nursinglawbandit

Workplace Incident to State Nursing Board Complaints to Career Blow Out to Professional Suicide and No Lawyer

The headline above is 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.

 

Kentucky Coalition of NP & NM Legislative Update

KCNPNM LEGISLATIVE UPDATE - 3/1/10

We have a new bill: HB 556

Urgent Call to Action

SB 75 is stalled in the Senate. Therefore we have switched gears. With 4 weeks left in this legislative session, we must move quickly if we want to pass legislation this year. Today, Representative Mary Lou Marzian filed HB 556 and is the chief sponsor of the bill. This bill breathes new life into our legislative effort!

Within hours, these Representatives signed on to the bill as co-sponsors: Rep. Keith Hall, Rep. Tom Burch, Rep. Charles Hoffman, Rep. Joni Jenkins, Rep. Charles Miller, Rep. Charles Siler, and Rep. John Will Stacy. Please send a thank you note to Rep. Marzian and to these Representatives. Please ask your Representative to be a co-sponsor!

 

All provisions in the previous Senate bill related to ARNP prescribing of scheduled drugs have been deleted from this bill. If passed, the current laws governing ARNP prescribing of scheduled drugs will remain the same. We believe this shows our willingness to compromise and our commitment to improving access to health care services.

 

 

Here is a summary of HB 556:

The bill improves access, especially in underserved areas, to quality,
cost-effective health care provided to Kentuckians by Nurse
Practitioners (NPs) and Nurse Midwives (NMs) 

 Makes NO Changes in Any Current Laws Governing ARNP Scheduled Drug Prescribing

• Limits on NP prescribing imposed in statute for each level of controlled substances remain unchanged.
• The Collaborative Agreement for Prescriptive Authority for Controlled Substances remains unchanged.
• The Controlled Substances Formulary Development Committee (CSFDC) remains unchanged.

Removes the Requirement for a Collaborative Agreement for ARNP Prescriptive Authority for Nonscheduled Drugs (CAPA-NS)

• Nurse practitioners in Kentucky have never been required to practice under the supervision of a physician. They   are considered licensed independent providers. However, Kentucky statute enacted in 1996 has required NPs to have a collaborative prescribing agreement with a physician in order to prescribe nonscheduled (legend)  medications. The agreement applies only to prescribing.
• Nurse practitioners have been safely writing prescriptions for non-controlled substances since1996.
• Nurse practitioners provide care in 116 of the 120 counties in Kentucky, showing a willingness to practice in  underserved areas. However, their ability to do so has been adversely affected by the difficulty in finding a  physician  to sign a collaborative prescribing agreement. Thus, NPs and NMs are increasingly limited in improving access to care,particularly for rural Kentuckians. Nurse practitioners who desire to open a practice must pay a physician a monthly fee to enter into a collaborative prescribing agreement. In some cases, this fee is very high.

Amends a limited number of statutes which currently require a signature, report, examination or order by a physician to allow NPs to perform these functions.

• Nine specific statutes which require a physician to sign, report, examine, order or certify such things as a child's immunization record, ordering and reporting HIV tests and results, certifying a family child care home provider's good health, the need for a telephone for the deaf, and reporting communicable diseases would now allow those functions to also be performed by ARNPs.
• These statutes currently limit patient access to services and limit the ability of nurse practitioners to provide continuity of care to their patients, consistent with their education and training. By amending these specific statutes, some of those limitations and barriers will be removed, and nurse practitioners will be able to make a greater contribution to protecting the public health of Kentuckians.

 

TALKING POINTS

Nurse practitioners have been prescribing non-scheduled drugs in Kentucky
for 14 years and have demonstrated that they are safe prescribers of these medications.

Research over 40 years shows that nurse practitioners:

• reduce ER visits
• reduce hospitalizations
• improve access to health care services
• reduce health care costs

The simple facts are that physicians do not want to go into primary care; the shortage of primary care physicians is projected to get worse; and NPs provide quality care and are willing help improve access to health care services.

HB 556 is not about competition among health care providers; it is about removing barriers to health care access, particularly in rural areas of Kentucky

 

CALL EVERY DAY TO SUPPORT HB 556

It is extremely important that Representatives hear from ARNPs, nurses, and the general public. Call each day until further notice and ask others to do the same. Tell the operator that you want to leave your message for your Representative and all Representatives

Legislative Message Line : 1-800-372-7181

The Message:"I am a Nurse Practitioner (nurse, physician, patient, constituent, etc.) and I urge you to support HB 556 to increase access to quality, cost-effective health care.”

FAX LETTERS TO LEGISLATORS

In addition to your calls, FAX letters to Frankfort to all Representatives asking them to support HB 556. Address your letter to "Dear Representative”. On the fax cover sheet, ask that the letter be distributed to all Representatives. You can use points from this message, previous messages, and the talking points on HB 556, which are available on the KCNPNM web site under legislative updates. Limit your letters to one page.

 

Legislators' Fax Number: 502-564-6543

 

PLEASE SHARE ANY FEEDBACK

If you receive feedback from Representatives on HB 556, please let us know.

Also, let us know if you have questions.

Thanks for all your efforts,

Beth Partin [email protected]Sheila Schuster [email protected]

This is what's needed in healthcare environments and law firms. A "no gossip" policy. If you are a nurse then you know what gossip can do in the workplace. Nursing is a female dominated profession and alot of the esteem and self-worth issues the profession has stems from this in my opinion. The law firm environments I worked in were no better with the gossip. I don't like to bring my personal life to work so it was easy for me not to provide TMI but for some their entire life and the lives of their co-workers are an open book. See this article in the NY Times and try practicing "no gossip" in your workplace. http://www.nytimes.com/2009/11/15/jobs/15pre.html?ex=1274245200&en=4ed581eee5d6aff0&ei=5087&WT.mc_id=JO-D-I-NYT-MOD-MOD-M124-ROS-1109-HDR&WT.mc_ev=click

I read this article in the WSJ last weekend and I have been thinking about this article all week. Its Life on Severance and what is being referred to as the Severance Economy. I know alot of us are just one paycheck or illness away from losing it all but for whatever reason this article hits home on so many fronts. See http://online.wsj.com/article/SB125780714976639687.html

I am looking forward to the remainder of November and December 2009. I am going to spruce up my blogs, twitter account, and law firm facebook account and start a virtual law practice complementary to my traditional law practice.

Are You a Nurse and considering law school?

See this article. http://www.abajournal.com/news/a_traditional_legal_jobs_dry_up_students_can_mold_unique_careers

25 Value Added Services to Offer Clients

See this article. http://www.law.com/jsp/law/sfb/lawArticleSFB.jsp?id=1202431410700&_ValueAdded_Free_Services_to_Offer_Your_Clients

Do you think this is applicable to consumer-oriented law firms such as nurse license defense firms?

Pro Bono work and Attorneys: Are You Providing Pro Bono Services to Clients?

See this article.

http://www.law.com/jsp/article.jsp?id=1202431941833

Kentucky Bar Association Executive Director is Leaving and the President is Facing a Disciplinary Complaint

I received my January 2009 Kentucky Bar Association Bench and Bar magazine which mentioned the limitation (this is first in the history of the KBA) of President Barbara Bonar's power as a president and then mentioned the resignation of the current Executive Director, Jim Deckard who hasn't been in the position very long. The last ED, Bruce Davis served in the position 24 years.

Bar Association ED are usually boomers and lifers, you stay in those position until you die or for twenty to thirty years and when you leave those positions you receive a blurb in the Bar Association magazine, a party with punch, cake and ice cream, a pension, small wood clock or cheap gold plated watch, and a plaque.

I don't follow bar associations as closely as I follow nursing associations, but maybe I should. What's up the Kentucky Bar Association? Things are on and popping it seems as the KBA.

See these links and make sure you read the comments. I thought it was interesting that one commenter mentioned Kentucky being a unitary bar as the problem. One blog speculated that Deckard being a Republican when the majority of Kentucky attorneys are Democrats was the issue:

http://www.courier-journal.com/article/20090206/NEWS01/902060397/1008/ARCHIVES

http://news.cincinnati.com/article/20090206/NEWS0103/902060411/-1/TODAY

http://bluegrassbulletin.typepad.com/bluegrass_bulletin/2009/02/ky-bar-association-exec-director-leaving-raises-questions.html

I didn't realize so many folks were making six figures in this country

Call me something, but I didn't realize there were so many positions that paid six figures in this country until I started reading the online articles via USA Today, NY Times, and CNN about the people who have lost these positions and who are accepting positions earning alot less.

I guess I didn't realize it because in my two professions, you don't start off or hit six figures without alot of time, education, experience, and developed expertise in general. Now of course, this does not include those law firms in NYC paying 160k to first year associates.

I would dare say from what I am reading, the average attorney in the United States does not make 100k a year.

So let me ask again, what's up with all the six figure positions in this country and why has nursing and law been left behind?