Ohio Nurses Under Probation May Not Be Able To Travel Outside of the United States Without Risking Disciplinary Action

Posted on July 12, 2016 by Beth Collis

If you are a nurse who is under disciplinary action with the Ohio Board of Nursing that requires you to submit to random drug testing, you may not be able to travel outside of the United States without risking disciplinary action.

Ohio nurses who are under probation with the Nursing Board are required to strictly comply with all terms and conditions imposed in their Consent Agreement or Adjudication Order. While under probation, some nurses are subjected to:

random drug or alcohol screens;
AA or NA meetings; and/or
counseling with a chemical dependency or mental health professional.

Traditionally, when a nurse is subjected to random drug testing, they are required to notify FirstLab (the Nursing Board’s contracted screening provider) and their Monitoring Agent at the Nursing Board if the nurse is going to travel so that an alternative screening site can be located for the nurse. However, this notification alone DOES NOT EXCUSE THE NURSE FROM THE DRUG TESTING REQUIREMENT!

In some cases, nurses have requested to be excused from the random drug testing requirement while on vacation. In very limited instances in the past, the Nursing Board has excused nurses from the drug testing requirement. However, these were extremely limited circumstances and compliance with all other probationary terms including abstinence was nevertheless required. More recently, the Board has denied requests to be excused from drug testing while on vacation.

If you are subjected to Nursing Board random screens, it is recommended that you first verify with FirstLab whether there is an approved testing site at your vacation destination (which also has weekend hours) prior to booking your vacation. If no approved testing site is available, you may request to be released from random drug testing while on vacation. However, based on our recent experience, you should anticipate that the request may be denied. If the Board denies your request, you may be subjected to discipline if you fail to provide a screen on a day you are selected to do so.

It is our understanding that FirstLab only has testing sites in the continental U.S., Alaska, and Hawaii and that there are no FirstLab locations on cruise ships or outside of the U.S.

Merely notifying your Monitoring Agent of your vacation dates does not excuse or waive any of the requirements of your Consent Agreement or Board Order. You must comply with all probationary terms while on vacation, unless you have been given specific written approval in advance by the Board.

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 the Collis Law Group LLC at 614-486-3909 or email me at Beth@collislaw.com.

Ohio Nursing Board imposes Permanent Practice Restrictions

Posted on January 31, 2015 by Beth Collis

In our practice at Collis, Smiles and Collis, we have the privilege of representing not only Nurses before the Ohio Board of Nursing but also other professionals before their licensure Boards. This has given us the opportunity to see how various licensure Boards in Ohio handle disciplinary matters.

Each licensure Board in Ohio has its own rules and regulations and has the authority to take any action including but not limited to revocation, suspension, and/or probation of a license. Under Ohio Revised Code Chapter 119, licensees in Ohio are entitled to an administrative hearing, which allows the licensee to introduce evidence in their defense.

Despite the similar due process that is afforded to most licensees facing a disciplinary action in Ohio, we have seen that many licensure Boards in Ohio (Nursing Board, Medical Board, Psychology Board, Board of Education, Counselor, Social Work and Marriage and Family Therapist Board) impose very different sanctions, despite the relatively similar nature of the offense.

In our experience, we have seen that, generally, licensure Boards in Ohio can be more strict/punitive than licensure Boards in other States in terms of sanctions.

Even within Ohio, based on our experience, the Ohio Board of Nursing imposes permanent practice restrictions on its licensees to a far greater extent than other licensure Boards in Ohio. Generally, a permanent practice restriction limits a Nurse’s ability to work in the following settings: hospice, home health, as an independent provider for an Ohio agency, as a private duty nurse, as a volunteer, as well as any position involving management of nursing or supervision or evaluation of nursing practice, including but not limited to Director of Nursing, Assistant Director of Nursing, or Nursing Supervisor. In certain instances, the Ohio Board of Nursing will include language in a Consent Agreement or Order that allows a Nurse to request on a case-by-case basis approval to work in an otherwise restricted position, however, such requests are given close scrutiny and are often denied.

Permanent practice restrictions are often imposed in cases in which a Nurse has been convicted of a crime, found to be addicted to drugs or alcohol, or where a Nurse has practiced below the standard of care. In certain cases, the Ohio Board of Nursing imposes practice restrictions that prohibit a Nurse from working in any position that would require a Nurse to have oversight or control over financial dealings.

Permanent practice restrictions place a significant hardship on a Nurse’s employment opportunities. Although we have seen Nurses with permanent practice restrictions on their license obtain employment, permanent practice restrictions create an enormous hurdle to overcome in terms of obtaining meaningful employment because, in our experience, many employers will simply not consider any Nurse who has permanent practice restrictions on their license.

Historically, it has been our experience that the Ohio Board of Nursing imposed permanent practice restrictions on a Nurse in cases where the facts of a case fully justified doing so based on significant practice or impairment issues, or in cases where a Nurse had been repeatedly disciplined. Presently, however, we are seeing the Ohio Board of Nursing impose permanent practice restrictions on Nurses in greater numbers and on their first disciplinary action.

While there are cases in which permanent practice restrictions are justified to protect the public, obtaining the advice of experienced legal counsel before you sign a Consent Agreement containing permanent practice restrictions or before undertaking to represent yourself at an Administrative Hearing (which could result in a Ohio Nursing Board Order imposing permanent practice restrictions) is recommended.

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

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.

Permanent Practice Restrictions on Nursing Licenses

Posted on March 4, 2014 by Beth Collis

For violations of the Nurse Practice Act in Ohio, the Nursing Board can impose a range of sanctions against a nurse which can include (but are not limited to) any of the following sanctions: revocation, suspension, reprimand, temporary or permanent practice restrictions.

Prior to the Board imposing a sanction against a nurse’s license, the Board is required to provide the nurse with a written Notice of the alleged violation and an opportunity to request a hearing. If the nurse properly and timely requests a hearing, the nurse can attempt to negotiate a Consent Agreement with the Board (similar to a plea bargain in a criminal case) or they are entitled to a hearing where the Board would be required to prove the alleged violation of the Nurse Practice Act.

The sanction that the Board imposes in each case is strictly dependent on the individual facts and circumstances that gave rise to the alleged violation. However, in most cases, the Board attempts to impose similar sanctions on similar cases.

Many nurses are surprised that in addition to a suspension of a nursing license, in many instances the Board will impose temporary or even permanent practice restrictions on the nurse’s license. The restrictions generally limit the nurse’s ability to pass narcotics or to work in certain settings such as home care or home hospice, through an agency, as an independent provider, as a volunteer or to contract individually with a patient. The Board also typically restricts the nurse’s ability to work as a nurse manager, DON, ADON or nursing supervisor.

If the Board places temporary practice restrictions on a nurse’s license, typically the restrictions will be lifted when the period of suspension and probation ends. However, in certain serious cases, the Board will impose permanent practice restrictions that will permanently bar the nurse from working in certain settings. Occasionally, the Board will include a statement that says that the practice restrictions are permanent “unless otherwise approved by the Board.” This specific language allows the Board to lift a permanent restriction in certain circumstances and for certain specific positions.

If a nurse has a permanent practice restriction on their license without the “unless otherwise approved” language, the permanent practice restrictions can NEVER be lifted. This is generally reserved for the most serious violations of the Nurse Practice Act, generally resulting from cases of significant impairment (drug or alcohol abuse) by the nurse.

Nurses are often disappointed that they may complete a period of suspension or probation but still have permanent limitations on their license. While the Board is one of only a few professional licensing agencies that will impose permanent restrictions on a professional license, it is a routine practice of the Board and is even imposed against a nurse who may have never been disciplined by the Board in the past.

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, LLC or email me at beth@collislaw.com

Yes, you can find a nursing job even if you have been disciplined by the Nursing Board

Posted on January 14, 2013 by Beth Collis

Each year, hundreds of nurses in Ohio face discipline to their nursing license based on a variety of circumstances ranging from violations of the Nurse Practice Act (R.C. 4734) to being found guilty of a criminal offense (such as a DUI) or for being diagnosed with drug or alcohol abuse or addiction. Often nurses face a temporary suspension of their license or are required to submit to random drug screens or other probationary monitoring terms once their nursing license is reinstated during a probationary period.

Under the Ohio public records law, an Order of the Nursing Board or a Consent Agreement that is negotiated between the nurse and the Nursing Board is a matter of public record. The sanction is noted on the Nursing Board website and the actual Order or Consent Agreement is often loaded on the Nursing Board website for anyone to download and read.

Based on the public nature of Nursing Board disciplinary actions, I am often asked “Will I ever find a job as a nurse in Ohio if I have a disciplinary action against my license?” In general, the answer is “Yes!”

Over the past fifteen years, I have represented hundreds of nurses before the Nursing Board. Based on my experience, even nurses who have received treatment for drug or alcohol abuse or who have been found to have violated the Ohio Nurse Practice Act, which has resulted in suspensions of their licenses, eventually can find employment in the field of nursing once their license has been reinstated. However, it is important to note that securing employment can be more difficult for a nurse who has a limited or restricted license.

I typically find that nurses who are honest with employers and clearly and accurately explain the basis for their disciplinary action, as well as the steps that they have taken to remediate the situation have the best chance of finding employment as a nurse. Employers are generally willing to give disciplined nurses a chance at employment if they believe that the nurse has remedied their situation, that they have taken responsibility for their actions, and that they are honest about their conduct.

To prepare to discuss a Board disciplinary matter with an employer, I always advise clients to prepare a “one minute elevator speech” in which the nurse discloses and addresses the disciplinary action taken. I have found that employers do not like to be blindsided about a disciplinary action after they have already employed an individual or to learn of a disciplinary action in a background check. It’s best to head off any questions that an employer might have about your past and tell them yourself up front.

This blog is intended as general guidance and may not fit your particular situation. As always, if you have any questions about this post or about the Ohio Board of Nursing in general, please email me at Beth@collislaw.com or call me at (614) 486-3909.

Do you have a prescription for that?

Posted on October 3, 2012 by Beth Collis

In most nursing positions, nurses are subjected to random, unannounced drug screens by their employer. Usually nurses are prepared to provide a drug test as a pre-condition for employment. However, once nurses have been working in a location for a while, they forget that employers may ask them to submit to a drug screen for cause (ie. if there are missing medications), when they are moved to a new unit, or just on a random basis.

If the drug test is positive for an illegal drug, the nurse may face suspension or termination from their job and the positive test result will also be reported to the Ohio Board of Nursing. However, often nurses test positive for prescription medications. If the nurse is able to provide their employer with a copy of a prescription showing that they have been prescribed the medication by their doctor, then it is not a problem. But, in many cases, nurses do not have prescriptions for medications they have taken. On occasion, nurses will take their friends’, spouse’s or kids’ medications, resulting in a positive drug screen.

Testing positive on a drug screen for a medications which has not been prescribed, may result in negative ramifications with your employment and your nursing license. The Ohio Board of Nursing regularly takes disciplinary actions against nurses who test positive for prescription medications, which have not been prescribed to them.

I recently spoke to a nurse who told me that her doctor told her to keep any old narcotic medications in her cabinet in case she or another family member might need the medication. This is improper advise. Medications can only be taken by the person who has been prescribed the medication. You can’t just keep a “stash” of prescription medications in your cabinet to be used by anyone who has access to the cabinet.

If you have left over medications, follow appropriate disposal procedures to discard the medication. Do not store unused narcotic medications in an unsecure location where other family members (including teenagers) may have access to the drugs.

Finally for nurses, if you have not been prescribed a medication, you should not ingest it as it may lead to a positive drug screen that may jeopardize your employment and license to practice as a nurse in Ohio.

As always, if you have any questions about this post or the Ohio Board of Nursing in general, please feel to check out my website www.collislaw.com or email me at beth@collislaw.com or call me at (614) 486-3909.

Nurses, if you drink this holiday weekend … take a cab home.

Posted on August 31, 2012 by Beth Collis

At the start of this holiday weekend, I wanted to reach out to Ohio medical professionals and remind them that their behavior is of concern to the Ohio Board of Nursing whether at work or at home. If you venture out this weekend to an end of summer holiday party and knock back a few beers or a couple of jello shots, take a cab home.

Each year, dozens (if not hundreds) of nurses receive alcohol related traffic violations. DUIs, OVIs, reckless operation charges, and any alcohol related misdemeanor may lead to discipline taken by the Ohio Board of Nursing against your nursing license. You don’t have to be “drunk at work” or fail a breathalyzer test on the way to work for the Nursing Board to be concerned about your ability to practice safely as a nurse in Ohio. Alcohol related traffic violations can lead to your nursing license being placed on probation and may subject you to random drug screens and Nursing Board monitoring for lengthy periods of time. The severity of the charges may also lead to suspension of your Nursing license.

I have written about this issue in the past. See my June 11 post about the requirement to disclose alcohol related convictions on your renewal application; my May 25 post about not being able to consume alcohol in ANY form if you are being monitored by the Board, and my April 30 post featuring the top three reasons the Nursing Board takes disciplinary action against a nurse (alcohol and drug usage being one of the top three reasons for Board discipline).

If you are going to “party” this weekend, be smart about it. Don’t get behind the wheel of the car if you have been drinking. Don’t risk your professional license.Take a cab home.

If you have any questions about this post or the Ohio Board of Nursing in general, please feel free to contact me at (614) 486-3909 or email me at beth@collislaw.com.

If you received a Notice for Opportunity for Hearing .. request a hearing

Posted on August 1, 2012 by Beth Collis

On Friday, July 27, the Ohio Board of Nursing held its bi-monthly meeting. At that meeting, the Board voted to take disciplinary action against dozens of nurses in the state of Ohio. Nurses who face discipline by the Board will be mailed a Notice of Opportunity for Hearing, Notice of Summary Suspension or Notice of Automatic Suspension of their nursing license by certified mail. This is not a final decision by the Board. These Notices outline the charges that the Board has alleged against you.

If you receive notification from the post office that you have a certified letter from the Nursing Board, immediately go to the post office and collect the letter as there are important time sensitive deadlines which, if not met, can have a permanent effect on your license.

If you want the Board to hear “your side of the story” you must request a hearing in writing to request a hearing by the deadline in the Notice. This can be done by following the instructions in the Notice. A request for a hearing is a simple letter sent to the Board stating that you would like a hearing. You do not need to list your defenses or reasons why you want a hearing. You simply need to state in the letter that you would like a hearing.

You only have thirty (30) days from the date the Notice was MAILED to you to request a hearing. The 30 day time frame starts on the date that the letter was mailed to you and not on the date that you received the letter. Failure to request a hearing will prevent you from providing any evidence on your behalf to the Board.

I am often asked “why should I even request a hearing … the Board has already made a determination.” This is not correct. These Notices only list allegations raised against you. While the Board has conducted an investigation prior to issuing the Notice, in most cases they have only considered one side of the evidence. By requesting a hearing you will be able to present your side of the story.

Even in cases where the nurse has violated the Ohio Nurse Practice Act, by presenting your side of the story and explaining what challenges you faced or what you were thinking when the error occurred, you increase the chances of getting a lighter sanction from the Board than if you simply do not even request a hearing.

You worked hard for your nursing license. There are always two sides to any story. If you receive a Notice of Opportunity for Hearing, a Notice of Summary Suspension, or a Notice of Immediate Suspension, request a hearing within the deadline and make sure the Board hears your side of the story before they make a final determination.

You should also consider hiring experienced legal counsel to defend you before the Nursing Board. When considering how to hire an attorney, check out my previous post on “How to Hire an Attorney”. Your livelihood depends on you finding experienced legal counsel that you trust to help in your defense.

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

What part of NO ALCOHOL don’t you understand?

Posted on May 25, 2012 by Beth Collis

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 contain alcohol and to stay away from cleaning products or aerosols that may contain alcohol. Nurses are usually surprised to learn that many cleaning products contain alcohol and they do not realize that hand sanitizers (the same kinds routinely used in hospitals, nursing homes, schools, etc.), aftershave, air fresheners (Febreze), contain some amount of alcohol.

Despite this requirement, nurses routinely test positive for alcohol or for the metabolites of alcohol in their system (positive ETG test). Ethyl Glucuronide (ETG) is a direct metabolite of alcoholic beverages (ethanol). Its presence in urine may be used to detect recent alcohol consumption, even after ethanol is no longer measurable. The presence of ETG in urine is a definitive indicator that alcohol was ingested.

When questioned, many will initially deny use. Then, they will try to argue that they used a hand sanitizer or over the counter medications, which may have resulted in a positive alcohol or ETG drug screen.

However, while the tests (specifically the ETG test) are very sensitive and can detect consumed alcohol, the cut off for the screening is above the level that would test positive in an “accidental” exposure. Generally, merely cleaning your house with Lysol or spraying your couch pillows with Febreze should not result in a positive screen. However, consuming Nyquil for a cold will result in a positive screen.

As always, if you have any questions about the Ohio Board of Nursing or this post, please feel free to email me at beth@collislaw.com or call me at 614-496-3909.

Ohio Legal Counsel to Professionals

advocating for nurses and other licensed professionals in Ohio

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