Ohio Nurses: New way to update your address with the Nursing Board

Moved? Changed your Name? Manage your Nursing License/Certificate Online

As a nurse licensed to practice in Ohio, it is your responsibility to notify the Nursing Board of any changes to your address or your name.

Beginning July 1, 2016, all name and address changes must be performed on-line by accessing the Nursing Board’s new eLicense 3.0 licensure system. (Simply sending an email or letter to the Board with your new address will NOT be sufficient to update your address.)

Listed below are the steps to register as a new user on the Nursing Board’s eLicense 3.0 licensure system. This information was obtained on the Nursing Board’s website under the section “Forms and Applications.”

Failure to notify the Nursing Board of a change in name and/or address could cause an issue for a potential employer performing on-line licensure verification. By not updating your name and/or address, it could hinder the Nursing Board’s ability to provide you with written notification in a timely fashion.

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

 

Ohio nurses: Watch when your Certificate to Prescribe Externship (CTP-E) and CTP expire!

As a registered nurse in Ohio, it has become routine to timely submit a complete RN renewal application at the same time every two years. However, a CTP-E is issued for one year and expires one year from the date of issuance, NOT one year after you start working as a nurse. In addition, once a CTP is issued, the renewal date may be different from the date the nurse renews their license. It is imperative that you know when you need to renew your license, CTP-E and CTP.  You will not receive a letter or notification from the Nursing Board to remind you to renew your certificate to prescribe.  It is illegal to continue to prescribe on a lapsed CTP-E or CTP!

The Ohio Board of Nursing requires advanced practice nurses who have had no prior experience prescribing medications or therapeutic devices to obtain a Certificate to Prescribe-Externship (“CTP-E”).  The purpose of the externship is to create a period during which the nurse’s prescribing activities are reviewed and evaluated by a supervising professional for the purpose of ongoing improvement of the nurse’s competence, knowledge, and skill in pharmacokinetic principles and the application of these principles to the nurse’s area of practice.

In order to apply for a CTP-E, the applicant must hold a valid Ohio R.N. license as well as a current Certificate of Authority to practice as a certified nurse midwife, nurse practitioner or nurse specialist.  In addition, the applicant must have completed required coursework on advanced pharmacology.  Once all materials have been submitted and reviewed by the Board of Nursing, the CTP-E will be issued for one year.  The year begins on the date the CTP-E is issued by the Board.  It is critical to remember this date.

During this year, the advanced practice nurse is required to complete 1,500 hours of supervised prescribing (500 hours under the direct supervision of a supervising professional).  Direct supervision means that the supervising professional is on-site when the nurse is prescribing.  300 of the 500 direct supervision hours must be supervised by a physician; the remaining 200 hours may, with the collaborating physician’s permission, be supervised by an advanced practice nurse with prescriptive authority, not a CTP-E.  The remaining 1,000 hours may be indirectly supervised.  This means that a physician, in accordance with a schedule documented in the standard care arrangement, regularly and timely reviews the nurse’s prescriptions and prescribing practices.

Once the advanced practice nurse has completed the required supervision hours through the CTP-E, the supervision must be documented by the collaborating physician and submitted directly to the Board of Nursing on Form B.  PLEASE NOTE that Form B must be submitted well prior to the end of the expiration date on the CTP-E to allow the Board time to review it and issue the advanced practice nurse applicant a Certificate to Prescribe.  Even if Form B is submitted timely, it is illegal to continue to prescribe after the year for the CTP-E has expired unless the nurse has received the Certificate to Prescribe.  Advanced practice nurses may face discipline if they continue to prescribe once the CTP-E has expired if they have not been issued a Certificate to Prescribe.

A CTP-E cannot be renewed.  It can be extended for a one-time period of 2 years, if a request to extend is timely received by the Board before the CTP-E expires.

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

OHIO LPNs – It is time to renew your license to practice nursing in Ohio!

According to the Ohio Board of Nursing’s website, starting on July 1, 2016, all Ohio LPNs will be able to renew their professional license online.

Important renewal information from the Nursing Board is located at: http://www.nursing.ohio.gov/PDFS/2Renewal_Momentum.pdf

Often, nurses have questions about how to respond to certain questions on the Renewal Application and what information needs to be provided to the Nursing Board in the Renewal Application.

Nurses are required to provide the Nursing Board with truthful and accurate information on their Renewal Applications.  Failure to do so can lead to discipline by the Nursing Board.

Additional Information May Be Required  (from Ohio Board of Nursing website)
• If you are asked to provide court documents or other information that may be required as part of your application, please be prepared to upload the documents electronically through the online system.  This information is usually required of applicants who answer “yes” to one of the additional information questions on the renewal application.  
• No hardcopies of court documents or other information required as part of your application will be accepted. Waiting until a deadline and then realizing you do not have all the information and in the form needed to upload the documents electronically through the online system will prevent you from renewing. 
• Incomplete renewal applications will not be accepted by the system.  If all required documents are not provided electronically, the renewal application is incomplete.

If you have questions concerning how to respond to questions in your Renewal Application, what information you need to include, and/or what Court documents you need to include with your Renewal Application, it is recommended that you obtain experienced legal counsel to help you complete your Renewal Application.

The attorneys at the Collis Law Group offer a 1-2 hour consultation to meet with a nurse, review all relevant Court documents, and assist the nurse prepare any necessary or required  response to a question on a Renewal Application.  In most cases, we offer this consultation for as low as a flat fee of $500.00.  Feel free to contact one of the attorneys at the Collis Law Group at 614-486-3909 to schedule a Renewal Application consultation.

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 by phone at 614-486-3909.  For more information about the Nursing Board, please feel free to visit our website at www.collislaw.com.

Although legal in other states, nurses have been disciplined for testing positive for marijuana in Ohio

Twenty-five states and the District of Columbia have legalized marijuana in some form.  Four states and the District of Columbia have legalized marijuana for recreational use.  Some states allow residents to possess up to one ounce of marijuana and to even grow up to six plants.  While there have been various marijuana initiatives in Ohio, to-date it is illegal to possess, sell, or cultivate marijuana in Ohio.

Historically, the Ohio Board of Nursing has taken a strong position against marijuana usage.  For example, where a positive test for marijuana in an employment drug screen is reported to the Board, the Board routinely places the nurse on probation for a period of at least one year, which typically includes random drug testing and can include narcotics as well as practice restrictions.

Even if a nurse has traveled outside of Ohio and consumed or smoked marijuana in a State where it is legal, if the nurse returns to Ohio and is reported to the Board for a positive drug screen, the nurse should expect to be subjected to discipline by the Board.

In our practice, we have seen nurses reported to the Board because they failed pre-employment drug tests who were subjected to discipline including at least one year random drug testing.  A nurse does not have to be actively practicing nursing in order be found by the Board to be impaired. By simply testing positive for marijuana, a nurse can be subjected to discipline.  Employers are required by law to report to the Board any suspected violation of the Ohio Nurse Practice Act.

Before you consider using marijuana on your next trip to Colorado or Washington, realize that if you test positive on a drug screen – even weeks later when you return to Ohio – you should anticipate that you will be reported to the Board and subjected to discipline.

As always, if you have any questions about this post of the Ohio Board of Nursing in general, please contact one of the attorneys at the Collis Law Group LLC at 614-486-3909.

 

What To Look for in a Defense Attorney

I am always surprised to hear from nurses that they hired a lawyer who is not responsive to phone calls or emails in a timely manner, confused the nurse’s matter with other clients, failed to keep the nurse informed of the status of their matter, or failed to provide the nurse with a monthly accounting of legal fees and expenses. However, I am most surprised to hear from nurses who tell me that they hired a lawyer who they do not feel comfortable confiding in.

I am often asked what skills, qualifications, and qualities a nurse should look for when selecting legal representation for a matter involving the Ohio Board of Nursing (or any other State licensing Board).  Because Administrative Law is a rather unique area of the law, it is important to consider the following:

Not All Cases Are The Same: It is important to select defense counsel who you feel comfortable confiding in, and who recognizes that each matter is different and can present to the Board the unique circumstances of your particular matter with passion and commitment.

Understanding: An attorney who understands and presents your matter to the Board in a clear and coherent manner is also an important aspect of the representation.

Responsiveness: Selecting an attorney who is responsive to your phone calls and emails, and who timely communicates with you concerning important information about your matter is critical to the client-counsel relationship.

Sound Legal Advice: An attorney who provides sensible options based on their knowledge of nursing laws and rules and administrative law procedure, is an essential element to the handling of your matter.

Experience: Hiring an attorney who has handled multiple matters before your licensing Board from the initial investigation through the administrative hearing process is of paramount consideration.

When selecting legal counsel for your Ohio Board of Nursing matter, please remember the acronym N-U-R-S-E.

As always, if you have any questions about this post or about the Ohio Board of Nursing in general, please 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 Disciplinary Process…What to expect

A nurse alleged to have violated the Ohio Board of Nursing’s (“Nursing Board”) laws or rules is subject to discipline by the Nursing Board.  Actions for which a nurse can be disciplined can be found here: http://codes.ohio.gov/orc/4723.28v1.  This article is a general guideline to the Nursing Board’s disciplinary process.

Stage One – Complaint

Any member of the public is permitted to file a Complaint with the Nursing Board.  Additionally, under Ohio Revised Code §4723.34(A), an employer of nurses who knows or has reason to believe that a current or former nurse employee engaged in conduct that would be grounds for disciplinary action by the Nursing Board must report to the Nursing Board the name of such current or former employee.  The Nursing Board’s Complaint form can be found here: http://www.nursing.ohio.gov/PDFS/Forms/2011ElecComplaintForm.pdf.  Generally, the Complaint includes the identification of the Complainant, the nurse at issue, and the allegations of the conduct at issue.

Stage Two – Board Investigation

Following the Nursing Board’s receipt of a Complaint, the Complaint is assigned to one of the Nursing Board’s Investigators (also called a Compliance Agent).  Typically, the Investigator will speak with and/or obtain documents regarding the allegations in the Complaint from the person who filed the Complaint.  In many instances, the Investigator will also contact the nurse at issue either by phone or email and request to speak with the nurse about the allegations in the Complaint or request that the nurse provide a written explanation of the allegations in the Complaint.  Generally, a nurse’s participation in the Board’s investigation is voluntary.  It is recommended to obtain legal counsel before speaking with or responding in writing to an Investigator, however, after consulting with legal counsel, there are circumstances when it is recommended to cooperate with the Investigator to the extent that it is in the best interest of the nurse to do so.

Stage Three – Notice

Following the Investigation, the Nursing Board’s Supervising Member reviews the matter and decides whether to not proceed with disciplinary action against the nurse.  A decision not to proceed with disciplinary action can be made because there is not sufficient evidence to prove that a violation of Nursing Board law or rule has occurred or, although there is evidence to prove that a violation of a Nursing Board law or rule occurred, the Nursing Board nevertheless determines that such violation is a “minor violation”.  The Nursing Board’s policy concerning minor violations can be found here: http://www.nursing.ohio.gov/PDFS/Discipline/BoardPolMinorVio4723.pdf.  If the Supervising Member decides to proceed with disciplinary action, a written Notice of Opportunity for Hearing (or Notice of Suspension) is issued to the nurse in which the nurse is given the opportunity to request and have an Administrative Hearing in connection with the allegations in the Notice.  The time frame (typically 30 days) and manner (typically in writing or email) in which the nurse may request a Hearing is set forth in the Notice.  If the nurse does not request a Hearing either timely or in the manner set forth in the Notice, the nurse will be deemed to have waived their rights to a Hearing and the Nursing Board has authority to impose discipline it deems appropriate without further input from the nurse.

Stage Four – Consent Agreement

In certain cases, the Nursing Board will offer a Consent Agreement to the nurse instead of having the Hearing.  A Consent Agreement is a written agreement between the Nursing Board and the nurse specifying certain admissions by the nurse and detailing the discipline to be imposed upon the nurse.  Consent Agreements have a broad range of discipline including reprimand, probation, and/or suspension, and have disciplinary requirements including but not limited to fines, CEUs, background checks, employer reports, drug screens, dependency and/or psychological evaluations, treatment provider and medication reports, and temporary or permanent practice and/or narcotic restrictions.  It is recommended to obtain legal counsel before signing a Consent Agreement so that the nurse understands their rights, the terms and conditions of the Consent Agreement, and (although no two cases are identical) whether or not the discipline in the Consent Agreement is reasonably similar in scope to similarly situated cases.  At the Consent Agreement stage, there may also be some opportunity negotiate the terms and conditions of the Consent Agreement.

Stage Five – Hearing

If the Nursing Board does not offer a Consent Agreement or if the nurse does not accept a Consent Agreement offered by the Nursing Board, the matter will proceed to the Hearing.  At the Hearing, the Nursing Board is represented by an Ohio Assistant Attorney General who presents the Nursing Board’s evidence concerning the allegations in the Notice to a Hearing Examiner.  The nurse may either be represented by legal counsel or by themself and may present evidence refuting the allegations in the Notice, as well as evidence of the nurses good nursing practice and character either by their own testimony and/or through character witnesses and other documentary evidence.  The Hearing Examiner receives all evidence and prepares for the Nursing Board a written Report and Recommendation which outlines all the evidence received at the Hearing and recommends a discipline.

Stage Six – Board Meeting

The Report and Recommendation is considered by the full Nursing Board at a regularly scheduled Board Meeting.  The Nursing Board meets every other month and its 2016 schedule can be seen here: http://www.nursing.ohio.gov/PDFS/2016-2018%20Meeting%20Schedule.pdf.  Typically, the nurse (and counsel, if represented) will present a statement to the Nursing Board in their support.  The Nursing Board has the authority to adopt the recommended discipline or it can reject the recommended discipline and order such discipline as it deems appropriate under the circumstances.  Although a nurse has the right to appeal the Nursing Board’s decision to the Court of Common Pleas, the Nursing Board’s decision can be overturned by the Court only where the Court determines that the Nursing Board’s decision was not supported by reliable, probative, and substantial evidence and is not in accordance with law (See Ohio Revised Code §119.12(D)).

Conclusion – Know Your Rights

At each stage of the Nursing Board’s disciplinary process, a nurse has legal rights.  It is recommended to obtain legal counsel in Nursing Board disciplinary matters because failure to understand and/or exercise a nurse’s legal rights can result in unintended consequences some of which cannot be reversed.  Contact Collis Law Group LLC at (614) 486-3909 if we may of assistance to you in your Nursing Board matter.

The information in this article is general in nature and is not, nor intended to be, legal advice.  You should consult an attorney for advice regarding your individual situation. © 2016 Collis Law Group

Effective February 1, Nursing Board to reduce time limit for nurses to personally appear to defend

Despite efforts by Collis Law Group and others, the Ohio Board of Nursing recently voted to reduce the amount of time which may be given to legal counsel to present a disciplinary case to the Board after a nurse’s Administrative Hearing.

At the November 2015 Board meeting, the Board changed its rule governing the amount of time which may be given to legal counsel to summarize a case concerning a nurse facing discipline after an Administrative Hearing.

The Board’s old rule permitted the Board to give legal counsel not more than 10 minutes to summarize a disciplinary case at the time the Board considers what discipline it will impose.  The new rule, effective February 1, 2016, reduces the time allotment to not more than 7 minutes.

At the November 2015 Board meeting, Collis Law Group attorney, Todd Collis, advocated for all Ohio nurses by suggesting to the Board that reducing the time allotment was not in the best interest of Ohio nurses or the Board.

Collis argued that it is unreasonable to afford legal counsel only 7 minutes in which to summarize a case for the Board under circumstances where a nurse is facing potentially career-ending discipline.  Collis also observed that the reduction in the time allotment would not result in any meaningful time savings for the Board and that the reduction in the time allotment might be viewed as curtailing access to the Board at a critical moment in a nurse’s career and life.

Effective February 1, 2016, Ohio Administrative Code 4723-16-12(C) provides that legal counsel who address the Board shall be given not more than seven minutes in which to do so. While this rule may appear to be a minor change, when a nurse is defending their professional license, they should be given more than just seven minutes to personally appear before the Board Members prior to the Board issuing a final sanction against their professional license. (This rule does not limit the amount of time that the nurse may present his/her defense at an administrative hearing.)

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 LLC at 614-486-3909 or email me at beth@collislaw.com.

46 Ohio nurses did not defend themselves?!

 

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 casesthe 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.

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

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

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.