Nursing Law & Order

Weed is the New & Final Frontier, Not Space!

I apologize but I need to "mess up the rotation." This is line is from Friday, the cult classic movie with Chris Tucker and Ice Cube. Puff, Puff, Give is the rotation with respect to smoking marijuana in a two or more person set-up. . http://www.imdb.com/character/ch0011184/quotes. I love the movie Friday! 

I am attending a webinar in August sponsored by the Ohio State Bar Association titled "Is the Grass Really Greener? Workplace Implications of Medical Marijuana." 

https://www.ohiobar.org/NewsAndPublications/News/OSBANews/Pages/5-things-employers-should-know-about-Ohios-medical-marijuana-law.aspx

I do not smoke marijuana and even if it legal in Ohio for WHATEVER purpose and to use by WHATEVER route (eating, inhaling, injecting, etc.) I will not use marijuana. I already have enough problems and weed will not be one of my issues. We all struggle with something and if you deny having a vice, whether it is sex, drugs, alcohol, gambling, gaming, social media, electronic devices, food/gluttony, gossip, exercise/fitness, work/career, etc., you are not being honest with yourself.   

The Tabletalk magazine for August 2016 focuses on Addiction from a Christian and Calvinistic theology perspective. http://www.ligonier.org/tabletalk/. This is an excellent read. 

If you are a licensed healthcare professional and you smoke weed, please stop the rotation. All it takes is a random UDS or a pre-employment UDS..... Ask yourself why you are smoking weed, self-medicating, and get to the root of the issue with self-reflection, professional counseling, and medical treatment if needed. You know what you do and if you need help, please get help before it becomes a workplace, license, and legal matter. It is so much more easier to deal with these issues proactively before the stuff hits the fan. 

Also medical marijuana laws or casual use marijuana laws cannot provide a safe harbor for licensed nurses. You cannot come to work impaired or intoxicated from any substance/drug/medication, legal or illegal and provide safe nursing care to patients. It is a violation of professional standards of practice and your State Practice Act/Regulations.

Marijuana use/abuse is the real deal now and a positive UDS for marijuana is investigated by State Nursing Boards. Why? It is a violation of your State Nursing Practice Act to test positive for an illegal drug. If you test positive for an illicit drug, an employer or prospective employer may report to the State Nursing Board.  I am interviewing for home health RN positions in Cincinnati, Ohio and I will also have to submit to a UDS soon. I do not use illicit drugs and I take vitamins and OTC medication.  

I practice law in Ohio, Kentucky, and Indiana. If we get weed laws in Ohio, Kentucky, or Indiana, I am going to further limit my law practice to representing nurses in weed cases. Weed, not Space, I postulate without any evidence, will be the Final Frontier. https://www.youtube.com/watch?v=S6R3MiAv9ac. Can I specialize in weed law? Maybe the Ohio State Bar Association, Kentucky Bar Association, or Indiana State Bar Association will develop an attorney specialization for weed law. 

Here is general advice to all nurses in any state if you are licensed nurse, do not drink alcohol, smoke crack, inject heroin, snort cocaine, puff, puff, pass marijuana or ingest any illicit or even prescribed medication which alters your mental, physical, or cognitive capacities before reporting to work or at work.  Yes, you have to be careful taking any prescription medication before you report to work or while you are at work as a licensed nurse. Why? Are you safe to practice? You should not be at work if you are hung over, high, under the influence, groggy, dazed, dizzy, in a mental fog from meds, etc. 

Of course, there is a difference between being an allegation of reporting to work impaired/intoxicated as nurse and "just" having a substance present in your system. But let me ask you, do you really want to spend the time, money, emotional energy and mental exertion/frustration to deal with the license, workplace, and career implications of sorting between the two in a given situation? Can you say legal headache? 

Also you should see the New Star Trek movie, Start Trek Beyond. It was awesome! https://en.wikipedia.org/wiki/Star_Trek_Beyond. 

 

$101.01 Ohio Nursing Board RN Renewal Application Review: A Veggie Delight

The 2013 Ohio Nursing Board Renewal is here! Yes, it is that time of the year again. If you are responding "yes" to a renewal question, as a risk management strategy for your own nursing practice, you should consult with an attorney. 

Don't you want to know what you are facing? There is always a tendency to underestimate the seriousness of your own actions, inaction, or conduct in any particular circumstances. Your mother, your husband or wife, your best friend, and your "boo" may tell you "it is no big deal" but don't believe the hype. Obtain an objective consultation and advice for a nurse license defense attorney on the completion of your 2013 Ohio Nursing Board Renewal Application. 

Do you need a nurse license defense attorney in Ohio to review your Ohio Board of Nursing Renewal Application? 

Are you disclosing a felony or misdemeanor criminal conviction?

Did you have a criminal conviction or plea expunged and you are questioning whether or not you are required to disclose the information to the Ohio Nursing Board?

Are you disclosing substance use or substance abuse treatment?

 

Are you disclosing action against your RN license in another state?

 

Are you disclosing action against another professional license or designation in the State of Ohio or another state?

Offer Expires: August 31, 2013

Are you interested in working with me? I would like to help you. Please do the following:

1. Call or email Tina 

Tina is my virtual office assistant and schedules ALL of my appointments. Virtual means Tina and I are not physically in the same office however she works at my direction. 

Please provide Tina with all of your contact information including your mailing and email address. Give her a summary of the reason why you are scheduling the legal consultation with me. Lastly tell her you want the $101.01 Veggie Delight Special.

 

Tina Thelen, Virtual Office Assistant for

LaTonia Denise Wright, RN, BSN, JD
317-721-5530 (My Business Office phone)

[email protected] (email)

2.  Appointment and Payment 

Tina will schedule the appointment, take your credit card information, and confirm the amount to be charged. I will process your credit card payment as I am the only person in my firm authorized to process credit card payments. 

You can also pay the fee on-line via my website at www.nursing-jurisprudence.com or SNAIL MAIL a check or money order to my attention. 

 

3.    Documents, Correspondence, and Forms: Oh My! 

Scan/email, fax (855-859-5079), or SNAIL MAIL your documents to me. Send me EVERYTHING. I would rather have too much information than not enough information to review prior to our appointment. 

DIY: Do It Yourself is for Yard Work Not a State Nursing Board Case

I am a DIYer. I work in my yard daily. I cut my grass, clean and sanitize my swimming pool, hot tub, and swim spa (I love water; I am a Cancer) and maintain my yard at my primary residence. I don't like to do the trim or use the blower but I grin and bear it. I use the self-propelled push mower on my front yard and the slopes in my back yard. I have a riding lawn mover for the remainder. It takes me about 2-3 hours to cut my front and back yard weekly but the workout is to die for and I take pride in the appearance of my yard. 

I am staining the lattice on my deck slowly but surely over the next two weeks although I had someone stain the rails, balusters, and flooring for me as well as paint the concrete around my swimming pool. I repaired my dog fence after the underground wire was cut by my fence installer last week. I pay someone $25.00 a week to cut the grass at my office. I do not open or close my swimming pool; it would take me about 6-8 hours by myself. 

However there are just somethings that I do not do because it is not efficient for me to do so (like cleaning my home and office; although I like to wash walls and scrub woodwork) or it is beyond my level of skill or common sense. I pay my cleaning lady before I pay my mortgages; it would take me at least 8-10 hours a week to clean my home and office. Just mopping and waxing the hardwood floors on two levels of the house takes about 4 to 5 hours. 

For example, I don't do my own taxes or accounting although theoretically, I could learn.  I have an accountant and bookkeeper. I don't do my own legal work; I have a civil attorney and an attorney I consult with for ethical, practice, and contractually matters. I have a financial planner and I am working on finding a local business coach. I don't have a criminal defense attorney yet, but if I need one, I know who to call to represent me. No plumbing, no sewing, no electrical work, and no premarital sex. Okay you just woke up didn't you? 

I am wearing my hair natural and therefore I wash and two strand twist my own hair because I swim almost daily; I see my stylist once a month to trim my ends and to deep condition my hair. I do as much for myself as I can as allowed by my schedule, endurance, and pocketbook. Yes, I am old school; I have several pocketbooks.

I do not wash or wax my vehicles but I do wash and wax my bike and dogs (sometimes; Luke is huge and sometimes it is easier on my back to take Luke and Leia to the groomer and also checked by their vet, Dr. Lisa. My dogs have allergies, a blood disorder, and are prone to ear infections. Most of the meds in my home belong to Luke and Leia. 

Why am I telling you this today? There is a thin line between love and hate and DIY and paying for a service. DIY is for yard work and personal chores and should not take the place of receiving professional and objective advice, counseling, coaching, and representation. 

A lot of nurses, nursing students, and NCLEX-Applicants DIY with the State Nursing Board. Sometimes it works out and sometimes it doesn't. Do you want to take a chance and gamble with your license, livelihood, and nursing career? DIY means you are representing, counseling, and advising yourself before the State Nursing Board, i.e. you are proceeding PRO SE.  

It always surprises me that nurses as educated and licensed professionals will spend tens of thousands of dollars to attend entry level and graduate nursing programs and then balk at spending a few hundred or thousand dollars on legal advice, counseling, and representation in a State Nursing Board disciplinary investigation. I always here "if I would have known I needed an attorney or IF someone would have told me I needed an attorney...."

If "if" was a Fifth (of the Wild Irish Rose) we would all be drunk.....is an slang idiom I heard someone say just the other day as I rode my bike to the post office. I love my bike. 

If I had hired a nurse license defense attorney in the beginning......

If I had consulted with a license defense attorney before I signed the Ohio Nursing Board Consent Agreement....

If I had talked to a nurse license defense attorney before I submitted my Renewal Application to the Ohio Nursing Board....

If I had retained an attorney to work with me while on probation and monitoring with the State Nursing Board.....

If I had consulted with an attorney before I submitted my Application for Licensure by Examination to the Ohio Nursing Board....

Don't DIY before the State Nursing Board; Consult with and retain an attorney with experience defending nurses before the State Nursing Board to assist you ASAP. Use your common sense; you know when you need assistance, guidance, and counseling don't you?  

Nurses Beware: There is Danger in Being Unlawyered

See this article in the Lawyerist which discusses the hazards of being unlawyered. http://lawyerist.com/defend-deposition-just-show-up/

I see the hazards of being unrepresented and unlawyered daily in my law practice.

1. Ohio Independent Providers

You are running a business and practicing in your business which means you should have an accountant, bookkeeper, and a Nursing Law attorney to assist you with regulatory compliance. 

If you don't have these as an IP, then work FOR a home health company as an employee as opposed to being a home health company. 

2. Self-Employed Nurses in Private Practice

You are running a business and practicing in your business which means you should have an accountant, book keeper, and a Nursing Law Attorney to assist you with regulatory compliance. 

You don't just start a business providing health care services and run with it without having legal advice, counseling, and coaching on your compliance with federal, state, and local laws and regulations.

This is especially true with APRNs in private practice. I actually had one APRN tell me that national and state nursing professional association dues should cover "legal advice" and "business counseling." Nursing professional associations are struggling and strapped for cash because of declining membership and dwindling interest. 

4. Representing Yourself Before the State Nursing Board during the Initial Complaint

I have seen it all in my 12 years of solo practice defending nurses before the State Nursing Boards. Being unlawyered and underlawyered (having an attorney who knows nothing about practicing before the Board) is becoming more and more of a common practice. 

There is always a tendency to minimize the complaint against one's license and rationalize the decision to "do it your way." 

4. Representing Yourself during a State Nursing Board Probation and Monitoring Period

I don't like being told what to do which is certainly why I hire professionals to do my taxes, book keeping, and legal work. I hire professionals to provide and render professional services. 

 Chances are you didn't have a lawyer during the Board investigation and case which led to discipline of your license; then do yourself a favor and retain an attorney to counsel and advise you while you are on probation for 15 years with the State Nursing Board.  

 

5. Counseling and Advising Yourself When Things "Go South" with your Employer

If your nurse manager says "this is reportable to the State Nursing Board", you need to talk to a nurse license defense attorney.  I know you have never had anything happen in your life outside of two speeding tickets, but when you hear "this is reportable to the State Nursing Board", the defecation is near the ventilation and it is time to start thinking about your nursing license, your employability, your career, and your next month's mortgage payment not you will no longer be able to chair the Facility Shared Governance Cultured &  Collaborative Cupcakes & Coffee Committee. 

6. The Criminal Stuff 

You know or you should know if what you are doing is illegal. If you don't know, ask a lawyer. For example are you

stealing narcotics from work? Criminal

stealing supplies from work? Criminal 

consistently driving while intoxicated (prescription drugs, alcohol, etc.)? Criminal

doctor shopping to maximize your ability to obtain prescription medication? Criminal

billing for healthcare services you did not provide? Criminal

putting your hands on folks (kids, spouse, parents, neighbors etc.)? Criminal

Your personal life and your professional life collide when matters turn criminal and also in domestic situations. Sh*t happens and frequently I might add; so unless you are dead; the end is not yet. Praise God!

You can use "The Force" and swim, crawl, waddle, walk, slide, run, dance, and skip from the Dark Side, Young Skywalker. Please note there is a cost and fees associated with accessing "The Force" because it is a professional service(s). Yoda isn't available. 

First remember this is not the end of the world although it may feel like it. I am a recovering drama queen so I understand the need for actions, emotions, behaviors, thoughts, and everything over the top and heavy heavy. Allow your time to process your feelings and emotions if you are a licensed nurse and you are involved in a criminal matter. However you have to come off the rollercoaster at some point. 

Practically you just need help sorting and shifting the wheat from the tares in a legal and nursing practice context of course, not spirtual. This is what a nursing law attorney does for a nurse confronted with criminal issues when addressing the nursing aspects of the criminal matter. 

 

Billy Bad A## Approach when Defending Yourself before the State Nursing Board

There are three essential components to traditional and full-scale legal representation: 

a. representation and advocacy in a formal legal matter; 

b. counseling a Client on the legal process and procedures involved in a legal matter; and

c. advising a Client of his/her options so the Client can make informed decisions on how to proceed in his/her case, matter, or situation. 

There is nothing wrong with making an informed decision to REPRESENT yourself before the State Nursing Board. It saves you money (you don't have to retain or pay an attorney) and you can have it your way, like at Burger King.

What is representing yourself before the State Nursing Board? This means you do not have an attorney who has entered a Letter of Representation or Notice of Appearance of Counsel which is the formal way of letting the State Nursing Board know you are represented by counsel. This means that State Nursing Board staff including investigators, attorneys, and others may contact you directly about the State Nursing Board complaint to interview you, schedule a meeting with you, ask you additional questions about a statement or information you submitted to the Board, etc. 

You are also COUNSELING & ADVISING yourself with respect to the decisions, actions, and tasks to be undertaken in your case and implications those decisions, actions, and tasks have for your nursing practice, the Board of Nursing case against you, and your current and future employment in nursing. 

How do you "counsel and advise" yourself? You ask your peers, neighbors, colleagues, nursing professor, church pastor, and others for advise on what you should or should not do in your situation. You join a nursing chatroom and you look for answers to your questions or you do  your own research. Again there is nothing wrong with counseling and advising yourself before the State Nursing Board. 

I would dare to say it is very American and Billy Bad A// to take on the establishment and prove a point after all you are "not guilty" of anything, you didn't do anything wrong, and once the Board hears your version of events, the Board will send you a letter of apology for wasting your time. You tried it!!!

I received a lot of "counsel and advice" from friends, family, colleagues, peers, and others during my divorce in the summer of 2011. I received the WORST advice and counsel from the MAJORITY of people with respect to dealing with the trauma associated with the failure of my marriage. Failure was something I was not accustomed to dealing with in my personal life (or professional life) and the failure of my marriage brought me to my knees.

At the time when I needed it most, I received what I know now (and I knew then) was super duper and just plain bad advice. Thank God, I did not follow the majority of the advice given to me by the majority. But these folks of course meant well.

I received some good advice but it was from professionals who were objective and a few others lay folks. I joined a Divorce Support Group at a local church, I started attending a small group for "the divorced", and I began the long tedious process of healing from the inside out; actually being transformed is more appropriate.

I am Type A, B, C, D, and E. I am the person who gave myself 6-8 weeks in my schedule in the Summer of 2011 for divorce healing, recovery, and rebuilding. What type of nut job calendars emotional healing? I can laugh about it now because my divorce was the best thing (right after attending nursing and law school, Walmart selling 1.5 liters of Pepsi, and my purchase of a three-wheel bike last summer) that has happened to me. I had in 2011:

a. my divorce in May;

b. my "I am 40?" mid-life crisis in July;

c. my retrospective childhood "I didn't get the dog I asked for in the 1st grade" tirade and temper tantrum over a few months witnessed by both sets of my grandparents. I love my grandparents; they observed in disbelief and prayed without ceasing for me as I festered in a funky furnace of fire only after bathing in my own milky mess of self-centeredness and applied lastly lotion lavishly; and  

d. my life changed by the effectual call from Christ in December. Busy year.  

W hy am I telling you this?

1. Because your White Swan and your Black Swan can meet and really be FB friends; and

2. The advice and counsel of professionals is INVALUABLE when faced with a life event. A State Nursing Board complaint is a life event and if someone tells you it isn't smack his/her face and then call, text, fax, and email me (from jail); I can defend you before the State Nursing Board. Anytime you are involved in legal matter which impacts your education, employment, license, credentialing, AND identity it is a life event. Professionals help you navigate life events and you have a retain and pay professionals, sometimes out of the pocket. 

If you are involved in a State Nursing Board case, take the time and consult with an attorney. It may cost you a few hundred dollars but at least have a nurse license defense attorney take a look at your matter for a "fresh set of eyes" of your case. I routinely send my cases for review by a nurse expert prior to a hearing so I can get a different perspective on the case. You should consider doing the same with your case. 

 

LaTonia Denise Wright offers Legal Coaching Services for Nurses in Ohio, Kentucky, and Indiana

My law firm is pleased to offer legal coaching services to nurses starting today. This a brand new service I am offering to respond to the demand for legal services. I receive a number of calls, emails, texts, and faxes from nurses who desperately need legal services but cannot afford or do not want to pay for the full scale legal services associated with the traditional attorney-client relationship. My law firm utilizes flat fees and I have done so for years. I am very comfortable quoting flat fees for representation. My flat fees for traditional legal representation before the State Nursing Board start at $2,500.00 and the fee charged varies depending on the issues involved in the case. 

My firm has offered legal consultations for a number of years which allows a nurse to pay for a one-time appointment with me. In the context of the consultation, I review documents usually Board Adjudication Orders, Consent Agreement, Alternative Program Agreements, criminal case records, etc. and then counsel and advise the nurse on his or her options. A legal consultation is a one-time appointment with me either by telephone or in-person and it is of course confidential. See this pdf file for additional information on legal consultations with my office.  Download Legalconsultations2012. 

The majority of RNs, LPNs, APRNs, nursing students, and NCLEX-Applicants involved in State Nursing Board disciplinary investigation represent themselves and I am sure this is because of the cost of legal services. I also believe it is because most of us fail to appreciate just how adversarial the disciplinary investigation and suitability for licensure can be. It is a formal legal process, not what you see on TV and it has vast implications on the careers of those who are involved. 

This is why I am offering legal coaching services for nurses in Ohio, Kentucky, and Indiana because it allows a LPN, RN, APRN, nursing student, or NCLEX-Applicant to pay for a certain number of hours of legal services which include reviewing correspondence and documents, revising documents, legal and nursing research, legal opinions, reviewing Nursing Board documents, agreements, and contracts, reviewing criminal case documents and then I counsel, advise, and coach my client on his/her options. 

This allows the Client to continue to represent themselves before the State Nursing Board, with an employer if negotiating an employment agreement or involved in a workplace investigation, etc. and still receive legal coaching, advice, and counseling from a nurse license defense and nursing law attorney.

In the legal world, this type of arrangement is called limited scope representation and unbundled legal services. See http://en.wikipedia.org/wiki/Unbundled_legal_services

 For example, let's say a nurse is involved in a criminal case and wants my involvement on a limited basis to review the nursing practice, Board of Nursing issues, and other nursing related facets of the criminal case. The nurse can pay for 3 0r 4 hours of legal coaching which is less expensive for nurse and allows the nurse to receive the specific advice, counseling, and support needed with respect to nursing licensure, credentialing, and employability.

Another example would be a nursing student who has to disclose criminal convictions to the State Nursing Board and needs legal coaching, advising, and counseling on the submission of the Initial Application for Licensure by Examination to the Ohio, Kentucky, or Indiana State Nursing Board. The nursing student could pay for 3 or 4 hours of legal coaching which would be less expensive than retaining me for traditional representation. Also the nursing student would need more time than the 30 minutes or 1 hour offered with a legal consultation.

Yes, this is Nursing Law & Order but in real life with real issues before the State Nursing Board and in nursing law and professional practice matters involving real nurses, I can't always resolve issues and wind up a case in 60 minutes like Olivia Benson and Elliot Stabler on Law & Order SVU. This is why I offer legal coaching services and full scale representation with a flat fee retainer. 

Another example, would be a nurse who has been reported to the State Nursing Board and wants my assistance reviewing the complaint, researching the issues, and assisting the nurse with a response to the Board of Nursing Complaint. This could be accomplished with legal coaching. However I would not file an appearance with the State Nursing Board or contact the State Nursing Board on behalf of the nurse because I am not "representing" the nurse before the State Nursing Board. I file an appearance indicating I am the attorney of the nurse if a nurse retains me for a flat fee which is involved in a traditional and full scale legal representation.

If you are involved in a formal legal matter before  the State Nursing Board and you do not have an attorney advocating for you before the Board as your attorney then you are "pro se." A nurse is proceeding "pro se" and involved in self-representation. What is Self-Representation? See http://en.wikipedia.org/wiki/Pro_se_legal_representation_in_the_United_States

My legal coaching service is a hybrid service and I see it another avenue to fulfill my calling (and make money; I am a lawyer now:) and as a go-between one-time legal consultations and traditional and full scale legal representation, counseling, and advising. 

Some nurses do not want to or need to work with an attorney over an extended period of time and this is a option for nurses who want to tryout legal services on a limited basis to start a nurse-owned business, review unemployment, workers comp., nursing malpractice, or other matters.

Do you want more information about the difference between the legal coaching, legal consultations, and traditional representation, counseling, and advising services offered by my law firm? You can email me at [email protected] or [email protected]. You can call my office at 513-655-6586 or text me your email and we will send you additional information. 

What are the costs of legal coaching with my law firm? See http://www.bookfresh.com/service/cincinnati/law-office-of-latonia-denise-wright-lpa/157503739. 

 I will also post a flyer in the next few days which discusses the difference between legal consultations, traditional attorney representation, counseling, and advising, and legal coaching services I offer for nurses. 

I actually see this as being a very popular service for nurses who want to get me involved in their case, matter, issues, or professional practice legal and ethical quagmires but do not want or need to (this is a personal decision) proceed with full scale legal services at this time.  You are the boss with limited scope representation and unbundled legal services and you are proceeding as an informed consumer who is essentially representing him or herself. 

 

 

 

Edie Brous, RN, Attorney at Law to present three Nursing Law & Order webinars in April 2013

Edie Brous, RN, JD is a licensed attorney in New York, New Jersey, and Pennsylvania. Ms. Brous is a nurse license defense attorney and represents nurses before the State Nursing Boards. Ms. Brous speaks nationally on legal issues in nursing and is an active member of The American Association of Nurse Attorneys (TAANA).

For additional information about Ms. Brous or to inquire about the legal services offered by her firm, see http://www.ediebrous.com/index.html. Edie can be reached by telephone at 212-989-5469. 

Ms. Brous with the Law Offices of Edith Brous, Esq. R.N. is presenting the following Nursing Law & Order webinars:

Monday, April 1, 2013 from 6pm to 7:30pm EDT

State Nursing Boards Complaints: The Who, What, When, Why & Where? 

The cost is $20.00. No CE credit is provided. To register click on the link below:

Registration Link: http://nursinglaw.enterthemeeting.com/m/YSCWIDRP

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Monday, April 8, 2013 from 6pm to 7:30pm EDT

Adjudication: What does a Hearing before the State Nursing Board Really Mean? 

The cost is $20.00. No CE credit is provided. To register click on the link below:

Registration Link: http://nursinglaw.enterthemeeting.com/m/GZ7RNKJ1

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Friday, April 26, 2013 from 6pm to 7:30pm EDT

Criminal Convictions, the State Nursing Board and Nursing Students Seeking Initial Licensure

The cost is $20.00. No CE credit is provided. To register click on the link below:

Registration Link: http://nursinglaw.enterthemeeting.com/m/YVVSJZMI

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I am pleased to offer webinars to nurses, nursing students, and others interested parties to learn more about the law, legal issues, and legalities in nursing practice. The focus of the April 2013 webinars is the State Nursing Board and Nursing Law & Order is offering a total of 16 webinars this month touching on the State Nursing Board.

Why the State Nursing Board? Nurses are more likely to be reported to the State Nursing Board Board and investigated for a complaint than to be named and sued as an individual defendant in a nursing malpractice or medical malpractice case. However nursing education, in-services, and seminars tend to focus more on nursing negligence than State Nursing Board Complaints against nurses. 

I can remember when I was in nursing school back in 60s (just kidding) and the only mention of liability concerned nursing negligence and medical malpractice. Then after graduating from nursing school in 1993 and 1994, most of the seminars I have attended that may have a topic or two on legal issues, the focus is usually documentation, negligence, and malpractice. 

You may ask  whose role is it to educate nurses and nursing students on the law, legalities, and legal issues in nursing practice? Does the role belong to individual nurses, nursing schools/colleges/programs, nursing employers, nursing unions, nursing professional associations, or another party? 

Nursing Law & Order is doing its part to educate nurses and nursing students on the law and the legal pitfalls in nursing practice. This is what I always considered Phase II to my license defense practice and I praise God that this is finally the year I am able to move forward with another component in my dream career.

What is your dream career? Are you working in your dream career? If not, build it.  

My law practice is evolving and risk management is the next component. Risk Management is usually associated with facilities and organizations however the term is applicable to individual nurses. I will always be a nurse license defense attorney and practice law before the State Nursing Boards but I have to reach up, down, back, around, and forward to educate, inspire, comfort, and help other nurses and nursing students with legal issues proactively. I feel this is my calling and having a nurse license defense practice was just the beginnning. This feels right and I am looking forward to a glorious 2013. 

Cynthia Mikos, BSN, Attorney at Law is presenting the April 10, 2013 webinar: APRN (Advanced Practice RN) Complaints with the State Nursing Board

Nursing Law & Order is sponsoring a cutting edge webinar for Advanced Practice RNs (Nurse Practitioners, CRNAs, CNMs, and CNSs) and APRN students. The webinar is titled APRN State Nursing Board Complaints, Discipline and the Legal Implications for  Nursing Practice. 

Nursing Service Organization (NSO), a division of AON Affinity, and their insurance carrier CNA released a healthcare industry resource, Nurse Practitioner Liability Update 2007-2011: A Three-Part Approach on November 13, 2012. The Update contains an analysis of nurse practitioner malpractice and license defense claims over a five-period. 

The Update noted 61% of licensing board actions against Nurse Practitioners resulted in "no action", while 3.1%of the licensing complaints resulted in the end of the nurse practitioner's career. This leaves 35.9% of licensing Board complaints resulting in some form of discipline of the license of a NP. See https://www.nso.com/pdfs/db/NSO_Claim_Study_PR_FINAL.pdf?fileName=NSO_Claim_Study_PR_FINAL.pdf&folder=pdfs/db&isLiveStr=Y 

APRNs which of course include Nurse Practitioners face a variety of legal issues in clinical practice which may result in a State Nursing Board complaint being filed against the APRN. This webinar will review the types of complaints filed against APRNs (CRNAs, CNMs, NPs, and CNSs) and the discipline implications for APRNs with respect to future employability, multi-state licensure, credentialing and privileging, and specialty certification. 

This is a 90 minute webinar presented by Cynthia Mikos, Attorney at Law with Allen Dell, P.A. There will be plenty of time alloted for questions and answers depending on the number of attendees. 

Wednesday, April 10, 2013 from 6pm to 7:30pm 

APRN State Nursing Board Complaints, Discipline, and the Legal Implications for Nursing Practice

The cost of the webinar is $20.00. No CE credit is provided. You can register online for the webinar at: http://nursinglaw.enterthemeeting.com/m/1ITTLHOK. 

Cynthia A. Mikos is a graduate of West Virginia University (B.S.N., 1977), University of Baltimore (M.B.A. 1983 with honors) and Stetson College of Law (J.D., 1993 with honors). She is rated AV Preeminent by the Martindale-Hubbell Law Directory.

Ms. Mikos is Board Certified in Health Law by the Florida Bar Board of Legal Specialization and Education and represents licensed health care professionals and facilities throughout Florida. Her practice focuses on licensure, fraud and abuse advice, Medicare, Medicaid and other payer disputes, Florida and federal regulatory compliance, and business issues for health care clients.

Ms. Mikos represents a broad spectrum of health care providers, including physicians, advanced registered nurse practitioners, physician assistants, nurses, mental health therapists, hospitals, durable medical equipment companies, home health agencies, pharmacies, sleep laboratories, rehabilitation agencies, long term care facilities, providers of services to the developmentally disabled and independent diagnostic testing facilities. As a former nurse and executive of a Fortune 100 health care company, Ms. Mikos values her prior health care experience as an adjunct to her legal advocacy.

Ms. Mikos currently serves as the Chair for the Executive Council of the Health Law Section of The Florida Bar and has participated as a member of its Executive Committee since 2003. She is a member of the American Health Lawyers Association, the Florida Association of Hospital Attorneys, the Hillsborough County Bar Association Health Law Section, The American Association of Nurse Attorneys (President 2006) and the Florida and Hillsborough Association for Women Lawyers.

Ms. Mikos can be reached at 813-223-5351. For additional information about Ms. Mikos, see

 http://www.allendell.com/our-attorneys/cynthia-a-mikos/. 

To download a complete copy of the NSO Claims Study for Nurse Practitioners see: 

https://www.nso.com/pdfs/db/NP_Claims_Study_2012.pdf?fileName=NP_Claims_Study_2012.pdf&folder=pdfs/db&isLiveStr=Y

 

Do You Think I Need An Attorney to Represent Me before the Board of Nursing?

If you have to ask me do you need an attorney then 9 times out of 10 you need a lawyer. 

I can tell you I don't represent myself in anything because I am my own worst enemy and I know it because I have a tendency to rationalize my own behavior, minimize my wrong doing, inappropriateness, or failure to do something, and think it is all going to be okay if I just tell my story. Also I can be a drama queen with respect to my own personal affairs at times. Does this sound familiar? 

I have a nursing license and three law licenses, if I get a speeding ticket, I call my lawyer and let him worry about it; that's his job. I worked hard to obtain my licenses and have been blessed in Christ to have a busy law practice doing what I love. Now why would I want to take on the risk of advising myself in a legal proceeding when I can have the benefit of independent and objective legal counsel. I want to hear what he has to say about my legal matter not what I have to say about my own legal matter. Legal fees are a business expense and an expense that all licensed healthcare professionals especially nurses need to consider. 

Yes, it cost money to retain an attorney and yes you can represent yourself before the State Nursing and counsel and advise yourself by doing your own research, relying on the statements of family, friends, and colleagues about what should happen and what is fair in your situation, and trolling the nursing chatroom and forums for information about legal issues in nursing and then applying this to your own case and situation. 

Spend the money and hire a lawyer to represent, counsel, and advise you. If you can spend a few thousand on Christmas gifts, a vacation, downpayment on a luxury vehicle, loaning family money, or living beyond your means to keep up with the Joneses, why can't you spend a few thousand dollars on legal representation, counseling, and advising with respect to your nursing license which directly impacts your employability in nursing? If you don't have a nursing license, you can't work as a nurse. I really scratch my head when I see APRNs represent themselves before the State Nursing Board. 

In a perfect world, nurses wouldn't need to retain lawyers and we all would have a perfect nursing practice and work in perfect nursing environments. We also would all hold hands and sing....

This isn't a perfect world. There are legal risks, potential liabilities, and action against the license behind almost every door in healthcare in addition to Vampires and Lycans. You counsel and advise yourself at your own peril and I see it everyday especially when nurses appear at hearings without counsel or just sign a Consent Agreement, Agreed Order, or Offer of Settlement with the State Nursing Board without understanding the implications for his/her nursing practice. 

I am not saying you have to retain me but retain an attorney in your state of licensure who practices before the State Nursing Board frequently and move forward. Retain an attorney with experience before your State Nursing Board and then work with your attorney for the best outcome possible and probable in your case. Yes, it cost money to retain an attorney but it may be the best $2,222.22 to $7,777.77 you have spent. Yes, you can afford it; LPNs, RN, and APRNs earn decent salaries and hourly wages; it is just a matter of do you want to pay the costs associated with legal services for defending your license? 

 

 

APRNs and the Pill Mill Bill Spill in the Commonwealth of Kentucky:House Bill 1 was effective July 20, 2012

See the attached. Download KBNPillMillBillSpill

I would encourage APRNs in Kentucky to submit written comments to Nathan Goldman, Acting Executive Director and General Counsel for the Kentucky Nursing Board. Comments are accepted until October 1, 2012.

So what do you think? Do you think the Pill Mill Bill Spill Legislation is necessary or is it overkill?

 

I Can Feel It! Living, Sweating, Breathing, and Bleeding Nurse License Defense for $995.95?

My law practice keeps me very busy. I love what I do for a living and it is my passion. Nurse license defense is still and has always been my dream job. Being on the frontlines in nurse license defense has shown me there is a need for additional services for nurses and nursing students related to the law, legalities, and legal issues. This is phase II for my practice and I am sooooooo excited that I am finally able to move forward with consulting practice while continuing with my bread and butter, nurse license defense in the context of my law practice.

Nurses just a few pointers however, attorneys provide a service to the public just like nurses provide a service to the public. The difference being that nurses are typically paid an hourly wage or salary by an employer for the services provided while most attorneys quote the fee or the amount for the service being provided to the public.

Why is this important and what am I saying? After 11 years of nurse license defense NOTHING surprises me anywmore in the context of my law practice; I am seen the worst in the profession and the arguably some of the best in the nursing profession also. I am not surprised but just puzzled by the number of nurses who need legal representation before the State Nursing Board but decide for "cost" not to retain ANY attorney.

You spend anywhere from $15,000 to $60,000.00 on undergraduate and graduate school nursing education for an ASN, BSN, MSN, or PhD. LPN or LVN programs cost $10,000-$20,000 now.

After spending tens of thousands of dollars on a nursing education, the majority of nursing students and NCLEX Applicants with affirmative responses on a State Nursing Board application will roll the dice and apply for a license without consulting with an attorney on the responses to the application questions. "My nursing instructor said this isn't a disqualification so I should just apply", "I am a different person than I was 5 years ago when I committed those 4 felonies and 3 misdemeanors and the Nursing Board will see this." You don't say?

A LPN, RN, RN-BSN, RN-MSN, or RN-PhD has an income potential of several hundreds of thousands of dollars or several million over the course of a lifetime of nursing practice. That's money. Nurses, as LPNs, general RNs, or APRNs don't earn server wages plus tips. Yet this is the disregard I see with respect to the severity and seriousness of a State Nursing Board complaint and the possible implications on licensure, employability, and the nursing career. You don't say?

I hear all the time "I don't have that kind of money for a lawyer", which is usually anywhere from $3,500 to $9,500.00 with most cases being at the $3,500 to $5,500 range (excluding probation and monitoring with the State Nursing Board) and the most complex cases ranging from $7,500 to $9,500.00. Even APRNs, with advanced education and who certainly earn more and have more scope of practice and more autonomy than LPNs or general RNs will frown at representation and proceed pro se. I quote a few cases over $10,000.00 but usually not because how I can structure my flat fees on case milestones. I don't quote low ball fees; I don't have to do this and it isn't a sound business practice. I quote a fee based on me working your case and we have to work license defense cases, in my law practice anyway. We go hard in my practice, just ask my paralegal.

I am even seeing cases where APRNs and RNs start their own businesses providing nursing services and maybe billing the government for services and fail to consult with and work with a nursing law attorney on the business basics before opening the doors. This is a recipe for disaster. Just look at the number of Independent Providers who have their license suspended and are indicated for fraudulently billing the State of Ohio for home care services. Why don't these IPs, both RNs and LPNs consult with a nursing law attorney? How can you bill for services and also practice in your business as a nurse with advice and counsel of a nursing law attorney? Not the corporate or general practice attorney who did your LLC, but an attorney who can assist you with the nitty gritty practice and operational issues like job descriptions, scope of practice, etc.  

Most nurses spend thousands of dollars on a vacation or two in a year, a bathroom remodel, or some other expense or luxury but will frown at the investment into representation, counseling, and advising in a State Nursing Board complaint which can silence, stop, end, terminate, or unfashionably cramp, crop, and crimp a lifestyle with its career and employability consequences. 

I can't represent you for $995.95 in ANY case and certainly not one where the Board has issued a Compulsory Psychiatric Evaluation (these cases are akin to doing that old school dance "the fight", Cabbage Patch, the Snake, and the Humpty Hump to slow music if you get involved late in the game. See http://www.youtube.com/watch?v=3suw_vb6-fY) and you are licensed as a APRN in Ohio, Kentucky, Indiana, West Virginia, Michigan, and Illinois. Sorry.

Nursing malpractice and nursing negligence don't end careers baby; State Nursing Board complaints and discipline of the license are the career enders pumpkin pie. Don't believe what you were told in nursing school or what you were lead to believe by colleagues. The issues isn't malpractice or negligence it is State Nursing Board discipline. This is why I am so excited about Phase II to my business, it only took me 10 years to get here but I am ready finally to offer additional services and products for nurses and nursing students on understanding the law and the practical implications for nursing practice. Better late than never applies to me and maybe you.

I am also planning to start volunteering as a nurse later this year to get my hands back in nursing practice. If you know where I can volunteer as a nurse here in Cincinnati, email me or call my office. Just a few hours a month.

Do yourself a favor and retain an attorney if a complaint is filed against you with the State Nursing Board and not necessarily the least expensive or cheapest attorney. Do your homework and retain an attorney who practices primarily before the State Nursing Board, there are usually several in any given state. I get calls from nurses who go with an attorney just because the initial fee was so cheap only to find the representation, counseling, and advising isn't that great. Retain an attorney who lives, breathes, sweats, and bleeds license defense and has represented  a lot of nurses. License defense is a cross between criminal defense and family law because the stakes are high and the emotions run even higher. Criminal law, family law, and license defense are intense but guess what Hot Mama (that's me) is intense also.

Also, I can't spend an hour in-person or by phone with a prospective client; unless you are paying me for my time. I offer legal consultations.

Nurses, you don't work for free as a nurse so don't expect me or any other attorney to review a shitload of documents (35-45 minutes plus any research time) and tell you your options and next steps on how to proceed and what to expect over 45-60 minutes "at no cost" as an attorney. Just the facts: this isn't a solid business model for a solo attorney and although I have found my passion, I am in business to make money (I have to pay bills too) and provide needed and necessary services to nurses.

I receive on average 35-60 calls and emails from nurses in Ohio, Kentucky, and/or Indiana who have pending issues with the State Nursing Board MONTHLY. If I (or my paralegal) spent 1 hour with each prospective client (who may or may not retain me) how could I work for my clients who actually pay me to provide them services? Just between Ohio, Kentucky, and Indiana, there are over 11,000+ complaints filed in a fiscal year, every year. Nursing malpractice and negligence complaints "go to your room" and take a nap because State Nursing Boards complaints are "in the house."  

We have free will and if you decide to proceed pro se in a State Nursing Board complaint, I sincerely hope and pray things turn out all right and okay for you. I pray for myself, my clients, and all of us as nurses.

Sometimes it turns out okay for nurses who represent themselves in State Nursing Board cases; others are not so lucky. The landscape is changing before State Nursing Boards in Ohio, Kentucky, and Indiana; I can feel it like DMX.    http://www.youtube.com/watch?v=I0nAjxPV-E8      

I see it and I am living, breathing, bleeding, sweating and practicing it daily; you can't say the same when you represent, counsel, and advise yourself in a matter which can/may break your nursing career.

 

Workplace Incident to State Nursing Board Complaint to Career Standstill to Professional Suicide and No Lawyer

The headline above is a worst case scenario but it is a growing reality for a number of nurses who represent, counsel, and advise themselves in legal matters involving their license. I cannot tell you how important it is for nurses, whether you are a LPN, RN, or APRN to seek advise and counseling from a private nursing law attorney when a patient care or other significant issues arises in the nursing workplace. No one, whether it is your nurse manager, nurse supervisor, union rep, risk manager, etc. is going to say to you "You need to consult with your own attorney about this situation." I haven't heard it in my 11 years of solo practice in nurse license defense. Not once. Most of the time, a nurse contacts a nurse license defense attorney or nursing law attorney ONLY AFTER the defecation hits the ventilation: the complaint is filed with the State Nursing Board, your union rep tells you "you may need to resign instead of being fired", your employer terminates you and says "we are required to report this to the State Nursing Board", you receive a letter of Complaint from the State Nursing Board, you are told you are being named as a defendant in a nursing malpractice case, you are contacted by local law enforcement about the "incident three weeks ago", etc.

I often hear nurses say "I didn't know there were nursing practice attorneys or nursing law attorneys that help nurses." Yes, there are nursing practice attorneys and nursing law attorneys whose primary role is to assist nurses and/or other licensed healthcare professionals. See www.taana.org.

It is not the role of your nursing manager, nursing supervisor, nursing union representative, risk manager, or anyone else to counsel and advise you objectively about the seriousness of an incident from a licensure, career, employment, or credentialing perspective. This is the role of a private attorney who has experience in nurse license defense, nursing law, and professional nursing practice matters. And guess what? You can't find an attorney with this type of expertise and experience in the yellow pages usually.

Yes, you can call the attorney who handled your divorce, you call the attorney who has helped your extended family in a number of cases, you can put on a blind fold and open the yellow pages and pick an attorney and call for a "free consultation" about your specific issues which is usually a combination of nursing law, professional nursing practice, employment law, labor law, credentialing, criminal law, nursing negligence, etc. Guess what? That attorney will not PROBABLY NOT give you the answer you need because the attorney does not have experience in the area.

Also I am pleasantly surprised yet again by the number of attorneys who represent nurses before the State Nursing Board just to take a case and make a few bucks and who know little or nothing about what it takes to adequately and effectively defend a nurse before the Board and counsel and advise the nurse on attending matters. Is a nurse a nurse a nurse? Of course not. Therefore an attorney is not an attorney is not an attorney. Why do you want an attorney who practices primarily wills and trust representing you before the State Nursing Board? Is it better to have any attorney (regardless of whether or not the attorney has ever practiced before the Board or has experience advising nurses) as opposed to an attorney who can competently handle your case and assist you?

It is your case, your license, and your livelihood and this is a question you as the nurse should answer and consider when retaining counsel. I only practice in the areas of nurse license defense, nursing practice, and nursing law; no wills, no personal injury, no workers comp, etc. You don't have to retain me in Ohio, Kentucky or Indiana; just retain an attorney who can effectively represent you and who has experience representing nurses. Nurses as licensed healthcare professionals have different legal needs than your average consumer and this is significant in the context of representation. These cases are time intensive and you don't want an attorney to take your case and not work it like it should be worked.

What am I saying? I don't say much on the blog these days because my law practice is keeping me busy but I am getting fired up again because I am seeing where nurses are being TOO TRUSTING and not looking after and protecting THEIR LICENSE, CAREER, CREDENTIALS, and hard earned EDUCATION.

Sorry to say this but I am a nurse first also. Nurses are fungible; just look at how nursing employers terminated and discipline nurses: at the drop of a hat. A healthcare organization will fire a nurse with 25 years of experience and loyalty to the organization just as fast as it will terminate a new employee. If you pass gas (and you are not a CRNA :) on a patient care unit, you will be terminated and reported to the State Nursing Board because it "looks better" from a liability, public relations, and accreditation perspective.

But guess what, more facilities are throwing nurse supervisors, nurse managers, and nurse executives to the wolves and under the bus also. This does make me feel better and it shouldn't please you either because it typifies the harsh reality & environment of nursing practice now. More nurse managers and nurse executives are being terminated and I am receiving more and more of these calls and these nurse managers and nurse executives are also being reported to the State Nursing Board.

What am I saying?

1. You know your practice area, don't you? If something happens and its triggers an investigation in the workplace and you are involved, get your own attorney involved to review the situation with you and give you OBJECTIVE legal advice and counseling. You need to have your own Nursing Practice and Nursing Law counsel you can consult with about situations which happen in the workplace. If you are a nurse supervisor, nurse manager, and nurse executive, are you aware of your exposure?

2. Stop listening to the advice and counseling of everyone and their momma about the seriousness of an incident. It is human nature to underestimate the seriousness of an incident to a friend, colleague, or relative because you don't want the worry the person and you want the best for the person.

If I call one of my grandmother's right now and say "mom, I slapped someone and I may be charged criminally", the response will be "it is going to be okay. You are a good person. Who did you slap?  and "I know you type a lot, did you hurt your hand when you slapped this person?"

This may help me feel better emotionally but it certainly doesn't help me deal with the criminal, licensure, legal, and career implications of pimp slapping someone.

By the way, my little sister's 1 y/o son, open hand slapped me so hard (yes, he pimp slapped me) he knocked my glasses off. My sister says he picked this up this behavior in daycare and/or watching cartoons. Really? This was last month and I still smile about it daily. Thank you Baby Chris for putting a smile on Auntie's face whenever I think of you!!!

3. Nurses don't have the income and prestige of dentists or physicians but nurses certainly have similiar liability just a different context. http://www.nso.com/. Take a look at the report, Understanding Nurse Liability from 2006-2010 from Nursing Service Organization.

The public is more aware than ever that you can be sued and you can be reported to a licensing board. Nurses are not self-employed like most dentists and physicians and therefore USUALLY do not have a personal and private attorney for practice, workplace, and career issues. This should not prevent you from consulting with an attorney even if it is one a time basis.

Most nurse attorneys or license defense attorneys may offer a legal consultation. Pay the money and consult with an attorney. It is only your License, Livelihood, and Career on the line. I receive at least 10-35 calls or emails a month from nurses who need legal services but do not want to pay for a legal consultation or legal services. Attorneys like nurses don't work from free (this one doesn't anyway) and it is worth the money to consult with an attorney for a few hundred dollars rather than gamble with your career, isn't it?

I never represent myself. Why would I because I am biased and I would see the facts as I want to see the facts. This is human nature and this is why now more than ever it is important for nurses, a front-line providers who work as at-will employed nurses or who are part of bargaining unit, to consult with a private nursing law or nursing practice attorney about situations in the workplace. Gone are the days when you could say a hospital, nursing home, or healthcare organizations acted in the best interest of its employees; an organization asks what is in the best interest of the organization, right? It is the role of YOUR ATTORNEY to ask what is in the best interest of YOU, as a licensed nurse.

4. If you can, try to negotiate an individual employment contract with a healthcare organization which afford you the same rights physicians have in the medical staff bylaws. Individuals employment contracts hold power for nurses; it is not at-will employment or even collective bargaining. The future of nursing should be Nursing Staff Bylaws and Individual Employment Contracts for All Nurses.

Yes, I said it and I stand by it. I am on the front lines of representation because my clients are front line and bedside providers. The future of nursing lies in securing power and negotiating a seat at the table in healthcare and in the nursing workplace; this power can be obtained in Nursing Staff Bylaws and Individual Employment Contracts not Collective Bargaining Agreements and certainly not At-Will Employment, which is for the birds. This is my opinion and you should have your own opinion. You can email me until the cows come home baby and I will not change my opinion which has been solidified from years of nurse license defense practice and actual nursing practice in a variety of healthcare settings. I seriously doubt I will see cows in my backyard at my home or my office; maybe deer at my home but certainly not cows. Also I don't eat meat, but I may start again, if I see a cow in my backyard.

 

State Nursing Board Non-Compliance: If It Ain't Rough, It Ain't Right!

Thank you again to a client who had to remind me three times, yes three times to change the picture on my blog and facebook pages. I have lost a lot of weight (almost 60 pounds) and I am wearing my hair differently, so here is my new picture. 

The law practice has been extremely busy this year and thank you again to those of you who retained my services. I am noticing over the last few months, the Board cases are becoming increasingly more complex with personal, mental health, impairment, practice, or criminal aspects. 

I reviewed and revised my Legal Services Agreement to reflect the changes I am seeing in my law practice. 

1. I fire clients more readily now than in the past for not providing us with the requested information in a timely manner because this slows down the processing and reviewing of information and can lead to me being unprepared for a hearing, investigative meeting, appearance, etc. If you want a lawyer who will forget you were supposed to send in your performance evals, update your prescription meds, etc., then don't retain me. I will remember, there is a task in my project management software, AND it is in my hand-written and barely legible notes. 

2. I have a paralegal who works with me part-time and her role is exclusively Client Service, Management, and Scheduling. This has been wonderful! Thanks, Dani. 

3. I like what I do and I like who I am. Therefore I am announcing: I am a workaholic and I am proud of it. No excuses anymore like "oh, it is the nature of the beast" or "I really don't work that hard." I do work hard and I enjoy it. Therefore I am looking for another part-time paralegal to work Monday, Friday, Saturday, and Sunday in the afternoons. Also my boss is nuts and she keeps giving me work at all times of the day. 

4. Non-compliance, non-compliance, and more non-compliance. Are you non-compliant? Hell, I am non-compliant with my personal monitoring.  

If you are struggling with State Nursing Board probation and monitoring or compliance with an alternative to discipline program, get some help. Retain a lawyer to assist you. I receive more and more calls related to compliance issues than I used to because non-compliance with a contract results in breach of the contract, i.e. the suspension of a license or the inability to practice nursing. 

Why would you hire a lawyer after you have resolved your State Nursing Board case on your own? Because you need help, because you don't really understand why or what you signed and initialed fifty times, or because you have a few extra thousand dollars in your night stand. 

Life happens when you are being monitored by the State Nursing Board. Things will come up and down during a 1 to 5 year period you are being watched by the Board. Who are you going to call for assistance? Your State Nurses Association, Your Union, Your Employer, or Your Cute Lawyer. Look at my current picture and tell me who do you want to call? Call me. 

I revised my legal services agreement because in the future, I am executing another flat fee agreement when patterns of non-compliance emerge. My best friend says "if it ain't rough for some, it ain't right." This should NOT be your Motto during State Nursing Board Monitoring; maybe in other contexts but certainly not in the healthcare licensing setting.  

5. Nurses, Self-Employment, and Private Practice

I am being contacted by more APRNs in Ohio, Kentucky, and Indiana who own their own business or are planning to provide primary health services. Please keep in mind when you open a business providing healthcare services, you will need a general business attorney AND an attorney like cute lawyer to help you with nursing law, regulatory compliance, and risk management. 

I am seeing more self-employed nurses who open shop and just practice. You do so at your own peril because healthcare is highly regulated and you are assuming too much unnecessary risk, exposure, and potential liability. Yes, it costs money for specialized legal services but it is a cost of doing business in healthcare. I see this with Independent Providers, RNs and LPNs in Ohio also as well as CNS and RNs who own businesses. You cannot practice in your business and run your business without some type of risk management and regulatory compliance plan. You can but the consequences for nurses are swift and cold.

 

 

Ready or Not: the $2,500.00 State Nursing Board case

http://www.youtube.com/watch?v=W7MUKF2uE6k&feature=related

http://www.youtube.com/watch?v=0GfUPXfw5Mg&feature=related

Lauryn Hill says it best: Ready or Not.....

Ready or not and (regardless of) whether you realize it or not:

1. The State Nursing Board is investigating you if you receive a Notice of Complaint from the Kentucky Nursing Board or Indiana Board of Nursing or if you receive a Potential Violation Report, telephone call, email, or official correspondence from a Compliance Agent (investigator) or Adjudication Coordinator (Juris Doctor (law degree) prepared Staff) from the Ohio Nursing Board.  

a. It is not the role, responsibility, job, or function of the State Nursing Board or anyone who works for the Board to explain to you what this means to you, for you, and what you shoulda, coulda, maybe, or mighta do or do not. The Board's role is pubic protection: no ifs, no ands, and certainly not buts.

b. You are representing yourself anytime you are not represented by an attorney in legal proceeding. YES, Board of Nursing investigations and complaints are legal proceedings. Therefore anything you do or don't do and how you proceed in the legal proceeding before the State Nursing Board, you are representing yourself.

c. Self-Representation in a legal proceeding is a right just like deciding whether or not you want to retain legal counsel (private or have one appointed  in a criminal matter) in a legal proceeding. No, sorry, attorneys are not provided by the State to represent healthcare professionals in licensure matters.

d. You are an educated and licensed healthcare professional i.e. you have something to lose: your employability, your career, your license, your....... Therefore ANYTIME you as a licensed nurse are involved in a legal proceeding, you MUST ask yourself, do I need a lawyer?

No one is going to hold up a sign and walk a picket line in front of your home saying "Retain a Lawyer."

No one is going to tell you "you are required to hire a lawyer."

No one is going to tell you "you are nuts if you attempt to work through this on your own."

Everyone will tell you:

1. Just tell your side of the story and it will be okay (this is my grandmother's favorite that I figured out to disregard at age 9);

2. This is not a big deal as I am sure the Board of Nursing has bigger fish to fry. I love this one because not only do I like to fish for sport but I also like to eat fish: the bigger the better.

3. It is going to be okay. When anyone tells me this, I immediately think "how and why would you know how it is really doing to be or be not for me?"

4. This is just a misunderstanding, just be honest and it will work itself out. Like what, a knot?

Lawyers can be expensive for corporate litigation and other matters but license defense is actually affordable because the fees are quoted to an individual healthcare professional. Most license defense attorneys will quote you a flat fee or a retainer and hourly fee based on your case and the complexities which is actually affordable when you consider your monthly, annual, or lifetime income as a LPN, RN, or APRN.

If you are NOT willing to spend $2,500 to $__________ to defend your license in a Complaint filed against you for whatever reason, what does this mean to you and for you?

This is why I have legal malpractice insurance that covers malpractice and Bar disciplinary investigations of my license. This is why I still maintain my nursing liability insurance. This is why I just purchased media insurance for my blog and online projects. Because I am a professional, I am licensed, and there is always always a chance I can be sued or reported because of legal, professional,and personal accountability, responsibility, duties, and obligations.

I know this isn't explained in school or discussed in the workplace this way but that's a fact Jack and if you are not comfortable or PREPARED for this, get prepared or surrender your license (as a teacher, nurse, lawyer, dentist, physician, PT, etc.) and work in a field that does not require a State issued license and does not have the regulatory complexities of healthcare.

A Notice of Complaint is a Notice of Complaint and a PVR is a PVR from the Nursing Board regardless of whether or not you appreciate the significance, complexities, or law, legalities, and legal issues therein: it is what is it.

The cases I am seeing in 2010/2011 vs. 2003/2004 before the State Nursing Boards are like day and night. http://www.youtube.com/watch?v=hlbQhD2sxz8

The cases now are much more complex than the $2500 fee from yesteryear. $2500 was the standard fee I quoted years ago but very rarely do I quote a $2500 fee anymore because of the issues involved. That's why I do my own initial phone calls to nurses who contact my office because I need to listen, listen, and ask a question or two before I can quote a flat fee for representation because the $2500 standard State Nursing Board case only comes around once every blue moon and every other purple sun. I also need to review a few documents for myself to get a feel for your case because although I understand what you are telling me, I need to see the paper: black and white.

Also do you want an attorney to quote you a fee of $1,110.56 for Nursing Board representation? Do you know how long these cases take to be worked up and eventually resolved? What type of representation do you honestly think the attorney will provide to you for $1,110.56? Does this $1,110.56 include any research or prep work? What is included for $1,110.56?

This is your State Nursing Board LICENSE, not a muni court case or a will. I do not quote low ball fees just to get a case or bring someone on board and then not work up the case or answer client calls. If you want an extremely low fee, I am probably (99.99% of the time) not that nurse license defense lawyer.  

So even when you say, I called Lawyer A and he told me $2500. I called Lawyer B and she told me $5000, don't expect for me to yell out "BINGO, I can represent you for $3,750.53 and a pack of Apple Now Laters."   

I represent my clients how I would want a lawyer to represent me if: my license, my career, my livelihood and my essence was at stake because I am my license. Sorry. I know others will say you are more than what you do for a living and "your job" but not me.  I am RNBSNJD and LDW Law.  I haven't decided which I want to have on my vanity license plates, what do you think? 

I am committed to my law practice, my nursing career, and the nurses I represent. http://solopracticeuniversity.com/2011/07/12/back-to-the-root-of-things-the-role-of-servant-lawyers/.

Also think about this: are you providing the service each and everyday you practice as a nurse that you expect other service providers to provide to you and your family? If not, Houston, we have a problem.....

NO LICENSE or RESTRICTED LICENSE means a lot to you as a LPN, RN, APRN who is LICENSED or a nursing student, NCLEX-PN or NCLEX-RN on the road to licensure. Your license is always at stake in a State Nursing Board case and ready or not, regardless of whether you realize it or not, it is what it is and what it is usually just the beginning because the Nursing Board investigation is a starting point on a dim and winding path and you may not see the forest because of the trees.

Take a look at these articles.

Download BillofRightsforNursespdf

Download Nurselicensedefenseattorney

 

It is Going Down like Charlie Brown: Nursing Students will Sue!

I attended nursing school "back in the day" when nursing students viewed their instructors and professors with admiration, respect, and "awe." This was in the early 90s for me. I received my ASN in 1993 and my BSN in 1994.

Things have changed in the almost 20 years and nursing students are willing to file complaints against instructors and professors with the State Nursing Board, file complaints against their schools of nursing with the Board of Nursing, and sue! That's right baby, litigate!

I tell you there is nothing like a civil law suit and the discovery process.  I tell you a Complaint for Damages smells like a warm strawberry PopTart with sprinkles to a defense attorney. Sometimes I miss med and dental malpractice defense work (only for 3 seconds).

Former Viriginia Western nursing students were awarded damages. http://www.roanoke.com/news/roanoke/wb/291572

I expect more of these lawsuits especially from nursing students are crim-ed out, attend nursing school and spend $30k+, only to find a restricted nursing license and little to "zip" employability because of the restricted license and being crim-ed out.

What is crim-ed out? I picked this up over the weekend while out and about. You know I am a single now and I am out and about and on the loose, 60 to 90 minutes every week now. It is start. But anyway.

It is crim like brim. So crim-ed out. Crim-ed out means multiple criminal convictions, either Misters or Fellows. I picked this up to this weekend also. And no, I did not visit anyone in jail or prison and pick this up and no, I didn't pick this up at a Bar association event.

Personally I think nursing students should be more proactive as adult learners. You are seeing this now with law students who take on 100k to 150k in debt from law school to realize most attorney positions start at 35k to 55k.

http://www.nytimes.com/2011/07/17/business/law-school-economics-job-market-weakens-tuition-rises.html?_r=1

http://www.nytimes.com/2011/01/09/business/09law.html?pagewanted=all

If you are a nursing student or NCLEX-Applicant and you have felonies or misdemeanors, you need to speak with a nursing law attorney before you submit your application for licensure to the State Nursing Board. Anytime you are REQUIRED to make affirmative disclosures on a renewal or initial application for licensure, you should talk to a nursing law, nurse license defense, or administrative law attorney in your state.

Like Yesterday, Nursing Board Compulsory Examinations and the definition of Routine, Ordinary, Common, or Mundane

If you look up the words ordinary, common, routine, or mundane in any dictionary, you WILL NOT see "State Nursing Board Compulsory Order for Examination" as an example.

Why? There is nothing ordinary, common, routine, or mundate about a Compulsory Order for an Examination.

It is usually written in the Nurse Practice Act that a State Nursing Board can order a licensee or applicant for licensure by examination for a compulsory examination or order, at the expense of the licensee or applicant being investigated by the Nursing Board may have a physical or mental impairment that MAY affect the ability to practice nursing safely.

In Ohio, see ORC 4728.28(G).

Therefore let's say today you open your mail and you find a Compulsory Examination Order from the State Nursing Board ordering you to submit to:

1. Forensic Psychiatric examination;

2. Medical Examination;

3. Behavorial Examination;

4. Substance Use and Abuse vs. Dependency examination;

5. Neuro-Psychiatric examination; or

6. Psychological examination like a Fitness for Duty

then you need to:

1. Review the document carefully;

a. Sit down and take a cold shot of H20 on the rocks to clear your head;

b. Re-read the document again because I know you didn't read it carefully.

2. If you are represented by an attorney, contact your attorney and discuss; or

3. If you are not represented by an attorney in the Board investigation, you need to speak with an attorney like yesterday.

These Orders for Examination are the real deal. Yes, I know you are a nurse and maybe in one of your nursing roles you were involved in administering, observing, or reviewing these types of examinations for patients, but.....

Ask yourself, what would a reasonable and prudent nurse do at this point in a disciplinary investigation when you receive this type of Order for an Examination/Evaluation?

Do you continue to rep yourself? There is nothing wrong (or wright) about repping yourself before the State Nursing Board. It saves a dollar or two and you can then spend this dollar or two at Walmart, Target, or Lowes. I am all for repping yourself and I advocate repping:

a. Your hood (you can do this with a block party or garage sale. Invite me, please!);

b. Your block (you can do this with a swim party, block party (with a permit), or yard sale); and

c. Your City (next time you are at a professional function, wear a t-shirt saying "I love Columbus, Ohio" or the "Cincinnati Bengals  Superbowl 2020).

But repping yourself in any legal matters can be a train wreck waiting to happen.

You only have one RN or LPN (with State Nursing Board A) and when this license is investigated and you receive an Order for a Compulsory Examination/Evaluation, is saving a dollar or two in the best interest of your nursing career, future employability, future plans for nursing education, and your sanity.

For example, I received three certified letters from the IRS that were not delivered yesterday because of my two horse like dogs which roam the yard stalking birds, bees, and anything that moves. I went into overdrive and contacted the IRS about my estimated taxes for 2011 and whether or not full payment was received for my 2010 tax liability. But I thought about the worse case scenario: Oh frack, I am being audited for 2011! My first thought was will I use my acountant or retain a tax attorney now: like yesterday.  Certified letters from the IRS means "hear ye hear ye" for me as small business owner and attorney just like a Notice of Complaint, Potential Violation Report, or Compulsory Exam Order from the State Nursing Board means "hear ye hear ye" for a RN, LPN, APRN, or RN or PN NCLEX Applicant.

You have to be able to appreciate the best and worst case scenario for any workplace, licensure, legal, or State Nursing Board issue and sometime this requires the assistance of legal counsel for informed decision-making: like yesterday.  I appreciated the best/worst and WTF scenarios from my certified letters from the IRS; the letters are related to my 2010 tax liability and estimated tax payments from 2011.  

When you receive certain items, documents, or information by mail that impact you as a professional and your livelihood as a licensed professional, your natural instincts should flare up and you should go into hyperdrive like the Death Start from Star Wars in less than 10 seconds and start critically thinking about your next steps.

For nurses: it is a medical mal complaint naming you individually as defendant (because you probably do not have your own liability insurance policy), criminal indictments, certified letter from your employer after you have been suspended from work pending an investigation, letters from the State Attorney General's or Department of Health related to a workplace incident, and State Nursing Board Complaints and Compulsory Examinations/Orders.

You have critical thinking skills (if you don't email me and I will send you an invoice to pay me to help you develop those skills) so use those skills to critically think and be objective about your situation. There is nothing routine, ordinary, common, or mundane about receiving a Compulsory Examination Order from your State Nursing Board and the fact that this is "lost" of most nurses and NCLEX Applicants is troubling and speaks volumes to where we are as profession with knowledge and education of the intersection of the nursing law and professional standards of practice and the practical applications in the workplace.

 

 

Legal Consultations: One Ring to Rule them ALL and Ketchup vs. Mustard

I have from 5 to 40 legal consultations in a month usually by phone with nurses throughout Ohio, Kentucky, and Indiana. 

The benefits of a legal consultation for a nurse are:

1. You have an objective attorney reviewing your case;

2. You are able to ask questions and receive solid advice and counseling about your situation; and

3. The cost is $150-$250.00 in my law firm. Some license defense attorneys charge $500-$1,000.00 for legal consultations. For example, there is an attorney who charges $750.00 for a 2 1/2 hour consultation and this is the minimum and includes all his preparation time reviewing your materials and performing research on the issues therein.

What I am a finding however is that I have a lot of nurses who become quite hostile and argumentative with me during legal consulations because I am not telling them what they want to hear, I am not agreeing with them, or I am being "too direct and too blunt."

I think this is why we lawyers get a bad rep because it is our role to "tell it how it is." If you are paying a professional and the professional is telling you exactly what you want to hear about yourself and your situation, then you are wasting your money. 

Objective advise and counseling: this is what an attorney does. However, most nurses involved in a State Nursing Board case are proceeding pro se, most nurses being monitored by the State Board are pro se, and most nurses who are in a Board Alternative to Discipline program are pro se.

Pro se meaning you are representing, counseling, and advising yourself in the matter. It is difficult to be objective and critically review and analyze your own situation from a legal, clinical, and professional practice standpoint. When you are representing yourself it becomes a epic battle for mankind and the fate of the world rests in your hands.

I had a nurse tell me the following in reference to a State Nursing Board investigation and an employment termination, "I now know how Jesus Christ felt when he was prosecuted." No comment.

It emotionally becomes One Little Nurse vs. the Big Bad State Nursing Board (not the Big & Bad, just Big Bad) which is huffing and puffing to blow down everything you  accomplished: your licensure, your career, your family, and your life. 

It is portrayed to colleagues, family, friends, and "anyone who will listen" as serious as the epic battle for Middle Earth and the "Rings of Power" akin to good vs. evil, the Jedi vs. the Sith, and Ketchup vs. Mustard.  

If you are representing yourself before the State Nursing Board consider a legal consultation with a nurse license defense attorney in your state; it may be the reality check you need to place the case in the proper prospective.  

Hello, my name is LaTonia, I am Your Legal Therapist. My office hours are 11:30pm to 11:45pm every 3rd Tuesday of any month ending with the letter "r" or "y"

I terminated my legal representation of a nurse in the past because this nurse was just too difficult to deal work with in a professional relationship. Also the nurse refused to accept any responsibility or accountability for the actions or even acknowledge the obvious.  

We remained professional with the nurse at all times but I should have terminated the representation  earlier. I shook my head when I received the correspondence requesting the client file from the new attorney of the nurse because I would not wish that client on any lawyer.

 The nurse developed a case theory the nurse just knew would work.

I told the nurse in a nutshell even if we pretend, this ain't CSI; it is Nursing Law & Order.

Anything is possible, Neo but let's discuss the probabilities because this ties into the burden of proof and persuasion.

The spouse of the nurse berated me for not "trusting in and believing in" the nurse. FTW, you are kidding me, right?

I trust and believe Jesus died for my sins.

The spouse told me the nurse would be CLEARED of all charges at a Nursing Board hearing with a new attorney who trusted and believed.

I thought to myself: maybe an imaginary hearing with the Snow White as a hearing officer but certainly not a formal adjudication in an administrative law matter.

The nurse was nasty. This nurse was my nastiest client. By the way, I fired my first, second, and third nastiest clients. Life it too short to deal with nasty clients because I love what I do. I don't want to start calling off at work, taking extended FMLA leaves, or start smoking and then disappearing for 2 hour smoke breaks before and after my lunch smoke as a coping mechanism. 

By nasty here I am referring to a aggressive disposition, a disruptive personality, condescending tone with everyone,  emotional and uncontrollable outbursts ranging from excitement to panic to sadness to rage in 15 minutes, etc. I don't know whether to continue to take notes or  make a run to an exit but not before closing the door to lock Jack in the room.

I am a counselor; a counselor at law that is  pumpkin, not a therapist unless you need legal therapy. I guess I am a Legal Therapist. LOL. My office hours are 11:30pm to 11:45pm every 3rd Tuesday of any month ending with the letter "r" or "y" if you need assistance. I see clients, return calls and answer emails or texts and conduct business only during the stated office hours.

Back to Nasty.

Angry Nasty;

Nasty Nasty; and now

Disciplined Nasty. I mean Disciplined Hard.  I had to read and then re-read the discipline. No hearing by the way: settled.

Just a word of practical advice:

1. Allow your license defense attorney to assist you in developing your legal strategy;

2. Be honest with your lawyer; why pay your a lawyer and then lie to your lawyer? 

That's like going to a weight loss clinic and saying you don't want pills; you just came in to be weighed. It makes no damn sense; 

3. Don't watch CSI and try to develop conclusions of law and findings of fact  for your case based on a CSI episode. It is Nursing Law & Order; and

4. I zealously represent my clients and I counsel and advise my clients. But remember I critically think for a living. I make my money critically thinking about nursing and the law. All day. Remember this when you retain me and start to shovel the ......

5. Life is too short to be nasty to anyone trying to help you help yourself.

Even though you were Super Nasty, I wish you the best with:

a. Securing employment during the years your nursing license is suspended;

b. Meeting the terms/conditions for the reinstatement of your nursing license;

c. Securing nursing employment during your Nursing Board probationary period;

d. Meeting the terms and conditions of your Nursing Board probation; 

e. Having the terms/conditions of your Nursing Board probation lifted; and

f. Your nursing career.  

RN and LPN Independent Providers in the State of Ohio: Stop, Look and Listen!

More and more nurses both LPNs and RNs are having billing, nursing practice, and other issues practicing as an Independent Provider.

Home care isn't for everyone and self-employment isn't for everyone. The combination of the two can ring disaster for nurses who just jump into being an Independent Provider without any preparation.

You are a licensed healthcare professional and you are a small business owner as an IP. You cannot just jump and then figure things out as you go. This is recipe for an ODJFS Notice of Deficiency, Plan of Correction, Ohio Nursing Board Complaint, and/or a certified letter from ODJFS saying "you owe us ten million dollars because you failed to...."

What is an Ohio Independent Provider?

 http://ohioip.net/

http://www.ohiohcp.org/provider.html#php1

If you are going to be an Ohio Independent Provider you need to learn the basics of home care before you just jump.

For example, consider taking a home care course to learn about the Ohio Home Care Program. See 

http://ochch.org/associations/11629/files/MarchHC101brochure.pdf

I am actually thinking about registering for this program as a refresher.

Also why not attend a coding and billing CE for home health to increase your knowledge?

See http://ochch.org/associations/11629/files/JuneAdvancedCodingBrochure.pdf. Oh, let me guess, you just have someone "do" your coding? Bullshit. That's like me saying as an attorney "oh, I just have someone do my billing, I don't have to know anything about it."

Nurses as a group do not support and join professional associations for a number of reasons. But guess what? As a Independent Provider, you need the support. You will probably not find it in a general national or state nurses association but you should at least attending CE and training offered by ODJFS and the Ohio Home Care Organizations. Its Risk Management, baby!!!!!!!

https://m360.ochch.org/frontend/portal/viewcalendar.aspx

http://www.ohpco.org/aws/MCA/pt/sp/education_homecare

Also as Ohio IP you should have the following professionals on your team:

1. Accountant;

2. Business Lawyer;

3. More experienced IP in your County; and

4. Nursing Law Attorney (that would be me).

Things are going to come up because you are a self-employed and you want to evaluate the situations as a licensed nurses and a business owner. Also for heaven's sake, BUY Professional Liability Insurance with a License Defense Protection Benefit!!!!!!

As an IP, you can pay it on the front end with risk management, paying for consultative services, etc. or you will pay it on the back end when mistakes (practice, billing, etc.) are made. and you have to retain a lawyer to represent you before the State Nursing Board and/or in an ODJFS matter proposing the termination of your provider agreement.  

Remember this isn't Disney World: you are billing the State for skilled nursing services and you are essentially your own agency: billing for services, scheduling visits, and providing care.

 

 

The Liquor Store: Unemployment Compensation, Nursing Schools, and the Saturation of the Employment Market in Nursing

This is not legal advice because no one paid me to say this but:

 1. If you are a LPN, RN, or APRN and you were terminated from your employment with a healthcare organization, consult with a nursing law attorney BEFORE you apply for unemployment compensation benefits. 

2. By a consult, I mean pay for 30 minutes to 60 minutes of the nursing law attorney’s time and provide the attorney with your documentation to review. This is not the sixty second call you have with a nursing law attorney and the attorney is typing, eating, and listening to a podcast while taking your frantic call.  

3. Why? If you were terminated from your job and you are awarded benefits, your former employer may contest the award. I think someone in HR screams “1, 2, 3, 4, I Declare War” then the healthcare organization receives notice of a former nurse employee request for unemployment compensation benefits. http://boardgamegeek.com/thread/65396/i-declare-war. I loved this game as a kid. I grew up in a very competitive household and this game along with monopoly always resulted in a shouting match, fist fight, profanity (I learned early), or a promise for a rematch for the “title.” 

4. Why? If you terminated from your job, you may or may not be reported to the State Nursing Board if you are in a mandatory reporting state. You won’t know you are reported until you open the mail and “claim your prize” or you receive a phone call from the State Nursing Board.  

5. I had to calm a nurse down by phone yesterday who opened her mail and “claimed her prize.” I opened my own mail two weeks ago and “claimed my own prize.” I am 0.75 CLE short on my Ohio law license renewal. I have to pay $110.00 and take a one hour CLE class by April 31, 2011. This blog is Nursing Law & Order, not Nursing & Law Disorder, so I plan to take my CLE online this evening and mail the check and my CLE transcript in the morning. Yes, I know its horrible and that’s why my walkie talkie handle is the Nursing Law Bandit. http://en.wikipedia.org/wiki/Walkie-talkie. 

6. The interplay of unemployment compensation benefit appeals and procedures and State Nursing Board complaints is something I am seeing in my law practice over the last 2 years. I used to handle unemployment comp. cases (years and years and years ago) and this is where I “cut my teeth” (learned the ropes) with telephonic hearings. 

7. It is a tough job market out here for nurses in certain areas and the proliferation of nursing schools and colleges does not help. Nursing Schools are the new pills mills like law schools. http://thirdtierreality.blogspot.com. 

8. Let’s see there are LPN, RN, RN to BSN, LPN to RN, BSN, MSN, post-MSN, and doctoral programs, schools, and colleges in nursing. Just in the Greater Cincinnati area, there are maybe 20+ programs. You can open a nursing school faster than you can open a liquor store in some states IMO. Nursing Schools are on every corner in some cities like a Pony Keg selling cigarettes, beer, and lottery tickets. Come here and get your nursing education; it is on sale for $35,000.00. http://www.ehow.com/how_4549219_open-drive-through-pony-keg.html.

9. The proliferation of nursing schools and programs across the states result in more and more new grads, new nurses, and not so new nurses competing for the same jobs. This IMO prompts more nurses who are termed from a HCO to apply for unemployment compensation benefits because you don’t know if you are going to get a job. It is not like it used to be when you could get fired today and start working somewhere else on Monday. The nursing employment market (in some areas) is more saturated than my 2 y/o niece’s Pull-Up at 7am.  

10. I attended a nursing function a few months ago and I was asked “where do you practice?” I replied “in a law firm, I am a nurse license defense attorney.” The nurse, who happened to be a “nurse educator” said “Oh, you represent those nurses in the Momentum.” The Momentum is the Ohio Nursing Board newsletter. I replied where you do you practice? She said “Proprietary XYZ Nursing School, Nail Tech, and Plumbing Program.” I said “Oh, you are educating those nurses in the Momentum.”

 11. Most nurses are repping themselves in the investigation of the State Nursing Board complaint as well as the unemployment benefits compensation process. This is a NO-NO.  Guess what? You may be excited and ready to fight the first 5 weeks but guess what you will move on after 2 months and this is the point where your former employer, the HCO has declared war and is ready to fight you to hell and back for those benes, baby. 6 months to 9 months later you are going to say WTF was I thinking? I don’t have the time and energy for this shit. Also you cannot be objective when you represent yourself. You just cannot.  Find an attorney who handles admin. law cases like workers comp and SSDI to represent you in an unemployment comp. matter. I am not taking unemployment comp. cases now because my nurse license defense practice is busy; but I may have to hire a Virtual Paralegal and start taking these cases again. Unemployment comp, workers comp and license defense are all administrative law practices. 

12. Don’t have your unemployment comp. lawyer rep you before the State Nursing Board unless the attorney has experience with this niche. Yes it is all admin law but guess what? I am a nurse license defense attorney and I can take an unemployment comp case but I would not take a SSDI or workers comp. case because I don’t have experience or even an interests in these areas. 

13. If you want to play around and represent yourself, do so in traffic court. You can follow behind me when I am driving to Columbus, Indy, Lexington, or Louisville and I am sure you will get a ticket. The State Patrol are out this month!!!! You can appear and represent yourself there. But don’t do the monkey in an unemployment compensation case and a Nursing Board complaint investigation case.