46 Ohio nurses did not defend themselves?!

Posted on January 22, 2016 by Beth Collis

Yesterday, I attended the January meeting of the Ohio Board of Nursing. On the morning agenda, the Members of Nursing Board voted to issue a Notice of Opportunity for Hearing, Notice of Immediate Suspension, or Notice of Automatic Suspension to over 60 nurses.

Additionally, the Nursing Board voted to impose a final disciplinary sanction (suspension, revocation, or limitation) on over 100 nurses’ professional licenses in Ohio. I was struck and saddened to learn that in 46 cases, the nurse failed to request a hearing and never introduced ANY evidence in their defense.

If a nurse fails to request a hearing, the Nursing Board is authorized to impose any sanction from dismissal of the case to permanent revocation of the nurse’s license. If a nurse fails to request a hearing, the nurse may not submit any evidence in their defense.

It cannot be understated the positive effect that can result when a nurse presents “their side of the story”, explains what happened, and puts the Nursing Board’s allegations into context. The Nursing Board members like to see that the nurse understands the gravity of the allegations, accepts responsibility (where warranted), and fights for their license. In certain instances, where the nurse presents evidence rebutting or refuting the Nursing Board’s charges, the Nursing Board has been known to dismiss certain counts in the Notice or dismiss an entire case against the nurse.

At the meeting yesterday, based on mitigating evidence that was introduced in one case, the Nursing Board modified the recommendation of the Hearing Examiner from a 6 month suspension to no suspension and simply placed the nurse on probation.

As a nurse, you have worked hard for your professional license. If you are notified by the Nursing Board that they propose to take an action against your license, request a hearing and defend yourself. While you may represent yourself before the Nursing Board, please note that the Nursing Board will be represented by an attorney from the Office of the Ohio Attorney General who will prosecute the case on behalf of the Nursing Board. It is recommended that you should also have experienced counsel to represent you in this stressful and difficult process.

If you have any questions about this blog post or the Ohio Board of Nursing in general, please feel free to contact one of the attorneys at the Collis Law Group, LLC at 614-486-3909 or email me at beth@collislaw.com.

What part of NO ALCOHOL don’t you understand?

Posted on December 16, 2015 by Beth Collis

I am reposting this blog from 2012 as nurses routinely test positive on random drug tests after consuming alcohol at parties or in cold products. No alcohol, means NO ALCOHOL. Please do not consume any products with alcohol.

Ohio Legal Counsel to Professionals

Nurses who suffer from substance abuse or substance addiction and who are monitored by the Ohio Board of Nursing in either the confidential Alternative Program for Chemically Dependent Nurses Program or pursuant to a Consent Agreement or other public disciplinary action, are typically required to submit to random (often observed) toxicology drug screens. The screens will detect not only alcohol content in the body but can even detect the metabolites of alcohol (evidence that the body is processing or breaking down alcohol). The tests are very sensitive virtually any consumption or exposure to alcohol in the 3-4 days proceeding such consumption or exposure will be detected.

Prior to initiating the screening process, nurses are advised that they may not consume any alcohol or any substances that may contain alcohol. They are clearly warned to not consume any alcohol, including: beer, wine, liquor, “non-alcoholic” beers and cooking wines. They are also warned to stay away from topical ointments that may…

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Ohio Board of Nursing Alternative Program: Underutilized by the Ohio Board of Nursing and Often a Bad Option for Nurses

Posted on October 15, 2015 by Beth Collis

Many nurses who realize they have a chemical dependency problem consider applying for the Ohio Board of Nursing’s Alternative Program for Chemical Dependency. The Alternative Program is a program designed as an alternative to public discipline for the Board to monitor nurses who suffer from chemical dependency issues who want to obtain treatment.

The Alternative Program could be an excellent option for nurses who know they need treatment in which to obtain treatment and not have it publically registered as “discipline” on their Ohio license. However, nurses should be aware of the following:

Limited Eligibility

Ohio Administrative Code 4723-6-02(B) prohibits a nurse from participating in the Alternative Program if the Board determines that the nurse’s compliance cannot be effectively monitored. This rule also specifies at least 12 different reasons why the Board can refuse to permit a nurse to participate in the Alternative Program.

Limited Admission

As of June 30, 2014, there were only 73 active cases in the Alternative Program (source: June 30, 2014 Nursing Board Annual Report). In Fiscal Year 2014, the Board reported that it mailed out 41 applications, received 32 completed applications, and admitted only 14 applicants.

License Inactivation

Most nurses are not aware that to even be considered for admission to the Alternative Program, they must inactivate their nursing licenses. Unfortunately, being denied admission to the Alternative Program does not automatically reactivate the nurse’s license. Instead, the nurse must request that his or her license be reactivated, a process for which there is also no timeline imposed on the Board. In our practice, we have seen nurses wait for months after having been denied admission to the Alternative Program before the Board re-activates their license.

Application Process

Alternative Program applicants must also complete a rigorous application detailing their chemical dependency history, including diagnoses and treatment, relapses, and related agency or law enforcement involvement. In addition, the applicant must undergo a complete chemical dependency evaluation and authorize the disclosure of all records related to the evaluation to the Board. There is no timeline imposed upon the Board for deciding whether to admit an applicant to the Alternative Program. Many applicants are denied admission without explanation.

Limited Confidentiality

In our experience, if a nurse is denied entry into the Alternative Program or is terminated from the Alternative Program, the Board uses the information that the nurse disclosed to the Board in the Alternative Program application to form the basis of a public disciplinary action against the nurse. Although the Alternative Program is described as a confidential program, there are limits to this confidentiality and many nurses are unaware of these limitations.

Rigorous Requirements

Based on the Alternative Program agreements we have reviewed, the Board imposes rigorous requirements on the nurse participating in the Alternative Program, including but not limited to monitoring periods sometimes in excess of monitoring periods we have seen in public disciplinary matters.

Conclusion

Prior to even requesting an Alternative Program Application from the Ohio Board of Nursing, consider obtaining the advice of experienced legal counsel to help you determine how best to proceed in your case.

As always, if you have any questions about this post or about the Ohio Board of Nursing in general, please feel free to contact one of the attorneys at Collis Law Group, LLC at 614-486-3909. You may also look for more information at http://www.collislaw.com.

Death and dying, from a nurse’s perspective

Posted on September 29, 2015 by Beth Collis

Since a close relative of mine passed away a little over a year ago, I have been fascinated with reading stories and articles related to end of life issues. So often in America, death and dying is a taboo subject that everyone dances around and which no one seems to be willing to openly and honestly discuss. As we are all going to die one day, I find it rather amazing that people really don’t want to discuss it.

Because I regularly represent nurses who are seeking initial licensure or are the subject of an investigation by the Ohio Board of Nursing, I was curious to see what type of training nurses receive related to end of life issues and how nurses deal with the death of their patients.

I recently came upon two books by a nurse, Theresa Brown, who is an oncology nurse from Pittsburgh, who addresses death and dying from a nurse’s perspective. In her recent book, The Shift, Brown follows the lives of four cancer patients over a 12 hour shift. Brown raises many important issues related to providing nursing care to patients in their homes, listening to patients and family members deal with their fears, and helping her patients deal with the inevitable future.

In her previous book, Critical Care, A New Nurse faces Death, Life and Everything in Between, Brown highlights her first year as a nurse. This book has been used by many nursing schools as part of their curriculum.

A story highlighting Brown and her books can be found on NPR at:

http://www.npr.org/sections/health-shots/2015/09/28/443468965/a-nurse-reflects-on-the-privilege-of-caring-for-dying-patients

I highly encourage all nurses (and others interested in end of life issues) to listen to the NPR story and consider reading Brown’s books or other literature on end of life issues.

As always, if you have any questions about this post or the Ohio Board of Nursing in general, please feel free contact one of the attorneys at the Collis Law Group at 614-486-3909 or contact me at beth@collislaw.com.

When the Ohio Board of Nursing can automatically suspend a license

Posted on September 24, 2015 by Beth Collis

The Nurse Practice Act in the State of Ohio (R.C. 4723) sets out certain instances when the Nursing Board can take a disciplinary action against a nurse. In most instances, the Nursing Board will issue a Notice of Opportunity for Hearing to the nurse that addresses the allegations against the nurse, note the Code section that the nurse is alleged to have violated, and offer the nurse an opportunity to request a hearing prior to the Nursing Board issuing any sanction against a nurse.

However, in instances when the Nursing Board believes that allowing the nurse to continue to practice presents danger of “immediate and serious harm to the public,” the Nursing Board can suspend the license prior to offering the nurse a hearing. In previous blog posts, I have noted instances when a nurse has been convicted of a serious crime (aggravated murder, murder, gross sexual imposition, etc.) in which the Nursing Board automatically suspended a license prior to offering the nurse a hearing.

The Nursing Board has automatically suspended a nursing license prior to offering the nurse a hearing though in less seriously instances. For example, if a nurse is under probation with the Nursing Board and subject to terms in an Adjudication Order or Consent Agreement and violates any terms of the Agreement the Nursing Board will automatically suspended their nursing license prior to offering them a hearing. Violations of Consent Agreements (such as testing positive on a random drug test or failing to notify the Nursing Board of their employment) has triggered an automatically suspension.

Once the license has been automatically suspended, the nurse can request a hearing and present evidence in their defense. However, during the hearing process or while negotiating terms of an Amended Consent Agreement, the nurse’s license remains suspended. It is imperative when entering into any Consent Agreement with the Nursing Board that the nurse understands the terms of the Consent Agreement, because failure to comply with the terms, limitations or conditions of the Consent Agreement can result in an automatic suspension of their nursing license.

As always, if you have any questions about this post or the Ohio Board of Nursing in general, please feel free to contact one of the attorneys at the Collis Law Group at 614-486-3909 or email me at beth@collislaw.com.

Ohio RNs, if you waited to renew your license at the last minute it may have expired!

Posted on September 4, 2015 by Beth Collis

If you are a Registered nurse in Ohio, you were required to renew your nursing license by August 31, 2015. This year, all renewals are required to be filed online. This caused many problems for nurses who could not access the Board’s online renewal system, did not have their access code and password, or who responded “Yes” to any of the renewal questions.

Nurses who responded “Yes” to any of the renewal questions were not renewed by the Board, but were requested to supplement their renewal with a written explanation and documents to support the affirmative response. Until the nurse submitted the supplemental information to the Nursing Board, their renewal was considered “incomplete” and their license was not renewed.

On September 1, 2015, if your nursing license was not renewed, it expired. You May NOT work as a nurse until your nursing license has been renewed!

As you can imagine, in the days leading up to the August 31 expiration date, the Nursing Board was swamped with nurses attempting to renew their licenses. Given the volume, many licenses were not renewed. This is the message that was issued by the Nursing Board:

From the OBN website:

ALERT: eLicense Renewal System, August 31, 2015

Due to an Ohio eLicense systems issue, some registered nurses who submitted renewal information on or about August 31, 2015, have not been processed. If a license credential indicates “ACTIVE IN RENEWAL – INCOMPLETE”, the license renewal application should be processed by 5:00 pm on September 2, 2015. If you have questions about a license in this status after August 31, please email: incompleterenewal2@nursing.ohio.gov. The State IT group is working diligently to resolve this system issue. We regret the difficulties you are experiencing.

In the future, we highly encourage nurses to complete their renewals in June or July and not wait until the week their license is set to expire.

As always, if you have any questions about this post or the Ohio Board of Nursing in general, please contact one of the attorneys at the Collis Law Group at 614-486-3909 or email me at Beth@collislaw.com.

You have a right to counsel when meeting with a Nursing Board investigator

Posted on August 21, 2015 by Beth Collis

The role of the Ohio Board of Nursing is to regulate the practice of nursing. This entails issuing professional licenses to nurses and also investigating and imposing discipline on nurses who violate the Ohio Nurse Practice Act.

Often, a nurse first learns that a complaint has been filed against them with the Nursing Board when they are contacted by a Nursing Board investigator. The Nursing Board has “field” investigators who work throughout Ohio and are each assigned to various geographic regions of the State. Once a complaint has been filed or initialed against a nurse, an investigator is assigned to conduct the investigation. This may include collecting records from the nurse’s employer or from the Court. It may also include contacting the nurse for a personal interview.

Prior to meeting with the Nursing Board investigator, please understand that under Ohio law, (R.C. 9.84) you have the right to be accompanied, represented and advised by an attorney and you are also required to be advised of the right to counsel BEFORE you are interrogated.

Unlike in a criminal proceeding, you will not be assigned legal counsel for your defense. You are required to seek your own legal counsel to assist in your defense before the Nursing Board or any other administrative agency. However, you have a right to have counsel present.

Many nurses have asked me whether they “look guilty” by attending the meeting with legal counsel or if it “appears that they are hiding something” if they take legal counsel with them to the meeting. Nothing could be farther from the truth. Meetings with investigators can be intimidating, overwhelming and threatening. Any information that is obtained by the investigator can and will be used against you before the Nursing Board. In addition, if the investigator believes that the nurse’s conduct violates the law, they can also alert the local sheriff’s department or criminal Prosecutor, and in certain instances, criminal charges can be issued against a nurse.

While I often encourage nurses to fully cooperate in an investigation, including meeting with the investigator, I highly encourage nurses to retain legal counsel to assist them throughout the investigative and disciplinary process. You have a right to counsel under Ohio law and it is in your interest to exercise this right to protect yourself.

As always, if you have any questions about this post or the Ohio Board of Nursing in general, please contact one of the attorneys at the law firm of Collis, Smiles and Collis, LLC at 614-486-3909 or you may email me at Beth@collislaw.com

Who Monitors the Ohio Board of Nursing?

Posted on August 1, 2014 by Beth Collis

The Ohio Board of Nursing’s mission is to “actively safeguard the health of the public through the effective regulation of nursing care.” http://www.nursing.ohio.gov/ The Board is responsible for issuing licenses to nurses, to regulate the education of nurses, and to discipline nurses who have violated the provisions of the Ohio Nurse Practice Act. (R.C. 4723). However, most nurses are surprised to learn that the Nursing Board is not created to “protect” nurses but has been created to “protect the public”.

In its role as an administrative licensing agency, the Board holds immense power. The Board has the power to license, deny a license, suspend or revoke a license. The Board can initiate an investigation, may order a licensee to a psychiatric or chemical dependency evaluation. (R.C. 4723.28(G)). However, the Board is not required to complete investigations in any time frame (no statute of limitations) and the Board is NOT REQUIRED to notify a nurse if and when an investigation has been closed. I often contact the Board after an investigation has been pending for months (or even years) to learn that the investigation has been closed and that the nurse was never notified that it was closed.

There is a check and balance system in place for the Nursing Board. Prior to denying an applicant a nursing license, or taking an action against a nurse (ie. suspending or revoking their license) the nurse is entitled under the U.S., Ohio Constitutions and Ohio State law (R.C. 119) the right to due process of law. This means that prior to denying a license or disciplining a nurse, the Board is required to provide the nurse with notification of the charges and a right to be heard (a hearing). Failure to timely request a hearing may bar the nurse from providing any evidence on their behalf.

An adverse decision of the Board may also be appealed to the local Court of Common Pleas. However, most nurses have neither the money, time nor inclination to appeal an adverse decision of the Board to the Courts. This is an expensive process that can take years to complete. In addition, the Courts are reluctant to reverse a decision of the Board and have shown that it will NOT reverse a sanction of the Board simply if it feels the sanction is too harsh.

A second check on the Nursing Board is the Office of the Ohio Inspector General. The Inspector General’s office is the Watchdog that is responsible for investigating state employees and state agencies. Complaints may be filed with the Inspector General by going to their website at: http://watchdog.ohio.gov/FileaComplaint.aspx

As always, if you have any questions about this post or the Ohio Board of Nursing in general, please feel free to contact one of the attorneys at Collis, Smiles and Collis at (614) 486-3909.

Be honest when filing an application or renewal with Ohio Board of Nursing

Posted on May 21, 2014 by Beth Collis

Honesty is always the best policy when working with the Ohio Board of Nursing.

Professionals should know that before submitting information to a licensing authority the information must be accurate. Whether it is submitting the responses on an initial application for a license, or answering the questions on the bi-annual renewal of a license, the responses must be truthful.

However, I am often asked, “how will the Board know if I answer a question on my renewal application or original application incorrectly?” We never know how the Board may be notified of a violation of their laws and rules. Complaints to the Nursing Board can be anonymous, and the complainant is immune from liability (absent a finding of bad faith in their report). This means that you can be reported to the Board without your knowledge and you will never been provided with a copy of the complaint or the name of the complainant. (O.R.C. 4723.28(H) and (I)(1))

You may have a neighbor, employer or co-worker file a complaint against you with the Board alleging that you had a DUI that you failed to disclose to the Board or violated a section of the Ohio Nurse Practice Act. If you have reported this infraction on your application and/or on your renewal, it goes a long way to possibly having the investigation closed with no disciplinary action. However, if the Board goes back and pulls your application or renewal form and finds that you failed to disclose this information to the Board, the Board has the authority under O.R.C. 4723.28(A) to take an action against your license for providing false or fraudulent information to the Board.

Even without a formal complaint, the Board has the authority to open its own investigation if it learns of a violation of the Nurse Practice Act. If a Board investigator reads a news article about a nurse who has been charged with a DUI or is admitted into a diversion program by the Court, these types of actions can lead the investigator to open an investigation against the nurse. (Please note, that the nurse does not need to self report convictions or violations to the Board until the time of renewal of the license. However, on the renewal application responses need to be truthful and accurate.)

So, when applying for a license or completing a renewal application never ask yourself,”how will the Board ever find out?” The question you should ask yourself is, “what is the right answer and how can I best provide that information to the Board.”

While I encourage nurses to be honest with the Board, I always encourage the nurse to seek experienced legal counsel to assist them if they have any questions about how to respond to specific questions or if they are called to attend a meeting with a Board investigator.

As always, if you have any questions about the Ohio Board of Nursing or this post, please feel free to contact one of the attorneys at Collis, Smiles and Collis at 614-486-3909 or email me at beth@collislaw.com.

Alcohol Prohibitions – Be Aware of the Things You Eat and Drink As Well As the Products You Use and the Medications You Take

Posted on April 14, 2014 by Beth Collis

In alcohol impairment cases before the Ohio Board Of Nursing resulting in Consent Agreements, the Alternative Program, Board Orders, or otherwise requiring nurses to undergo screening for alcohol, nurses are typically required (among other things) to abstain completely from the use of alcohol or any products containing alcohol.

It is critically important to avoid beverages, foods, hygienic and beauty products, household products, over the counter medications, and prescription medications which contain alcohol.

BEVERAGES: Beverages, including but not limited to, distilled spirits, beer, ale, malt beverages, wine, and cider contain alcohol. Additionally, beverages such as Communion Wine or beverages labeled “Non-Alcoholic” or “NA” also can contain alcohol.

FOODS: Foods prepared with cooking wine, sherry, wine vinegar, soy sauce and items containing flavoring extracts (such as vanilla extract), can contain alcohol. Additionally, certain cooking sprays contain alcohol.

HYGENIC AND BEAUTY PRODUCTS: Certain hygienic and beauty products can contain alcohol, including but not limited to certain:

Perfumes, colognes, and after shaves

Lotions and balms

Body sprays and mists

Makeup removers

Hand sanitizers

Antiperspirants

Deodorants

Mouthwashes

Hair Products

Cosmetics

HOUSEHOLD PRODUCTS: Certain household products can contain alcohol, including but not limited to certain:

Antibacterial products including antibacterial gel, dishwashing liquid and hand soap

Cleaners

Detergents

Dishwashing liquids

Air fresheners

Insect repellents

Disinfectant sprays

Sanitizing wipes

Liquid bandages

OVER THE COUNTER MEDICATIONS: Certain over the counter medications can contain alcohol, including but not limited to certain:

Cough suppressants

Expectorants

Nasal decongestants

Oral antiseptics

Anti-asthmatics

Antihistamines

Bronchodilators

Decongestants

Mouthwashes and gargles

Laxatives

Analgesics

Supplement

Vitamins

Anti-diarrheas

PRESCRIPTION MEDICATIONS: Certain prescription medications, including but not limited to certain asthma inhalers, contain alcohol or ethanol.

CONSULT YOUR PHYSICIAN: If you are unsure whether a particular food, beverage, product, or medication contains alcohol, read the label and consult your physician prior to eating, drinking, using, or taking it.

This article provides general guidance and is not a substitute for the advice of your physician.

As always, if you have any questions about the Ohio Board of Nursing or this post, please feel free to call one of the attorneys at Collis, Smiles and Collis at 614-486-3909 or check out our website at http://www.collislaw.com.