Nursing Law & Order

RN and APRN 2011 Renewal: Does the Ohio Nursing Board have your correct address?

This is part of an email I received from the Ohio Board of Nursing about renewing my RN license:

All RN and Advanced Practice Nurses who are eligible to renew their licenses this year will receive notification by mail (at the end of March) along with instructions on how to renew their license on-line. Nurses who do not wish to renew their license on-line MUST submit a request for a paper application via mail, fax or e-mail. Telephone requests will not be accepted.

Renewal notices or applications will be mailed to the address on file with the Board. If you have moved since your last renewal, and have not notified the Board of the change, you must do so immediately to ensure that your renewal notice is mailed to the correct address. Address changes cannot be accepted by telephone and MUST be submitted in writing. When notifying the Board of your address change, please include your full name, license number, and new mailing address including your county and telephone number.

Address changes can be submitted to the Board by using one of the following methods:

 

By Mail:   Ohio Board of Nursing
                  Attention: Renewal
                  17 South High Street, Suite 400
                  Columbus, Ohio 43215-7410

By FAX:    (614) 466-0388
                  Attention: Renewal

By Email:  [email protected]

The Good, The Bad, The Ugly, and the Unrepresentable vs. Unforgiven and Unrepresentatble

The Good, The Bad, and The Ugly with Clint Eastwood and Unforgiven are two of my favorite movies.

What is unrepresentable? Well, first it is not an acceptable word but that has never stopped me before....

Nurses when you represent yourself for so long in:

1.  a State Nursing Board investigation, adjudication, or post-disciplinary monitoring;

2. You are involved in a med mal or nursing malpractice cases that transitions to a Board of Nursing investigation, adjudication, or post-disciplinary monitoring;

3. A criminal case that transitions into a Board Alternative Program monitoring and/or Board Disciplinary Action and post-disciplinary monitoring

you may become UNREPRESENTABLE. I can actually see this as nice legal drama and cowboy movie.

Unrepresentable means attorney representation, counseling and/or advising is of no benefit to you because of YOU; its usually not the case because all cases can be worked through, it may take time, but.... You are unwilling to see anything in the case but your own point of view. Most of the time it involves taking a victim approach and that you are being picked on for whatever reason by whomever and "this" is the result.

There is also a tendency to see everything as "Me against the State Nursing Board." Sorry, but you are no Tupac and "Me against the World" has no place or meaning when defending your license in a disciplinary investigation, hearing, or post-monitoring period. http://en.wikipedia.org/wiki/Me_Against_the_World

I am seeing this with nursing students, NCLEX Applicants, LPNs, RNs, and APRNs who have represented themselves over a period of months or years in State Nursing Board cases and who really would have been benefited from legal representation and counseling and advising earlier: days, weeks, months, or years earlier.

I don't think a nurse can appreciate just how much impact these types of cases can have on you until it happens to you. You of course take it personal but its not personal; its a complaint against you in your professional capacity and therefore it should be handled professionally. This is why you don't represent yourself and you have someone helping you.

However, the benefits of representation, counseling, or advising are lost in the present and the "now" as well as in the future because of the past. We all have crap in our closet that we don't want to come out (you are not perfect) but if the crap in your closet is directly or indirectly related to the State Nursing Board complaint, guess what? The closet has to be cleaned up somewhat. I like to use a cleaning combination of bleach, holy water, and baking soda.

I don't have a "S" on my chest. But I do have a pair of red boots and you certainly won't catch me in a Red Cape (at this time of the year anyway in the Midwest) for SUPER Nurse Defense Lawyer. But I will probably wear my red blood red cape to see this movie. http://www.imdb.com/title/tt1486185/.

Sorry, but I cannot fly (I can barely walk in my Red Hot Red Knee Boots) around the State Nursing Board Office at the speed of light and turn back time to the exact point in time where if you knew then what you know now, you would have proceeded differently before the State Nursing Board.

Some nurses do just fine representing themselves in State Nursing Board cases. But how do you know if this will be you? How do you know depending on the allegations in your case if you can adequately represent, counsel, and advise yourself before the State Nursing Board?

You don't know what you don't know until you find out you didn't know.

If you are trying to save a few dollars and you are representing yourself, read up and arm yourself with the knowledge and information you need. But, when you get to that point, where your gut and instinct says:

1. I don't know what the hell I am doing here!;

2. Your license is suspended and you don't know why?;

3. You are signing legal documents from the State Nursing Board faster than you sign and cash your income tax refund check;

4. You feel as if you are backing yourself in a corner;

5. You are unsure of what you need to do next; or

6. You are becoming overwhelmed with the process

Its time to contact an attorney now instead of waiting until you are unrepresentable. Some nurse license defense attorney won't tell you this and hell depending on how the legal fees are structured some will take your case on a hourly basis at $200.00 or $250 an hour with a 5k evergreen retainer and "go as hard as" you can afford to pay if those are your wishes. Go Johnny, Go! http://www.youtube.com/watch?v=uMY5VGYh2Go

If you are struggling in a complaint investigation pending against your licnese, obtain an objective opinion or advise from a license defense attorney about the past, present, and future of your nursing license. Just my two cents!!

You received a Compulsory Order for an Examination from the Nursing Board: Retain a Lawyer, Now!!!

I don't like to beg, but in these cases I will make an exception. Please retain legal counsel ASAP. It does not have to be me but hire a nurse license defense attorney to represent you if you receive:

1. An Order from the Kentucky Nursing Board requiring a Chemical Dependency Evaluation; or

2. An Examination Order from the Ohio Nursing Board.

A.   Schedule an appt. with a nurse license defense attorney immediately after you receive the Order to review the Examination Order and your case from Day 1 until today;

B.   Seriously consider whether or not really should be representing yourself before the Board in this case. Of course you can represent yourself and you have represented yourself up to this point BUT is it in your best interest to represent yourself going forward; and

C. I don't need a lawyer because:

1. Its too expensive.

Call around and obtain a few quotes from license defense attorneys about the cost of representation. If you need to borrow the cash, take a loan from the 401K or 403B, borrow money from your in-laws or parents, etc. just do it!

2. Hiring a lawyer make me look guilty.

Really. I am a nurse and a lawyer and if I am sued, charged, or being investigated for ANYTHING, my lawyer is involved.

Don't ask if you need a lawyer in these cases start with asking yourself why would you not have a lawyer here.

These cases are some of the most serious and priority cases before the Board because the case may suggest impairment, an inability to practice nursing safely, and other issues and you are representing yourself without  a sense of urgency.  

Hell just writing this blog post and the mention of an Examination Order from the State Nursing Board makes me nervous. I always take a deep breath and breathe slowly when I review an Examination Order from the State Nursing Board. Those docs are never nice.

You say hiring a lawyer makes you look guilty well I am honest (unless I am lying) and continuing to represent yourself in some complaints before the Board especially when Compulsory Orders have been issued is mind boggling.

How in the hell can you maintain the objectivity needed to represent yourself when an Order for a Chemical Dependency, Mental Examination, Behavioral Examination, Physical Examination, or Psychiatric Examination has been issued by the State Nursing Board?

In this cases and I am a seeing more and more and more, when I quote a fee I am going to do the following:

1. Take my usual flat fee range and multiple it by 3;

3. Substract $556.55 because the fee looks a little heavy;

4. Add the cost for extra Pepsi and Mountain Dew for 2-5 years; and

5. Divide by 1.5 which is the number of vacation days I have for 2011.  

Verified Response to a Kentucky Board of Nursing Complaint: Why is this a big deal and the real deal?

The Kentucky Nursing Board isn't playing with nurses involved in disciplinary investigation before the Board.

When you open the mail and receive the Notice of Complaint, you won't here a violin in the background and you certainly shouldn't have a picture of you and the Kentucky Nursing Board investigators meeting for afternoon tea if your investigative meeting is schedule after 12noon or chatting about the details of the complaint over coffee if your investigative meeting is scheduled in the morning.

I love it because it out there and in your face. It says Notice of Complaint and it required a Verified Response. The Board requires a Verified Response to a Complaint filed against a license within 30 days of receipt of the Notice of Complaint.

Why is this a big deal?

Well let's see. The rationale for a Verified Response to a Complaint is simply:

1. You have to verify what you are saying to the Board in response to the Complaint is accurate. No more just saying whatever to the Board.

2. The Verified Response must be notarized. This is significant because you are legally attesting to what is stated in the Verified Complaint on the date the response is notarized.

3. If you don't respond or respond with false or inaccurate information, this can lead to other alleged violations of the nursing law and rules.

Why is this a big deal?

1. This tells me as a license defense attorney that some nurses (certainly not all but enough) have been submitting statements to the Kentucky Nursing Board which are not accurate; and

2. This tell me as a license defense attorney that some nurses (certainly not all but enough) have been dishonest, deceitful, and deceptive with the Board in complaint investigations.

Dishonesty, Deceitful, and Deceptive= Dumb, Dumber, and Dumbest IMHO in licensing Board cases. This is why one should really consider having legal representation instead of representing yourself before a State Nursing Board.

Just saying anything and just putting anything in writing doesn't cut with a Verified Response to the Notice of Complaint.

Pardon my french, this is strictly my opinion, and if asked (unless I am asked in a Verified Response to a Notice of Complaint) I will lie about it; a 30 day Verified Response to a Kentucky Nursing Board Complaint, is the first step when differientating the sh*t from the shinola. http://en.wiktionary.org/wiki/you_don%27t_know_shit_from_Shinola

Its my job as a license defense attorney to do the same.

A Verified Response to the Notice of Complaint is fairly new and this isn't something the Kentucky Nursing Board has always done for years or decades prior. As a nurse license defense attorney,

I am actually glad to see the Board take this approach. Why?

a.  It impresses upon the nurse the seriousness of the Verified Response and that you can't just say anything to the licensing Board governing your nursing practice in response to a complaint filed again you with the licensing board;

b. You must respond and the failure to respond can be lead to more problems. This is common with attorney disciplinary investigations; as attorneys we just can't respond to a Bar investigation because the failure to respond is an issue in and of itself.

c. You must respond within a required period of time and the failure to respond within this period of time can lead to more problems. This is the consistent with Bar investigations of attorneys and some other licensing Board investigations.

d. The majority of nurses represent themselves in State Nursing Board complaints and having to respond with a Verified Response may cause a nurse to pause and consider the complaint and what is alleged and before drafting a 29 page handwritten response to the Complaint, seriously consider one's response and whether or not legal counsel would be beneficial; and

e. I like it because its, IMHO, the Kentucky Nursing Board's Miranda Warning who receive a Notice of Complaint. Please tell me you know Miranda. http://en.wikipedia.org/wiki/Miranda_warning.

The Board is saying "here's the complaint, here's what is required, and here's what can happen if you don't do what's required." Its out there and in your face.

Please tell me that you knew these cases, investigations, and adjudications were adversarial?

http://en.wikipedia.org/wiki/Adversarial_system

I love it because this is what a Nursing Board should do when a complaint is filed against nurse. The Board's role should be stated and again "out there and in the face" of the nurse who is being investigated. . 

I however would suggest one minor change to the Notice fo Complaint. It would be nice if the Kentucky Nursing Board ended the Notice of Complaint with "Do you feel lucky?" http://en.wikipedia.org/wiki/Dirty_Harry

Although I am just kidding of course with the Dirty Harry quote and I am adding a little humor, the Notice of Complaint is a big deal and the Verified Response required by the Kentucky Nursing Board is the real deal.

We live in Serious Times and so of course there are Serious State Nursing Board cases

The State Nursing Board cases and the allegations are becoming more complex.

1. Med Mal/Nursing Negligence and the State Nursing Board

If you are or will be named a defendant in med mal case listen up. Hopefully you have your own professional liability insurance to provide for your defense and for your own defense attorney to work with your employer or former employer's defense attorney.

Find an attorney you trust, who you like (somewhat), and you can work with over a period of months or years. If you need to meet with several attorneys then do so.

Also, imagine this. If you are named as defendant in a med mal case or your conduct, actions, or inactions are one of the focuses in a med mal case, chances are you are going to be reported to the State Nursing Board. Talk to a nurse license defense attorney initially.

I am seeing a trend where nurses blame their attorneys for the outcomes of the representation, counseling, and advising.

2. My Attorney Fracked Up My Case!

#1. If you call my office and you start blasting another attorney, red flags, bells, whistles, and fireworks go off in my mind. Why?

You probably won't be working with me because I am not going to be the next target. Also I am pretty good with reading clients and the issues and I know in a few minutes if this is someone I want to work with or refer out to other license defense attorneys , in Columbus. LOL.

#2. If you are not satisfied with the representation then talk to your current attorney, don't call me. I don't like that I will tell you so.

#3. Talk to your attorney and work it out and terminate your attorney and retain another lawyer. I usually don't represent nurses who have been represented by more than one license defense attorneys because this in and of itself tells me alot.

#4. Do your research and find the right nurse license defense attorney for your case. Ask questions and if necessary speak with several attorneys before you retain a lawyer. Ask for referrals from other nurses, your State Nurses Association, and conduct your own research about the attorney and the law firm. Its your license and its just that important.

#5. Just a hint. Don't call my office or any attorneys office and say to an attorney "I don't like, trust, or respect lawyers."

I am a nurse and I am also a lawyer. I was offended another nurse would call my office and be that damn rude. I wasn't surprised because nothing surprises me anymore in a nurse license defense practice. But don't call my office and tell me you don't like lawyers and then ask for my assistance. Why?

I am going to put you on speaker phone, give the phone the middle finger (I know; its so passive aggressive but I am a nurse also), and start reviewing emails. Then after five minutes, I am going to thank you for calling, tell you I cannot assist you, and refer you to the State Bar Association of What-Chu-Ma-Call-It.

This was nurse whose self-representation before the State Nursing Board was a disaster and the nurse was angry, very angry.

3. Criminal Convictions, the State Nursing Board, and Dual Diagnosis, Substance Use/Abuse, or Cognitive Impairments

When I meet with clients who have a combination of the above, I bring a pillow, cover, and Pepsi to the meeting because its going to be a long one and justly so.

You need to have attorney representation in these cases, period. There are just too many issues to consider and too many short and long-term implications for self-representation here.

4. Patient Injury or Death and a State Nursing Board Complaint

Retain a nurse license defense attorney.

5. This is your 2nd, 3rd, or 4th State Nursing Board Complaint

Retain a nurse license defense attorney. Bring your check book and a credit card.

6. APRNs and State Nursing Board Complaint

Don't represent yourself in these cases. Unfortunately I am seeing this more frequently and the consequences of not making informed decisions and thinking about the long-term and the short-term can shorten or kill your nursing career. Retain a nurse license defense attorney.

7. Nursing Students and NCLEX Applicants & Criminal Convictions

a. You don't know what you don't know.

b. Talk to a nurse license defense attorney before you submit your State Nursing Board application, please. I charge a fee for consultations; you may find someone who does not.

c. Don't rely on the advice given to you by nursing instructors, professors, and others which essentially "just submit your application, it will be okay, as you are a different person now." WTH and who in hell says this? You are NOT applying for a job at Diary Queen when you submit a State Nursing Board Application for Licensure by Examination. 

d. NCLEX-Applicants may benefit from attorney representation as well. I know your nursing program or nursing instructors didn't tell you this but I am telling you this. If you have ANY affirmative responses on your Application for Licensure you need to speak with a lawyer and schedule a consultation. Pay a few hundred dollars to find out what you are facing here instead of blindly submitting your App. Last but not least

8. Criminal Convictions and State Nursing Board Renewals

a. Schedule an appt. with a license defense attorney to discuss the renewal application.

b. Consider attorney representation in these cases.

Yes, they are just that serious.

Also if you have falsified your renewal applications with a State Nursing Board, bring your checkbook and 2 credit cards to the meeting with the attorney you retain. Don't represent yourself in these cases; its a recipe for disaster.

The Ohio Nursing Board renewal is fast approaching. We should receive our renewal applications here soon and when I do, I will post the language in the questions.

 

Nurses and Prison: The Interplay of Criminal Convictions & Nurse Licensure Laws

If you are charged with a serious felony and you may actually do jail or prison time, listen up.

1. You certainly need a private criminal defense attorney or public defender to represent you in the criminal proceedings.

a. This sounds like a no brainer but make sure you keep your appointment with your criminal defense attorney;

b. Attend all of your court appearances with your attorney;

c. Review your criminal discovery and take an active role in your criminal defense;

d.  Do not rely on your criminal defense attorney to advise you on how the criminal issues will impact your nursing license; and

e. Make sure your attorney knows you are a nurse and this may also impact your license.

2. You should also consult with or try to retain a nurse license defense attorney as well while the criminal charges are pending.

a. Ask the nurse license defense attorney if they are willing to work with your criminal defense attorney; and

b. Consult with or retain an nurse license defense attorney with experience representing nurses before the State Nursing Board and who also has represented nurses with criminal convictions or criminal dispositions before the Nursing Board.

c. Be proactive as possible. Yes, its embarrassing but even more embarrassing when there may be a chance to do chest compressions on your nursing license now.

I am seeing more cases were nurses are actually going to prison and incarcerated for months or years. Most of these nurses have public defenders in the criminal case (there is nothing wrong with public defenders because they actually have alot of court room and trial experience) and in the State Nursing Board case represent themselves.

When you are facing prison time, you probably are not concerned about your nursing license but you should be because once you are released you may want to transition back into nursing or employment in healthcare. Its harder to do this if you did not proactively handle the State Nursing Board complaint while during the litigation of the criminal case.

I will say this until I am blue in the face but nurses really should consider having attorney representation when faced with a Board of Nursing complaint. There are just too many issues to consider, review, and make when you are doing this alone and especially if you are also facing criminal charges or you have been charged and your case is winding through the criminal justice system.

Also realize this: If you are involved in a State Nursing Board complaint and you don't have a private lawyer, you are representing yourself. I am always surprised when I am told by nurses they were not aware that they could retain an attorney to represent them before the State Nursing Board.

There is tendency to assume your case is "not that bad" when compared to other cases. You may think your State Nursing Board complaint is a 2 on a scale of 1-10 when actually its a 6 or 7.

Its human nature and a effective coping mechanism to rationalize your behavior, action, or inaction. Its what we all do. But saying:

1. I am sure the Board has bigger fish to fry that my case;

2. I am not one of the druggie nurses;

3. You would have though I killed someone the way the Board is acting here;

4. The criminal conviction has nothing to do with my nursing practice;

5. I didn't do anything wrong here (remember you are not in church);

6. Everyone else was doing this and I am taking the fall;

7. This really isn't that bad;

8.  I know a nurse who did "way worse" and she is still practicing;

9. This is just silly, I told the Board everything and they are at my throat; and

10. My favorite told me recently, "Frack it, it is what is and what it is is BS."

But the above, IMO are the reasons why nurses don't have attorney representation in a State Nursing Board complaint. There is a failure or an inability to see the complaint for what it is, an alleged violation of the nursing law and rules, not a statement that you are bad person and a crappy nurse.

There is confusion about the role of the State Nursing Board, which is to protect the public. Complaints are investigated for public protection.

You need to at least consult with a nurse license defense attorney to discuss your options. You should also consider attorney representation for someone to work with you throughout the process.

I hate to see anyone go jail or prison, I really do. This is probably why I besides coming close to "slapping someone", I stay on the right side of criminal law because I don't want to go jail, I don't want to go directly to jail, I want to pass Go, and I want to collect $200.00. I grew up playing Monopoly and we would play this games for hours until someone left crying or started throwing the game pieces.

If you are a nurse and there is a high probability you are going to jail for a few weekends/weeks/months or you are going to the Big House for 6 months to several years, think now about your nursing license. I know you have alot of other things to deal with and arrangements to be made with your family for kids, etc.

But if you can think about your nursing license and take some time now to work on some of the licensure issues; do it now rather than later.

Speaking of prison. I had a State Nursing Board investigative meeting in Chillicothe, Ohio. There is a state correctional facility in Chillicothe.

Every week since January I am driving somewhere so friends and family will ask where you are traveling next, LaTonia? I kept saying Lucasville instead of Chillicothe. There is a state correctional facility in Lucasville, Ohio also.

I had never been to Chillicothe which is a 90 minute drive from Cincinnati, Ohio. Its actually a nice drive and all E-Way driving. I am actually glad the investigator suggested meeting in Chillicothe because it was a shorter drive time for the investigator and my client and it gave me another location where I can meet with my clients who live in Southeastern and Central Ohio.

There is more to Chillicothe than a prison of course but when I hear Chillicothe, I think prison. So when asked where are you going this week LaTonia, I replied Lucasville and then my husband would laugh and then I would say "no, I am sorry, I have to drive to Chillicothe."

Sorry that's the lawyer in me. If you say Marysville (state women's correctional facility in Ohio), Chillicothe, or Lucasville, I think prison.

If you are a nurse and you need to meet with me near Chillicothe, Lucasville, Warren, Marysville, London, Lebanon, Madison, Ross, Mansfield, Pickaway or Marion, just call us.

Jack's back in town and he can drive.  http://www.drc.ohio.gov/web/prisprog.htm

 

Ohio Senate Bill 5: Eliminating Collective Bargaining for State Employees. Should Ohio Nurses Be Concerned?

This a cut and paste of an email I received from the Ohio Nurses Association:

Background/Update:

Ohio Senate Bill 5 is currently in the hearing stage in the Ohio Senate. This bill would eliminate collective bargaining for state employees, and eliminate essential collective bargaining for other public employees. It removes the voice of nurses in decisions about patient care and workplace conditions and it is a clear threat to patient safety.

Senate Bill 5 would make it impossible for nurses who work in the public sector to use their collective strength to affect change. 
 
Senate Bill 5 is bad for all RNs and their patients.
 
Senate Bill 5 would impact critical issues, like:

-          Safe nurse staffing
-          Safe patient handling
-          Medication errors/adverse event prevention
-          Maintenance of a safe environment for patient care
 
 Two days of testimony for this bill took place last week. During this testimony, union members from across the state, including
ONA members, converged in the Statehouse Atrium to show their opposition for this bill. Opposition for this bill is growing, and
this was shown in the numbers of union members who came to oppose Senate Bill 5.
 
Thousands of Ohioans attended testimony at the Statehouse and made their opposition for Senate Bill 5 known.  We need YOU to help show that nurses oppose Senate Bill 5, and the silencing of nurses that it represents.
 
What you can do: All RNs are encouraged to come to the state house to show your
elected officials that you care about this issue.
 
Where: The Ohio Statehouse (1 Capitol Square, Columbus, OH 43215)
 
Date: Tuesday February 22, 2011
 
Time: Testimony starts at 4:00 pm. Due to space limitations ONA supporters are encouraged to gather around 2:00 pm on the East side of the Statehouse.
 
If you are unable to come when testimony first starts, we encourage you to come whenever you can.
ONA staff will be there from 2:00 pm until testimony ends (sometime in the evening).
 
 
Dress: To show your professional identity, we are encouraging our members to wear scrubs. 
If you do not have scrubs, please wear ONA logo wear.

-----------------------------------------------------------------------------------------------

So, what do you think?

Don't Even Try to Huffington Post Me! Stop with the Links for your Promotional Links, Articles, and Websites!

Okay, I am drowning in email.

Its a daily struggle to tame the beast and I readily admit and will confess without being flogged, my email is beating me down like I stole something. My law office also receives faxes via email and voicemail messages via email.

So when I receive email from a company attempting to promote its product, service, or items to nurses, my first response is you are kidding me right.

You need to work on your SEO instead of trying to link here pumpkin.

I do link with nurses and other nurse license defense attorneys and I will publish your website in a comment if your comment is on point.

Don't try to Huffington Post me. Get it and grab it with Google on your own!!

http://www.mediabistro.com/fishbowlny/huffington-post-bloggers-looking-for-compensation_b28154

Client Meetings and + 1, 2, 3, or 4 friends or family members present. Where is Waldo and the dirty dirty?

Can I bring someone with me to a legal consultation?

Of course. Who you bring in to the appointment is up to you, ultimately. However, please know that there may be a point during the consultation when the attorney asks your friend or family member to wait separately during part of the consultation because their presence could jeopardize the Attorney-Client Privilege. I retained Ms. Wright. Can I can bring someone with me to my in-person meeting with her? Of course. Who you bring in to the appointment is up to you, ultimately. However, please know that there may be a point during the meeting when the attorney asks your friend or family member to wait separately during part of the consultation because their presence could jeopardize the Attorney-Client Privilege. What is the rationale? The presence of a friend, family member, colleague, partner, or spouse during initial meetings, I have found in general is helpful because these individuals can contribute significant information and details. Also these individuals are just as concerned as you are about your license, the next steps, and how long is this going to take? However, I am finding that its difficult to say "I relapsed LaTonia" to me and of course this is extremely important information in a license defense case when you have a spouse or parent present and the spouse or parent is not aware of the relapse. Its even tougher for a nurse client to say "I started an intimate relationship with Patient B immediately after discharge" and the spouse of my client who is also a RN and works at the same facility in middle management is also present. So for this reason and others (I care not to mention) its my law firm policy (I think this is only my second or third law firm policy; I have to ask Jack) effective NOW that a friend, family member, or spouse will be asked to leave the meeting at some point so that attorney can speak with her client privately. The nurse is my Client regardless of who paid or is paying my flat fee true retainer. I am representing, counseling, and advising the nurse and I don't want my client concerned about his/her responses to me or unwilling to answer my very pointed questions to the best of their ability because +1, 2, 3, or 4 are present. Its not personal but I know when I am being spoon-fed water droplets through a dirty sock during a consultation or client meeting when there is the nurse + one, two, three, or four in the room. For me its not some much of a concern with a one-time legal consultation but with the traditional attorney-client relationship and ongoing representation cases, its unacceptable. I completely understand because the details in some of the State Nursing Board cases are too hot for even cable TV at 3am. But its a waste of your time and my time if you are providing with me fluff and buff because + one, two, three, or four are also in the conference room or my office with us. State Nursing Board complaints are the real deal. The Boards mean business in these cases and I need information, facts, documents, and "the dirty dirty" from my clients so I can provide the best legal representation, counseling, and advising available under the circumstances. I also need to know the "dirty dirty" so we can formulate a plan to become "fresh and clean" or at a min. "dingy but wearable." I have to go to the laundromat and wash our comforters, the bulkier bed linens, rugs, and our dogs linen (I know) this weekend, can you tell?  Seriously Waldo couldn't find the "dirty dirty" through the layers of fluff, buff, and just plain bullsh*t I am sometimes attempted to be fed on a small spoon like its Stage 1 baby food. If you are meeting with me and I: 1. Put my head down on the table; its not because I am tired; or 2. I excuse myself, thank you for meeting with me, and ask Jack to wrap up the meeting; its not good. It takes Jack 15 to 20 minutes to even wind down the meeting, 5 minutes to summarize, 7 minutes to conclude, and another 10 minutes to walk you down or out to the lobby and then resummarize and conclude because he forgot something.  If I want fluff and buff, I go to my stylist. I have an appt. in the morning at 11am. I just revised my medical, substance use/abuse and/or mental health Intake Form for  clients, and legal consultations. This is used in certain cases in additional to a general Client Intake Form. Oh, you didn't know? Although I may not check your blood pressure and do a head to toe physical assessment, I am a nurse and I am performing others assessments in license defense cases because its a necessity.

Substance Abuse Counselors who give legal advice and counseling: Here we go again!

A Substance Abuse Counselor wrote a nurse was in "very very big trouble" for drug theft. Okay, how do you distinguish very very big trouble from very big trouble from "just plain trouble" in drug diversion. Maybe its Just Plain Trouble like Just Plain Brenda on The Closer. That's Deputy Brenda Lee Johnson. My nephews do the very very very's at ages 6-10.

Its is based on the whether or not is a Felony 1st, 2nd, 3rd, 4th, or 5th degree in O-HI-O or the number of charges in the indictment?

Another counselor writes a nurse felt legal counsel was "necessary" so nurse hired lawyer and then did T, U, V, W, X, Y, and Z. Oh and also AA, BB, and CC.

How is what the nurse decided to do at the advice and counsel of his/her attorney relevant enough to the substance use and abuse treatment that it needs to be mentioned in records that would be provided to the State Nursing Board?

Did you ever think that the information a client conveyed to you as a result of the attorney-client relationship may be something that doesn't need to be shared in treatment records? Why not keep a professional journal with notes that are not appropriate for the treatment records but you want to write somewhere so you don't forget? You fickle frack maybe you need to review your position description that hasn't changed in 8 years, your employee handbook that changes qid, and your facility policies and procedures and guidelines which are located in the basement of "our old building." 

I get this crap all the time by those licensed by the State Board of All Things to All People and who want to dive into providing legal advice and counseling to a nurse who is dealing with substance use/abuse, mental health, or interpersonal issues and have a past, present, or future State Nursing Board complaint in the oven.

You don't have enough to do with addressing all aspects of the medical treatment plan that you need to also provide bootleg legal advice. Is this a professional boundaries issue as well where you are over-involved with this nurse client?

A. Why are you giving legal advice and counseling to someone at one of the their most vunerable times?;

B. Why are you telling nurses they "don't need a lawyer and this is what happens with nurses in our Program." Please go and take a nap.

Are you kidding me? And when you as "counselor" receive a complaint against your license from your Board, you are dialing for an attorney like you are ordering pizza from an office phone and contacting your insurance company related to your license defense protection benefit on your cell phone while trying to email or IM your spouse.

Its good enough for you but not your nurse clients, right?

C. Stick to what you know. I am not writing treatment plans in my law practice for nurses so why the hell are you providing legal advice and counseling to nurses in-patient, IOP, aftercare, or during stage of treatment and counseling?

D. If you don't know your scope of practice and what you can and cannot do, review your State Practice Act and Board regs. Is there any mention of providing legal advice and counseling to clients? Attorneys have a monopoly on the provision of legal services, pumpkin in the US. This may change in the future but not really (I don't want to sound to smug because sh#t happens).

You want your State Board licensees to be able to give legal advice and counseling along with substance abuse advice and counseling and then serve fries with that vanilla shake while wearing skinny jeans and a tank top? Try it.

You would think Coach was giving away free leather briefcases to the first 15,000 card carrying lawyers at the courthouse and statehouse in CMH there would be so many attorneys prepping for mortal combat related to another Board wanting to provide legal services. This would be our rallying cry and an accurate depiction of our "street fighting" skills:

http://www.youtube.com/watch?v=UMf40daefsI

Stay within your scope and your role and keep a summary of the 3 bullet points comprising the entirety of your job description for easy access and reference by you throughout the day as needed.

Your board= therapy, treatment, and recovery.

Lawyers= legal advice (very broad), legal counseling and represention on all things licensure, criminal, employment, etc. when a nurse presents for treatment, counseling, and therapy.  

Its Just a Public Reprimand! Thirsty Thursday and One Long Island Iced Tea

Its Just a Public Reprimand is like saying Its Just a Hemorrhoid.

Okay next time you see me ask me to tell you about similarities and differences between a public reprimand and hemorrhoid. I can't do it on the blog; its too offensive and I don't want to receive a private email (which I will have to publish here on the blog) or written correspondence by mail (which I will have to publish here on the blog) from some nurse saying how offended she (its always a she) was by my blog post.

Why am I harping on a public reprimand this week? After all it is the least amount of discipline available and its not probation, suspension, or revocation.

What is a public reprimand?

http://www.rn.ca.gov/enforcement/dispaction.shtml#term

A public reprimand is not a private reprimand.

A public reprimand is a big deal because like Long Island Iced Tea (LIIT), its no big deal initially but give it time. I went out with a group of my girlfriends and I had a LIIT last month; I sipped and danced and sipped and danced a little more. This wasn't a watered down LIIT but a "real long" LIIT made at a serious bar for serious drinkers who seriously want their monies worth.

http://en.wikipedia.org/wiki/Long_Island_Iced_Tea

It was 6pm and I met my friends for Happy Hour. I don't get out much because I work 12-16/6. So I am thinking oh this isn't too bad, its 6pm on Thursday, I will hang out until 9pm or so. I also assumed the drinks would not be too stiff because folks have to work the next day, right? I know.

I asked for a glass of champagne or sparkling wine and the bartender at this club laughed. This should have been a clue for me, right?  My BFF said "oh give her a LIIT."

Then, she says "you know its Thirsty Thursday, so drink up." Okay, this should have been my second clue, right? Drink up on a Thursday? Really? I have to work on Friday and to me that's like saying drink up on a Sunday evening.

It was Thursday but I wasn't Thirsty for a beverage.

I am always Thirsty for the big faces (large bill denominations) but never alcohol. Maybe I can have a Thirsty Thursday once a month in my law practice where I charge $75.00 for a 30 minute telephone legal consultation. I may try this next month and set aside one Thursday (9am to 7pm) for legal consultations at $75.00. Stay tuned.

I had ONE LIIT. One LIIT. My husband picked me up and drove me home on a Thursday. On a Thursday. One LIIT. Enough said. Needless to say I am not "allowed" to go to Thirsty Thursdays.

But please invite me if you have a Meaty Monday. I like chicken and turkey.

How about Tired Toes Tuesday? I would love to have a manicure, pedicure, and 45 minute massage.

Before you sign a Public Reprimand, have a nurse license defense attorney review it with you and discuss the implications of the public reprimand with you.

 

Requesting a Coke from a Lawyer who adores Pepsi; Pepsi, Coffee, or H20 only!

Okay, folks its come to this. There are some lines that just have to be drawn when doing nurse license defense work and this is one of them.

I had a client who requested a Coke during a meeting this week and laughed.

I could tell you about my fascination with Pepsi which started at age 2 but I will not because I am not trying to convert you. There is nothing like an ice cold fountain Pepsi from Speedway with not one but two straws. Try it.

What about hearing the pop on a can of Pepsi at 1am in the morning when I have 2 to 3 more hours of emails and documents to review? Its music to my ears. 

Effective immediately, we only serve Pepsi, Coffee or Water during client meetings.

Please don't ask for tea. If you want tea during our meeting, I probably won't represent you.

Its Pepsi, Coffee, or Water only.

Thank you for your understanding:)

APRNs and Self-Representation before the State Nursing Board and in Nursing Practice Matters

Advanced Practice Registered Nurses have an expanded scope of practice, more responsibility, more accountability, and potentially more liability for a general RN or LPN.

Also APRNs have the same issues for general RNs and LPNs and also prescriptive authority, credentialing, certification, and other issues generally not associated with RNs and LPNs.

If you are a APRN and you are representing yourself before the State Nursing Board in a complaint filed against your license, listen up. Here is my Top 10 like Letterman:

1. Everyone thinks a PERM; that's permanent revocation. Let me tell you there is "discipline" where you don't get a perm but it damn sure feels like it for APRNs; a public reprimand IS NEVER just a public reprimand for a APRN. Trust me on this one pumpkin;

2. Discipline, ranging from a public reprimand and up to a suspension can be the kiss of death for a APRN if you just sign on the dotted line (and have notarized in some cases) without considering the short-term and the long-term implications. Remember its never JUST a public reprimand. Also I want to know what SOBunny started saying "its just a public reprimand" because I am sure it wasn't a nurse license defense attorney;

3. Things are never just the way you see it; so that's why you need an bitter but objective attorney (like myself) to work with you;

4. Retain an attorney who practices before your State Nursing Board and who has handled more than one or two cases before your State Nursing Board.

Its nice the attorney practices is a pharmacist and practices before the Pharmacy Board and takes Nursing Board cases or practices primarily before the Medical Board (big dollar cases for physician representation) and will take on your case. Do your research and find an attorney, it can be a non-nurse but an attorney who practices before your State Nursing Board.

Why? Cases proceed differently before different licensing boards and while its all administrative law, you want someone who is going to take your case and work it not just take your case, take your money, and settle it without considering the short and long-term implications of any proposed discipline.

In a State Nursing Board case, you always want the best case scenario. In some cases the best case scenario is discipline, just a matter of how much. In others it may be resolving the case without discipline.

That's why I quote a flat fee for representation because I know this time next year if I am alive, guess what I will be doing. Two years from now; Five years from now. You guessed it and I work with my clients even after resolving a case throughout their nursing career.

5. APRN cases are complex. I charge more for APRN cases because APRN cases are complex. No ifs, No ands, and certainly no butts.

I was told by a APRN who is involved in a State Nursing Board complaint that the APRN spoke with several other APRNs who stated the care provided was consistent with the collaborating agreement and therefore the APRN would respond to the complaint without attorney assistance.

That's great, but you contacted me; I don't just call nurses around the state and say "hey this is LaTonia from CVG. I know what you did last summer? Have you received a complaint from the Board yet? No, your kidding me?"

I have been doing this for a long-time and if you can have a nurse license defense lawyer to review your statement, provide legal advice and counseling to you, and spend 25-40 minutes on the phone or in-person with you, then hop on that train. With APRNs, there are just too many documents I need to review and you can't just tell me "my SCA or collaborating documents are okay", I need to review those myself. Sorry.

This brings me to my next point with APRNs.

6. APRNs in general can and do make more money than general RNs and LPNs. I said in general okay. APRNs especially CRNAs have the means to pay for legal advice, counseling, or representation however most don't see a benefit to legal representation because "I didn't do anything wrong."

I think everytime I hear this on the phone, I willl place my speakerphone on mute and pimp slap myself in the face.

I think everytime I hear this during an in-person meeting, I will excuse myself and go to the men's restroom and just sit on the floor and smoke a cigar (I don't smoke), chug a tall boy of Colt 45 (I sip slow so I may need 4-6 hours to finish a tall boy without background music), and pop a Perc (I have a legally valid script for Perky from dental work in 1989).

7. APRNs this ain't legal advice but don't go to an investigative meeting (that's where you meet with a State Nursing Board investigator(s) without legal counsel). Be unNike and just don't do it! If you want to do it and you plan to do it; don't do it! You can thank me later.

8. APRNs if the complaint involves the State Nursing Board, State Pharmacy Board, or the State Office of Inspector General or Law Enforcement, call a nurse license defense attorney and don't say do I need representation just say "oh frack, we just paid property taxes, how much is this going to cost me?"

I immediately perk up when I hear someone else complaint about property taxes. I will say "really we did too! I hate paying property taxes, SOBunnies, but I don't mind paying federal, state or local income taxes. I like you and I will work with you on payment."

Hint, Hint. I am a solo and its my law firm. I don't have a laminated fee chart covered with dried ketchup from eating Chick-fil-A waffle potato fries and mouth watering droppings from an extra chicken Chipotle burrito in my law firm. No sir re, Bobby Junior, I threw it out yesterday.  I am hungry now!

I set the prices quoted for legal representation and I pull the number out of my magic hat. I can say that will cost you "one dollar, sir." No seriously, I quote "blue light special" and "bottom basement" type fees if I am drinking Pepsi and chewing Extra sugarless gum and you make me smile or laugh.

9. APRNs if you are abusing your prescriptive authority and its reported (writing scripts for friends, family members, other nurses, etc.) to the State Nursing Board, you need legal representation. Oh, you didn't now that may be construed as abusing your prescriptive authority? Snap, you need a consult. Complaint involving your prescriptive authority? You need to be repped.

10. Last but not least, scope of practice and/or unsafe practice complaints or allegations of drug diversion. Long and complex cases. You need to be repped.

This is what an APRN needs. Assistance with the licensure matter and also an attorney who can essentially serve as "outhouse" counsel for the APRN when issues arise and issues do arise.

If you are a APRN regardless of whether you are self-employed, employed by a hospital, employed by a physician, or employed by a pharmacy chain, you need to have your own Nursing Practice Legal Counsel.

Do I stand a chance if I represent myself? The Price is WRIGHT

I need help. I am getting screwed over royally by the State Nursing Board. I can't afford to hire an attorney. One attorney wanted 1500+.

Do I stand a chance if I represent myself??

------------------------------------------------------------------------------------

Thank you for your comment on my blog. As you can see, I edited your comment as you disclosed alot of information in your original comment.

Guess what?

 You are representing yourself.

You are representing yourself whenever you have a legal matter with a licensing board and you don't have an attorney. You may not realize it, but you are already representing yourself.

You are representing yourself now, you have represented yourself in the past with your dealing with the State Nursing Board, and your representation of yourself had lead to you this point. The here and the now.

Therefore I think you have enough information to answer your question which is: do I stand a chance if I represent myself?

I don't mean to be harsh but I don't think many nurses realize that you are representing yourself before the State Nursing Board anytime you don't have an attorney and you are involved in a disciplinary investigation, complaint, hearing, or application for endorsement or initial licensure and there are affirmative responses which trigger an investigation.

But I asked the Board investigator do I need an attorney and I was told no?

Really? You are not required to have an attorney for ANYTHING because there is a RIGHT to self-representation in this country. So therefore when you ask a Board investigator, do I need an attorney, the answer is no.

But ask yourself this, if you have to ask a Board investigator do I need an attorney, do you need an attorney? Probably so. 

But I didn't do anything wrong?  

This isn't Sundary, you are not at church and we are not talking about moral right and wrong. Nursing Board investigations are about alleged violations of the State Nursing Practice Act and Board of Nursing regulations. If you want to speak of and deal with right and wrong, speak with your spirtual advisor. 

If you want to know whether or not your alleged conduct, actions, or inactions violated the State Nurse Practice Act and/or Board of Nursing regulations, then come on down, you are the first contestant on the Price is WRIGHT. Call me, text me, email me, fax me, or send me a smoke signal.   

Did your actions or inactions violate the Nurse Practice Act and/or Board of Nursing Regulations? Oh, damn, I didn't look at it like that.

There are pros and cons to representing yourself.

The best thing about repping yourself is you save money and who doesn't want to save money.

The worst thing about repping yourself is you fail to be objective, you are biased, you don't see any issues with anything, you see this as a matter of right or wrong, good nurse vs. evil State Nursing Board, east coast vs. west coast rappers, Pepsi vs. Coke (let's not even go there, pumpkin with the Cola Wars today), you rationalize your actions or inactions, you minimize your actions or inactions (what about those nurses who steal drugs?) and /or frankly you can't "see me" i.e. yourself when you represent yourself. Are you Tupac?  

That's why attorneys are told to never represent themselves. An attorney who represents themselves has a fool for a lawyer and a client. We were told this in law school.

I don't have money to hire an attorney?

This is income tax refund season and you can ride through certain neighborhoods (like where I grew up) and see all the new "30 day" temporary tags on vehicles. Why? Tax refund checks. I smile when I hear I am getting "4k", "8k", or "3k" back.

But honestly I love watching the Income Tax Refund Mania from January to April of every year. Your average person goes "willy nilly" with a refund check and buys flat screens, designer clothes, etc.

Are you pimping your ride, your home, or your kids out with your tax refund this year? I have a better idea.

Why not use your income tax refund to hire a nurse license defense attorney? As a bonus, this also helps to stimulate the economy because I am going to Walmart, Big Lots, Bob Evans, and Kenwood Mall for clothes and shoes. I may also gamble a little and help the ecomony in Indiana as well. I may also get a manicure; I can't do tips or any artificial nails because I type alot and hard.

Do you know I type so hard the letters are missing from my most used keys on my external keyboard? I know. I can't wait until Spring so I can start walking outdoors again, kicking trees, breaking sticks and branches, and throwing rocks at passing cars until I am tired again.

No seriously, if I am talking to a client and typing at the same time, I will hear, "oh my God, that's not you typing is it?" I will say no, that's just me eating a ear of corn.

Okay back to my point, you can't afford NOT to hire an attorney at this point. Your attorney can't change the past but the attorney can counsel and advise you going forward on your options so that you are making informed decisions.

If you are going to rep yourself, put your options (oh, you may not know your options because you are repping yourself) in a magic hat and pick one. Or flip a coin, "heads" I met with the State Nursing Board investigator without an attorney "because its just an investigation" or "tails" I bring my best friend who is studying to be a legal assistant with me to the meeting.

This way with the magic hat or flipping a coin, you can blame "everything that happens thereafter" on "chance" and not your decision to retain legal counsel at the beginning or initial stages of the State Nursing Board matter.

In all seriousness, the slightest discipline against the license can have long lasting implications and consequences on a nursing license. Hire an attorney to work with you throughout the process and to be on your team throughout your nursing career. Consider having Nursing Practice Counsel.

We are getting to the point with the legal, regulatory, clinical practice, employment, and other issues in nursing where I think RNs especially APRNS should have their own personal legal counsel for practice issues like physicians. But that's another post.