wanted "just the facts" when she contacted the Board. She remarked "we are all nurses and we have to have common interests and concerns." She asked her monitoring agent personal questions like how many kids do you have, how long have you been a nurse, etc. The Nursing Board monitoring agent became defensive and clarified the nature of the relationship between the nurse and monitoring agent.

We are all nurses whether you are a staff nurse, nurse educator, nurse regulatory, nurse attorney, nurse manager, etc. Whenever I meet someone who is a nurse, I feel there is an instant connection because we are nurses.

I reminded the nurse that Nursing Board staff have a job to do and function in accordance with a position description. When you are being monitored by the Nursing Board you have a professional relationship with the Board staff. There should be boundaries in this relationship just like in the nurse-patient relationship.

Making nice and establishing a personal relationship with every nurse who is being monitored by the Board would without a doubt cloud the professional relationship and make it more difficult for the Nursing Board staff to do their job. Don't take offense because the person is just "doing their job" because you too need to be doing your job and doing what is necessary to complete the probation.

Unconscionability and Board of Nursing Consent Agreements and Agreed Orders

This isn't a term I have used since my law school contracts class. Unconscionable means unreasonable, unfair, and unjust. See http://webster.com/cgi-bin/dictionary?va=unconscionability

I spoke with a nurse this week. She signed a legal document with a Board of Nursing resolving a complaint filed against her. Almost one year later the nurse wanted to know about her appellate rights in this case.

She had heard that contracts could be voided if the contract was one-sided, unfair, and signed by one of the parties to the contract under duress. Unconscionability is a legal term and can depending on state case law be used to nullify a contract. The contracts involved are typically commercial and retail contracts.

She was told by Board staff that the Contract had to be signed and returned within a few days to the Board's office. She was under significant financial strain already and didn't really want to retain an attorney at that point. Also she didn't know where to find an attorney who handles these types of cases and she didn't want to retain the wrong attorney.

The Consent Agreements and Agreed Orders that I have reviewed over the years and have standard language that 1. Informs the nurse of his/her right to legal counsel and 2. Has language stating the nurse knowingly and voluntarily agrees to the language therein.

My comment to her was that you NEVER sign a legal document (whether its a licensure, workplace, or criminal matter) when you don't agree with or understand ALL of the language and conditions in the document.

What do you think? Do you think that Boards of Nursing should give nurses at least 30 days to review and consider these documents?

In my opinion, thirty days would provide a nurse with ample time to consider the document, to have the document reviewed by an attorney, or to retain an attorney. It is unfair and an abuse of power to provide a nurse with this type of legal document on a Tuesday and inform the nurse that the document has to signed and returned to the Board by Friday or the Board will proceed with formal disciplinary action.

Several nurses have told me that they ask Board staff if they need to retain an attorney and Board staff reply "we can't tell you if you need an attorney." This is how Board staff should answer. Its not their role to advise you whether or not to retain legal counsel. Board staff are Board employees, who represent and speak for the Board. Remember this is an adverserial process. Its not the job of the Board staff to inform the nurse of his/her options related to the licensure matter or to explain the licensure and employment implications of signing the document to the nurse.

HINT: If you think you need an attorney, then you do. Have we as nurses become so accustomed to being submissive and following orders that we need someone else to tell us that we need an attorney? Please say it aint so!

Taking Control of Your Nursing Practice

An article, Malpractice Suits Against Nurses on the Rise, http://news.nurse.com/apps/pbcs.dll/article?AID=/20070827/CA09/308270004 advises nurses to assume control of their nursing practice. What do you think? Are we assuming control over our nursing practice? Or are we content allowing "others" to control our nursing practice?  

Anyone Can Give Legal Advice, Right?

I posted the information below on my website today. I feel strongly about this issue because I am finding that more and more student nurses and graduates of basic nursing school are relying on the informal advice of family, friends, and others when completing a state board of nursing Application for Licensure by Examination and for counseling and advice in licensure matters.

I belong to several nursing chat rooms and the chat room administrators have to warn nurses repeatedly not to seek legal advice or give legal advice on the site. One nurse in a chatroom questioned whether she really needed to hire an attorney, although an evidentiary hearing was scheduled in her licensure case for early October. Another nurse warned that attorneys require ethics related CLE (continuing legal education) for reason and to careful when retaining an attorney.

Why do we as nurses seek informal counseling and advice regarding licensure matters? Is it because of the lack of perceived value of a nursing license? Your license is your livelihood, so why do we as nurses continue to accept informal counsel and advise from various sources and only consider attorney representation, counseling, or advising as a last resort when ALL else has failed?

I value my law licenses and my nursing license. I wouldn't under any circumstances attempt to represent myself in an investigation of my law licenses or my nursing license, although of course I could represent myself. Why not you say and this is what I do for living? There are several reasons. 1. There is too much at stake. 2. I couldn't be objective and represent myself before the Ohio Board of Nursing; I am licensed as a RN only in Ohio. and 3. I am not sure I would like to have myself as a client.

Moreover there is a saying that an attorney who represents himself/herself has a fool for a client.

NCLEX-RN and NCLEX-PN Applicants
STUDENT NURSES, NURSING STUDENTS, and GRADUATES OF BASIC NURSING SCHOOL

Please Consider the following If a state board of nursing Application for Licensure by Examination requires you to make an affirmative disclosure of a criminal conviction(s), chemical dependency, mental illness, etc.

Consider consulting with a licensure defense attorney in your state before you submit your Application for Licensure by Examination to a state board of nursing.

DO NOT rely on the informal advice provided to you by friends, family, nurses, student nurses, nursing instructors/professors/faculty, and others when:

1. Determining whether or not to disclose information on the Application;
2. Considering how the state board of nursing will review your Application;
3. Analyzing the specific facts related to your situation; and
4. Evaluating your options for licensure.

This is the role of an attorney. YOU NEED LEGAL ADVICE FROM A LICENSED ATTORNEY in your state.

Consider obtaining legal advice and counseling (it can be in the form of a legal consultation) from a licensed attorney in your state who has experience in nursing licensure matters. Contact your state nurses association for a referral to an nursing licensure attorney (www.nursingworld.org) or contact The American Association of Nurse Attorneys (www.taana.org.)  You can then decide whether or not you need to retain an attorney to represent you before the state board of nursing in regards to your Application for Licensure by Examination.