Nursing Law & Order

Thank you for Your Support over the Years!

My law practice is using an online service as a software (SAAS) practice management system. My assistant is entering the data online and as I review the number of nurses who have contacted me over the last several years I am humbled. Thank you for contacting my firm and thank you for trusting me with your legal matters.

Nurses and Law School: take a look at these videos on You Tube

I graduated from law school in 1997 and have been in active law practice for 12 years. Times have changed since I attended law school as students are taking on even more debt and the employment prospects after law school are not as "peachy and rosy" as you would believe.

I receive emails and phone calls from nurses considering law school. If you want to go to law school then just do it like Nike but anyone seriously considering law school now needs to look at the tier of the law school you are attending, your undergraduate, graduate, and/or law school debt, your employment options post-graduation, and a boat load of other factors before taking the leap.

I took the leap and law school was one of the best decisions I made. I can smile now but it was tough and there were many days I went to work in tears, left work in tears, and questioned whether I made the right decision as new lawyer in years 1-4 post graduation. I have a journal of my law school journey and post-graduation years from 1-5 and it still brings me to tears.  

As a nurse you may or may not have better employment options post-graduation from traditional law students. But nothing prepares you the long hours, learning curve, politics, and social dynamics of a law firm (small, medium, or big firms) and law practice not even working days in a busy teaching hospital. You think working with physicians is a challenge try working with  partners and senior associates in a law firm. Solo practice and starting your own firm (which is what I did) is an option but this is another leap in itself.

Nothing is certain and guaranteed in life and the same holds true with a law degree as many law graduates and attorneys are learning:

See http://www.youtube.com/watch?v=g-_wDwmOQ1U&feature=response_watch

Also make sure you view a Law School Carol 2, 3, 4, and 5 and also A Law School Carol Epilogue and Versatility of a Law Degree videos which are available on the right side of the page.  

Are you considering a career change or transition? Jump start your search with this 2 hour seminar in Cincinnati, Ohio

If you are in transition, or considering a career change, this event is for you! Join the Business Courier for this fast-paced, interactive 2-hour session led by Mike Lynch of Centennial Inc. You will learn specific steps you can take to: Repackage your skills and identify the best and highest use of your abilities Master the Art of Networking Unlock the valuable resources contained in the Business Courier to give yourself a competitive edge

During the last eighteen years, Mike Lynch has successfully assisted hundreds of professionals to reach their career transition objectives. Mike has strong experience in assisting individuals transitioning from one industry to another, and has helped several entrepreneurial clients grow and develop their own businesses. Mike's career transition coaching experience has laid the foundation for his Executive Coaching practice, working for and with corporations to grow and retain their top talent.

When: Tuesday, January 12, 2010   7:30-8:00 a.m. Registration and Networking 8:00-10:00 a.m. Program Where: Centennial, Inc., 8044 Montgomery Rd. (1st Floor Conference Room), Cincinnati, OH 45236   Cost is $25 per person. Register now, or call Amy Goodwin at 513-337-9468 for more information.

What if I need an attorney and I cannot afford an attorney? This is why you need liability insurance

I spoke with one NCLEX applicant and three nurses this week who all needed some form of legal representation, counseling, and advising. One nurse contacted me specifically to ask if I take license defense cases pro bono. I do not take pro bono nurse license defense cases because I don't think its fair to my clients who are paying me to provide legal representation, counseling, and advising.

Nursing students and NCLEX-Applicants times have changed and you have a criminal conviction(s), depending on the circumstances these conviction you may hit a bump or two once you apply for a State Nursing Board license. If you can afford to, contact a license defense attorney in your state and pay for a legal consultation. Some license defense attorneys offer legal consultations or brief phone meetings at no charge and may also review your documents for no charge. If you cannot find a license defense attorney who offers free consultations then contact your State Nurses Association for assistance and guidance BEFORE you submit your application to the State Nursing Board.

I am also receiving more phone inquiries for drug theft, medication discrepancies, impairment (physical, mental, or chemical), and professional boundaries. Most nurses don't have their own professional liability insurance policy which would cover attorneys fees and costs in the State Nursing Board case. Purchase your own insurance policy and make sure it has a license defense protection benefit. A liability policy with your homeowner's insurance may not have a license defense protection benefit.

So for the majority of nurses if you are involved in a State Nursing Board investigation and hearing then you must pay out of pocket for your attorney. You may read this and say "oh that's no big deal" but it is for the majority of us as nurses. Alot of us are living paycheck to paycheck like the rest of America and to come up with a flat fee or retainer fee of several thousand dollars is next to impossible. This is why you need to seriously consider having your own professional liability insurance policy with a license defense benefit.

I am covered by my employer's policy, is that what you are saying? Okay so tell me when its usually the employer who terms the nurse and reports to the State Nursing Board, do you think your employer would provide you with an attorney to represent you before the Board? I think not.

If you are a licensed professional chances are at some point in your career you will need an attorney for a minor or major event(s). You are much more likely to be reported to the State Nursing Board than you are to be named as defendant in a nursing malpractice case. You can "pay as you go" for legal representation, counseling, or advising or you can purchase your own individual professional liability insurance policy with a license defense benefit to defray some, most, or all of the legal fees and costs.

All is not happy and snappy in nursing unionville: United American Nurses (UAN) litigation involving the Super Union Merger

I have no comments at this point. I need to review the complaints but here it is:

Download BNA article[1]

Download Converso[1]

Download Ross[1]

See also

http://op.bna.com/dlrcases.nsf/r?Open=mamr-7y4ufv, and
http://op.bna.com/dlrcases.nsf/r?Open=mamr-7y4ue9

What's wrong with a little alcohol? You are an attorney, don't you know its legal to drink alcohol!

This isn't legal advice but I am putting this out here for anyone involved in a State Nursing Board complaint, investigation, and/or adjudication for drugs and/or alcohol or in a State Nursing Board Alternative to Discipline Program for Chemical Dependency. I am not a drug & alcohol counselor or therapist.

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A prospective client told me this and I had to pause. In general, there is nothing wrong with a little alcohol and yes as a highly educated and licensed professional I know alcohol is legal. But there are alot of exceptions to just a little alcohol. However if:

1. You are being monitored in a State Nursing Board alternative to discipline program for Chemical Dependency (you voluntarily entered into this program); or

2. You are being monitored by the State Nursing Board and agreed to or had action taken against your license after a hearing

A. You agreed to or you are required to:

1. Abstain from drinking alcohol;

2. Abstain from  using illegal drugs; and

3. Abstain from ingesting any prescription medication unless you have a legally valid prescription

B. If the basis for action or your involvement in an alternative program involves drugs and/or alcohol. There is a daily call in process for alcohol/drug screening as a condition of licensure that you agreed to or that was imposed upon you after a hearing.

As unfair as it may seem or as difficult as it may be to understand you cannot drink alcohol and be monitored by the State Nursing Board whether its via the discipline route or alternative program route if the basis for monitoring and the underlying issue involves drugs and/or alcohol. If you drink alcohol, you will violate test positive at some point and this is a violation of the agreement, contract, or order you have. Your nursing license will be suspended pursuant to the agreement, contract, or order you have. Read it!!!!

My suggestions are as follows:

1. You need a lawyer. I told you this on the phone and I am telling you again. It doesn't have to be me but you need a lawyer ASAP to assist you with your license issues and "keep it real" with you;

2. You need to speak with a chemical dependency counselor or therapist ASAP to get a handle on how and why you are where you are now; and

3. You will be okay and don't despair. But you need to seek assistance and help now. Please reach out and get the help you need now to start the recovery process.

Nurses are taking their State Nursing Board Case to the Mat: Top 10 Why Nurses Represent Themselves

Nurses around the country depending on how State Nursing Board complaints are investigated and adjudicated are taking their case "to the mat." What is taking a case to the mat? Its borrowed from wrestling jargon. http://www.osaa.org/wrestling/owwmp/Mat.pdf. Its optimal performance and preparing for a showdown like in the western movies. I love Tombstone!

I am using "taking it to the mat" here to mean that nurses are taking their case to "trial" i.e. a hearing before the State Nursing Board or a Hearing Officer to have "their day in court." Nurses "are going the distance" and taking their case to the mat. Its nothing perjorative.

If you represent yourself and you take your case to the mat on your own and you do go the distance on your own, at LEAST speak with a license defense attorney before your hearing. Pay for a few hours of an attorney's time to review your case with you, look over your exhibits, your opening statement, your closing statement, and discuss the best and worst case scenarios.

Why? I am receiving more phone and email inquiries from nurses in Ohio, Kentucky, and Indiana who have a State Nursing Board hearing and then don't understand or know what to do with a Board Order. For example, I spoke with a nurse two weeks ago who wanted to know if the nurse could appeal a Board Order two years after the entry of the Order. The time limits for the appeal of a State Nursing Board Order are specified in the Order and its usually a matter of days or weeks for the filing of a timely appeal not months or years.

Nurses represent themselves before the State Nursing Board for a variety of reasons including but not limited to:

1. I didn't do anything wrong so why do I need an attorney?;

2. If I hire an attorney I look guilty;

3. If I hire an attorney it will make the Board angry;

4. This is going to be resolved in my favor anyway so why hire an attorney?;

5. I don't trust lawyers;

6. I am going to ignore this and hope it will go away;

7. Lawyers are too expensive;

8. I spoke to my spouse, colleagues, friends, etc., no one believes this case has any merit, and the State Nursing Board has bigger fish to fry than this (just saying this makes me hungry; I may fry beer battered fish tonight);

9. Another nurse (in an online chatroom, forum, or board or who I work with) had the same issue and it turned out okay for him/her; and

10. Lawyers turn a simple case into a complicated case. I was actually told this last week by a nurse. I had to chuckle because maybe your case was already complicated and an attorney is just objectively pointing out the issues based on his/her experience in these types of cases.

If you are representing, counseling, and advising yourself before the State Nursing Board "do your thang." I can understand the feeling of why you don't want to contact an attorney. I don't like to contact my own attorney or my CPA. Its never a positive when you contact a license defense attorney. No one has ever called me to say Hi, LaTonia. How are you? Do you want to go bowling this weekend?

Do your thang and hopefully it will be resolved without issue. But if you get to a point where the tide is turning in the investigation and "doing your thang" isn't enough then talk to someone. If you are proceeding to a hearing, you can continue to "do your thang" but talk to someone before the hearing for objective advice and counseling.

Kentucky Board of Nursing Meeting Yesterday in Louisville, Kentucky

I know you hear me say this every month or so but I will say it again. If you have never attended a State Nursing Board meeting in the state(s) where you are licensed, you don't know what you are missing. Oh or maybe you do. 

The Board conducts its business at these meetings. If you don't have time to attend these meetings this is understandable but you should also consider joining a nursing professional association that then sends paid staff to attend these meetings to stay abreast of the issues.

The Board follows an Agenda which is usually published online well in advance of an actual Board meeting. At the Kentucky Nursing Board meeting there was a discussion of confidentiality and Alternative to Discipline Programs for Chemical Dependency in Compact States, Clinical Internships for New Nurses, Use of Nursing Assistive Personnel to Administer Medication in the School Setting, and Dialysis Technicians just to name a few subjects.

I am giving a "Shout Out" to my Nurse Clients who are being released from State Nursing Board Probation

I am so excited!!! I have several nurse clients who should be coming off State Nursing Board probation and monitoring in December 2009 and January 2010. This is a time for celebration and reflection: you celebrate the formal lifting of the terms and conditions of the probation and you reflect upon why you were on State Nursing Board probation. Part of this reflection is developing a risk management plan to make sure that you don't go back there in the future.

NO MORE STATE NURSING BOARD COMPLAINTS!!

NO MORE STATE NURSING BOARD PROBATION AND MONITORING!!

I charge more for repeat State Nursing Board "offenders." No seriously, my fees have increased since you retained me several years ago:)

These nurses have worked hard to get to this point and I am so proud of you and for you. I told you when you retained me that we would get to this point, eventually. This is one milestone in your nursing career that you won't soon forget.

I am going to send you a card, candy, and probably more stuff because I love to shop for personalized but general gifts at the Dollar Store and I am sincerely happy for you. Its has been a long road (years if you count the disciplinary investigative process, adjudication or complaint resolution process, plus the State Nursing Board probation and monitoring) and while I am happy for each and every one of you, I understand and don't take it personal that you don't ever want to hear from me (or Jack) in the future:)

Parting is supposedly such a sweet sorrow but I understand. No more phone calls, in-person meetings, webinar meetings, emails, correspondence, text messages, IMs, and/or faxes from your attorney. You can always contact me however but if you don't I understand. My business office and cell phone numbers will never change. 513-771-7266 (office) and 513-RNs-LAWs (just kidding; don't call this number)

I am sipping a McAlister sweet tea and here is a toast to my State Nursing Board clients:

1. Starting and/or ending 2010 without State Nursing Board probation (although the world may end in 2012); You are at the end of the disciplinary road, listen to  http://www.youtube.com/watch?v=XZcG0NBMcDA (The End of the Road by Boyz II Men); and

2. Starting 2010 and moving towards meeting the terms and conditions for reinstatement or reactivation of your nursing license in 2010, 2011, or 2012. We are starting another leg of journey together like Frodo and Sam.

National Nurses United: Is it the largest professional association of nurses now?

See http://www.uannurse.org/media/press.html?view=press_release&press_id=551&year=2009.

What does this mean for the American Nurses Association here and internationally if another nursing union and professional association is saying "its the largest" professional association for nurses in the United States?

Is this the beginning of the end and/or the end of the beginning for one or more national professional nursing associations? What do you think? In a Mortal Kombat battle and pure slugfest between the American Nurses Association and the National Nurses United, who would you root for to win? Which organization has the stamina to go the distance? Which organization better represents individual nurses and the profession of nursing? What do you think?

The Hottest Up and Coming Nursing Specialities: Do You Agree?

See http://www.nursezone.com/Nursing-News-Events/more-news.aspx?ID=18834.

Online Legal Self-Help for Nurses: an Evolutionary Boom or the Sonic Doom!

I am reading The End of Lawyers? Rethinking the Nature of Legal Services by Richard Susskind. This is by far one of the most transformative books I have read this year.

On page 244 of the book a parallel is made between online medical self-help and online legal self-help and the reality is a greater willingness among citizens to seek further help where in the past they may have felt deterred.

On the same page the author notes there is a harsh reality: one to one consultative services and advisory guidance from a lawyer is not always a resource or a service a citizen can afford.

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Legal self-help is abundant online for nurses in a variety of chatrooms,forums, boards, blogs, websites, and discussion groups. This is a positive and a negative.

Legal self-help saves money for nurses. Its allows nurses to obtain general information and facilitates issue spotting. Legal self-help can also assist with issue spotting. Sometimes you can get what you need from legal self-help sites to assist you in resolving your situation on your own without paying for legal advice, counseling, and representation. I would say this is a win-win. 

The majority of nurses involved in State Nursing Board investigations and adjudications represent, counsel, and advise themselves and therefore use forms of legal self-help to navigate this process and procedure.

But there is a flip side. I see several times a week cases where legal self-help has gone astray. These are nurses who have represented, counseled, and advised themselves for a period of time whether its days, weeks, months, or years in a State Nursing Board investigation, hearing, or licensure matter.

There is a failure to see a complaint and the allegations in the complaint for what it is, a failure to appreciate the seriousness of a contract or legal document resolving the complaint, and another long list of issues that come along with representing, counseling, and advising yourself. This can be the most challenging cases not necessarily before the State Nursing Board but dealing one on one with the nurses who must come to grips with the decisions and steps THEY have chosen to take in the handling of THEIR case before the State Nursing Board.

Legal self-help for nurses has a very important place in understanding the law, legalities, and legal issues confronting nurses and the nursing profession. It would be too expensive to call an attorney for everything remotely legal just like it would be too expensive to call a physician for everything remotely medical.

BUT. A nurse however when confronted with a legal issue as serious as a State Nursing Board complaint that can directly impact your license, your livelihood, your career, and your life must decide how do I want to proceed, what can I realistically afford, do I want an attorney or do I want to engage myself in this process and rely on self-help, and am I prepared to accept the consequences of representing, counseling, and advising myself before the State Nursing Board (best case scenario you resolve your own complaint or worse case scenario.....) in the matter at hand.

You Own It! Personal and Professional Responsibility and Accountability as a Nurse

Growing up my grandmother would tell us if you directly or indirectly created a problem, an issue, or a situation, you own it and its yours until it is resolved. The ANA Code of Ethics for Nurses talks about accountability and responsibility for your nursing practice and so does your State Nurse Practice Act.

What is responsibility? http://www.merriam-webster.com/dictionary/responsibility

What is accountability? http://www.merriam-webster.com/dictionary/accountability

See the ANA Code of Ethics at Provision 4 and its discussion of responsibility and accountability at http://www.nursingworld.org/MainMenuCategories/ThePracticeofProfessionalNursing/EthicsStandards/CodeofEthics.aspx

The professional regulation of nursing practice and the legal regulation of nursing practice both require accountability and responsibility for your nursing practice. Why am I saying this? I had maybe a one hour course in nursing school on nursing ethics and it didn't stick. I think nurses should be required to take a one hour course on the nursing practice act and nursing ethics each year to drive these types of concepts home in plain english, free of the legalese of course, with concrete examples.  

There is a push to "push out more nurses" like its an assembly line process because of the nursing shortage. What about the quality of nursing education vs. the rush to open more schools and push out new graduates? How are nurses transitioning into the professional practice of nursing especially when you see more and more stats about the increase in litigation and State Nursing Board complaints? You don't see a push to open hundreds or thousand of medical schools and other training programs for healthcare professionals and there is a rationale for this. But everyone and there mother is opening or expanding a LPN, RN, RN to BSN, RN to MSN, RN to PhD, or RN to DNP program for nursing. Yes its a money maker but what about social responsibility and accountability to the nursing profession.

You only need to attend a State Board of Nursing Meeting to hear about the problems some of these nursing programs have especially the proprietary schools of nursing.  Don't email me if you teach in a proprietary nursing school about how you help disadvantaged students become nurses and how you help non-traditional students because "I ain't hearing it because I see it in my law practice." I am going to post on proprietary nursing schools later this month but I have to clear the post with my attorney first:)

I met with a new graduate yesterday who recently received her nursing license six months ago and has had a complaint filed against her license with the State Nursing Board for a practice issue. My heart sank during this meeting because I couldn't imagine being in her shoes when I was 6 months out of my ASN program. What is the root cause analysis? I am seeing more cases involving new graduates and new nurses in my law pactice. What does this mean?

Okay, I am rambling. Responsibility and Accountability. This is a major underpinning of discipline before the State Nursing Board, discipline in the workplace, criminal issues for nurses, and nursing malpractice. You are responsible and accountable for the actions or inactions in your personal life just like you are responsibile and accountable for the actions or inactions in your nursing practice; Its also to important to remember that your personal life may overlap with your nursing practice and your professional career when you are a state licensed professional.

Coulda, Woulda, Shoulda, and Maybe: I didn't know action against the license was reported to several national databanks

I spoke with a nurse this week who is very upset. He signed a contract with a State Nursing Board to resolve a pending complaint against his license. The nurse was upset when she received correspondence from the National Practitioner Databank and Healthcare Integrity and Protection Databank regarding the action taken against her license. The nurse feels as if this is excessive punishment, unfair, and wants to write a letter to the State Legislature to complain.

The nurse did not have attorney representation before the State Nursing Board, which is fine. There is a right to self-representation in any legal matter. However he could have retained an attorney.

The nurse did not have an attorney review the State Nursing Board contract before signing and returning the document to the Board, which is fine. There is a right to self counseling and advising in any legal matter. However he could have consulted with an attorney (usually a few hundred dollars) and had an attorney review the contract and discuss the implications of signing the contract on his nursing license and career going forward.

So what am I saying? You have choices and options. To retain or not to retain an attorney. To consult or not to consult with an attorney. State Nursing Board action against the license has far reaching implications for your license and your nursing career and YOU have to decide whether or not YOU need representation, counseling, or advising in a matter. There are going to be things that you don't know in these types of cases but someone who practices in this area can point out to you. Coulda, Shoulda, Woulda, and Maybe are not things you want to say to yourself in critical and "code red" matters involving your license, career, and your livelihood.  

CRNAs and Prescriptions in Ohio

SB 200 would authorize nurse anesthetists in Ohio to issue prescriptions and write orders in some cases. See http://www.toledolegalnews.com/articles/index/id/5812.

http://www.legislature.state.oh.us/bills.cfm?ID=128_SB_200

http://www.ohnurses.org/AM/Template.cfm?Section=Home&TEMPLATE=/CM/ContentDisplay.cfm&CONTENTID=5247

Its December 1, 2009: What are your plans for the month and 2010 to 2020?

Do you have any special plans for this month? My sister and my niece and nephews from ATL stayed with us last week for 7 days and we had a ball. My sister has a 13 month old who says "mama" every 5-10 seconds and after three days of "mama" I didn't know whether I was going or coming.

We have decided to do something a little different for Christmas this year. I am cooking a small dinner (for Thanksgiving my mother, grandmother, and I cooked together and we had a feast like Soul Food, the movie) and we are planning to make rounds this year visiting different family members. I am planning to bake cookies, brownies, and other sweets for Christmas gifts for adults. I have to be in the mood to do serious baking and I am trying to prepare myself. I am not doing alot of Christmas shopping this year. We may travel out of town to visit relatives or for a mini vacation.

2010 is a new decade and I am bring in 2010 different than how I brought in 2000. Did you party like it was 1999 on December 31, 1999? We did!

You know you are getting older when you start to count the decades. In 1999, my law and consulting practices were fairly new and I was going on alot of road trips in early 2000-2004 with speaking engagements, being hyper active and involved in nursing professional associations, and trying to establish my practices. My son was in junior high school and I started dating my sweetie. I can remember being on the road for days or a week straight at times. I actually spoke at the Alaska Nurses Association convention in Anchorage for 3 days!

2005 to 2009, my son graduated from high school, we moved from being around the corner from most of my family to 3 miles from most of the family (this was a big deal:), my law practice grew with more cases in Ohio and Kentucky and a few in Indiana, and I got hitched.

What will 2010 bring? What's in store for us as nurses and the professional practice of nursing from 2010 to 2020?