Nursing Law & Order

Tis the Season...State Nursing Board Investigations Don't Slow Up in a Recession

The economy may have grind to a halt however this doesn't stop, prevent, or decrease State Nursing Board complaints filed against nurses for alleged violations of the Nurse Practice Act and Nursing Board regs.

There will be little to no down time for me except maybe a day or two before Christmas and New Years Eve and New Years Day. My office telephone has been ringing all month with calls from nurses who are being investigated by the State Nursing Board or who are scheduled to appear before the Board for a hearing.

Tis the season to be ....

This has been a good year for me personally and professionally. My son started college and I am engaged to be married to a man I am crazy about. I finally have the law and consulting practices I sheepishly dreamed of back in 1999 and a career with a focus on nursing law, standards, and practice. I wouldn't be an attorney-entrepreneur if I didn't mention something about "showing me the money." Well, the revenues are increasing each year as well.

Blood, sweat, tears, and faith.

As you take stock of 2008 and move forward to 2009 consider the following:

1.Is this the year you purchase and maintain your own individual professional liability insurance policy?

2. Is this the year you start taking care of yourself as well as you take care of your patients?

3. Is this the year you become more active in the profession by joining and actively participating in a professional nursing association? 

4. Is this the year you hire yourself as risk manager for your nursing practice? 

5. Is this the year you will map out your goals and strategies to obtain those goals for your nursing career? The sky is the limit for nurses and I am proud to be a nurse.

Evolving Taxonomy of Nurse Practice Act Violators

Congrats to my fellow nurse attorney colleagues Suzanne Edgett Collins (http://www.ut.edu/detail.aspx?bio=1&id=4474) and Cynthia Mikos (http://www.allendell.com/) for their publication of a very interesting article in the Journal of Nursing Law, Vol. 12, Issue 2 (2008).

The article and their research found six common categories of nursing practice violators from case content analysis:

1. Bad Apples who intentionally violate standards with a bad motive;

2. Impaireds who have know or suspected addictions;

3. Incompetents who don't intentionally violate standards but are not competent to perform the assigned task;

4. Criminals who have a history of one or more interactions with the law in a jurisdiction whether its a felony/felonies or misdemeanors;

5. Rule Benders who intentionally violate standards but do so with a good motive, thus differientating them from the bad apples; and

6. Good Nurses having a bad day. These errors are attributable to systems errors because the nurses are competent and very knowledgeable.

So what do you think about the evolving taxonomy of Nurse Practice Act violators identified by Collins and Mikos?

I am planning to incorporate the Collins and Mikos taxonomy into my presentations on Nursing Board complaints, investigations, discipline, and adjudications.

Nursing Student Incivility in the Classroom, Clinical Setting, and On-Line

There is an excellent article in the Journal of Nursing Law, Vol. 12, Issue 2 (2008) I received in the mail yesterday titled:

Managing Nursing Student Incivility in the Classroom, Clinical Setting, an On-Line

There are a number of nursing students who frequent this blog, so please tell me, is this an issue? Are today's nursing students more hostile towards nursing faculty? Why is Nursing Student Incivility such a hot topic at nurse educator CE meetings and seminars?

Are the nursing students of today less civil than the nursing students of yesteryear?

As a nursing student, do you think nursing faculty treat students fairly? Are the generational issues between boomers, Ys, and Xs, etc. the issue here or is it something more?

Waiting Until the 4th Quarter with 10 Seconds to Go Before You Seek Assistance

I am not a football fan. Its the end of the year and if I have to give you as a nurse a little advice for the upcoming year it would MANAGE the RISK.

All too often I receive frantic calls and emails from nurses, nursing students, and nursing school graduates who are failing to appreciate and manage the risks associated with being or becoming a licensed healthcare professional.

Be your own risk manager and manage the risk and seek professional advice and counseling if needed on a particular situation it escalates or morphs into something else.

I have reviewed at least 75 (I keep good records) Ohio Nursing Board Consent Agreements this year in the context of legal consultations. Typically, the nurse or graduate nurse signs the Consent Agreement and after its ratified and considered a legally binding contract between the nurse and the Ohio Board of Nursing, starts to ask questions that should have been considered prior to signing.

I have been contacted by several nurses on the eve of State Nursing Board hearing seeking attorney representation. Why wait until a week or two before a scheduled hearing to consult with an attorney?

I hear alot, I didn't know there were attorneys who handle licensure cases. Well, you didn't look because most attorneys who practice licensure defense have websites and are not hard to find with internet searches. There are several attorneys in the Columbus, Ohio area that handle these cases exclusively for licensed healthcare professionals in Ohio, a few in Louisville, Kentucky that handle licensure cases in Kentucky, and several in Indianapolis, Indiana representing licensed healthcare professionals in Indiana. Then there is me in Cincinnati representing nurses in all three states. Do your due diligence and find someone to speak to about your matter.

Something comes up at work and you need to talk to someone. Contact your state nurses association or seek a workplace or legal consultation with an attorney who is familiar with employment, licensure, and nursing professional practice standards.

Do not wait until the 4th quarter with 10 seconds to go on the clock before you say, hey, I think I might need to talk to someone about this. 

And for heavens sake, purchase professional liability insurance with a licensure defense protection benefit. Most nurses who need attorney representation before the State Nursing Board have to pay out of pocket for representation because the lack of insurance. I have a few cases where nurses or another licensed healthcare professional has insurance, but the vast majority are private pay. Buy the insurance and sleep easier at night. Its not being named as a defendant you have to worry about anymore, its being reported to the State Nursing Board and your license being investigated.

Legal Webinars for Nurses for 2008-2010

See this attachment for the complete legal webinar schedule for 2008-2010. Tell me what you think about the legal webinar titles.

As you may know, I am consultant for the Center and we would be interested in knowing what other legal webinar topics would be of interest to nurses.

Download LEGALWebinarTotalSchedule[1][1]

Don't Hire An Attorney; Represent Yourself; After all it is a trend

See this article appearing on www.law.com.

http://www.law.com/jsp/law/sfb/lawArticleSFB.jsp?id=1202426435052.

With this economy, I think more and more individuals will represent themselves. However, I am not one of them. My fiance and I are seeing a family law attorney earlier next year to draft documents in anticipation of our marriage in July 2009.

You Want Detail in a Nursing Board Complaint, see this Potential Violation Report

I like this form used by the North Dakota Board of Nursing for complaints and alleged violations of the nursing law and rules.

See

http://www.ndbon.org/documents/1205333808.pdf.

I thought the State Nursing Board complaint was resolved!

I hear this statement alot from nurses who represent themselves before the Nursing Board. You met with an investigator and/or you submit a statement in response to the complaint and you don't hear anything for a while (several months to years) and you assume the complaint has been filed away, dismissed, or closed.

You were told or you assumed "no news is good news."

Then you open your mail and are extremely shocked when you received a Consent Agreement, certified letter indicating your license has been suspended and you can request a hearing, a date for a Hearing and a copy of the formal charges filed against you, a proposed Settlement Agreement, etc.

You are upset because you have put this all behind you and moved forward. How dare the Nursing Board take this long to get back to you, right? Why is this happening now?

Keep in mind, depending on state law, there is usually no statute of limitations in Nursing Board investigations and adjudications. Nursing Board investigations and adjudications in general do not have to be investigated in a certain amount of time, filed by a certain amount of time, or concluded in a certain amount of time.

If this angers you, write to your state legislator.

Admin law and licensure cases move slowly and if you are representing yourself, you may not know where your case is in the system.