Nursing Law & Order

Thank you for the inquiries via email and phone; We will try to assist you if we can or refer you to another attorney

I am receiving more email and phone inquiries from nurses who are licensed to practice nursing in states where I am not licensed to practice law.

I am licensed to practice law in Ohio, Kentucky, and Indiana only. I receive emails and phone calls from nurses across the country about legal issues. Thank you for contacting me and you can continue to contact my firm.

However I cannot assist you with a licensure issue before the State Nursing Board unless it involves the Ohio, Kentucky, and/or Indiana Nursing Boards. The American Association of Nurse Attorneys (TAANA) has a nurse referral hotline. See www.taana.org. We will refer you to one or more nurse attorneys or attorneys in your state or jurisdiction or refer you to your state nurses association.

You may be able to get your questions answered by someone at your state nurses association or you may have to schedule a consultation with an attorney in your state or jurisdiction.

Ohio Black Nurses Coalition Mental Wellness Luncheon and Reception on September 23, 2009 in Columbus, Ohio

See  Download Post Card for Sep 23 ready[1]      Download Reception Hotel information

If you live in or near Columbus, Ohio and you are able to attend, please do so as it sounds very interesting.

I would love to attend the luncheon and the reception however I am already driving to Columbus on Thursday, Sept. 24th for Day 1 of the Ohio Nursing Board Meeting and then driving back to Cincinnati. Its about a 90 minute drive each way depending on the traffic.

I am driving to Louisville, Kentucky on Friday Sept. 25th for the Kentucky Nursing Board conference and then driving back to Cincinnati. Its about a 75-90 minute drive each way depending on the traffic. I always get stuck in traffic driving back to Cincinnati from Louisville or Lexington in Northern Kentucky or downtown Cincinnati.

On Saturday, Sept. 26th, the two day road warrior will rest.  

Center for American Nurses: September 2009 Activities for Nurses

Nurses and Retirement Security

Nurses appear to be taking far better care of their patients than they are their financial futures, according to a survey released today by the Center for American Nurses and the Women’s Institute for a Secure Retirement (WISER).   The Nurse Investor Education Survey reveals that nurses may be saving for retirement, but few are planning and investing to meet retirement needs.  In fact, most nurses say they do not know what those needs will be.
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Legal Webinar for Nurses:  Nursing License Compact:  Pros and Cons

Presented by Carol Roe, RN, MSN, JD
Wednesday, September 16, 2009, 7:00 – 8:15 pm Eastern Time
CNE Contact Hours:  1.25

• Recall at least of one of concerns with the identified with the Nurse Licensure Compact
• Identify at least two benefits of the Nurse Licensure Compact
• Define the Nurse Licensure Compact
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Webinar:  Embracing the Joint Commission’s Leadership Standard on Conflict Management
Wednesday, September 16, 2009, 2:00 pm Eastern Time    
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For more information call 1-800-685-4076.

Reinstatement of Your Nursing License after a Suspension

I spoke with a nurse last month who has been going through the reinstatement process with her State Nursing Board for over 3 years and still has not complied with the terms and conditions for reinstatement of her RN license. This isn't legal advice but consider the following:

The first step is to always read the Board order, contract, or agreement.

The second step is to read the Board order, contract, or agreement again along with a colleague or friend who is also a nurse.

The third step is to either meet in person or by phone with your State Nursing Board contact to review the terms and conditions for reinstatement. Try to figure out where you are in the process and what you need to do to get to reinstatement.

The fourth step may be getting an attorney involved to assist you. Again its not the actual represenation that is so important here (because your license is already suspended) at this point, it is the counseling and advising you on the process and procedure for reinstatement using the experience of the attorney.

Scope of Practice and Nurse Practitioners

This is an excellent article.

See http://www.osbn.state.or.us/OSBN/pdfs/KleinMedscapeArticle.pdf

5,501 Ohio Nursing Board Complaints in FY 2009: 5501 is my Pick Four Number for Next Week

We are a large state here in Ohio (not Texas or California type large but large enough) so we have more complaints. I can remember a few years ago when the complaints were around 2,400 a fiscal year here in Ohio.

The number of the complaints filed each year in Ohio (yes, I keep up with this type of stuff) is dramatically increasing each year. Whether its NCLEX applicants with criminal convictions, mandatory reporting, punitive reporting, voluntary reportig, self-reporting, prosecutorial reporting, reporter reporting, or just more patients, family members, and others being aware that they can file a complaint against a nurse and "watch them squirm." The number of complaints filed against Ohio Board of Nursing licensees here in Ohio are increasing.

See http://www.nursing.ohio.gov/PDFS/NextMeeting/M1/2.2-2009AnnualReportDraft.pdf

I think I will play 5501 in the Pick Four next week. I don't usually play the numbers but I think I will next week. And don't try to file a complaint against me with the Ohio Board for my repeated discussions and inferences to slot machines and other forms of gambling on this blog.

Nursing Students and Nurses in Florida with Criminal Convictions: Beware of SB 1986

Here is the cut and paste and the link from the Florida Nurses Association website regarding SB 1986.

See http://www.floridanurse.org/legislative/index.asp

Here is the cut and paste of the information available on the Florida Nurses Association website:

LEGISLATIVE ALERT: (posted 8/11/09)
It is important for nurses and those considering entering nursing school to be aware of the implementation of SB 1986 which is a 160 page Medicaid Fraud bill which was passed in the last moments of session. It contains provisions which got past everyone concerning the licensure of healthcare providers convicted of certain felonies. If a provider or applicant has a history of a conviction for any felony relating to medical fraud, non-medical fraud or controlled substances, they may not be issued a license for 15 years after their probation has ended. The new law also requires that providers who have these convictions may not be issued a renewal license. This law is going to present serious problems for a number of providers and those who want to be providers. For example, a recent graduate of a nursing program was denied a license because as a freshman in college she had an issue with possession of marijuana. She has been through drug treatment and has successfully completed nursing school. Now she cannot get a Florida license due to this new law. There were a number of cases like this during the last Board of Nursing meeting.

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It is becoming more and more difficult to obtain and remain licensed in some states as LPN, RN, or APRN. Don't shoot the messenger but nursing is not necessarily the best career choice anymore for persons with criminal convictions regardless of whether expunged or diverted.

If you are a Florida nursing student or a Florida nurse who will have issues because of SB 1986, all hope is not lost. You may have to seek licensure in another state. Talk to a license defense attorney in a State where you are considering licensure before you just apply for a license however.

State Nursing Board case, Criminal case, and an Employment lawsuit: Is One or Two Attorneys Enough for Three Separate Cases?

Hindsight is always 20/20 but when you are involved in a State Nursing Board investigation, you are charged with a crime (which is part of why you are being investigated by the Board), and you are contemplating a civil suit against a former healthcare employer, slow down and think it through.

Is it better to have one attorney, two attorneys, or three attorneys? One attorney, Two attorneys, Three Attorneys, Four.

The criminal case always take precedent but the State Nursing Board investigation shouldn't be too far behind in your thoughts. I see the criminal case as being just one shoe length ahead of the State Nursing Board matter. But that's just me and you know I have a bias.

I am seeing more cases where nurses retain a criminal defense attorney to handle the criminal issue and retain a civil or employment law attorney to sue a former employer and then take a self-representation approach to the State Nursing Board investigation and adjudication and only involve an attorney (if at all) towards the end of the matter.

I am also seeing cases where nurses retain a criminal defense attorney for the criminal case and then represent themselves or conduct fishing trips (contacting multiple attorneys who practice license defense for nurses) to obtain the process and procedure information needed to represent themselves before the State Nursing Board.

There are benefits beyond representation in the actual Nursing Board proceedings to attorney representation in State Nursing Board matters. The right attorney before the Board can realistically and objectively talk to you about your case and the alleged violations of the State Nurse Practice Act and/or Nursing Board regulations. The counseling and advising is just as or sometimes even more important.

The Nursing Board matter will be resolved at some point. Then you are left trying to unravel the knots of the decisions you made without the benefit of legal counsel (advice provided by nurses in online chat rooms and forums is not legal advice) related to your nursing license and career which is your livelihood. Some knots whether large or small can't be unraveled, you either deal with the knot, work around the knot, or cut the knot. I had to cut two knots out of my hair this past weekend from microbraids:( 

Again, I think most nurses think this will be like Law & Order; the State Nursing Board complaint will be dismissed as "unfounded" or "for a lack of evidence" after a hearing and the Board staff will issue a formal apology for a conducting a "baseless" investigation against the nurse. It just ain't gone happen.    

Alot of nurses will represent themselves in the State Nursing Board investigation and case thinking of course, its only the State Nursing Board, I didn't do anything wrong anyway, the Board has bigger cases than this, I  already have two attorneys for representation in other cases, and I will be fine.

Is it more prudent to spend money on a criminal defense attorney and a license defense attorney and then wait on the civil case? What about hiring a criminal defense attorney who also handles license defense cases? Think about your goals of representation in each matter and take a systematic approach to your situation initially and decide whether you can afford:

1. Retaining a criminal defense attorney for the criminal matter;

2. Retaining an administrative law attorney at the BEGINNING of the State Nursing Board investigation; and

3. Retaining a employment law attorney to handle your civil suit against a former employer; this case may be a on contingency basis and you may not have to spend alot of money upfront and initially in this matter.

It is possible and in some jurisidictions probable: Being sentenced to Actual Jail Time for theft of drugs or drug diversion!

See http://www.roanoke.com/news/roanoke/wb/217557

Here is the cut and paste from the Roanoke Times (I get scared just saying Roanoke after watching the Stephen King's Storm of Century):

Nurse anesthetist gets 6 months in hospital drug theft

Alvin Earl Parkes had pleaded guilty to stealing the drugs at Pulaski Community Hospital.

By Mike Gangloff
  981-3336

A nurse anesthetist whose career in the New River Valley spanned decades will serve a six-month prison sentence for taking drugs meant for patients.

Alvin Earl Parkes, 62, had pleaded guilty in June to two counts of possessing a controlled substance tied to his theft of fentanyl citrate, a synthetic opiod used to treat pain. In U.S. District Court in Roanoke on Wednesday, he was given the longest prison term recommended by federal sentencing guidelines and fined $3,000.

An emotional Parkes apologized for what he described as an ill-considered bid to ease the strain of long shifts and tough hospital conditions. He said his working life had begun as a child and he had just wanted to stay at his current job long enough to pay down the debt on his farm in Draper.

"All I know is work," Parkes said.

Trained in the U.S. Air Force in the 1970s, Parkes said in June that he came to Pulaski in 1979 and worked most of the time since then at the town's hospital.

The charges against Parkes resulted from his stealing drugs at Pulaski Community Hospital between July and September 2008. A document filed by the prosecution stated that two years earlier, Parkes similarly took fentanyl while working at Carilion New River Valley Medical Center.

Parkes said Wednesday that the amount of painkiller to be administered to each patient was determined on a moment-to-moment basis by a nurse anesthetist and a supervising anesthesiologist, a medical doctor who would oversee several patients' surgeries or other treatments simultaneously. Various monitoring equipment also tracked bodily functions that would be interpreted as signs of increased pain, Parkes said.

He said he kept the fentanyl not needed by patients, administering it to himself by an injection in his wrist, where his watchband would cover it.

He said he never felt impaired by the drug but admitted that once he found himself signing a hospital form in an unusually tiny, precise script and realized he was more affected than he had anticipated.

Assistant U.S. Attorney Charlene Day said there was no evidence that patients suffered because of not receiving sufficient drugs.

Parkes said he sometimes filled vials with distilled water to help conceal his actions but kept track of which vials were water and which were fentanyl.

Day said in June that hospital staff became aware of Parkes' activities because he began reporting a much higher rate of broken vials to explain the missing drugs.

Several witnesses, including Parkes' daughter, testified Monday that stealing and using drugs was out of character for him.

A longtime co-worker, Judy Dalton, praised his manner with patients, saying he had been part of her own medical team when she underwent two procedures.

"Patients still come through and ask for him," Dalton said.

Judge Samuel Wilson said he recognized that Parkes had led "an otherwise exemplary life" but said the problem of drug diversion within the health care industry is a serious one. He opted for the upper end of sentencing guidelines that ranged from no incarceration to six months behind bars. Wilson said that Parkes will be supervised by the federal probation office for a year after his release.

Parkes has given up his license to practice medicine.

Ohio League for Nursing-Southwest Ohio Regional Meeting

http://www.ohioleaguefornursing.org/associations/4237/files/SW%20Region%20Flyer.pdf

I am attending and its good to hear the Ohio League for Nursing is cranking up its efforts in Southwest Ohio.

2009 Kentucky Board of Nursing Conference

Rest up, its Labor Day! Unless you are working today.

I may attend this conference this month. See http://kbn.ky.gov/NR/rdonlyres/4EB587C8-BB72-4B32-9C0E-08D77177E642/0/Brochure.pdf

National Legislative Conference for Nurses hosted by New York State Nurses Association

See http://www.nysna.org/advocacy/natl_leg_conf/main_intro.htm.

Entry level to practice in nursing should be at the BSN level; not ASN or Diploma

I have a ASN and BSN but at some point nursing needs to move forward with a BSN as the entry level to practice nursing in this country. http://www.usatoday.com/money/economy/employment/2009-09-01-jobs-community-college_N.htm

See this article in USA Today where registered nurses are listed as hot jobs not requiring a bachelor's degree. Nurses, we cannot have it both ways; we cannot continue to scream we want and deserve respect but we don't have the educational credentials and qualifications as a profession needed to sit at the table with physicians, physical therapists, occupational therapists, pharmacists, and other healthcare professions. Most healthcare professions have moved to a Masters or Doctor level degree for practice and nursing is still struggling, arguing, and divided over whether the bachelor's degree should be the entry level to practice.

Just my opinion but we need to set the BSN as the entry level to practice starting in 2015, grandfather others in, and move on to something else. If we ever want to be really respected and really valued then we really need the education to elevate the profession as a whole; its not just about the individual nurse.

I Don't Have Time to Submit Documents to your law firm or pay for your services; I need assistance and answers to my questions now

The RN renewal deadline in Ohio was August 31st and the renewal deadline for RNs with the Indiana State Nursing Board and Kentucky Nursing Board licensees is October 31st. My office is more than willing and able to assist nurses in Ohio, Kentucky, and/or Indiana with criminal convictions or other affirmative responses to the State Nursing Board renewal application.

The cost of a 30 minute telephone consultation is $150.00 and the cost of a 60 minute telephone consultation is $250.00. The cost of a one hour face-to-face consult (if you live in the Greater Cincinnati area) is $250.00. These fees can be paid via check or money order (mailed to my office) or with a credit or debit card online via my website at www.nursing-jurisprudence.com (click the online payment tab). I can also process your payment directly with a credit or debit card if you don't want to fool with PayPal.

You can:

1. Call my office at 513-771-0360 and let my receptionist know you want to schedule a legal consultation;

2. You can pay for a legal consultation first and then contact the office or my assistant;

3. You can email me directly at [email protected];

4. You can email my assistant Jack directly at [email protected];

5. You can call my assistant Jack directly at 513-328-7253; or

5. You can fax us documents to 513-771-0360, pay the consultation fee, and then email or call us.

We respond to phone or email inquiries routinely throughout the day and how fast the process proceeds depends on the nurse.

Criminal charges and/or convictions tend to bring out the worst in some of us. My office fielded a call from a nurse last week who has a recent felony conviction nd wanted to know how the conviction will affect her license, employment, and her career. She wanted to speak with an attorney NOW, ASAP, and did not feel she had the time to gather documents or pay for a legal consultation.

I want help now and I need help now. Okay that's fine and of course it is understandable but I don't provide free legal advice and I cannot adequately advise a nurse in a consultation without reviewing the criminal charges, conviction, and/or some of the discovery documents in the criminal court case. 

Some attorneys may do things differently and of course you can search the internet to find another nursing law or nurse license defense attorney in your state or jurisdiction.  

My standard procedure is to email nurses information and mail a packet of information. My standard procedure is also to have my assistant contact the nurse to obtain additional information and to inquire if the nurse wants to schedule a legal consultation. Legal consultations can be scheduled the same day or very quickly and certainly within the same week if you have the necessary documents and the fee is paid. Obtaining documents usually isn't an issue because the documents may be available online on a county clerk of courts website or through PACER if its a federal criminal case. 

We can access your criminal documents most of the time independently however you must pay for a legal consultation. There are no exceptions.  

You have to schedule a legal consultation with me to discuss criminal convictions and your nursing license if you are not a client of my firm. It doesn't matter if you have one question or fifty questions; you have to pay for a legal consultation (this can be done online via my website with PayPal) prior to speaking with me about your criminal issue. This protects my firm and its protects the nurse.

Now there may be nurse attorneys, administative law attorneys, or nurse license defense attorneys who will answer your question(s) without charging a fee when its a criminal conviction, but not the kid. You can search online or contact www.taana.org for assistance or for a listing of attorneys who offer pro bono services to nurses (if any) in your state or jurisdiction.

I understand having recently been convicted or pleading to a criminal offense is stressful and a nurse wants to know NOW how this impacts the license but most if at all but most attorneys don't provide legal advice and counseling, and certainly not representation without the payment of a fee.

Thank you for your understanding. I wouldn't ask or expect you as nurse to work for free or without compensation and I would appreciate the same courtesy and understanding from nurses who need legal advice and counseling and who contact my office for assistance.  

State Nursing Board Alternative to Discipline Programs for Dependency: 3 to 5 years or 5 to 10 years

If you are in an alternative program for dependency with a State Nursing Board, congrats on getting help and moving forward with your recovery.

I am being contacted by more and more nurses in Ohio, Kentucky, and Indiana as well as other states where I don't practice law about State Nursing Board Alternative Program for Chemical Dependency compliance issues and monitoring.

Here is something quick to consider:

1. An alternative to discipline program is wonderful because it allows you to be monitored and for the Nursing Board not to propose disciplinary action against your license for your violation of the Nurse Practice Act;

2. Read the agreement or contract and then read it again;

3. You MUST strictly comply with the Alternative Program contract or agreement. Partial or substantial compliance isn't enough;

4. Failure to complete the program may result in a suspension of your license or your case being referred for a disciplinary investigation;

5. These programs are not "quick fixes" and require long-term compliance and monitoring of 3years to 5 years;

6. Consider having attorney representation, counseling, and advising while you are in the program. You will have questions and concerns and these are things you can discuss with your attorney. Hire an attorney with experience in State Nursing Board cases and familiarity with addiction and nursing practice; and

7. If you relapse, report your relapse in accordance with the contract or agreement you signed. Don't look for avenues, ways and excuses not to self-report your relapse. I have been contacted by more than one nurse seeking to "get around" not self-reporting a relapse and trying to "knit pick" the definition of a relapse.  Addiction is a disease and relapse isn't uncommon. Report your relapse as required by the agreement or contract you signed. Failing to report a relapse can result in your termination from the program;

8. Before you enter into a State Nursing Board Alternative to Discipline Program for Addiction, speak with a nurse license defense attorney in your state or jurisdiction. Even if you don't retain the attorney, at least have a consultation with the attorney to review the terms and conditions in the agreement/contract with you before you sign the agreement/contract;

9. If you are in an alternative program in State A and State B and you want to apply for a license in State C and also apply to State C's alternative program, contact a nursing license defense attorney in State C before you start this process. Each State Nursing Board alternative to discipine program for addiction is different and all states don't have an "open admission" process; and

10. Don't despair because its a process and you will get through this also. Continue to work your recovery plan. Don't be afraid to ask for assistance from family, friends, and colleagues. Don't be to frugal to pay an attorney for a consultation or legal representation if you are hitting a brick wall and need counseling and advising on navigating the system. Yes, it costs money to hire an attorney and you may have to borrow the money or tap a retirement account. But this may be money that it well spent.

I am speaking with more and more nurses navigating a combination of the State Nursing Board alternative program enrollment, termination, and/or license suspension phases (depending on where you are in the program and how long you have been enrolled before the termination) for 3-5 years which may then be referred to the State Nursing Board for the discipline, reinstatement, and monitoring process which may be another 5-10 years (if you count the alternative program time or sometimes in addition to the alternative program time) without much success. Hire a nursing license defense attorney to work with you.  

A waste product of Tort Reform: Aggrieved consumers turning to state licensing boards like the State Nursing Board for redress and sanctions

See this post by nurse attorney Taralynn Mackay, RN, JD. http://nurseattorney.blogspot.com/2009/08/tort-reforms-unexpected-impact-on.html. This is cause for concern because as Taralynn notes the due process and discovery afforded to licensees in State Nursing Board investigations and adjudications does not and cannot compare to the rights afforded to litigants in civil medical malpractice or nursing malpractice case.

Damn as if mandatory reporting by healthcare employers or former employers wasn't enough. Now nurses have to be concerned about more patients and family members using a State Nursing Board complaint to gain an advantage in a medical malpractice or negligence case or because there are caps on how much money can be awarded in some states, a consumer may say why not go after the professional license and livelihood of those healthcare professionals involved.  

I have personally been involved in 4 cases where this was an issue in the last 3 years and everyone has a different agenda. This are the Tylenol with coffee at 8am type cases where I wake up thinking about the case and my nurse client.

How wonderful and you can thank business lobbying groups like the Chamber of Commerce and physicians groups and others pushing and lobbying heavy for tort reform in some states. I am sure those groups didn't count on this as a waste product of tort reform when bashing trial attorneys and the legal profession.

How amusing and I may be able to do the "money dance" if and when tort reform talk starts again here. Bottomline. As a healthcare professional, with tort reform you may not have to worry about punitive damages and other concessions driven in a tort reform package, but who cares about malpractice and negligence claims if you don't have a license to practice or your license is so restricted that you cannot find employment anyway. 

The Nurse License Compact is Coming, The Nurse License Compact is Coming!

What is the Nurse License Compact or Nursing License Compact? What does it mean for your practice? Is your State part of the Compact? Will all 50 states be part of the Nurse License Compact at some point in the near or distant future? Do you want to know more about the Compact?

If so, register for the Center for American Nurses September 2009 legal webinar on the Nurse License Compact. It should be very exciting. The presenter is Carol Roe, RN, MSN, JD is a dear colleague of mine and an excellent presenter. Carol has worked for the Ohio Board of Nursing and the Ohio Nurses Association and is currently the Director of the Risk Management and Regulatory Compliance with the Centers for Dialysis Care. See her biol at https://m360.centerforamericannurses.org/event/speaker.aspx?eventID=9557&speakerID=1229423

See https://m360.centerforamericannurses.org/event.aspx?eventID=9557.

I am really looking forward to this presentation and the discussion on the portability of a nursing license. I practice law in a Nurse Compact State, Kentucky in addition to practicing law in other non-Compact states, Ohio and Kentucky. However I do not have a compact license because I reside in Ohio and Ohio is non-Compact state.