Nursing Law & Order

Ohio Medical Board's Resolution Regarding Prescription Drug Abuse: And So It Begins!

Thanks, Jack "The Smack" Stem at http://www.peeradvocacyforimpairednurses.com/why.html for emailing this to me yesterday.

Everything that has a beginning has an end, Neo. http://www.youtube.com/watch?v=orXDu3Stb-c

The Ohio Medical Board issued a resolution regarding prescription drug abuse last week.

See http://www.med.ohio.gov/pdf/PrescriptionDrug%20Abuse.pdf.

See also http://www.zanesvilletimesrecorder.com/article/20110311/NEWS01/103110309/DeWine-Ohio-medical-board-must-fight-prescription-drug-abuse-harder for an idea of what's coming for licensed healthcare professionals with prescriptive authority like MDs and APRNs.

Why is this important for nurses?

* Nurses who are prescribed controlled substances by their physicians or APRNs and practice nursing. Its a balancing act yet I don't think there is an appreciation of the risks and liabilities for nurses who take "prescribed" controlled substances and then report to work or who take meds while at work; and

* APRNs in private practice or who work for/with docs in private practice and have prescriptive authority. The State Medical Boards and State Nursing Boards go hard in these cases and unfortunately the majority of docs and nurses will represent themselves with the "I didn't do anything wrong" defense.

More about the "I didn't do anything wrong defense" and how it applies to me this week.

Guess what? I saw this coming two years ago and put together a webinar sponsored by the Center for American Nurses titled:

A Balancing Act in the Workplace, Managing the Risks When a Nurse Takes Prescribed Medication

This is one of my fav. Center webinars and I provide this CD to clients.

See http://www.can.affiniscape.com/storelistitem.cfm?itemnumber=13

What are you saying LaTonia? Just give it to me straight without the legal mumbo jumbo.

If you are a nurse (RN, LPN, and APRN) and you are prescribed controlled substances for chronic pain, a nurses back, etc.; is this affecting your nursing practice? What are the risks and potential liabilities for you and your nursing practice? Remember you are your own risk manager on Nursing Law & Order; this isn't Nursing Law & Disorder, not yet anyway.http://advocatefornurses.typepad.com/my2cents/2011/03/the-plan-do-you-need-assistance-with-revising-reviewing-or-developing-the-plan-we-can-help.html

If you are APRN with prescriptive authority, what does this mean for your nursing practice? How can you develop strategies to protect your nursing practice and your nursing license with the "heat" being placed on prescriptive drug abuse?  http://advocatefornurses.typepad.com/my2cents/2011/03/the-plan-do-you-need-assistance-with-revising-reviewing-or-developing-the-plan-we-can-help.html

Allegations involving the inappropriate prescribing of controlled substances are complex because multiple state, federal, and/or national agencies or groups are involved on various levels. The implications for MDs and APRNs who prescribe and for LPNs, RNs, and APRNS who use controlled substances and practice are really starting to take shape in the last 3 years. Get ahead of this issue if this applies to you and your nursing practice, its risk management, baby!

This isn't an issue where you want to be caught with your pants down with the pics on FB and the video U-Tube. Be proactive and manage the risk and if you need assistance managing the risks, seek assistance. This is just how licensed healthcare professionals should roll!

 

 

 

Alcohol Use vs. Alcohol Abuse vs. Alcohol Dependency: State Nursing Board Renewals and DUI, OVI, or DWI. DEATH by Evaluation!

Nurses if you have been charged or convicted of a DUI, OVI, or DWI and you have to renew your Ohio RN license, Indiana RN license, and/or Kentucky nursing license (RN or LPN) this year, consult with an attorney.

Schedule an appt. with a nurse license defense attorney to discuss your situation before you self-report to the Ohio, Kentucky, and/or Indiana State Nursing Boards. This isn't legal advice because you didn't pay me to say this its just plain common sense.

Why would you self-report "anything" to the State Nursing Board without speaking with a nurse license defense attorney? Okay, I know I am biased but really? Would you walk into a police station and "confess" and admit to committing a crime verbally and in writing? Probably not, so why do nurses self-report to the State Nursing Board when anyone and everyone including but not limited to Direct TV  Service Technician to their friends tells them its the right thing to do. Its the good thing to do.

WTH, does that mean anyway? Save right vs. wrong for the 8 hour graduate level symposium on Ethics and Morality and Nursing's Social Policy Statement. Save good vs. evil for Sundays and you are welcome to join me at 8am service at a Baptist church.

You are not Luke Skywalker (actually Luke is here with me. My dog's name is Luke Skywalker and he uses the force on mommy) and the State Nursing Board or Alternative to Discipline Program in Ohio, ISNAP, or KARE does not represent the Dark Side of the Force. Let's turn it down a notch and focus on the issues.

1. You are a licensed nurse.

2. You were charged and/or convicted of a DUI, OVI, or DWI.

3. You may have been charged with other crimes along with the DUI, OVI, or DWI.

4. You are practicing as a nurse.

5. You are receiving more "helpful" advice from family, friends, foes, and strangers than a politician caught in a whorehouse.

Speak with a nurse license defense attorney about your situation. There are license defense attorneys in every state, see www.taana.org.

Don't fire off the 25 page handwritten letter to the Board (that you don't keep a copy of for your records) disclosing everything you have done right vs. wrong and good vs. evil since the 6th grade. 

You need advice and counseling and maybe representation. This is the role of a state licensed attorney just like its the role of state licensed nurse to provide nursing care. Don't bootleg it! 

I offer 40 minute legal consultations for nurses with licensure renewal issues. You can pay for and schedule the legal consultation online. This is for nurses licensed in Ohio, Kentucky and Indiana. I am licensed to practice law in these states only.

Also, a nurse emailed me this weekend and inquired whether I could obtain a license in State C and represent the nurse. The State Nursing Board applications for licensure pale in comparison to the Attorney Licensing Applications and the Character & Fitness Interviews. The Bar Applications make you cry like you are running a 10 mile marathon in a size 5 pump and you wear a size 10, in gym shoes. Yes, we have to interview!!!!

I have NO plans to sit for another bar examination or regurgitate every speeding ticket since age 16, discuss my credit report and score and why I was late 30 days late paying my Spiegel's charge 20 years ago (I loved Spiegels), and disclose every civil, criminal, administrative matter, case, issue, or thought or anything remotely legal (this includes purchasing a hotdog at the food stand next to the court house) and not to mention mental health issues on a State Bar Application for Licensure as an Attorney. 

When I say NO plans, I mean never ever neverland Peter Pan. Three Bar Exams, Three Bar Apps, Three Bar Charter & Fitness interviews, and Three times passing the Bar on the first try. I am stopping while I am ahead.

I am sure you have heard of Death by Meeting? Okay, I am writing an e-book titled DEATH by Evaluation and self-reporting is Chapter 1.  

Why? Hell just from my posts on this blog, I am sure the Bar Examiners if I wanted to apply for a law license in another state would want a psychiatric evaluation (forensic nonetheless) and maybe a fitness for duty  (I am sure my employer would not object:) not to mention maybe a chemical dependency evaluation because of my references to Long Island Iced Tea, Moscato, Bartles & James wine coolers (traditional, berry, or strawberry), Miller Lite and Miller Genuine Draft vs. Bud Light vs. Keystone Light (hint: only if your money "ain't" right this week) and my fav, Martini & Ross Asti Spumante over the years.  Also I have lost 35 pounds since November 2010 so they may want a medical evaluation or a return-to-work evaluation (before I can step foot in my home office or my traditional office) as well. After speaking with one or more of my clients, they may also want a behavioral examination.

Okay, I am just kidding here but you get my point about self-reporting without obtaining objective advice and counseling, right?

Oh, snap, the link for the License Renewal Application consultations:

http://www.bookfresh.com/profile/157503739

The cost of a 45 minute legal consultation (conference call) for 2011 nursing license renewals in Ohio, Kentucky, or Indiana is $225.00.

 

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.

 

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.

 

Bills, Bills, Bills, and more damn Bills: I don't have money to pay for a legal consultation

Okay, January is always a rough month for most of us because credit cards statements come in from the manic shopping sprees not to mention property taxes in some states (like Ohio; we just received the property tax bill for our rental property), grade school or college tuition payments, estimated tax payments (don't even get me started), and other bills.

Its Bills, Bills, Bills, and more damn Bills in January. What a way to start the year, right? But unless you are filthy rich, bills, bills, bills  and more damn bills is part of ordinary life.

However bill, bills, bills should not put on in an "analysis paralysis" and stop you from seeking legal advice and counseling.

How do you know that you need legal advice and counseling and maybe representation despite bills, bills, bills, and more damn bills?

1. You receive a Notice of Complaint from the Kentucky Nursing Board and you slap your husband in the face because you think he mistakenly filed the divorce petition (you have been waiting on) with the Kentucky Nursing Board;

2. You receive a phone call from an Ohio Nursing Board investigator. You return the phone call after you "smoke" because you want to be "loose.";

3. After a bar brawl, which was not your fault, although you have a BAC almost corresponded with your college GPA (non-nursing courses of course)  you tell the arresting officer and every officer in the station that  "I am a RN at ______ Hospital on the ____ unit and I am going to have your badge" so many times that the Chief of Police contacts the State Nursing Board to verify that you are really a nurse because according a bartender you can "throw a mean right hook"; and

4.  You appear for your licensure reinstatement hearing before a Board Hearing Panel with "an attitude."

Even if you have bills, bills, bills, and more damn bills, you may have to go  "cheap and dirty to get the skinny." Get your mind out of the sewer, this is a legal blog.

Cheap and dirty is a legal consultation. Its cheap because you are spending a hundred dollars or so for a consultation vs. several thousands for a retainer or flat fee for traditional representation.

Its dirty, not in the filth sense of the term, but dirty meaning "worse case scenario, best case scenario, and everything in between" that you can obtain in 30, 60, or 90 minutes; almost like a speed date. The skinny = options.

Bite the bullet and seek a curbside legal consultation if you have burning questions or issues related to your nursing practice or license. Yes, it going to cost you money, but your sanity and your piece of mind are: priceless.

I wish I could help everyone who contact me; I really wish I could help everyone. Jack reminds me all the time that we can't "save" everyone. I want to save everyone even if its from themselves; this is the nurse in me. I know it because I want to help everyone who contacts my office.

However I cannot provide legal advice or counseling without establishing an attorney-client relationship: either as a legal consultation or retaining me for a traditional attorney-client relationship. This requires the payment of a fee.

Bills, bills, bills, and damn more bills.

 

 

This is it! RN and APRN License Renewal with the Ohio Nursing Board is coming soon....

My hands are itching. There is an old saying that if your hands itch its because you have money "coming your way soon."

Maybe I need to use more lotion but I think its because this is a license renewal year for RNs licensed by the Ohio Nursing Board. Requests for legal consultations are "off the hook" and "off the chain" in RN and APRN renewal years with the Ohio Nursing Board.

I am also having more consultations with respect to the Kentucky Nursing Board renewal application (annual) and the mandatory reporting of criminal convictions to the Kentucky Nursing Board. The Indiana Nursing Board is also kicking up dust, sand, and rocks with its renewal application questions, especially the one which asks "have you ever been terminated, discharged, or demoted in a nursing position?" Really!

I can tell you what I know and it ain't much.

1. The license renewal applications for the State Nursing Boards are changing and becoming more specific in reference to criminal convictions. Yes, I am sure the Ohio renewal app. will still have the moral turpitude language which includes everything, your socks, and the kitchen sink but there is a trend now towards specific and direct questions related to the disposition of criminal cases.

2. There are alot of nurses who are not (for whatever reason) truthfully responding to renewal applications and this is a problem. Big problem. It may catch up with you. Maybe you should speak with a license defense attorney to discuss the criminal case disposition and obtain a definitive response on whether or not "something" needs to be reported to the State Nursing Board.

3. Don't rely on the advice and counseling given to you by a criminal defense attorney UNLESS your criminal defense attorney is also a license defense attorney. Your criminal defense attorney may know his way around the courthouse but unless your criminal defense attorney practices before the State Nursing Board and is familiar with nursing law and practice (Nursing Law & Order, baby), your criminal defense attorney CANNOT and SHOULD NOT advise you on how the disposition of the criminal case will impact your nursing license(s), employment, career, and educational goals. Yes, damn it, I said it again this year.

Consult with a nurse license defense attorney if you are charged or indicted in the criminal court system for ANYTHING except a traffic ticket like speeding. Yes, pumpkin, this includes DUIs/OVIs/DWIs. Don't wait until your crim case is resolved before you start thinking about your license and your career.

4. Last but certainly not least, multi-state licensure. I am going to talk more about this in future blog posts because I was presented with a case, a very complex case, which touched on licensure issues before the Ohio, Kentucky, and Indiana State Nursing Board. I quoted a high fee because the case was complex. But actually complex is starting to become the new norm in license defense cases.

If you are licensed in multiple states and you have licensure issues try to obtain an attorney licensed in one or more of those states. Don't have three different lawyers (if you can prevent it) representing you before Ohio, Kentucky, and Indiana State Nursing Boards. It just doesn't make sense. Do your research, take your time, and find an attorney with the license and qualifications needed for your license defense case.

4. Endorsement Applications for Licensure in a State. If you have to make affirmative responses on your application for licensure by endorsement, talk to a license defense attorney before you submit your application to get an idea of what to expect. Don't go into the process with a towel over your head and then become upset when you run into a wall.

Just Sign and Date on the Dotted Line!

There are alot of nurses or NCLEX Applicants who receive a Consent Agreement, Agreed Order, Consent Decree or another legal document from the State Nursing Board and just sign and date on the dotted line.

There is nothing from with just signing and dating on the dotted line but keep this is mind:

1. A Board of Nursing Agreement, Contract, or Addendum is a legally binding document between you and the Board of Nursing;

What is a contract? http://en.wikipedia.org/wiki/Contract

2. Make sure you understand the short and long-term consequences of what you are signing. Understand the who, what, when, why, and where of the Agreement or Contract;

3. Consider reviewing the Agreement and making notes. Then re-reviewing the Agreement and making additional notes and questions. Those questions should be answered (either by discussions with Board of Nursing staff, your own research, speaking with other nurses, or consulting with a license defense attorney) before you sign on the dotted line; and

4. Where do you see yourself in 30 days, 90 days, 6 months, 1 year, and 5 years after you sign on the dotted line?

As nurses, we enter into contracts everyday without a second thought when we sign up for a credit card, refinance a home, purchase a vehicle, etc. We are also accustomed to signing our name on legal documents: the medical record and patient or resident chart is a legal document also.

Just a note of caution. Before you just sign and date a legal document you receive from the State Nursing Board, pause and consider the consequences and implications of your signature.

Also stating you signed the State Board of Nursing Contract while intoxicated or under duress are not affirmative defenses in administrative law and license defense cases to VOID the contract.  

What kind of duress is needed you say?

* you were in a warm, small, and dimly lit room @ the State Nursing Board office for 15 hours which smelled of motor oil;

* you were not offered food or water for those 15 hour; although you were given two Tic Tacs q 15 min x 1 hour; q 30 min x 2, then q 1 hour thereafter;

* you were not permitted to leave the room as staff blocked the exit;

* your requests to use the bathroom were denied but you were given a gently used Chux; 

* you were not allowed to apply lip balm (which for me crosses the line);

* your cell phone was in front of you but you were not allowed to touch it; This drives you insane and you start pulling at your hair (I would anyway) because you received at least 185 emails, texts, IMs, pics, and/or calls (I do) in 12 hours; and

* you are emotionally distraught because you only placed a quarter in a downtown parking meter.

Then you finally scream out in pain (because let's face it no caffeine or Extra Classic Bubble gum for 12 hour is pain) and utter exasperation and despair (because you want to make it home to watch the Walking Dead marathon on AMC) yes, damn it, yes, I did it! I can't live with this anymore!

I can't take it? I will do whatever it takes, to resolve this now?

I confess to violating the State Nurse Practice Act while employed at Crappy & Uncaring Memorial Hospital; just give me the fu*%ing Contract, and I will sign and date on the dotted line.

Happy Holidays from me to you and your family.

 

Ohio Board of Nursing: Notices of Opportunity for Hearing issued November 19, 2010. Is it hot in here or is it just me?

I am looking through the Notices issued at the November 19, 2010 Board meeting last month this afternoon. Holy Moly Batman!

What initially struck me was the number of the Notice cases in which the nurse or DT doesn't have attorney representation. Notice cases are the more serious cases before the Ohio Nursing Board and the majority of the nurses in these cases don't have attorney representation.

Also what struck me more so than in other months with Notices cases were the severity of the allegations in the November 2010 Notices. I haven't seen cases this serious since Sept. 2010 when I believe the Board issued 90 Notices and I posted on this blog.

The November 2010 Ohio Nursing Board Notice cases included:

1. Illegal Processing of Drug Documents and Theft of Drug convictions;

2. Felony convictions which trigger the ever-expanding moral turpitude standard.

If you pass gas in the check out line at Kroger's (a few hours before a major snow storm) and you fan it to the person in the back of you is this considered moral turpitude?

I think it should be as this is what happened to me over the weekend. I didn't appreciate it one bit.

3. Fact intensive misdemeanor convictions;

4. One individual is noticed who allegedly did not graduate from high school but has a DT and RN license.;

5. A "hit and run" or two;

6. Several positive drugs screens with no legally valid prescription;

7. Board of Nursing action in another state;

8. Falsifying renewal and initial applications for licensure;

9. NCLEX Applicants with criminal convictions;

10. Professional Boundaries;

11. Home Health fraud and documentation issues;

12. Professional Sexual Misconduct;

13. Unsafe nursing care allegations; and

14. garden variety practice issues and mishaps which are reported to the Board.

I recognize some names as nurses who have contacted my office. I have a good memory and sometime all it takes is the full name or a glance at the allegations in the Notice. A quick search of our SAAS law practice management system confirms this. I then compare my initial notes and documentation with the information in the Notice. Interesting!

I saw one case in particular that I have been expecting to see. This person contacted my office when already represented by counsel seeking answers to questions. I referred the individual back to his/her attorney of record. Don't try to pay for a $150.00 consult with me (to answer questions the attorney you retained should answer) when you have already paid another license defense attorney a retainer fee. Not here, boo boo.

I quoted the individual a high fee because I knew the case was complex and the nurse was a shopper. By a shopper, I mean a person who contacts multiple attorneys for advice, counseling, and possible representation or a nurse who has been represented by several attorneys.

Shoppers are a red flag for representation because the things they say about their former attorney (1st or 2nd attorney) will be the things they say about me (their 2nd or 3rd attorney) to the attorney they hire after I terminate them or discharge them or they discharge me (3rd or 4th attorney).

Speaking of red flags, I just terminated a client who I spotted as a "red flag" initially but the facts of the case were so very interesting. I take on a limited amount of red flag cases. What are red flag cases? I will post on this later in the week.

Back to shoppers. I can spot these folks a mile away and I quote high fees. I have had more than 10 shoppers this year and I can remember them all by the fact patterns.

Also looking at 2010, I can tell you I am seeing more and more complex cases involving the State Nursing Board(s). I am seeing more issues with falsification of renewal applications, criminal convictions and practice issues with LPN and RNs and I am seeing more complaints being filed against APRNS in Ohio, Kentucky, and Indiana.

Now, back to the Bat Cave!

 

Your State Nursing Board Complaint is coming and just like Christmas its only 3 weeks away!

You work in a very busy ER in the downtown of a mid-size city. You are a seasoned ER nurse and you have worked at this facility for 12 years. The last 2 years have been rough however. You divorced from your spouse of 15 years last year in 2008 and have shared custody with your 5 kids ages 15, 10, 7, 4, and 2. Also your elderly parents live in the area and you take on the primary responsibilities of keeping them in their home through a combination of home care and other social services. You have one sibling, who lives in another country and only returns to the country every three to five years to visit.

You received a verbal warning in January 2009 for being rude to a patient who was in the ER with drug seeking behavior. In May 2009, you were wrote up for the inappropriate remarks and verbal tongue lashing you gave a floater nurse who was "moving to slow" during a code situation.

You written up in July 2010 after being a verbal swearing match that almost turned physical with a nursing house supervisor related to the process of admitting ER patients. There were conflicting accounts of staff of what actually happened but you were viewed as the aggressor and a fitness for duty was ordered. You were evaluated and you followed the recommendations. You return to work after a 3 week paid leave and you are welcomed back by the nurses, docs, and other staff in the ER.

A pregnant woman comes in to the ER with her husband. The women is having chest pain. Within 20 minutes of her arrival to the ER, several of the couples friends, family, and colleagues also arrive at the ER.  This is the couples first pregnancy. They were married two years ago and both have successful careers as pharmacists. The woman is 4 months pregnant.

While you are assessing the woman, she tells you she is nervous and scared. You tell her "Honey, I have 5 kids and this is nothing. Just wait and you will see, this is only the beginning."    

You arrive at work the next day and find the ER Manager, the Assistant CNO, and HR waiting for you. They ask you about your care of the pregnant women. You recount your care and state there was nothing out of the ordinary as the woman was admitted for observation. They ask about your statement about "this is nothing" and you say it was taken out of context and you were only trying to help calm her down.

They tell you that you are being terminated effective today, December 4th for being rude to a patient. They tell you this incident as well as the previous infractions are being reported to the State Nursing Board. They also tell you that the pharmacists are really upset and are also planning to report you to the State Nursing Board.

Its December 4th. You have been terminated from your employment and reported to the State Nursing Board. You don't have your own professional liability insurance policy because you didn't think you needed it. Its Christmas time and you certainly don't want to spend any money on hiring a lawyer because you didn't do anything wrong here as this is ajust a  misunderstanding of the worst kind.

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

1. Should the employer report her to the State Nursing Board?

2. Do you think she violated the State Nurse Practice Act, Board Regulations, or any professional standards?

3. Do you think her termination was fair? She is of course at-will employed.

4. Do you think she should hire a lawyer now to represent her in the State Nursing Board case which is coming just like Christmas?

5. What are the personal issues here?

6. What are the professional issues here?

7. What are the goals for the future?

I consider myself as a license defense defense attorney to be "a clean up woman." http://www.youtube.com/watch?v=vh-2_kdVcyA. No, honey, I am not stealing anyone's man (I have my own) but I am legally responding to what happens when a variety of "shelved" factors collide and the results (whether intended or unintended) are complex and may include but not limited to personal, financial, emotional, professional, licensure, criminal, employment, civil (med mal), mental health, regulatory, workplace, credentialing, or privileging stressors or events.

Sometimes, just sometimes, the license, while the obvious concern in a State Nursing Board complaint investigation and adjudication, is really not "that important" when everything else is considered.

I will give you an extreme example. If you are the Black Swan (which damn it I CAN"T WAIT to see. We may drive to Indy or Columbus to watch next weekend) and you have an active and valid license to practice nursing, the question is not can you practice but should you practice? http://www.imdb.com/title/tt0947798/  Maybe there are somethings you need to do for yourself before you should practice although you can practice now. This is the hallmark of a professional putting the needs of the industry you serve and service before your own needs, wants, and desires.

So what are you saying LaTonia. As a nurse license defense attorney, I will you tell; your license is important but there are always things more important than your nursing license right at this given moment. Sometimes its my role as your attorney to help you see this.

 

 

 

The writing is on the wall but you are pretending you can't read it: Is it time for you to develop an "exit strategy" with your current employer?

Sometimes its time to move on and for some of us RNs and also LPNs we adopt a philosophy of the following:

1. Its my unit;

2. Its my hall;

3. These are my residents;

4. I am innocent and I didn't do anything wrong so why should I leave;

5. I will "wait it out" until this DON, administrator, unit manager, CNO, etc. leaves;

6. You are right and they are wrong and you are staying here to prove a point and based on your principles;

7. Any other excuse we make to stay in a position we now isn't working out.

If its not working out for you, then move on. Its just that simple. Apply for other nursing positions with the same, similiar, or better pay, benefits, and hours and move on. Its your nursing license that's important not your employment with a specific facility because they will "term you and report you to the State Nursing Board" faster than you can say "But I have worked here for 10 years as a RN, 3 years a LPN, and 5 years as a CNA."

The writing is on the wall but you are pretending you can't read it.

I know you have friends and colleagues who you have worked with for years or decades but sometimes its time to move on and I see this with alot of nurses I speak with in legal consultations or representation.

You can't spot the signs, then I can for you. Schedule a consultation with my office and we can talk about it. No job (and its essentially what you have with your current employer) is worth being terminated and then reported to the State Nursing Board. You are a nurse and you can nurse anywhere in your state not just with your current employer. I can assist you with your exit strategy and I do it routinely.

Don't adopt a "do or die" or "do or die trying" approach if you are working in a dysfunctional nursing environment. Cut back to part-time or prn to keep your foot in the door and then secure employment elsewhere.

Honestly this is why I never worked as full-time RN with any facility because of the drama and the work environment you experience when you work in a female dominated profession like nursing. Its a roller coaster ride. I always worked part-time or prn with one or more agencies because if I want FT drama and soap opera like behavior I get plenty in my large extended family (the majority of us live within 10 square miles of one another); I don't need drama at work also.

Don't get caught up in the unit drama or if you are caught up in it, then recognize you are caught up and you need to transfer to a different unit or change employers. These types of work environments drain your energy and you are consumed with negativity which then starts to flow in your personal life and personal relationship.

 

 

I am not Willy Boo Boo! The truth will set you free. However retain a lawyer first.

Growing up with my cousins and we would role play with props. We would play for hours together and imagine ourselves on the moon, sailing across the seas on a pirate ship, or as super heroes saving the world from injustice. We had vivid imaginations. When one of us said something so unbelievable and so preposterous even by 8-10 year old standards, some one would yell "I am not Willy Boo Boo."

Who is Willy Boo Boo? Willy Boo Boo is a fictional person of course who believes anything and everything he is told without question. You said it so therefore it is and must be the truth.  

As a nurse license defense attorney I certainly cannot be a Willy Boo Boo because its not in the client's best interest. Sometimes I am thinking "I am not Willy Boo Boo" but I can't say this. I just seek clarification and independent means to verify a particular statement and establish facts. I am searching for the truth like Neo was searching "something" in the first  Matrix movie. (I watched the Matrix this weekend on my I-pad).

I have been told there are three versions of the truth: yours, mine, and the actual truth. The actual truth being an unspoiled, untouched, unblemished, and unadultered version of facts located somewhere in the middle of a closed room without ventilation filled with a thick and impenetrable green fog of teenage flatulence, carbon monoxide, and cigarette smoke.

The truth will set you free. http://wiki.answers.com/Q/Who_Said_The_Truth_Shall_set_you_Free. Amen, if I am at church.

"The truth will set you free. But not until it is finished with you." http://www.goodreads.com/quotes/show/18719. I really like this one.

How about this one? The truth will set you free. However retain a lawyer first.  

 

My Criminal Defense Attorney contacted the State Nursing Board and was told........

If you are a nursing student or a LPN, RN, or APRN and you are charged with a misdemeanor (unless its strictly a traffic infraction. DUI/DWI/OVI ain't just a traffic infraction) or a felony, you probably have an attorney whether its a public defender or a criminal defense attorney you retained to represent you.

I know you probably don't want to spend anymore cash but you need to speak with a nurse license defense attorney also about your situation.

What is a license defense attorney? See Download Licensedefensebrochure

I have had multiple consults with nurses who were convicted of misdemeanor(s) or felony(ies) in the last 3 months who told me "my criminal defense attorney contacted the Board of Nursing attorney and was told" one of the following:

1. Nothing is going to happen with this;

2. The case will be reviewed at a later date;

3. It depends;

4. We may be in touch with the nurse.

The Board staff are not being evasive, IMO. Its not that cut/dry to provide a definitive answer on the spot without a complete picture of the facts, criminal case history, and records. Also its not the role of State Nursing Board staff to tell your criminal defense attorney what can, may, might, should, would, or could happen after you are convicted of a state or federal crime.

Then the nurse receives a Notice of Opportunity for a Hearing from the Ohio Nursing Board or receives a Notice of Complaint from the Kentucky Nursing Board or the Indiana Attorney General Office of behalf of the Indiana State Nursing Board.

This is why you need to speak with a license defense attorney who practices before the Board because a license defense attorney can tell you more precisely where this is going based on his/her experience and what your options are before you accept a plea or after you accept a plea in a criminal case. Criminal convictions, licensure, and employability are the second Bermuda Triangle in nursing IMHO right after the application of nursing law, ethics, and professional standards in the nursing workplace. Did you know I published an article on the same a few years ago? See http://www.ncbi.nlm.nih.gov/pubmed/18524302.

Healthcare licensing boards across the country are asking about criminal convictions on licensing renewal applications and may also require criminal convictions to be reported to the Board within 30, 60, or 90 days of a conviction.

If you want to know "what's up" with your license, then you need to speak with a nurse license defense attorney in your state or jurisdiction. See www.taana.org.

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.

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.

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

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

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

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

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

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

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

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

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

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

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

Kentucky Board of Nursing

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

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

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

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

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

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

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

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

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

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

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

Overwhelmed with compliance with a State Nursing Board order, agreement, or contract? Settle down, tuck in your shirt, and iron your skirt!

Some of my time as a nurse license defense attorney practicing before the Ohio, Kentucky, and Indiana Nursing Boards involves compliance: working with nurses who are probation with the Nursing Board or working with nurses whose licenses are suspended and meeting the terms/conditions for reinstatement of the RN, LPN, or APRN credentials.

Please keep the following in mind if:

1. your license is suspended and you are working on reinstatement

2. your license is probated; or

3. your license is monitored in an Alternative to Discipline program for Substance Use/Abuse:

A. Nursing Board staff are Nursing Board staff. Don't get it twisted. Again, Nursing Board staff are Nursing Board staff. Nursing Board staff function within their position and job descriptions. The role of the State Nursing Board is public protection and the job descriptions of Nursing Board are written and drafted with this premise at heart.

B. Its not the role of Nursing Board staff to counsel or advise you on your options. Just like the Nursing Board staff can't represent you before the State Nursing Board, the Nursing Board staff cannot counsel or advise you on your legal options.

C. Nursing Board staff may also be nurses but guess what? Nursing Board staff are nurse regulators. Its not the role, function, or job description of State Nursing Board staff (Board attorneys, investigators, compliance agents, monitoring agents, etc.) to advocate for ANY individual nurse. Again don't get it twisted thinking "I'm a nurse, you are a nurse, and things are all peachy and creamy." I am on a diet but I really want some ice cream, now!

D. There is thin line between general information and education about a topic and giving legal advice IMHO whenever a nurse has a regulatory, license, criminal, malpractice, or employment issue. Everyone and their momma wants to give what I think is "legal advice" and preface it by saying "I am not a laywer but..." Stop relying on the bootleg "legal advice" given to you by counselors, therapists, colleagues, friends, family members, etc. Only a state licensed attorney can you give legal advice and counseling and representation before the State Nursing Board.

E. You have an Agreed Order, Adjudication Order, Board Order, Consent Agreement, or some other legal document which resolved or adjudicated the pending complaint(s) against your license. This document is a contract. You may need assistance complying with the terms/conditions in the contract. Retain a lawyer because there is only sooo much info you can obtain on a fishing expedition (calling different attorneys and asking questions) or asking questions on the online nursing forums.

F. If you are facing discipline against your license or your license has been disciplined and you need advice and counsel, then you should retain a license defense attorney. No ifs, no ands, and no buts. Stop asking everyone what you should do and hire an attorney to assist you and guide you through this process.

G. There are alot of nurses who throw in the towel and surrender their license out of frustration dealing with the State Nursing Board related to license reinstatement, probation, and/or monitoring. Lots of my clients attend NA/AA meetings and are discouraged when they meet other nurses who tell them "its not worth it dealing with the State Nursing Board", "you might as well give up your license now because...",  "I was on probation with the Board for 6 years and I didn't do anything wrong but forgot to submit a few papers and...."

I remind my clients most if not all of those nurses didn't RETAIN and have a nurse license defense attorney working with them throughout this process. Don't throw in the towel because you worked hard for your nursing license. I know I did! Before you say frack it, hire a nurse license defense attorney to assist you.

I tell my nurse clients to settle down, tuck in your shirt, and iron your skirt because we are going to be together for a few years working this out. Its just the nature of the beast in some of these State Nursing Board complaints and cases.

Like Hillary Clinton, we are in it to win it. Yes I know what she didn't "win" the first round, but there is always round 2,  round 3, and round 4. That's why you need a lawyer in these cases to see the forest when you are surrounded by trees and some of the trees have only superficial roots, are weak because of the lack of water and nutrients, and are ready to fall at any given moment.  

My clients know even after their Nursing Board case is resolved to call me for anything license, regulatory, career, workplace, employment, criminal, or anything indirectly, directly, or remotely related to the RN, LPN, or APRN credentials. That's just the way we roll here. You need to file a grievance against your current employer, call me. You got fired and you want to vent, call me.

As matter of fact, call me first when something happens even if its 5 years post-Nursing Board probation. My contact info is the same and I am ready and waiting for your call:)

Are the allegations in your State Nursing Board complaint as complex as a John Grisham novel? Then here is your sign and you need a lawyer!!

I am seeing more new grads being reported to the State Nursing Board and complaints that are much more complex than 3-6 years ago.

Money is tight for most in this country now. I know alot of nurse license defense attorneys in Ohio, Kentucky, and Indiana and across the country and I don't know any attorneys who work for free or pro bono in these types of cases because the cases are long and tedious. Its administrative law and to be expected.

If you need to hire an attorney borrow the money from a friend, relative, or pull it from a retirement or savings account. Maybe you should postpone the family vacation which may be the last vacation if your license is restricted or revoked anyway because of your failure to appreciate the seriousness of the charges and allegations at hand.

We just paid an attorney to draft our estate plan. It costs money but its money well spent in the big scheme of things. So many nurses will say "I cannot afford an attorney" when the phrase should be "this is my license and my livelihood and I cannot afford not to have an attorney."

Complex and a fact pattern from a John Grisham book=attorney representation.

How do you know if your case is complex and complicated? Contact a license defense attorney. Any attorney who practices in the field should be able to give you the "skinny" on what you are facing when defending your license before the State Nursing Board.

Also if your case involves anything of the following you really need to speak with a nurse license defense attorney ASAP:

1. Substance Use and Abuse or Theft of Drugs. Anytime, I mean anytime you are stealing drugs you need a lawyer, NOW, and I mean like yesterday. Theft of drugs is a felony and this cases are long and resolve over an extended period of time; think years boo boo not days, weeks or months.

a. If you stole drugs from work and you are a nurse=retain a license defense attorney

b. If you deny stealing drugs from work and you are a nurse=retain a license defense attorney

c. I am trying to make a point here because I see so many nurses who have a substance use and abuse disorder repping themselves before the State Nursing Board, sometimes with success and alot of times with anger, frustration, and eventually leaving the profession. Spend the money and retain a lawyer. Nurses will drop several bands (that's slang for one thousand dollars) on a vacation, private school child, college for an adult child, or for a home remodel but will not in general make the same or similiar type of investment in themselves for legal representation, counseling, and advising which allows one to maintain the license, livelihood, and a career.

2. Prescription medication and suspected impairment;

3. NCLEX-RN or NCLEX-PN Applicant disclosing criminal, mental health, or substance abuse info to the State Nursing Board;

4. Misdemeanor or Felony Conviction(s) and License Renewal and Initial Application for Licensure;

a. If you are a LPN and working on your RN or if you are a RN and working on your APRN and you have a complaint pending against your license with the State Nursing Board, hire a lawyer.

5. You reportedly failed to establish and maintain professional boundaries with a client, patient, or family member;

6. Professional Sexual Misconduct;

7. Cognitive, Mental, or Behavior Impairment and Unsafe Nursing Practice Allegations;

8. Allegations of Falsfication, Destruction, or Tampering with Documentation or Falsification of a License Renewal Application;

9. You are licensed in several states by endorsement and you are facing investigation in one or more states;

10. You are a nurse practicing in Compact State and being investigated by another State Nursing Board outside of your Home State;

11. You test positive for a medication or drug and you don't have a script;

12. You allegedly practiced outside of your Scope of Practice. Scope of Practice allegations are serious and please don't blow these off;

13. You have prescriptive authority and you have prescribed outside of your legal boundaries;

a. If you are a APRN and you are reported to the State Nursing Board for anything, you need a lawyer. This includes CRNAs, CNMs, CNS, and NPs.

b. If you are a APRN, hire a lawyer because discipline can impact credentialing and privileging and has alot of consequences for your career that may not be readily apparent now.

14. Medical errors which result in patient harm or death;

15. Any action or inaction that results in patient harm or death;

16. You are being investigated by two or more State Nursing Boards or you hold licenses in several states;

17. You are charged with a felony or misdemeanor, you may plead to a lesser offense, and you don't know what it means for your license;

18. You are a dually licensed professional, meaning in addition to being a RN or LPN you are also a RT, OT, PT, MT, therapist, counselor, dentist, or you have independent provider. Action against one license impacts the other license so get an attorney involved in the beginning of the first investigation. For example if you are a RT and a RN. If you RT license is disciplined then this must be reported to the State Nursing Board and this starts another investigation.

19. You are being encouraged to "self-report" to the State Nursing Board by your employer or a former employer

20. You are a new nurse (0-3 years) and a complaint is filed against your license with the State Nursing Board.

Call my legal assistant Jaren directly at 513-328-8217 or contact my office at 888-571-1110 if you have an issue with the Ohio, Kentucky, and/or Indiana State Boards of Nursing.