Nursing Law & Order

I am blogging from the Ohio Board of Nursing meeting today. There will be a presentation on Just Culture. The Board is voting on Consent Agreements, issuing Notices of Opportunity for Hearings, Immediate Suspensions, Temporary Suspensions, Hearing Officer and Hearing Panel Findings of Fact and Conclusions of Law, Requests for Reinstatement, Temporary Suspensions, and other matters today. I have several cases on the Compliance Agenda which is why I attend the meetings to hear the voting and comments of Board members in open session.

Its a 1099 world out there for nurses who are willing think outside of a W2

Do you want to own your own business and utilize your nursing skills, experience, and license?

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

As a nurse entrepreneur, I can tell you, the sky is the limit if you are willing to embrace some risk and take a few steps outside of a comfortable and predictable W2 existence. Its a 1099 world and there are so many opportunities to combine your nursing education, practice, and skills set with a novel or ordinary business opportunities.

This is why I am starting graduate school for my MSN. I am creating my career path which will include the practice of law and the practice of nursing for the next stage of my career.

State Board of Nursing and Licensure by Examination: 1+1+1 doesn't equal 3 always

In an ideal world, criminal background checks wouldn't be necessary for licensure or employment but we don't live in an ideal world do we?

Before you spend $30-$50K on the nursing diploma or degree and the privilege for the ATT and sit for the NCLEX-RN exam or NCLEX-PN examination, please do the following if you have a history of substance abuse, mental health, and/or criminal convictions (felony and/or misdemeanors):

1. Where are you planning to apply for a license? Take the time to review the State Nursing Board Application for Licensure by Examination NOW.

2. Look online NOW at a few healthcare employer applications for employment.

3. Speak with a representative at the Nursing Program about your history before you apply for admission into the Program. You need to know "point blank" if you will have issues with certain clinical sites;

4. Contact your State Student Nurses Association and/or the National Association of Student Nurses and speak with an advisor about your situation and ask for guidance and direction (notice I didn't say advice);

5. Contact your State Nurses Association. Maybe the Association can assist you with questions you may have; and

6. Lastly speak with a license defense attorney and have the attorney review your criminal, mental health, or treatment records. You want to have a frank discussion with the attorney about your suitability for licensure and your employability in healthcare especially with criminal convictions.

An evidentiary hearing before a healthcare regulatory agency isn't the best place to be without an attorney

If you have an evidentiary hearing scheduled before a State Nursing Board, State Department of Health, the Dept. of Jobs & Family Services, or any other state regulatory agency, ideally hire a lawyer to represent you.

If you cannot afford an attorney, retain an attorney to provide you with unbundled legal services. For example helping your prepare exhibits or identify witnesses, prepare your opening/closing, etc. but not appear on your behalf and represent you at the hearing.

Don't just show up to an evidentiary hearing and represent yourself. You are doing yourself a disservice.

For example, I am involved in an administrative law case now that involves filing a petition for civil enforcement of an administrative law subpoena because a healthcare organization refuses to comply with the subpoena issued by the administrative law judge for our discovery prior to an evidentiary hearing. If you were representing yourself would you know how to proceed in something like this if you didn't have legal training?

Administrative law hearings are trial-like and do not underestimate the time and energy necessary to adequately prepare for an administrative law hearing.

If you are going to represent yourself, read as much as you can and prepare as best as you can.  

More Cash Strapped Litigants Don't hire a Lawyer: Repping Yourself

See http://online.wsj.com/article/SB10001424052748704229004575371341507943822.html

I see this alot in my law practice also and I don't think most nurses are cash-strapped. IMO the perceived value of State Nursing Board attorney representation doesn't justify the cost for the majority of nurses across the country who represented themselves before the State Nursing Board.

After all, its just a State Nursing Board complaint, why would you need representation?

There isn't an awareness of the State Nursing Board for what it really is in these cases.

1. The Board protects the public and is a regulatory agency of the State.

2. The Board functions in an administrative law capacity in disciplinary investigations and hearings functions involving licenses.

3. What is administrative law anyway? http://en.wikipedia.org/wiki/Administrative_law

We are all familiar with criminal law and the criminal court system from Law & Order and other court TV dramas.http://en.wikipedia.org/wiki/Criminal_law

We are all familiar with the civil court system also and what it means to be a plaintiff and a defendant. http://en.wikipedia.org/wiki/Civil_law_(common_law)

But hardly anyone has a real appeciation of administrative law and State regulatory agency investigations and adjudications. I think this is another variable why alot of nurses rep themselves.

Repping Yourself?

http://advocatefornurses.typepad.com/my2cents/2009/10/indiana-nursing-board-hearing-and-repping-yourself-.html

http://advocatefornurses.typepad.com/my2cents/2008/03/representing-yo.html

http://advocatefornurses.typepad.com/my2cents/2009/03/representing-yourself-before-the-nursing-board-until-you-dont-like-where-the-case-is-going.html

http://advocatefornurses.typepad.com/my2cents/2008/11/should-i-represent-myself-before-the-nursing-board-the-question-to-a-question.html

http://advocatefornurses.typepad.com/my2cents/2010/01/my-top-10-for-diy-representing-counseling-or-advising-yourself-when-legal-ethical-or-professional-pr.html

http://advocatefornurses.typepad.com/my2cents/2009/12/nurses-are-taking-their-state-nursing-board-case-to-the-mat-top-10-why-nurses-represent-themselves.html

4. Also a complaint against your license is personal for most of us and the instant reaction is "I didn't do anything wrong" without really appreciating its not about right or wrong from a moral perspective, but whether or not there is a violation of very broad and all-encompassing State Nurse Practice Act and/or Board of Nursing regulations.  

Double Fresh, Double Fun, Double Smooth: Two State Nursing Board Complaints in less than 6 months

This is why its so important to speak with an administrative law attorney when you have a pending complaint with the State Nursing Board. If you have a complaint filed against your license, speak with an attorney to review the allegations and your course of action. Research law firms and attorneys online and schedule an appt. with an attorney to further discuss your case. What is the benefit in waiting a few weeks or months to speak with attorney when a complaint is filed against your license?

I spoke with a nurse this week who has two pending State Nursing Board complaints against his license related to allegations of drug diversion and the State Nursing Board suspended his license (without a hearing as permitted to do so by law when a nurse is threat to public safety; this is an emergency measure) after the 2nd complaint was filed.

Pull the money out of the mattress because you are going to need it in these types of cases. Two State Nursing Board complaints ain't double fresh, double fun, or double smooth but it will cost you double money.

I am returning to graduate school in the Spring of 2011 for my MSN

I have been playing and toying with this for several years: LLM in health law or a MSN. My husband gave me the green light and I am returning to college in the Spring of 2010 for my MSN. Part time, of course.

I haven't decided on a track. I need to do some research on my options. I am planning to do the traditional route as opposed to online or maybe a program that allows a combination of online and traditional classes. I also need to look at the costs.

Do you have any suggestions on where I should apply? We have several programs in our area: University of Cincinnati, Xavier University, Mt. St. Joseph, Northern Kentucky University, Wright State University near Dayton, Ohio, etc.

I do like the idea of being a psychiatric CNS or NP. This would fit nicely with my law practice and I could work part-time in private practice as a CNS/NP. However the psychiatric CNS/NP track at University of Cincinnati College of Nursing is online only. I really wanted to attend traditional classes.

I am also considering adult or family NP. Personally, I think I would really like to work in home care as a NP and I am seeing more positions advertised in the Greater Cincinnati area for home health NPs. What do you think?

I have no plans to leave my law practice (I plan to take 2-3 classes a quarter). I see aMSN as professional development and enriching the services I will provide to my law and consulting practice clients. I am excited.

What is my goal? Primarily self-enrichment and professional development.

If you are going to hire a nurse license defense attorney do so before the cat gets out of the bag!

I am seeing more and more cases where nurses are initially representing themselves in State Nursing Board investigations, meeting with State Nursing Board investigators and Pharmacy Board investigators, attending investigative meetings with State Nursing Board investigators without legal counsel, and providing verbal, written, and recorded responses to the complaint to various law enforcement and State Nursing Board personnel, and submitting a written response to the allegations in the complaint without the assistance of legal counsel to the State Nursing Board.

If you receive a phone call and a State Nursing Board investigator, Pharmacy Board investigator, and/or Detective LaTonia Denise Wright from the _________County Drug Diversion Task Force wants to meet with you at the local McDonald's, its not because they want you to sample the new Strawberry/Banana or Berry Berry Smoothie at McDonalds.

So many nurses receive the initial complaint from the State Nursing Board and write a 5-10 page response and submit it to the State Nursing Board without blinking an eye, taking a deep breath, or passing go and collecting $200.00.

I am also seeing cases where a nurse has a license defense protection benefit with NSO or Marsh Affinity/Chicago Insurance Company and do not contact the insurer immediately for a referral to an attorney.

If a complaint is filed against my law license, I am going to retain an attorney to represent me. No questions asked because its my license and frankly I couldn't be objective enough to represent myself. Your first thought is "I didn't do anything wrong." Its not about right or wrong and its about violating a State Nurse Practice Act/Board of Nursing regulations.

Also this is why I have legal malpractice insurance that costs my firm a few thousand dollars a year. Yes, my legal malpractice insurance costs several thousands dollars a year. There is no way in hell I would attempt to respond to a complaint filed against my licenses with the Indiana, Ohio, and/or Kentucky Supreme Courts without hiring an attorney who specializes in representing lawyers in disciplinary cases. Why?

As a licensed professional, you MUST afford a certain amount of deference to your State Licensing Agency and to its process and procedure for the investigations and adjudication of complaints. Some nurses and other licensed healthcare professionals take a "its just the Board" or "the Board has bigger fish to fry than this case" and really rationalize the behavior, actions, or inaction underlying a State Nursing Board complaint.

So many nurses are so busy yelling "I can't believe this was reported to the State Nursing Board", " I did NOTHING wrong", "they didn't do this to so in so" or "this is so unfair" that they are not mounting a defense to the complaint initially.  This doesn't help you. The online nursing chatrooms, boards, and forums are filled with angry and bitter nurses dealing with a State Nursing Board complaint/discipline and most (if not all) without the benefit of legal representation.

In serious cases, I tell my clients we will be working together for years. Yes, years pumpkin not days or months. We are doing time together: 1-3 years, 2-5 years, or 3-6 years.

I have said it once and I will say it again until I retire from law practice (20-25 years), its not nursing negligence or nursing malpractice you have to worry about as a nurse; its having a complaint filed against your license with the State Nursing Board or another heatlhcare regulatory agency like the Department of Health, Attorney General, or Jobs & Family Services.

Are you at the Point of No Return (PNR) in your State Nursing Board case?

I said this to a client the other day. We are at the point of no return in your State Nursing Board case and these are your options.

What is the point of no return? http://en.wikipedia.org/wiki/Point_of_no_return.

In a State Nursing Board case IMO its a irreversible action or decision where you must continue on the current course of action because turning back is legally and practically impossible.

I talk about the PNR in cases where:

1.   I suspect or know my client is not being completely upfront and forthcoming with me;

2.   Is just outright lying about the circumstances  and facts in their situation; or

3.   In cases where a client is in an extreme state of denial.

I saw Predator at the movies on Friday. So I watched the original Predator, Predator II, Predator Requiem, and Alien v. Predator Friday morning and afternoon while working on my laptop. The PNR is mentioned  also in AVP.

The Point of No Return is also a pretty decent movie. See http://en.wikipedia.org/wiki/Point_of_No_Return_(film)

Shared Governance vs. Collective Bargaining vs. Employment Contracts vs. Nursing Staff Bylaws: Which is better IYO?

Is shared governance "the" model for nursing practice in the future? What do you think?

I personally think Nursing Staff Bylaws are the key, not shared governance, collective bargaining, individual employment contracts, and certainly not at-will employment which is where the majority of nurses are in the spectrum.

At-will employment is cold, harsh and arbitrary. HR and lower and middle nursing management wield "at-will employment" like a Young Jedi with a new lightsaber. http://en.wikipedia.org/wiki/Lightsaber.

Do you know how many nurses are terminated and then usually reported to the State Nursing Board? Alot. The number of State Nursing Board complaints across the county is increasing.

See http://www.nursetogether.com/tabid/102/itemid/889/Worried-About-a-Malpractice-Lawsuit-The-Board-of.aspx 

http://advocatefornurses.typepad.com/my2cents/2009/01/state-nursing-board-complaint-vs-nursing-negligencemalpractice-complaint.html 

 http://www.camorrison.com/.

See also http://www.leichterlaw.com/ld_license_defense.php.

 Its not nursing negligence or nursing malpractice you have to worry about, baby, its being reported to the State Nursing Board or suitability for licensure in you are applying for a license. This is one of the reasons why nurse license defense attorneys like myself are so busy.

One of my clients who is an excellent RN was terminated from her employment with an Indiana hospital after 20 years of solid employment. She was terminated to send a message to other nurses on the unit who have been there longer than most if not all of the nurse managers and nurse executives at the facility. She was also reported to the State Nursing Board. A two-fer, fired and reported which is more and more common these days.

Some (I didn't say all okay but some) nurses in positions of power (lower and middle nursing management) have "blood lust" similiar to newbie vampires, are worse than docs and lawyers (because we are and can be overly power and money hungry; I know I am), and certainly more manipulative and fem fatale with the passive-aggressive routine. Maybe this stems from nursing being primarily a women-dominated occupation. I went to see the new Twilight movie yesterday again, can you tell? What did you think of the newbie vampires?

I am attending a few webcasts on shared governance in nursing this summer to gain a broader perspective on the future of shared governance. Maybe I am wrong about shared governance but nursing staff bylaws that afford nurses the same rights and due process as physicians governed by medical staff bylaws IMO are the ideal for hospital-based nurses.

Nurses Retirement Decision Making Guide from the Center for American Nurses

See http://centerforamericannurses.org/associations/9102/files/wiserNursesDecisionMkingGuideFINAL.pdf

USA Today article on Bad Nurses Able to Work in Other States

See http://www.usatoday.com/news/health/2010-07-15-1Anurses15_CV_N.htm#SignOut

State Nursing Boards are tough enough already in disciplinary cases. And there is a little thing called procedural due process in administrative law cases. Administrative law rRespondent-licensees are already provided less rights and process than what you see in civil and criminal cases, what's next? No due process, no investigation, just turn in your license and go to jail, go directly to jail, do not pass GO, and do not collect $200. Yes, I am old school and its the board game Monopoly.

What are you advocating for anyway? Permanent License Revocation and Protective Isolation for nurses involved in State Nursing Board complaints, investigations, and adjudications!

Three posts in one day and I am on a roll, baby!

Also what is bad? Having a med error now makes you a bad nurse?

Greater Cincinnati Nurses Networking Group via Meetup

What's one of my surprises for July? I launched this meetup in July 2009. My timing was off with me getting married and all in July and a new legal assistant starting in July. But guess what? Its back!

If you are a RN, LPN, APRN, or nursing student in the Greater Cincinati, Ohio area join the Greater Cincinnati Nurses Networking Group. See www.meetup.com/nursinglawandorder. Spread the word!

We have three activities planned for the upcoming month already. If you have any ideas or suggestions for CE, professional development, or networking activities for RNs, LPN, nursing students, and APRNs please let me know. If you would like to host a meeting or present a topic, let me know. If you want to get involved join and then call or email me. I would really like to have one or two meetups a month for nurses in the Greater Cincinnati area. We are starting small but who knows where it will go!

My goal is to have a networking group for nurses in the Greater Cincinnati area. Greater Cincinnati is Cincinnati and its suburbs, Northern Kentucky, and southeastern Indiana.

I will also try to have events in conjunction with professional associations which are active locally.

If you are involved in a nursing professional association in the Greater Cinti area and you want to plan a joint event, email or call me.

If you have an event for nurses in the Greater Cinti area, email me and I will include the event on the Group calendar.

We are also looking for sponsors outside of my law firm, if anyone is interested. If your company or business wants to sponsor an activity for nurses, email or call me.

I am hiring two part-time legal assistant this month, actually a legal/marketing assistant and a legal assistant and both will also be active in planning, scheduling, developing, and marketing the Greater Cincinnati Nurses Networking Group.

My law firm has 8 CE and 4 Ohio Nursing Law and Rules programs approved for CE credit. I will most likely plan to offer free CE to nurses throughout the remainder of the year along with other activities and events. I am going to twist and pull Jack Stem's arm and bite him if I have to so he can present on Addiction & Recovery in Nurses later this year. See http://www.peeradvocacyforimpairednurses.org. Also Jack is back as he is going to start working with me again in a peer mentor role on addiction and recovery issues in my law and consulting practice.

The Best Case Scenario isn't always a realistic option in the State Nursing Board complaint

Whenever or if you have a complaint filed against your license with a State Nursing Board you want the best case scenario which is for the Nursing Board to review the evidence and close the case file or issue a non-disciplinary letter of concern, advisory letter, or other non-public letter. This is the best case scenario.

The best case scenario isn't possible in some State Nursing Board complaints and as a license defense attorney I am discussing case strategy, defense, and the long-term goals for the representation which also includes short-term goals. In some cases, discipline is coming and its just a matter of how (Agreed to or via an evidentiary hearing) when.

The worst case scenario in a State Nursing Board case is permanent revocation of the license.

There is everything in between the best and worst case scenario in State Nursing Board investigations and adjudications. How do you know what's in store for you if you don't have someone assisting you with your case?

But sometimes, just sometimes, "it is what is" and if "it is what it is" in your case then you need a license defense attorney to be frank with you and discuss your options. My mother says this all time: "it is what it is." See No. 2 at http://www.urbandictionary.com/define.php?term=It+is+what+it+Is.

You want the "skinny" on your case not the buff and fluff. HIre a lawyer who will give you the skinny while trying to steer you towards the buff and fluff.

You don't need peers, colleagues, friends, and family rationalizing your behavior, action, or inaction and telling you "it will all work out in the end." Sometimes it doesn't "work out" in the end especially if you don't do what needs to be done in the beginning and/or the middle.

Free Webinars for Nurses offered by the Center for American Nurses

The CENTER Gets a New President Donna Warzynski, MSHSA, RN, NE, BC, was sworn in as the CENTER's new president at the annual Membership Council Meeting, June 2, 2010.  Donna is the Nursing Administrator of the Wisconsin Veterans Home where she oversees the care of veterans in a healthcare complex totaling 741 beds.  A registered nurse for over 40 years, Warzynski has been an acitve member of the CENTER since its establishment in 2003.  She will lead the national nursing organization for the next 2 years.        read more... Free Webinar:  Publication for Nurses -   Putting Practice into Print  Florence Nightingale, the founder of modern nursing, was a prolific writer.  Today, writing is a neglected area of professional development for most nurses.  The reasons for this are many including lack of time, being mystified by the publishing process, and experiencing a lack of comfort with writing skills. However, it is important for nurses to write for both personal and professional reasons as it is a means to share information, increase knowledge, and achieve recognition. The benefits of writing greatly outweigh such fears.   Join Judith Mitiguy, RN, MS - Executive Vice President, Gannett Healthcare Group (publishers of Nursing Spectrum & NurseWeek) as she shares tips on Putting Practice into Print.  Navigate Nursing is a product of the Institute of Nursing Research & Education which is a nonprofit affiliate of the Center for American Nurses.  Navigate Nursing is dedicated to helping professional nurses navigate their nursing career.  Our website, www.NavigateNursing.org, brings you the latest news, career tips, education, innovative products, and an online community to support RNs in all roles and specialties in creating health work environments.   CENTER, Department of Labor, WISER  Present Free Webinar  Planning for Retirement:  A Guide for Nurses and Other Busy Women When you walk out the door at the end of your workday, you have given your all.  But you rally.  You take care of the things your life demands of you—whether it is the kids or your partner, the house or the bills.  The last thing you are inclined to think about is your retirement planning.  But here is the problem: women face a bleak retirement future.  Women are twice as likely as men to live in or near poverty in old age, and many women who were never poor during their working years, will find themselves struggling to get by in retirement.  The time to start planning for these years is now   Here is one simple way to get you on the road to financial security:  Join us as we talk about ways to increase your financial fitness and save for retirement, including making the most of employer-based retirement savings plans.       Nurse's Retirement Decision-Making Guide Wins Award The Busy Nurses Retirement Decision-Making Guide won a bronze award from the Mature Media Awards which honors the best marketing, communications and education programs for older adults.  The Guide was entered in the  "Community Organizations" category for Brochure/Booklet (Mature Work & Retirement). Download a free pdf      The CENTER and Women's Institue for a Secure Retirement (WISER) is partnering to provide nurses with the information and tools they need to plan effectively for retirement.    See all the resources - Save and share this link with other nurses!

IN THIS NEWSLETTER CENTER Gets New President Webinar:  Writing for Publication Webinar:  Financial Fitness Busy Nurses Guide Wins Award Call for Nominations Medication Error/Reporting Survey View Previous Newsletters     REGISTER NOW! Publication for Nurses  Tuesday, July 27,  2:00 - 3:00 pm (ET) Presenter: Judith Mitiguy    REGISTER NOW! Planning for Retirement Thursday, July 29 2:00 - 3:00 PM (ET) Presenter: Kathy Stokes Murray Order a hardcopy of The Busy Nurses Guide to Planning for Retirement, a companion publication to the Decision-Making Guide Download a free pdf!

Call for Nominations The CENTER is currently seeking nominations for four (4) Board Positions as well as persons to be appointed to the Program & Services Advisory Council (PSAC) and Subscriber Engagement Advisory Group (SEAG).  PSAC will provide oversight and coordination of the program and service development activities for the CENTER and the Institute.  SEAG will craft and implement strategies to develop and grow the individual and organizational subscriber categories approved with the adoption of the CENTER's new bylaws.  August 24, 2010 is the deadline for submission of nominations packets.  Qualifications for all Board positions and appointments are listed in: 2010 - 2012 Board Nominations Packet Program and Services Advisory Council Nominations Packet Subscriber Engagement Advisory Group Nominations Packet Should you have questions, please feel free to contact the CENTER Staff - 301-628-5243. Medication Error & Reporting:  Call for Survey Participants How would you like to help improve patient safety in our country's hospitals?  You can do that by participating in a research study about medication errors and medication error reporting.  The study is being conducted for dissertation  research by Joyce Shanty, Co-Investigator, (under the guidance of Dr. June Larrabee, Principal Investigator ([email protected] or [email protected]). This survey will take approximately 15-20 minutes of your time.  "West Virginia University Institutional Review Board (IRB) has acknowledgment of this study on file." To find out more about the study and your opportunity to win 1 of 20 $50 gift cards, click on the link below:   http://iup.qualtrics.com/SE?SID=SV_b7NEQYjkj7EbE4k

Are you a difficult client? Recognizing difficult client types.

My latest edition of Law Practice, a magazine published by the American Bar Association Law Practice Management section arrived on Friday. There is a wonderful article for attorneys on dealing with difficult clients. Managing difficult clients is a skill for attorneys as we sometimes represent clients at their worst.

The article warns attorneys that dealing with a difficult client can result in an ethics complaint or a malpractice claim. Its suggests confirming an understanding with these clients and documenting everything! Now that's very practicable. The article suggests attorneys recognize the types of difficult clients and then be proactive in handling these clients and their cases.

Wow!  I have a better piece of advice for attorneys. Recognize the types of difficult clients and the red flags and then ask yourself with your current case load is this a client you and your staff have the time and energy to represent. If yes, increase your fee and  take the case. If no, refer to another attorney.  

In my law practice, nurses don't  call me just to say hello. You call because there is an issue in the workplace or a pending or forthcoming investigation against your nursing license with a State Nursing Board.

The following were identified as difficult client types:

* The Angry or Hostile Client;

I see this alot in my law practice with legal consultations and nurses who contact me. These are usually nurses who for whatever reason have decided to represent themselves only to find out later they don't like where the case is going with the State Nursing Board. I can understand being angry with your situation but take steps now to hire someone to assist you.

I also see alot of anger when a nurse realizes a complaint has been filed with the State Nursing Board and several months or almost a year has elapsed. Being angry is okay initially but move pass your anger to effectively deal with your situation and the pending complaint.

* The Vengeful or Zealous Client;

I see this also especially on the online nursing forums and boards but also in my law practice. I also see this in cases where a nurse has been investigated more than once by one or more State Nursing Boards and in cases where a nurse has had action taken against the license and represented herself/himself throughout the case from start to finish. 

Life is too long (we have good genes in my family) and I refuse to work with clients who are "off the chain" or "off the hook." I have a nose for drama because  I have a very large extended family (there are 100+ family members within 20 miles or less of our home)  and trust me I get plenty of excitement in my personal life; I don't need it at work also.  I usually decline representation in these cases or charge alot more money for representation.

* The Overinvolved or Obsessed Client;

When one's livelihood is at stake, I don't think you can be too involved so I see this as an aspect of client relations in a license defense practice. We can email, text, fax, and/or meet in-person or by phone.

* The Emotionally Needy or Dependent Client;

I see this sometimes also.

* The Secretive, Dishonest, or Deceitful Client;

 I would love it if any and everyone who called my law office for legal advice was open and honest about everything but....

* The Depressed or Mentally Challenged Client; and

* The Unwilling Client i.e. thanks for the advice but this is what I want to happen here.

In my 13 years of law practice I have worked with all of the above. If you are planning to hire an attorney now or in the near future, you don't want to be labeled as a difficult client. You can be involved with your case and work closely with your attorney and ideally the expectations and goals for representation should be discussed and agreed to before the attorney-client relationship begins.

Publication for Nurses: Putting Practice into Print. A free webinar for nurses

Publication for Nurses: Putting Practice into Print

Presenter:  Judith Mitiguy, RN, MS - Executive Vice President, Gannett Healthcare Group (publishers of Nursing Spectrum & NurseWeek)

Florence Nightingale, the founder of modern nursing, was a prolific writer.  Today, writing is a neglected area of professional development for most nurses.  The reasons for this are many including lack of time, being mystified by the publishing process, and experiencing a lack of comfort with writing skills. However, it is important for nurses to write for both personal and professional reasons as it is a means to share information, increase knowledge, and achieve recognition. The benefits of writing greatly outweigh such fears.  

Join Judith Mitiguy as she shares tips on Putting Practice into Print. To register for the webinar,

See https://www2.gotomeeting.com/register/344559618

 

Criminal Defense Attorney, License Defense Attorney, and the State Nursing Board: Oh me, Oh my!

Thank you for wishing me a Happy 39th Birthday.

If you are charged with a felony or misdemeanor which will have license implications (this includes all felonies and most misdemeanors depending on the State Nursing Board), please listen to this:

Criminal Defense Attorneys

1.  You want an attorney who practices criminal defense primarily, not just a case or two here and there. You want an attorney whose law practice is primarily criminal defense.

2.  Research criminal defense attorneys in your area before you hire a lawyer.

3.  Have a list of questions to ask the attorney and bring a friend or family member with you to also ask questions when you meet with the lawyer.

4. Don't just retain a lawyer. Research the lawyer, his/her firm, and the lawyer's experience.

5. Ask the attorney bluntly do they have time for your case and what can they do for you? I like being asked this question and it doesn't offend me. You are the client and the attorney is seeking your business and you are paying for a service: ask questions about the representation.

I am seeing instances where nurses are hiring lawyers who just don't have time to work their case or their case is considered "small fries" when compared to other cases the attorney or law firm is handling.

6.  Has the criminal defense attorney represented nurses or other licensed healthcare professionals  in criminal matters? In what types of cases?

7. Talk to other nurses and your colleagues and ask for referrals.

8. Contact your State Nurses Association and ask for a referral.

9. Contact your State or local Bar Association for a referral.

10. See www.taana.org.

11. Speak with more than one attorney about your case to compare fees.

12. Most importantly you have to be comfortable with your lawyer. Keep looking until you find an attorney who you feel comfortable with handling your case.

13. Obtain a written fee agreement for you to review. Ask questions about the agreement.

14. How accessible is the lawyer? This is extremely important. Who will be your primary contact with the law firm? The lawyer, a paralegal, legal assistant, or a receptionist? Can you communicate with the lawyer by office and/or cell phone, fax, email, text, IM, mail, etc?

15. Clarify up front whether or not the criminal defense attorney will be involved with the State Nursing Board. Will you have a criminal defense attorney and a license defense attorney or you will have one attorney who handles the criminal and the licensure matter? IMO, I think nurses should have two different lawyers when a licensure case and criminal case presents.

16. Don't wait to hire a license defense attorney when you have a criminal matter pending, especially if you have been charged with a felony or felonies. Get a license defense attorney on board ASAP after you hire a criminal defense attorney.

Who should you hire first? Criminal defense or license defense. It depends on the way your case presents.

Please, please, please keep in mind that administrative law and nurse license defense is niche. Most lawyers don't have experience representing, counseling, and advising nurses and other healthcare professionals in professional practice and licensure matters. Actions in the criminal case can impact your nursing license and the ideal situation is the following:

A. Having a criminal defense attorney to represent you in the criminal case(s);

B. Having a license defense attorney to represent you before the State Nursing Board; and

C. Having your criminal defense attorney and license defense attorney speak as necessary about case strategies.