National Prescription Drug Take-Back Day October 26, 2013

Saturday, October 26, 2013 from 10am-2pm is another National Prescription Drug Take-Back Day. For information on where to take unused and unwanted medications you may call 1-800-882-9539 or go to:
http://www.deadiversion.usdoj.gov/drug_disposal/takeback/

Before the previous take-back day in April 2013, I entered the following post:

I regularly meet with and represent nurses before the Ohio Board of Nursing who are addicted to prescription medications. Some nurses take medications from work, however, many nurses tell me that they take medications from home that have been prescribed to other family members or that they buy them off the street.

There is also a disturbing trend in this country of teenagers and young adults who go to parties and pass around bowls of prescription medications they have obtained from home, which they take in an effort to “get high”.    All too often, prescription drugs are easy to obtain and are easily misused and abused, sometimes leading to devastating consequences.

As nurses, I urge you to support and spread the word of the United States Department of Justice, DEA National Prescription Drug Take Back Day, which is scheduled for Saturday, October 26, 2013.

According to the DEA:

In the five previous Take-Back events, the DEA, in  conjunction with our state, local, and tribal law enforcement partners, has collected and removed from circulation more than 2 million pounds of prescription medications.

The National Prescription Drug Take-Back Day aims to provide a safe, convenient, and responsible means of disposal, while also educating the general public about the potential for abuse of these  medications.”

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

How to request a hearing with the Ohio Board of Nursing

I have posted about requesting a hearing with the Nursing Board in the past, but this information is so important to Ohio licensed nurses that I thought it was important to run this post again.

The Ohio Board of Nursing meets six times per year for regularly scheduled Board meetings. At these Board meetings, the Members of the Board vote to initiate disciplinary actions against a nurse. This can result in a nurse being issued a Notice of Opportunity for Hearing, which outlines charges that have been brought against the nurse or can result in an Immediate Suspension or Automatic Suspension of a nursing license.  The Board met last week (January 16-17, 2014) and issued dozens of notices to nurses throughout the state.

Nurses who are subject to a potential disciplinary action by the Nursing Board will receive the Notice of Opportunity for Hearing or Notice of Immediate or Automatic Suspension of their licenses by certified U.S. mail. If you are issued a Notice, you have thirty (30) days from the date the Notice is MAILED to request a hearing. Failing to request a hearing within thirty (30) days will bar the nurse from being able to present any defense of his/her license to the Board.

To request a hearing with the Nursing Board, you simply need to submit a request in writing to the Board that states: “I am writing to request a hearing with the Ohio Board of Nursing”. The request should be submitted as instructed in the Notice. I also recommend that you call the Board a few days after you submit the request to verify that it was received.

You do not have to submit a written explanation or defense to the Board when you request the hearing. This type of information can be submitted to the Board after the hearing is scheduled. After the Board receives the hearing request, you will be sent a letter scheduling the hearing with the Board.

In many cases, nurses are able to negotiate a settlement agreement with the Board that will avoid them having to proceed to a hearing. This agreement, known as a Consent Agreement, is a binding agreement between the nurse and the Board that provides an opportunity for the nurse to present mitigating information and sets forth the discipline taken against the nurse. However, even if the nurse wants to attempt to negotiate a Consent Agreement with the Board, they still MUST first request a hearing as outlined above.

Nurses are not required to have an attorney to help them through the Board’s disciplinary process. However, whether the nurse goes to hearing or negotiates a Consent Agreement, the Board will be represented by an attorney or by an Assistant Attorney General who will be assigned to the case. So, I always advise that the nurse seek experienced legal counsel to represent them before the Board. You worked hard for your nursing license. You should work just as hard to defend yourself before the Board.

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

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

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.

Three Days in the ICU

Last week I was not in my office. I flew to the west coast to be with a relative who had been taken to the hospital.  When I arrived, I found the relative had been taken to the ICU at their local small community hospital. For the next three days and nights, I stayed with the relative in the hospital.  What I found was really quite amazing.

I was raised in a family of medical professionals and I have spent the better part of twenty years representing medical professionals before their professional licensure boards. I have been to the hospital before, for simple trips to the ER for stitches or a simple fracture. I also spent two nights in the hospital after the births of my children. Nothing in my past prepared me for the time I spent with my relative in the ICU.

I was thoroughly amazed at the level of care that was provided to my relative. I had always known that nurses provided the bulk of the care to patients, but to see it first hand was awe-inspiring. While it was a small hospital, all records were maintained electronically and all medications dispensed were logged into the record. However, since my relative did not have a local physician, they were cared for by the in-house “hospitalists”. Specialists were called in throughout our time at the hospital to evaluate various aspects of the patient’s care, however, it was the nursing staff who provided the constant care to the patient, advocated for the patient, and updated the physicians of the patient’s current medical condition.

Given the fact that the patient did not have an internist who coordinated care, they saw a different hospitalist at each shift. Over the three days that the patient was in the ICU and the other days that they were on a med/surgical floor, they never once saw the same hospitalist. However, the nursing staff provided the continuous care and continuity of treatment to the patient by updating each hospitalist who examined the patient and each specialist as to the patient’s medical history, demeanor and current medical condition. It was a great relief that I did not have to continue to update each physician as to the patient’s condition since they had been prepped daily by the nursing staff.

As a nurse, never under-estimate the superior service and value that you provide to patients and to their families.  To the nursing community at large, this blog post is a huge “thank you” to your service to the community.

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

Do you have a prescription for that?

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.

Who makes decisions at the Ohio Board of Nursing?

It’s Board week at the Ohio Board of Nursing. This means that Board members from around the state will meet at the Board offices in Columbus on Thursday, September 20 and Friday, September 21, 2012 to review the official business and make decisions regarding such matters as the implementation or change to a Board rule, granting licenses to nurse applicants, closing or continuing investigations, issuing citation letters to nurses, and ruling on final disciplinary matters against nurses. Ohio Revised Code §4723.06.

The Nursing Board is governed by the Nurse Practice Act, which outlines the powers and duties of the Board members. R.C.§4723. The Board is composed of thirteen Board members: eight are licensed RNs, 4 are licensed LPNs and one is a public member. Board members are not compensated but are reimbursed for their expenses. Board Members are appointed by the Governor and serve four-year terms. O.R.C. §4723.02.

Under the Board’s rules, the Board is only required to meet as often as necessary to carry out its duties. O.A.C. 4723-1-01(D). The Ohio Nursing Board has six regularly scheduled meetings each year. Meetings are typically held the third week in January, March, May, July, September and November.

While the Board members make all final decisions, the daily operations of the Board is managed by an Executive Director, who is also an RN. The Board also has a bevy of attorneys, investigators, licensure specialists, and support personnel that work at the Board office on a daily basis and carry out the daily operations of the Board. In addition, any disciplinary matter that proceeds to an administrative hearing, is prosecuted by an Ohio Assistant Attorney General.

The Board is not governed by a statute of limitations. Therefore, if an investigation is initiated against a nurse or nurse applicant, the Board has no time limit in which it must begin or complete the investigation or license (or deny) the application of an applicant. Investigations and applications for initial licensure can take months before the individual is notified if they will be granted a license or subjected to discipline by the Board.

I am always asked “who makes all the decisions at the Nursing Board?” and “why does it take so long to get through the application or investigation process?”  The short answer is that the Board members make all final decisions.  However, since the Board only meets six times a year, official Board decisions are only issued at those Board meetings.   Therefore, if your case is not presented by the staff to the Board Members to review at a Board meeting, your case will not be acted on until the next board meeting.

The Ohio Nursing Board licenses and monitors thousands of nurses each year. For the vast majority of nurses, they will be issued a license or their license will be renewed quickly and without delay. However, if your license application is subjected to additional scrutiny because of a prior conviction, prior impairment, or action by an other state agency, it can take months to be licensed. Similarly, if you are the subject of a Board investigation, even if your license has been summarily suspended by the Board, it can take months to work through the Board investigative and disciplinary process.

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

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

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.

You can be licensed as a nurse in Ohio with a criminal history … depending on the crime

In Ohio, it is possible to be licensed as a nurse even if you have a prior criminal background. However, there are certain crimes that are considered absolute bars to licensure and if convicted of one of these particular crimes, you will be permanently barred from ever being licensed as a nurse in the state of Ohio. Crimes that are an absolute bar to licensure include: Aggravated Murder, Murder, Voluntary Manslaughter, Felonious Assault, Kidnapping, Rape, Sexual Battery, Aggravated Robbery, Aggravated Burglary, Gross Sexual Imposition, and Aggravated Arson.

If you have a prior criminal history that does not include one of the absolute bars listed above, you may attend nursing school and apply for a license in Ohio. You will be required to inform your nursing school at the time of admission of your criminal history and the school can choose whether or not to admit you to their program based on the severity of the crime. However, each school has a different standard for their admission criteria. You should speak to the admissions director at the school prior to applying to determine if your prior criminal history would prevent you from entering the nursing program.

However, completion of a nursing program, even from an accredited nursing school, does not guarantee that you will be licensed as a nurse in Ohio. Even if you have not been convicted of one of the absolute bar listed above, you must disclose your conviction on the application for a nursing license in Ohio. The nursing board reviews all applications in detail and will decide on a case by case basis if they will grant you a license. In considering whether the Ohio Board of Nursing will issue you a license, they will consider factors such as your age at the time of the conviction, whether the conviction involved drugs or alcohol, whether you placed someone else’s life in danger, and whether the conviction involved a minor.

In addition, the Ohio Board of Nursing will not advise you in advance of you attending nursing school whether you will be granted a license. So, if you have a criminal conviction, you do run the risk of attending nursing school and not being licensed in Ohio or being licensed subject to disciplinary action. However, the Board will consider the individual facts in your case and if you have not been convicted of one of the absolute bars listed above, the Board has the authority to grant you a license.

For more information about seeking a license as a nurse in Ohio with a prior criminal history, go the following link at the Board’s website: http://www.nursing.ohio.gov/PDFS/Discipline/CriminalHistory.pdf

As always, 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

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.

Nursing Board Consent Agreements Are Binding Contracts and Generally Can Not Be Changed

A Consent Agreement is a written contract between a nurse and the Ohio Board of Nursing. A Consent Agreement is a voluntary agreement that outlines the discipline that will be imposed against a nurse. A Consent Agreement is similar to a plea bargain in a criminal case. The nurse agrees to certain disciplinary conditions, in lieu of proceeding to an administrative hearing before the Board. By entering into the Consent Agreement, the nurse generally admits to certain misconduct and agrees to comply with certain disciplinary terms.

It is important to keep in mind that once you enter into a Consent Agreement, you are required to complete all terms. Depending on the specific language of the Consent Agreement, you can, in certain circumstances, request modifications to a Consent Agreement after a period of time. However, if the Consent Agreement does not specifically provide that the Consent Agreement may be modified, generally you cannot “get out” of or change the terms of the Consent Agreement.

In most cases, for the probationary period to toll, the nurse needs to work in a position where a nursing license is required. Consent Agreements typically always provide that any time that the nurse is not employed in a nursing position will not reduce the probation or monitoring period.

Generally, once you enter into the Consent Agreement, the only way to “get out” of the Agreement is to comply with its terms. Often nurses have “buyer’s remorse” when they enter into a Consent Agreement and after several months, they no longer want to comply with the terms of the Consent Agreement. However, in most cases, unless the nurse has complied with all the terms of the Consent Agreement the probationary period will not be lifted or modified.

Also, at the end of the probation period, the Consent Agreement does not automatically end. The nurse needs to affirmatively request to be released from all probationary terms of the Consent Agreement.

Consent Agreements are contracts entered into between the nurse and the Board of Nursing. As you may be subject to compliance terms for many months, years, or even indefinitely, it is imperative that you understand the terms of the Consent Agreement BEFORE you sign it.

You worked hard for your professional license. As I have said in previous posts, prior to entering into any agreement with the Ohio Board of Nursing, it is important that you seek experienced legal counsel to assist and represent you.

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