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

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 requiredMore 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 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.

 

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.

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.

When the Ohio Board of Nursing can automatically suspend a license

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!

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.