Nursing Law & Order

Don't Put Things in Your Mouth and Just Swallow: Think Fast Nurse & Name that Pill!

Get your mind out of the gutter. This is a professional and legal blog for nurses.

I don't know about you but I don't just take any pill given to me by someone, even if it is handed to me by one of my dear sweet grandmothers I have questions. The first being what are you going and why are you handing me meds to take? Do I look like a Paula Pill Popper?

I would be offended if someone gave me a pill to take. Actually I would probably smack the person's hand and the pill out of my personal space. But that's just me and I have "anger" issues (so I have been told by my son, my sisters and my mom).

Why? It is probably no big deal for the vast majority of Americans to take prescription medicine that belong to someone else. What I mean there are more than likely NO legal, career, employment, or licensure ramifications for the average American who pops a pill given to them by their uncle at a cook out.

For example, let's say, at my Fourth of July swimming pool party, I have too much to drink and I want to take something for the headache I know I will have in the morning, I wouldn't send someone in the house to "get me a pill." Why? I keep all the medication in my home in one of the kitchen pantries and the person could give me a pill prescribed for:

1. LaTonia;

2. My EX-HUSBAND;

Yes that's right. The Nursing Law Bandit is single and back on the loose. Actually I am "on the loose" maybe 30 minutes a week because of my work schedule.

But yes, I am no longer married and for that matter was never married: legally or spirtually. Name that legal procedure.

I am actually picking up my engagement, wedding band, and anniversary band today; I had the rings resized to wear on my right hand. My jeweler suggested sizing and wearing the wedding and anniversary bands as thumb rings to break up the set.

Really? I don't think so, pumpkin. My rings are gorgeous.

More later. But...

If you know a single handsome & nice man (mid thirties, early/mid forties) who is small business owner, with real and personal property, no children under 18 y/o,  and a mid-six figure income, and a decent business and personal credit score, skype me.

3. Luke (my dog);

4. Leia (my dog); or

5. My son.

Don't put things in your mouth and swallow unless you know exactly what you are swallowing: think fast and name that pill Nurse! Is it Tylenol, Profen, or Darvocet, Perc, or a Vic?

I keep my medication identifier with my calendar in my briefcase not at the poolside.

Use common sense. Nurses are licensed professsionals and you are a nurse 24/7/365. They actually should tell folks on the applications for nursing school when the schools are bragging about how much money you will make; the schools should also explain the accountability and responsibility that comes along with being licensed in an occupation with easy, easier, and easiest access to controlled substances and the skinny on what this really means now and in the future.

So here is the skinny:

1. Do not take any prescription medication that it not prescribed for you. WTH you say? I know it is a shocker but do not do it! 

2. Do not taken any medication or pills given to you by ANYONE without you viewing the medication container or pill bottle.

Anyone includes me, your mother, your father, your husband, etc.

3. If the prescription container/bottle does not have your name on it, DO NOT take the medication.

4. Do not mix your prescription medication with the prescription meds of any human, animal, or imaginary spirit. You are a nurse damn it, why are you adding different pills to the same container for ease of transportation. Really? It is one more container in your purse, book bag, or pocket book.

I keep my wallet, two prescription meds containers, three pens, small note pad, business cards, and bubble gum lip gloss in my purse along with my cell phone. What's in your pocket book?

5. Stop asking docs you work with or NPs you know to write scripts for you. It is tacky and a red flag. This isn't the 80s, 90s, or even the early 2000s when that type of conduct was tolerated. It is a risk management and compliance issues which can turn into a legal issue. Therefore ask yourself is it really worth it in light of the national spotlight on prescription drug abuse and misuse. Also it is never an issue until something happens and when it happens, it is what it is!!!

I know it happens everywhere (ER, ICU, OR, etc.) and all the time but it is not good practice. Remember you are not working at Burger King and you certainly cannot have it your way!!

5. If you are being monitored by the Nursing Board in an alternative to discipline program for substance use/abuse or in a disciplinary program for substance use/abuse or practice issues related to controlled substance documentation, you need to live and practice by #1-4 each and every day while you are being monitored by the Board and even after monitoring ends.  

The $997.00 retainer plus an Oreo Blizzard from Diary Queen: Nurse-Owned Business

Let's say you are planning to start your own home care agency, consulting practice, medical practice, staffing agency, LNC group, or any other nurse-owned business.

You will need an accountant and book keeper at some point. You may also need a practice advisor. You may also need a business law attorney to assist you with incorporation and other general business issues.

At some point however you are going to need the services of a nursing law attorney to assist with a matter, provide an opinion, or provide risk management and regulatory compliance services. 

There is only soooooo much you can obtain from websites, blogs, chatrooms, forums, and self-help and "for dummies for dummies books." I have my share of "for dummies" books. For dummies provides a general overview of what you or may not need to know on any given topic. But how do you know what you don't know if you don't know what you are doing?

I purchased one for Quickbooks for Law Firms last week. I am still on page 1. I had my personal assistant schedule an appt. with my accountant and I am going to work his book keeper and probably use Quickbooks Online for my law firm going forward. It is not an efficient use of my time to pull my hair out with Quickbooks along with the other projects, tasks, and cases I am working on in my law firm.

Trust me this law firm will not be one of the many law firms you read about that had "a bizillion dollars" stole by ABC a long-term and trusted employee over a 2 year period. How can you not miss hundreds or thousands of dollars in your own cash? I don't even keep "cash" in my wallet because I want to track/trend my spending.

There is nothing wrong with saving a dollar or two but when you are self-employed and a small business owner you have to delegate at some point. You must also pay for professional services for your business. I am a small business owner and I also practice law which means I had to find a system/process for delegation which fit my non-traditional law firm and niche law practice: just nursing.

I finally figured out how to make it work for my law practice. My office manager is Tina. Tina works me virtually M-F, 9am to 3pm. Tina manages my online calendar, schedules my appointments, and assists me with new case intake and processing.

I have two personal assistants. Maya works 0930 to 2pm M-F with me and Jaren works with me from 10am to 5pm M-F. Jaren and Maya work together and directly with me on a variety of law firm, professional, and personal projects/tasks.  We are working with a new project management software which syncs perfectly with Google Business Apps.

Google Business Apps (paid version) is the truth.

Jack works me sometimes a little, sometimes a lot, depending on the caseload and what he has cooking in his own business.

Hiring staff, independent contractors, or retaining professionals to provide professional services costs money.  However the key is reviewing what works for you depending on your business and practice model; it took me 3 years to figure out what works for my law practice and my law firm.

It is worth every penny to have client calls answered promptly, to have client meetings scheduled immediately, and to have a team to really work up and run the lenght of a case that is needed in license defense and a nursing law practice. My overhead with my part-time staff is reasonable and certainly signficantly less than what you see with a traditional law firm staffed with a receptionists, secretaries, paralegals/legal assistants, practice managers, attorneys, etc.

There are only so many "For Dummies" books and manuals you can read. I have Excel for Dummies and I have not opened the book in 3 years. I hate Excel because I was not trained properly and it is not a skill which I need in my knowledge, skills, and abilities to practice as a nurse license defense attorney.  

I am waiting for release of Vegetable & Chicken Noodle Soup (with crackers) for Dummies. I will pre-order my copy on Amazon.com when available.

At some point you have to bite the bullet and hire a professional to assist you in providing specialized services for your business. Also there are soooo many arrangements available now outside of the traditional employer-employee relationship.

During my two and half weeks off in the form of staycation (I am too busy to take an actual vacation this summer) I spoke with a number of nurses involved in State Nursing Board investigations and post-discipline cases. Some retained me and some did not, for whatever reason.

I am not the cheapest attorney and if you are looking for someone who can give you the " K-Mart Blue Light Special" on a flat fee; 99.99% of the time, it will not be me.  There are a number of attorneys who handle these cases (Columbus, Indianapolis, Louisville, and then there is me here in Cinti practicing in all three states) and I quote the fee based on the information I have and the intake interview. If your case is more complex, the fee will be higher.

If you had licensure issues as a LPN, RN, and now again as a APRN, this will be reflected in the fee I quote; your fee will not be $2,500.00. Sorry. Maybe in another practice but not here. I am not just taking cases to take cases; I take cases to work the case for the long run. I am "in it to win it" like Hil Clinton. She is coming back, you know.

Maybe once I hit the lotto, I can advertise that I will accept any licensure case, any case, and represent from investigation to hearing to post-disciplinary monitoring and beyond (head to toe) for $999.97 and a large Oreo Blizzard from Diary Queen, but not today.

Nurses who are small business owners will eventually need the services of a nursing law attorney to assist with some aspect of the business. I am a nurse who owns a small business. Retain an attorney and move forward with your business; it is a cost of doing business and it helps you safeguard your nursing license if you are also practicing in your business.

Similiarities between Criminal Defense and Nurse License Defense: Doing Time & the Expecations of Representation

I am on a staycation for the next two and half weeks. My first stayaction but certainly not my last. I am taking new cases and scheduling legal consultations and using the "staycation" to work up my cases. I am also taking time off for one week in July and one week in August. I am actually planning to take a one week staycation every month going forward for the remainder of the legal career so that I can make sure I am taking care of myself in addition to my clients, etc. I am also rearranging my work schedule and my life in the process. More on this later.  

I want to introduce you to my personal assistant Maya. Maya works as my personal assistant Monday-Friday 10am to 2pm. I am training Maya to essentially function as my legal assistant and paralegal and to assist me with my cases, marketing, and other law office projects. Maya works with me from my home office and she also works from my traditional office as well. Maya's direct dial and Skype is 513-258-2876.

Why a personal assistant? I do not have a traditional law firm and therefore my attempts to hire someone trained as a legal assistant or paralegal failed miserably because most could not wrap their minds around the setup of my law firm because their background was traditional law firms: punch a time clock, receptionist, paralegal, secretaries, stacks and stacks of paper files, and everyone on one floor in the same building. This is why I hired a personal assistant and I plan to train her to my practice.

Also I want to introduce you to Tina, my Intake Specialist and Scheduler. Tina manages my calendar and schedules all of my appts. Tina's lives in central Indiana and works for my law firm virtually. Tina works Monday-Friday 9am to 4pm . Tina's direct dial and Skype is (765) 588-4304.

I am attending a webinar for criminal defense attorneys. I tell you there are more similiarities between criminal defense and licensure defense than differences.

How do you deal with a client with unrealistic expectations? This was the first question posed by the presenter. I deal with this issue every day, day in and day out. Expectations of the Representation.

The presenter also mentioned that the role of a criminal defense attorney usually boils down to persuading a client to take a miserable sentence vs. a horrible sentence. Wow!!!! Although action against the license isn't a "loss of liberty" or even remotely similiar to jail time or doing time in a state or federal prison, the reality is "action against the license" whether a public reprimand, probation, suspension, non-permanent revocation, or permanent revocation is akin to a professional and career jail sentence in a sense.

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.  

Nursing Law & Order is Seeking Four Nurses to serve as Regular Contributors

Seeking Freelance Nurse Authors to serve as Regular Contributors

I am seeking four freelance (hint: 1099) nurses to serve as the regular contributors for a monthly publication.  

Each nurse author will be paid a flat fee for a 500 word article with web references. The regular contributor will have his/her name listed as the contributor for the piece and will be able to include a short bio with his/her contact information including email address.  There are several benefits to being the regular contributor for these column including opportunities for professional growth and development.

 The monthly publication is not a nursing journal. Therefore the writing style required is  somewhere between a nursing blog and a nursing magazine.

Nursing Law & Order: Criminal Intent™

* This column will focus on forensics and criminal law with a nursing and healthcare twist.

Author Qualifications:

* RN, BSN with at least 5-10 years direct care experience;

* active nursing license in any state; and

* law, legal, or forensics education, experience, training, or interest preferred.  

* RN/JD, LNC, Nurse Paralegal or RN law student encouraged to apply.

Nursing Law & Order: KVO™

* This column will focus on the latest and most current news and professional practice matters facing nurses.

Author Qualifications:

* RN, BSN with min. of 5 years direct patient care experience;

* active nursing license in any state; and

* diverse nursing background, training, and experiences in a variety of healthcare settings.

Nursing Law & Order: NPO™

* This column will focus on addiction, substance use and abuse as well as recovery, relapse, and return to work issues for recovering nurses.  

Author Qualifications:

* RN, BSN disciplined by the State Nursing Board and/or who has completed a Nursing Board Alternative to Discipline Program for Chemical Dependency. Disciplined nurses encouraged to apply;

* has at least 5 years of sobriety;

* has a active nursing license; and

* has returned to nursing practice providing direct patient care.

Nursing Law & Order: Scoped Out™

* This column will focus on practice and trends for those of us with the broadest scope of practice and possibly the most potential for liability: APRNs.

Author Qualifications:

* APRN with at least 5 years of direct care experience as a APRN;

* active nursing license in any state; and

* diverse RN background, training, and experiences in a variety of healthcare settings and roles.

How to Apply?

If you are interested in being the regular contributor for one of the columns above, please send the following as attachments by email [RE: Nursing Law & Order Contributor] to Tina, my virtual assistant at [email protected]  (you can copy me on the email at [email protected]) by May 16, 2011: 

1. an updated resume/CV;

2. writing sample or journal publication;

3. a copy of your State Nursing Board license (just print it from the Board website); and

4. a cover letter detailing why you are interested in being a regular contributor for the column and what skills you bring to the role.

Additional information will be made available. Thank you for your interest. If you have questions, you can email me at [email protected].

Nursing Law & Order Blog is accepting Guest Posts from Nurses

Do you have something you want to say to the Nursing Law & Order readership?

Do you want to write and publish but not necessarily in a traditional nursing journal or magazine?

If so, consider submitting a Guest Post to the Nursing Law & Order blog.

Why? More of us need to publish and formally express our thoughts online outside of an online chatroom or forum.

Benefits? Money, Power, Prestige, and a New Lexus. (just kidding)

I would love to see Guest Posts on the following topics:

* Unions and collective bargaining;

* Predictions for nursing in 2020;

* Legal issues encountered in a specific practice setting;

* Night Shift Nursing;

* Nursing education;

* Self-employment for nurses;

* Career coaching for nurses;

* Career development for nurses;

* Substance use and abuse;

* Recovery, Addiction, and Impairment;

* Clinical practice issues;

* Transitioning from a student to NCLEX-Applicant to newly licensed nurse;

* Entry level nursing management and how to transition from staff nurse to manager; and

* Emerging issues in the nursing workplace and workforce.

  Guidelines for a Guest Post on Nursing Law & Order

• Your Post must include full name and a personal email address. No blind posts will be accepted for publication;
• Your post must be original and must have never been published before on the Internet;
• You agree to not publish the post anywhere else (i.e., in your own blog or as a guest post in other blogs);
• You can include one link in the byline, which will be displayed at the bottom of the post;
• Your post must be educational or informational.
• Your post must of course involve nurses or nursing.
• Your post should be at least 400 words.
• Your post cannot mention a specific organization, group, or association unless you are authorized to speak on behalf of the organization, group, or association.  
• Your post cannot trash a State Nursing Board or a nursing employer, group, or association.
• Your post should directly or indirectly relate to one or more of the many categories for blog posts on Nursing Law & Order.
• You must be a nursing student, LPN, RN, APRN or have nursing training (if your license is suspended or revoked).

Email your Guest Post as an attachment [RE: Nursing Law & Order Guest Post Submission] to Tina, my virtual assistant at [email protected]. You can also copy me on the email at [email protected].

If your Guest Post is not accepted for publication to Nursing Law & Order, you will be notified by email. I reserve the right to reject any Guest Post for any reason but an unlawful reason at any time, something like at-will employment. If you have questions you can email me at [email protected].

Alot vs. A lot: Constructive Criticism about Nursing Law & Order. What about allot?

When you blog alot and you have an extensive readership, you can expect alot criticism. You put yourself out there. I have no problem with alot of constructive criticism of Nursing Law & Order. It goes with the territory and I have a thick skin. For example, I know my alot blog posts throughout the years since I have blogged since 2006 have typos and grammatical errors. I used to run alot of my blog post through a spell check and grammar check software but when you wear multiple hats as a solo and you are trying to get the information out to nurses something has to give. When I post a blog post, I am not writing an article to a nursing journal and if I put the time into my blog posts that I put into reading, re-writing, and proofing a document, I would have may 85 blog perfect blog posts instead of 1100+ blog posts. Yes, I blog hard, baby. I blog alot.

However incorrect grammar and typos should not appear in any blog or in any publication especially one written by a lawyer. What is the solution for someone like me with a heavy case load who loves to blog but can't take 4 hours to draft and proof a blog post like a legal document? Tina, my VA.

I recently hired a virtual assistant to work with me on alot of administrative projects and tasks. My virtual assistant Tina will actually start with my most recent blog posts and work her way back, one hour each week, correcting alot grammar and typos in my blog posts. If you find something and you just feel the need to pass it along on the blog, send it to Tina at [email protected] with the Date and Name of the Blog Post and she will take care of it. Actually she may thank you, Lisa the NP for providing her with alot of additional tasks to bill. Make sure you include [RE: Nursing Law & Order Typo and Use of Alot]

Who is Lisa, the NP? She is a NP who sent me an email this evening about using alot (which is not a word) instead of a lot because use of alot instead of a lot is a Pet Peeve of hers. I like alot instead of a lot because that extra space is wearing down my thumb and  I am sure I have alot and/or a lot throughout my blog posts alot over the years as Lisa also noted. Although, Lisa noted I used alot more than a lot in alot of my blog post; she did not give me a percentage however of my use of alot as compared to alot vs. allot. Lisa, the NP, thank you for taking alot of your time with your review and thanks alot for the constructive criticism of my blog. You spent alot of time reviewing my blog and the only thing you commented on was my use of alot vs a alot; nothing about the content. Go figure!

I will make sure Tina corrects my use of alot in all not just alot of my blog posts from 2006-2011 starting with this one. I may also take a refresher course this year on the proper use, balance, and mixture of the King's English vs. Urban and Rural Slang in niche blogging. Thanks alot, Lisa. Thank you alot more, Tina.  

My Name is Jack: I am a Recovering Addict and a former CRNA who is clean and serene!

This is a guest post by Jack Stem.

My name is Jack, and I'm a recovering addict who is grateful to be clean and serene today.

20 years ago, when I began my journey in an attempt to be “normal” again, I wouldn't have been able to say those words out loud, let alone write them down and then publish them on one of the most read nursing law blogs available. As a health care professional, I believed that my training would keep me safe. Guess what...that's one of the biggest myths associated with this disease (and yes, it IS a disease).

I was an emergency room nurse and then went on to become a Certified Registered Nurse Anesthetist (CRNA). I had found my dream job. I was good at what I did. Every day was a new challenge that would test my skills and knowledge. Shoot, there were times when I thought to myself, this all has to be a dream come true. Beautiful wife, wonderful, healthy daughters, a great job, nice home. My colleagues respected my abilities and I had one of the highest request rates of anyone in the department. That all changed in 1990.

 I had spondylolisthesis and dealt with chronic back pain since my late teens. Nothing I couldn't handle with a day off and a couple of doses of percocet. In 1990, my pain flared up and I did my usual prescription and a little time off. This time was different. This time the pain didn't improve. In fact, it became worse.

 Our case load was high and I couldn't take any more time off. If I did they would have to close one of the OR's. Being the good, co-dependent nurse, I sucked it up and returned to work. When I'd get home, I would lie on the floor with an ice pack and take my percocet. One pill became 2, then 3, then 4. After several prescriptions my doctor wouldn't write anymore (“Jack, your pain can't possibly be as bad as you say.” Thanks doc!)

 When I couldn't get any of the residents to write me a prescription, my addicted brain (yeah, there's no doubt in my mind my disease had developed by then) said, “Jack, you are squirting perfectly acceptable fentanyl down the drain everyday. How dumb is that? Take the waste home and get a good night sleep!”

 So that's what I did. Well, once the beast is released, the speed at which the disease progresses is determined by the potency of your “drug of choice”. I always find that phrase to be ironic. As an addict in active disease, THERE IS NO CHOICE!

I almost ended up dead...twice. The first time was because I didn't want to be alive. I didn't want to hurt and embarrass my family (which is exactly what would happen if I was ever found out). I had prepared a mixture of drugs that would have killed me and 5 other people. Fortunately, I never was able to put that plan into motion. Someone walked into the locker room before I could complete the deed. It gave me plenty of time to reconsider what I was about to do. I had 2 daughters who loved me. My wife and other family members did too. So I changed my mind (thank GOD!)

 A couple of days later I had a semi-emergent spinal fusion (foot drop and numbness that wouldn't go away). I was off work for almost 5 months. When I returned to work, I wasn't prepared for what happened. When I opened the first vial of fentanyl for my first case, I broke out in a total body sweat, my hands and legs began to shake, and I thought I was going to puke! I had just experienced my first “trigger”. Since the brain of an addict is transformed as a result of their genetics (yes...addiction is a genetically based disease) and the chronic misuse of large quantities of mood altering chemicals, repeating some of the actions associated with “using” can trigger huge activity in the limbic areas of the brain. This activates a craving (the uncontrollable desire to obtain and use your drog of choice). I didn't return to use that day. But when I did later in the week, I accidentally overdosed. Fortunately, my then 4 year old daughter forgot her swim suit for lessons and had to return to pick it up. She came into the bedroom where daddy was taking a nap to give me a kiss. She told my wife, “Daddy is a funny color.”

The next thing I know I'm in the back of an ambulance heading to the ER. That's when I finally admitted I was addicted to opioids and entered treatment. I struggled for quite awhile before I finally was able to get clean and remain clean. My addiction cost me almost everything...my career, my marriage, my home, and almost my life.

Today, I am able to say I have 16 years and ten days clean. I'm a peer advisor for Ohio's CRNAs. I consult with LaTonia to assist her clients dealing with substance abuse and chemical dependence. I provide educational presentations to schools of nurse anesthesia and nursing programs to fill the huge gap that all nursing schools, medical schools and other health care programs leave out...education about the disease of addiction. I'm grateful to those recovering individuals who have helped me achieve and remain clean. I'm grateful to LaTonia for having the foresight to allow me to use my experience, strength, and hope as well as my anesthesia and nursing background to assist my colleagues in achieving recovery and return to the practice of nursing. I'm grateful to be able to help one person at a time realize that they aren't stupid, evil, people.

 The person unlucky enough to develop the disease of addiction isn't a bad person trying to become good. They have a chronic, progressive potentially fatal disease affecting the brain, and they want to become well. Sadly, our profession rarely helps their colleagues when they suspect someone may be struggling with substance abuse or addiction. No, too many nurses ignore their colleague until they can no longer ignore them anymore, or until they find them dead in the locker room or call room. I'm doing my best to change things.

Look for more posts in the future. Until then, keep taking it one day at a time!

Look for some of my posts on AllNurses.com in the “Nurses in Recovery” section.

 Jack Stem

Peer Advocacy for Impaired Nurses, LLC

www.peeradvocacyforimpairednurses.com

513-833-4584

[email protected]

 

Nursing Bermuda Triangle: Educational & Legal Self-Help Service for Nurses™

Although these are tough economic times nurses need legal counsel and advise AS issues arise.

You know me and my need to offer "bespoke" legal services for nurses. This isn't the End of This Lawyer; Just the Beginning.  

http://www.ignitelaw.com/2011/03/bespoke-legal-services-in-an-off-the-rack-culture/

http://myshingle.com/2011/01/articles/myshingle-solo/ten-solo-and-small-law-firm-trends-2011/

http://www.susskind.com/endoflawyers.html. By the way, I love this book!!

This is why I am offering an Educational & Legal Self-Help Service for Nurses™.  The cost is $500.00.

Never boilerplate just bespoke here because:

1. You pay for the service;

2. You tell me what are your practice and legal issues;and

3. We develop the content for you.

* Don't know what you don't know. We can brainstorm by phone and/or email first.

* Have documents you can't make sense of but you know are important because its from the State Nursing Board?

* Need email consultative services.

* Need a legal opinion.

The service includes a 30 minute telephone or video teleconference with me to review the content with you and discuss your practice, situation, or matter. It may also include articles, podcasts, etc. depending on your comfort with technology. I can also point you in the right direction if you need legal services from a licensed attorney in your state or jurisdiction.

Nursing school and nursing practice does not prepare nurses IMO for strategies to address the Nursing Bermuda Triangle: The Application of Nursing Law, Ethics, and Professional Standards in the Nursing Workplace.  

http://www.ncbi.nlm.nih.gov/pubmed/18524302

This is another service offered to nurses across the country. This service will be expanded in the near future to include other benefits.

Stay tuned because there will be additional products and services rolled out this year along with a redo of my blog and website.

Bespoke baby Bespoke!!!!!

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

 

 

Please do not retain me as your nurse license defense lawyer if......

Don't retain my services if you want:

1. A lawyer to tell you did nothing wrong and the Nursing Board Complaint is 100% factually and legally invalid;

2. A lawyer to tell you what you want to hear about your nursing practice;

3. A lawyer who allows the professional attorney-client relationship to become social, like a "Girls Night" or too personal. Like EPMD, I am Strictly Business when it comes to nurse license defense and the practice of law.

http://www.youtube.com/watch?v=a4LVRg_TNZo&feature=related

Don't get me wrong. We are involved with our clients but it is a professional relationship with personal aspects of involvement of course. You get enough personal about me on this blog don't you???

Also I don't subscribe to "mixing of personal, professional, and business" social media accounts like facebook, twitter, etc. that some of the marketing and social media consultants suggest.

http://www.jeffkorhan.com/stand_out_in_your_market_/2011/02/business-relationshiops-are-personal.html

http://www.jeffkorhan.com/stand_out_in_your_market_/2010/11/personal-vs-professional-social-media-accounts.html

Its all business for me with a personal twist here and there. Sorry but I am old school and not changing here because there are way too many issues with boundaries, ethics, and conflicts of interest when you become friends with your clients; afterall it is a professional relationship and it is a professional relationship for a reason.

4. A lawyer who just holds your hand and tells you its going to be okay;

5. A lawyer who does not ask questions and then more follow-up questions and then asks for documents, records, and other correspondence including but not limited to your first grade picture;

6. A lawyer who believes everything you say is 100% factually accurate and the Gospel, just because you said it;

7. A lawyer to tell you what you want to hear about your case;

8. A lawyer who allows you to run the case and the defense; its your license and its your case but we work together;

9. A lawyer who will not call you on your bullshit;

10. A lawyer who will not question you because:

A.  a APRN; I have a apron also.

B. You are doctorally prepared (to give enemas);

C. You have a three lines of certifications and degrees behind your name including but not limited to FAAN; I have a fan in my home office and I plan to buy one when I receive my tax refund for my real office.

D.  You are older than me. I am 39 y/o. If you want a boomer lawyer your age then find one;  

E. You are married to, dating, shacking, and/or fracking a physician, lawyer, and/or dentist?

10. A lawyer who you can spin; I have been doing this a while, no spinning.  

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.

 

 

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

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

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

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

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

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

Why is this important for nurses?

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

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

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

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

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

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

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

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

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

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

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

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

 

 

 

Legal Audit: Nursing Career Plan™ is a Risk Management, Workplace, and Career Guidance Tool & Service I am offering for Nursing Students, NCLEX-Applicants,LPNs, RNs, and APRNs

Legal Audit: Nursing Career Plan™

The Legal Audit: Nursing Career Plan™ is Your Nursing Care Plan

I know you still remember nursing care plans even though the NCPs are generated by software these days.

 http://www1.us.elsevierhealth.com/MERLIN/Gulanick/Constructor/

I graduated from my ASN program in 1993 and my BSN program in 1994 so NCPs were done the old fashioned way: by hand.

The Legal Audit: Nursing Career Plan ™is similiar to the nursing care plans we developed in our entry level nursing programs.

What is included in your Legal Audit:Nursing Career Plan™ depends on where you are with your nursing career whether its pre-licensure, post-discipline with the State Nursing Board, in an alternative to discipline program, in graduate school, going up (or down) the clinical ladder in a particular institution, etc.

Why do you need a Legal Audit:Nursing Career Plan™? Every nurse needs a Legal Audit: Nursing Career Plan™ because it takes into the risks and liabilities and specifics of your education, licensure, practice area, specialization, certifications, and assists you with the self-regulation of your nursing practice. Essentially you are caring for yourself, your license, your practice, and your career by being your own risk manager and advocate. The Legal Audit: Nursing Career Plan™ involves you reflecting and assessing your practice with the assistance, advice, and counsel of a nursing law attorney.  

What is self-regulation of nursing practice?

http://www.cna-nurses.ca/CNA/documents/pdf/publications/NN_Understanding_Self_Regulation_e.pdf

http://www.cna-nurses.ca/cna/documents/pdf/publications/SelfregulationFeb2001_e.pdf

I have wanted for sometime to offer a risk management product and service for individual nurses regardless of the state of licensure and the Legal Audit: Nursing Career Plan™ is it.

For nurses who are of course, in Ohio, Kentucky, and Indiana, the Legal Audit: Nursing Career Plan™ offered by my law firm can of course include legal advice and counseling.

For nurses in other states, the Legal Audit: Nursing Career Plan™ offered provides workforce and worplace counseling but no legal advice. Sorry, no legal advice but I can offer workplace and career counseling.

How will you benefit from a Legal Audit:Nursing Career Plan?

1. Let's say you are probation and monitoring with the State Nursing Board. The Legal Audit: Nursing Career Plan™ will review with you the strategies to work through this process establish goals, interventions, and tasks, address common issues, and review legal concerns.

2. Let's say you are in a State Board alternative to discipline program. The Legal Audit: Nursing Career Plan™ will review with your the strategies to work through this process, establish goals, interventions, and tasks, address common issues, and review legal concerns.

3. I hear alot, do I need my own professional liability insurance policy? This would be part of your Legal Audit: Nursing Career Plan™ and along with reviewing your practice area, certifications, employment, licensure, and case law in your state to determine the necessary coverage offered by various nursing insurer if you identify this as an issue.

4. Let's say you are ARNP and you have an employment agreement and collaborative physician and a collaborative agreement. Your Legal Audit: Nursing Career Plan™ could entail of a review of these agreements and with plans to review and discuss your areas of concern.

5. Let's say you are planning to start your own nurse owned business. Your Plan could review the basics and address some of the liabilities and legal issues presented.

6. You are a home health RN and you are also self-employed as an Independent Provider in Ohio. Your Legal Audit: Nursing Career Plan™ could focus on the legal issues facing nurses practicing dually as home health nurses and as a IPs. Are you working as nurse for multiple facilities? Are working as a RN here and as a APRN elsewhere? Same for ICU, ER, Telemetry, Skilled Nursing Facilities, Ambulatory Care, Clinic, Self-Employed, Private Practice, etc.

7. Let's say you are work primarily as a charge nurse in a hospital, your Legal Audit: Nursing Career Plan™, will be different from a charge nurse in a nursing home or from unit manager or middle manager in a hospital.

8. The Legal Audit: Nursing Career Plan™ for APRNs will different from LPNs and RNs and certainly the same can be said based on roles such as Clinical Nurse, Nurse Educator, Nurse Manager, or Nurse Expert Clinician.

9. New graduates, Nursing Students, and NCLEX-Applicants. Your transition into professional nursing practice can be alot smoother with a plan because you don't know what you don't know until you know it and its usually the hard way. Why not start your nursing practice with a Legal Audit: Nursing Career Plan™ that identifies the risks associated with your practice area, takes into account your strengths and weaknesses as a new nurse, and assists you with the transition to professional nursing practice and developing your career.

Every Legal Audit: Nursing Career Plan™ will be different and there is no standard plan because the audit is based on the three issues and concerns you identify and is tailored to meet your specific licensure, education, certification, practice areas, etc. and the documents you provide me to review.

The Legal Audit: Nursing Career Plan™ focuses on the three issues you identify and I assist you with addressing, reviewing, identifying, and mitigating legal, licensure, career, and other pitfalls in a 30 minute conference call.

This is a basic risk management service offered to nurses because the majority of nurses don't have a nursing practice counsel or nursing law attorney on retainer to assist the individual nurse with law, legal, workplace, career, or the legalities associated with nursing practice.

Also most nurses don't belong to a professional association which may or may not offer this type of service which is combination of licensure, career, employment, legal, workplace, labor, and "as otherwise identified" issues specific for RNs, LPNs, and APRNs.

Please don't send me hundreds of pages of documents and expect that this can be covered in a 30 minute consultation and video or conference call because I will refund the fee and cancel the appt. Sorry. You need to retain me if you have hundreds of pages of documents you need to be reviewed:)

We can skype your Legal Audit: Nursing Career Plan™ as a video conference call or a just plain conference call.

My law office skype name is: nursinglawattorney

My law office skype number is 513-729-6989.

I am offering the Legal Audit: Nursing Career Plan™ service FREE to my law office clients. Happy Birthday and Merry Christmas to my law office clients.

If interested:

1. Pay for and schedule a date and time for the Legal Audit: Nursing Career Plan™ at  http://www.bookfresh.com/profile/157503739.

2. The cost is $250 for a 30 minute Skype video call or telephone conference call.

3. I will need an updated CV/resume and work history. You will receive an email listing the information and documents I need from you prior to the consultation based on the issues and concerns you identify.

4. If you have legal documents, contracts, or agreement for me to review. Scan/email, mail, or fax to me prior to the consultation please. My fax number is 888-580-1119.

5. Once you pay for and schedule the Legal Audit: Nursing Career Plan™, you will review a packet of information for you to complete and return to my office.

6. Based on the issues/concerns you identified, you will also receive a packet or a package of informational and educational materials and documents by mail and information via email. Yes, there is homework because you will have to "stay the course" after the consultation. I want you to suceed (this isn't a scheme just to take your money) and I am going to provide you the materials to assist you with this process. I will be your Legal Cheerleader!!!

7. After the Legal Audit: Nursing Career Plan™ video call or conference call, you will receive your "plan" as a PDF file from me.

Take charge and grab "self-regulation of nursing practice" by its horns by identifying, managing, and mitigating the legal risks of nursing practice  while plotting the trajectory of your nursing career with your very own Legal Audit: Nursing Career Plan™.  I love it! This sounds so sales like; I am also selling a used car and a tattered blood pressure cuff if you are interested:) Just kidding!

 

 

 

 

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

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

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

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

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

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

1. You are a licensed nurse.

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

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

4. You are practicing as a nurse.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

 

Nursing Nirvana vs. I am nursing just for the paycheck. I am Nurse Paycheck

If you work on a unit, floor, hall, or facility and there is a consistent amount of turnover between 25% to 85% of the direct care staff, ask yourself why are you continuing to work at the facility in a 1.0 or .9 FTE position?

http://www.kcbd.com/Global/story.asp?S=14155122

http://roa.sagepub.com/content/28/4/454.abstract

http://www.longwoods.com/content/19594

http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Volume122007/No3Sept07/NurseRetention.aspx

If you are working on a unit, floor, hall, or facility and this is your 3rd nursing manager in 14 months, what does this say to you about the work environment?

We all need money and everyone who is reading this blog is probably working full-time plus however working hard and working smart are two different premises.

http://can.affiniscape.com/associations/9102/files/October%202006-NTW%20Being%20a%20Self%20Advocate.pdf

http://can.affiniscape.com/associations/9102/files/November%202006-NTW%20Collaboration%20With%20Your%20Boss.pdf

http://can.affiniscape.com/associations/9102/files/NTW2008July.pdf

Is there a perfect work environment? Yes, but not when are you working for someone else. I learned this early in my nursing career and then again early in my legal career.

However as professional nurses its not about finding the perfect work environment because in the highly regulated and fast changing healthcare environment, nothing is perfect. Professional nurses MUST have a written career plan.

Is your current employment with Hospital A, Nursing Home B, or Home Health Agency C your career plan or a step or level in your career plan?

If you are a nurse strictly and primarily for the paycheck then it may show in your interactions with staff, patients, and families. There is nothing wrong with nursing just for a check but there is nothing right about it either. However the same can be said for any profession, occupation, or trade.

Are you Nurse Paycheck?

Did you transition into nursing just because the potential for high earnings when compared to the length of education (one to two years)?

If so, don't go in a patient's room and say I am _____, your nurse for 3-11. Be honest and say,

Hi, I am Nurse Paycheck and I will be working with you, hopefully for as little as possible and just enough to meet the basic standards of care. I am here today, just for the check.

IMO a Professional Nurse can become a Nurse Paycheck from burn out, despair, lateral violence, or just being "beat down" from working with a particular nurse manager, on a particular floor, unit, department, specialty, or specific patient population too long.

I never wanted to be a Nurse Paycheck and I certainly won't be Lawyer Paycheck.

IMO its about finding an environment where you feel valued as an employee, you are able to practice nursing safely, and you are fairly compensated. Having a "plan" for your nursing also helps; don't just show up to work, punch in, and work year after year. What is your plan for your nursing career?

Have you found your Nursing Nirvana? I am still working on mine over here.

 

 

 

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

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

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

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

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

 

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

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

By Email:  [email protected]

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

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

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

2. An Examination Order from the Ohio Nursing Board.

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

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

C. I don't need a lawyer because:

1. Its too expensive.

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

2. Hiring a lawyer make me look guilty.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Why is this a big deal?

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

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

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

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

Why is this a big deal?

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Okay, I am drowning in email.

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

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

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

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

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

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