Nursing Law & Order

If you test positive for marijuana on a pre-employment drug screen, is it reported to the board of nursing?

If you test positive for marijuana on a pre-employment drug screen, is it reported to the board of nursing?

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In most states this is reportable offense to the State Nursing Board. See https://www.ncsbn.org/163.htm.

Some prospective employers will report to the State Nursing Board while others may not bother.

If a complaint is filed against you with the NJ Nursing Board, contact a nurse license defense before you respond to the complaint.

I joined a Nurse Voluntary Recovery Program (VRP) and I am disgusted with the VRP!

I am an RN who made a medication error at work and it was reported to the supervisor. They "investigated" my narcotic administration and said that it was "suspicious" that I gave meds out to other nurses patients. I was unable to prove that these nurses were either on break or needed help at the time and I was fired for this, and my file was sent the the Pennsylvania BON. I decided to join the VRP and am just disgusted with it and i'm wondering if i have violated anything with my license that i couldnt prove to the BON? They thought i was stealing medications but i havent done this and dont feel i have done anything unethical. The VRP program does not care about me from anybody else and i can rarely get in contact with them which is why i cant to quit. I also want to consider going back to school but if my license does get suspended or revoked am i able to be licensed as a physical therapist or pharmacist for example?

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Thank you for your comment on my blog. You were terminated by your employer for suspicious narcotic administration . Your employer filed a complaint against you with the State Nursing Board and to resolve the pending complaint you requested participation in a Voluntary Recovery Program(VRP) the State Nursing Board or State Nurses Association offers for nurses with a substance use and abuse disorder.

Okay, now that I have the facts straight.

1. You really need to speak with a license defense attorney in your State ASAP about your situation.

I decided to use your comment as a post to discuss the importance of having legal advice and counseling before one moves forward with a Nurse Recovery Program, VRP, or an Alternative to Discipline Program for substance use and abuse or mental health issues. Of course, I haven't reviewed your VRP contract but it sounds as if you could use some help sorting out the issues here.

2. A nurse license defense attorney in your State can also answer your specific questions about what happens if your nursing license is suspended or revoked and then you start and complete training to practice in another health discipline. In general, anytime action is taken against one license in healthcare it has to be reported to another healthcare licensing board. It depends on the wording in the Application for Licensure as a Pharmacist or PT but I would dare to say most applications for licensure ask about the discipline, revocation, or surrender of another healthcare license. Why? Because its relevant and a factor to be considered when reviewing one's application for licensure to practice in any given occupation or profession.   

3. The role of the VRP, Nurse Recovery Program, or Alternative to Discipline Program is to protect the public from unsafe nursing care; its role isn't to advocate for the nurse or to counsel and advise you on what to do in your given situation. So many of us as nurses confuse the role of the State Nursing Board with the role of a State Nurses Association, which is to advocate for nurses. This is why you really should consider legal representation, counseling, and advising to steer you through this process. An attorney who practices before your State Nursing Board can be an asset to you throughout this long process. Admin Law cases don't resolve in a day or two and you need an attorney who is going to be with you throughout your case. I don't know what your finances are of course but I would suggest you consider retaining a license defense attorney to assist you with your issues with the VRP. See www.taana.org to find a license defense attorney in your state.

I falsified my Application for Licensure by Examination with the State Nursing Board! What should I do?

Its that time of the year baby. Nursing students are graduating and submitting their Applications for Licensure by Examination to the State Nursing Boards in Ohio, Kentucky, and Indiana. LPN license renewal started with the Ohio Nursing Board. LPN license renewal is coming with the Indiana Nursing Board and LPN, RN, and APRN renewal is coming with the Kentucky Nursing Board.

Licensure Renewal and Licensure Applications=Disclosures for some. To disclose or not to disclose shouldn't even be a question when it comes to the State Nursing Board Apps for Licensure and Renewal Apps.

Being proactive is the best defense when you have to disclose criminal convictions, substance abuse treatment, mental health treatment, malpractice/negligence judgments, discipline by another State Nursing Board or another healthcare licensing or regulatory board, or other information on a State Nursing Board Application for Licensure or the Renewal Application for Licensure.

Talk to a nurse license defense about what to expect before you submit your application and for assistance on completing your application. 

If someone tells you "its okay" or encourages you to falsify your State Nursing Board Application you laugh at this person and tell them "you worked too hard and too long for the privilege to practice nursing." Its never okay to falsify a legal document and a State Nursing Board Application for Licensure by Examination and State Nursing Board Renewal Application are legal documents.

Falsification of an Application with the State Nursing Board is grounds for revocation of the license and it usually states this on the form in a several States. If you are debating whether or not to disclose or debating whether or not disclosure is mandatory, consult with a license defense attorney in your state. See www.taana.org to find a nurse license defense attorney in your state or jurisdiction.

Ohio Board of Nursing-Alternative Program for Chemical Dependency Updated Fact Sheet

See http://www.nursing.ohio.gov/PDFS/Forms/ALTP/AP%20FAQs.pdf.

This form was updated on June 17, 2010.

See also Download AP%20FAQs.

If you are accepted into the Ohio Alternative Program for Chemical Dependency:

* This is good news!

* Congratulations and we wish you success in your recovery.

* If you need attorney representation, counseling, or advising while you are in Program, we can assist you.

If you are denied acceptance into the Ohio Alternative Program for Chemical Dependency:

* You should retain a nurse license defense attorney to assist you in the disciplinary and adjudicative process.

If you are terminated from the Ohio Alternative Program for Chemical Dependency:

*You should retain a nurse license defense attorney to assist you with the disciplinary and adjudicative process.

I was criminally charged with a Hit and Run! Will this impact my nursing license?

I am RN. I recently got into a car accident and drove away because 

I was afraid.. It was 4am. I did not get arrested but did get a 

citation for a Hit and Run. I was not cited for a DUI or DWI. I hit 

a car with 2 Undocumented Mexicans. Their car had no "papers" either. 

They got arrested. No injuries. I haven't gone to court yet but from 

what I have researched on the internet, it looks like I'll have to 

pay a fine. I think it'll be considered a misdemeanor?? Do I have to 

report this to my State Nursing Board? If so, will it affect my 

nursing liscence??? Please help!

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I am not licensed to practice law in your State and therefore I 

cannot assist you. However I would seriously and 

strongly encourage you to do the following:

1. Internet research is cool to a certain point. The disconnect for most comes with applying the research to your situation and the practical applications of representing, counseling, and advising yourself in a criminal and a State Nursing Board matter;

2. Hire a criminal defense attorney ASAP to represent you in this case. You may be surprised to learn the facts you consider important are not really very important to your case from a legal perspective. This is why you need an attorney.

This is why you need a criminal defense lawyer ASAP;

3. Hire a nurse license defense attorney ASAP to counsel and advise you on the licensure implications of a hit and run conviction and to represent you before the State Nursing Board if necessary; and

4. Its going to cost cold hard cash to hire two defense lawyers so start thinking now about how you can raise the green from friends, family, savings, retirement, etc. 

Serious Allegations in a State Nursing Board Complaint and Investigation: Seriously, you should seriously retain serious legal counsel, seriously!

The summer is here and I am looking forward to the warm weather. State Nursing Board staff like most of us take vacations and time off from work in the summer so things tend to slow down (just a little) in my nurse license defense practice in June, July, and August.

If you have a serious State Nursing Board complaint, seriously, you should seriously retain serious legal counsel, seriously!

Red serious: You are representing yourself, can you objectively tell if your complaint is serious?

Blue serious: You are really planning to represent yourself in a case where your license, livelihood, and career are at stake?

Green serious: No, really you really planning to represent, counsel, and advise yourself in a case where your license, livelihooh, and career are at stake?

Orange serious: Speak with and retain a nurse license defense attorney or an attorney who regularly practices before the State Nursing Board, has represented others with your credentials and licensure, and who is genuinely interested in your case.

Pink serious: With your license "on the line" and State Nursing Board discipline across the country on the rise, do you feel lucky and competent enough to do this on a "pro se" basis?

What are serious allegations? You tell me.

 What do you consider serious allegations in a State Nursing Board complaint?

Nurse Monitoring Programs: What did I just sign?

Before you sign up for a Nurse Monitoring Progam affiliated with a State Nursing Board, you should really consult with a nurse license defense attorney before you sign on the dotted line to discuss and review the pros and cons of the Agreement and the Program with you. You need to obtain legal advice from a license defense attorney about your situation.

What is a Nurse Monitoring or Alternative to Discipline Program?

http://www.oregon.gov/OSBN/monitoring_program.shtml

http://www.njsna.org/displaycommon.cfm?an=1&subarticlenbr=40

http://www.nursingworld.org/MainMenuCategories/ThePracticeofProfessionalNursing/workplace/ImpairedNurse.aspx

http://www.aana.com/Resources.aspx?id=1150

See also http://www.hhs.gov/ohr/discipline.html

I spoke with a nurse over the weekend who signed a 5 year agreement for monitoring with a State Nursing Board and who is having second and third thoughts about the Program after only 60 days of monitoring in the Program. The best time to ask questions about a Nurse Monitoring Program is before you sign and make a legal commitment.

Nurses, we really need to be proactive and not reactive when licensure, career, legal, criminal, employment, clinical, professional practice, ethical, moral, and regulatory issues arise in our nursing practice. We operate in a society based on law and order and it should not come as a surprise when legal or law related circumstances present in your nursing practice. Don't panic just seek assistance and counseling. You owe this to yourself.

There are far too many nurses, nursing students, and NCLEX-Applicants who still confuse the role of the State Nursing Board with the role of a State Nursing Association and the distinction between the two is mission critical.For example see http://www.wepapers.com/Papers/55541/The_Role_of_The_State_Board_of_Nursing

Nursing and Entrepreneurship: Perfect Together

See http://www.can.affiniscape.com/associations/9102/files/NTW2009May_33_Nurs%26Entrapreneur.pdf.

Do you see more nurses starting entrepreneurship enterprises?

Resources for Nurses dealing with current Workforce and Workplace Issues

See http://can.affiniscape.com/displaycommon.cfm?an=1&subarticlenbr=34.

Nurse Investor Project: Are you planning for retirement?

See http://www.wiserwomen.org/index.php?id=37&page=Nurses`_Investor_Education_Project.

Felony OVI (operating a vehicle under the influence of alcohol) and the Ohio Board of Nursing: The Real "Thang"

Don't believe the hype and what you hear on the online nursing boards, forums, and chatrooms. Multiple OVIs, DUIs, and/or DWIs can impact your nursing license. See Download DUIsmultipleandOhioNursingBoard

This nurse was convicted of OVI in Jan. 2004, July 2004, and June 2006 and therefore his/her subsequent conviction in Feb. 2010 was a fourth degree FELONY (3 prior convictions in 6 years. This is a new law in Ohio).

Did you know most states have laws where multiple DUIs convictions in a certain time period result in a felony conviction?

The Ohio Board of Nursing issued a Notice of Opportunity for a Hearing at the May 21, 2010 Board meeting against this nurse.

I am going to profile actual cases before the Ohio, Kentucky, and Indiana Nursing Board (redacting names and case information because its not necessary for this educational exercise) from time to time for my readers so you can see first hand how the State Nursing Boards review and adjudicate these cases.

What should you take from this case?

1. If you are charged with a DUI, OVI, or DWI, retain a criminal defense attorney and speak with a nurse license defense attorney.

2. If you have multiple DUIs, OVIs, or DWIs in the past and you are charged with another DUI, OVI, or DWI, retain a criminal defense attorney and retain a nurse license defense ASAP, like yesterday.

3. Criminal matters turn to licensure matters turn to employment matters for nurses. Hire an experienced nurse license defense attorney to assist you going forward. There is only so much "information" you can obtain online on blogs, websites, chatrooms, boards, and forums and this is NO SUBSTITUTE for the real "thang", i.e. retaining your own nurse license defense attorney to represent, counsel, and advise you before the State Nursing Board.

Focus on Health in Nursing and for Nurses

See http://www.can.affiniscape.com/displaycommon.cfm?an=1&subarticlenbr=90.

Conflict Engagement resources for Nurses

See http://www.can.affiniscape.com/displaycommon.cfm?an=1&subarticlenbr=235

Best Practice in Drug Testing for Professional Health Monitoring Programs webinar was excellent!

I participated in a webinar this afternoon discussing drug testing and drug testing monitoring program. It was an excellent webinar sponsored by CLEAR. http://www.clearhq.org/. I would dare say this was the best CLEAR webinar I attended thus far. The content was interesting and far from basic or being to technical as both presenters are experts in the drug testing and monitoring field.

My question was the last question answered:

What do you see at the future of drug testing with healthcare professionals with a substance use/abuse disorder?

Both presenters indicated UDS (urine drug screens) would be an intergral part of drug testing for healthcare professional monitoring programs and were an important consideration for public protection, which is of course the role of a state regulatory board like the Board of Nursing.

One of the speakers mentioned relying on the science of drug testing and monitoring is important and its also important to look at the big picture of the recovery of a specific individual when making licensing, reinstatement, and monitoring decisions.

Better Care by Design: Nurse Involvement Improves Building Projects

	See https://www2.gotomeeting.com/register/209777851     Better Care by Design: Nurse Involvement Improves Building Projects

Webinar Registration

	Presenter:  Kerrie Cardon, RN, AIA, ACHA Kerrie Cardon, RN, AIA, ACHA, Healthcare Consultant, Herman Miller Healthcare.   A strong link exists between the design of healthcare environments and patient safety, making it important that nurses understand how the principles of evidence-based design can be implemented to create work environments that are efficient for staff and therapeutic for patients. As a registered nurse and architect, Kerrie Cardon understands the important role nurses serve on design teams. Join Kerrie on Friday, June 25th at 2:00 pm (ET) for a 60-minute webinar as she shares her secrets to understanding and contributing to the evidence-based design process for renovations or new buildings.

	When: Friday, June 25, 2010 2:00 PM - 3:00 PM EDT Use the form on the right to reserve your Webinar seat. * Indicates a required field		Fri, Jun 25, 2010 2:00 PM - 3:00 PM EDT Show time in my time zone * First Name: * Last Name: * Email Address: State/Province: Choose one... Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Puerto Rico Virgin Islands Guam Alberta British Columbia Manitoba New Brunswick Newfoundland Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon Other Organization: Job Title: By clicking this button you submit your information to the Webinar organizer, who will use it to communicate with you regarding this event and their other services. View system requirements

1,000 Blog Posts at Nursing Law & Order: Are nurses trained to be future healthcare leaders or are nurses trained to work for the future healthcare leaders?

I will have 1,000 blog posts sometime in July 2010 and to celebrate I am going to offer several promotions in July because its my birthday (July 2nd) and my 1st year wedding anniversary (July 8th), and my man's birthday (July 28th). Do you really need to a reason to party likes it 1999 anyway?

I think I am going to offer two free teleseminars on legal issues and maybe a free webinar, a discount on workplace consultations for nurses across the country, and free legal consultations for nurses in Ohio, Kentucky, and Indiana for 2 days only. I may also have a drawing for "free" legal representation for a nurse facing a complaint before the Ohio, Kentucky, or Indiana Nursing Board. I have to research this, speak with my attorney and clear the "free legal representation" contest with my lawyer first and contact the attorney ethics hotline.

Speaking of retainers, do you have an attorney on retainer? My best friend works as an Ohio Independent Provider and asked me if she could retain me for regulatory compliance. My BFF isn't a nurse. I thought wow! Here is a non-nurse who works as a IP who is interested in retaining me for regulatory compliance related to her IP practice and business recognizing there are legal risks and pitfalls . I actually offered a contract for Ohio IP-RNs and Supervising RNs and sold a few several years ago.

I am going to market and offer a full range of services for Ohio IPs including RNs, LPNs, and Aides because regulatory compliance is needed. You only need to look at the number of the Ohio Nursing Board Notices of Opportunity for a Hearing and Proposed Adjudication Orders terminating a provider number issued by ODJFS (Ohio Dept. of Jobs & Family Services) to recognize there is a need.

But the $2.99 question as always is whether or not nurses are willing to pay for a risk management service (which is what regulatory compliance is as matter of fact) and having an attorney on retainer? In my experience most nurses don't hire an attorney to represent them before the State Nursing Board so why would a nurse practicing nursing in his/her own business owner retain an attorney for regulatory compliance?  Also the nurse business owners who practice in their business I have encountered in my experience only hire an attorney when something happens. This is being reactive and not being proactive.

Most docs and dentists who run their practices have attorneys and other professionals assisting them with regulatory and legal compliance. Why don't nurses do this? Docs and dentists are trained in med/dental schools to run and manage their own business. Why don't nursing schools and colleges do the same for nurses?

Are nurses trained to be the future health care leaders and the business owners of tomorrow or are nurses being trained decade after decade to be the at-will employed employees of the future healthcare care leaders and business owners of tomorrow?  

You can't run a business and practice nursing in your business without risk management and regulatory compliance, can you?  You can of course but you are assuming alot of risk and potential liability. Willy Nilly, Hodge Podge, and the Whack a Mole approach isn't the best solution for risk management and regulatory compliance for individual nurses or a nurse owned and operated business.

http://advocatefornurses.typepad.com/my2cents/2008/10/independent-practice-and-self-employed-are-you-regulatory-compliant.html

http://advocatefornurses.typepad.com/my2cents/2009/03/aprns-and-independent-practice-dont-wing-it.html

http://advocatefornurses.typepad.com/my2cents/2009/04/advanced-practice-nurses-and-legal-issuestrends-in-my-law-practice-.html

Now back to my BFF. I am greedy (hence my diet) and I also like money but I wouldn't charge my BFF for counseling and advising and regulatory compliance but I have to charge you unfortunately. Damn our mortgage:)

If you run a nurse-owned business or practice as a IP and run your IP business, do you have an attorney on retainer? If you are in Ohio, Kentucky, and/or Indiana, I am of course available to assist you.

Bullying and Lateral Violence in Nursing resources

See http://www.can.affiniscape.com/displaycommon.cfm?an=1&subarticlenbr=283

When the State Board of Nursing Calls: a two part article series

See http://centerforamericannurses.org/displaycommon.cfm?an=1&subarticlenbr=202

Nursing Law & Practice legal webinars for Nurses for purchase at the Center for American Nurses

See http://centerforamericannurses.org/displaycommon.cfm?an=1&subarticlenbr=286.

Can a LPN delegate nursing tasks to a RN? State Nurse Board Complaints served hot and fresh for everyone!

I was asked this question yesterday by a RN in Ohio.

LPNs and RNs have a different legal scope of practice based on the State Nurse Practice. The education and training of RNs is broader and more expansive than the training of LPNs which is why there is difference in the legal scopes of practice between LPNs and RNs.

See these brochures from the Ohio Board of Nursing discussing the differences.

  http://www.nursing.ohio.gov/PDFS/Practice/RN-LPN-ScopeofPractice.pdf

http://www.nursing.ohio.gov/pdfs/Practice/Decmodel.pdf

http://www.nursing.ohio.gov/PDFS/Practice/RN_LPN_FAQs_6_09.pdf

Kentucky Board of Nursing

http://kbn.ky.gov/NR/rdonlyres/1D42B514-A2E5-4AE6-93D8-D3195397C367/0/LPNSCopeofPracticeBrochure.pdf

http://kbn.ky.gov/NR/rdonlyres/74A5FF75-543D-4E12-8839-720B7623DA87/0/ScopeDeterminGuidelines.pdf

In general a RN functions independently and is authorized to perform in all aspects of nursing practice. The LPN has a dependent role and functions at the direction of the RN, MD, or another licensed healthcare professional as indicated in the State Nurse Practice Act.

So why the confusion? Because some employers (hint: primarily skilled nursing facilties but also home health agencies) don't craft and draft job descriptions, assign patient care, or develop nursing workflow processes which the State Nurse Practice Act and Board of Nursing regulations as the guiding principle.

If this was done, an explanation and rationale could be provided and all nurses would really understand "delegation" and the difference between the RN and LPN scope of practice and how this is applied in a particular facility, on a specific unit or floor, and/or with this patient population. This would also help ease the tension seen in some facilties between RNs, LPNs, and nursing assistive personnel like STNAs and HHAs.

In general it is outside of the scope of practice of a LPN to delegate nursing tasks to a RN. This doesn't mean a LPN can't do the scheduling and other clerical or administrative tasks because these are not NURSING tasks.

Do LPNs in some facilities delegate nursing tasks to RNs? Of course and we all know it happens and we know "management" is aware of the practice. This doesn't make it right or acceptable and IMO this is where the journey to the dark side of the force starts as it did for Young Anakin Skywalker. http://en.wikipedia.org/wiki/Anakin_Skywalker

Violations of the Nurse Practice Act which everyone assumes are "no big deal" and "an accepted practice" are tolerated and accepted which in IMO leads to additional rule bending and violations of the Nurse Practice Act (we are doing this and its accepted so why not do try this also).

All of this is "okay" until something happens and things get reported to the State Department of Health and then the State Board of Nursing. That's where the finger pointing starts. Can you say State Nursing Board complaints served hot and fresh for everyone including the LPN, the RN, the RN unit manager, and maybe the ADON and/or DON?

My nurse attorney colleagues Suzie Collins and Cynthia Mikos from Florida published an excellent article discussing State Nursing Board complaints and the impact of rule bending in the workplace. I will find the cite and publish it later.

As a nurse you are a licensed professional. Its your license not your employers and you should know the legal and professional underpinnings and regulations/rules/policies governing your nursing practice. Don't rely on your employer to interpret the State Nurse Practice Act for you. You are individually accountable and responsible  and potentially liable for your nursing practice. If something doesn't feel right, ask questions and seek assistance. You shouldn't perform tasks you know violate your Nurse Practice Act and you should under no circumstances practice outside of your legal scope of practice. This isn't legal advice, its common sense. Happy Friday!!!