Ohio Nurses: How to comply with a Nursing Board Order or Consent Agreement during the COVID-19 Stay at Home Order

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Posted on April 9, 2020 by Beth Collis

Many nurses who are currently being monitored by the Ohio Board of Nursing, under the terms of a Consent Agreement or a Board Order, have asked how they can comply with the terms of these Orders, while under the State of Ohio Stay at Home Order in effect until May 1, 2020.

In general, each nurse needs to continue to comply with all terms and conditions of your Board Order or Consent Agreement. If you unable to comply in any way, contact your monitor immediately. While the Nursing Board staff is currently working remotely, the staff has access to emails and they are continuing to respond to questions and requests.

Random Drug testing:

Nurses who have stopped daily call ins to First Source, based upon the Ohio Department of Health Stay at Home Order, need to begin daily calls effective Monday, April 20, 2020.

Random Drug Testing will be scheduled after May 4, 2020. Testing will include hair and blood specimens in addition to urine specimens. These highly sensitive tests will be able to detect if you ingested alcohol, medications or illegal substances in the days or weeks before the test. So, just because you are not submitting to random drug testing does not mean that you can consume alcohol (if prohibited by your Board Agreement or Order) or that you may use medications not prescribed to you or illegal substances.

Any requirement that is not met, such as a missed screen or support group meeting attendance, or a positive screen based on the use of hand sanitizer will be evaluated considering the coronavirus (COVID-19).

Attendance at AA meetings:

You may now “attend” AA meetings online.If you participate in an on-line support group meeting or discussion, please document this on Form #4 and include dates and type of meeting attendance. A co-signor is not necessary.

Here are links for on-line meetings:
(AA)
(CA)
(NA)

If you participate in an on-line meeting or discussion, please document this on form #4 and include the date of the meeting and the type of meeting attended. A co-signor is not necessary. Again, contact your monitor if you choose to “attend” an AA meeting online.

Request to modify the terms of your Consent Agreement:

The Nursing Board has also received multiple requests to remove Board monitoring and restrictions or to modify Board Orders. Board actions will not be held in abeyance or suspended. Board Orders are final and there is no provision to modify a Board Order. The Board will not alter permanent restrictions in Consent Agreements or Orders.

Ohio Department of Health has established an outline for essential healthcare workers, which can be found here.

More info about Covid-19 and Ohio can be found here.

As always, if you have any questions about this post or about the Ohio Board of Nursing in general, feel free to contact Beth Collis or Todd Collis.

Ohio Nurses with Narcotic Restrictions: You CANNOT Observe Waste

Posted on November 8, 2018 by Beth Collis

A nurse who is the subject of a disciplinary action by the Ohio Board of Nursing may, in certain instances, have one or more restrictions placed on their nursing license. One type of restriction is a narcotics restriction.

Although the language of a narcotic restriction can and does vary depending on the facts and circumstances of each case, the Ohio Board of Nursing’s narcotic restriction typically provides:

“Unless otherwise approved in advance, in writing, by the board or its’ designee, NURSE shall not administer, have access to, or possess (except as prescribed for NURSE’s use by another so authorized by law who has received a complete copy of this Consent Agreement prior to prescribing for NURSE) any narcotics, other controlled substances, or mood-altering drugs in which NURSE is working in a position that requires a nursing license. In addition, NURSE shall not possess or carry any work keys for locked medication carts, cabinets, drawers, or containers. NURSE shall not count narcotics. NURSE shall not call in or order prescription refills for narcotics, other controlled substances, or mood-altering drugs.”

As stated noted above, a nurse with a narcotics restriction may not count narcotics. Counting narcotics includes, but is not limited to, observing the waste of unused narcotics by another nurse because observing waste is considered part of the counting process. If you have a narcotics restriction on your license, you may not observe waste and you should ensure that your employer is aware that your narcotic restriction prohibits you from observing waste before you are in a situation where you are asked to witness another nurse wasting.

Narcotic restrictions can be permanent or temporary. If the narcotic restriction is permanent, the nurse must comply with the narcotic restriction on a permanent basis, unless the narcotic restriction includes the language, “Unless otherwise approved in advance, in writing, by the board or is designee”. This language permits the nurse to request the Nursing Board’s approval for a specific exception to the permanent narcotic restriction.

If the narcotic restriction is temporary, the nurse must comply with the narcotic restriction during their entire probationary period or, in certain cases, for a shorter period. If the temporary narcotic restriction includes the language, “Unless otherwise approved in advance, in writing, by the board or its’ designee”, the nurse may request the Nursing Board’s approval for a specific exception to the temporary narcotic restriction.

As always, if you have questions about this post or the Ohio Board of Nursing, contact one of the attorneys at Collis Law Group LLC at (614) 486-3909 or contact me at beth@collislaw.com.

Nurses who enter into a Consent Agreement with the Ohio Board of Nursing MUST complete all conditions OR negotiate terms to modify to the Agreement.

Posted on July 20, 2018 by Beth Collis

A Consent Agreement with the Ohio Board of Nursing is a negotiated contract between the nurse and the Board that specifies the terms and conditions under which a nurse on probation may continue to practice as a nurse and/or seek reinstatement of their license, if suspended. By signing the Consent Agreement, the nurse agrees (among other things) to waive their right to a hearing and to comply with the terms in the Consent Agreement.

Failure to comply with the terms of the Consent Agreement can result in the Nursing Board automatically suspending a nurse’s license to practice in Ohio.

Typically, a Consent Agreement which includes a suspension will outline conditions for a nurse to seek reinstatement of their license or, for a Consent Agreement that includes probation, will place conditions on a nurse’s license. Often, nurses are subjected to random drug testing, are required to attend weekly AA/NA meetings, or complete additional continuing education courses. In some cases, a nurse may have a license limitation that does not allow them to work in certain settings or dispense medications.

Actions including, but not limited to, missing a mental health or chemical dependency examination, failure to check in daily for alcohol or drug screens, or failure to submit to a screen when selected are a few examples of a breach of the Consent Agreement.

Even when unemployed as a nurse, the nurse is still required to comply with the Consent Agreement. For Consent Agreements that include a probationary period, the nurse must actually work in a nursing position for the probation period to count down.

Compliance with a Consent Agreement can be time-consuming and costly. Nurses are often unable to afford the random screens or become frustrated with the lengthy probationary period, especially if they are not working as a nurse.

I am often contacted by nurses who want to stop compliance with the terms of their Consent Agreement because they can no longer afford the random screens or are no longer interested in completing all compliance terms.

A Consent Agreement is a negotiated contract between a nurse and the Nursing Board. The nurse MUST negotiate alternative terms in writing with the Nursing Board. If the nurse simply stops complying with the Consent Agreement, without first negotiating a written amendment or modification to the Consent Agreement, their license will likely be automatically suspended by the Nursing Board for failure to comply with the Consent Agreement.

To seek an amendment or modification to the Consent Agreement, the nurse must be in full compliance with all probationary terms. Even if in full compliance, the Nursing Board may only agree to place the nurse’s license on indefinite suspension. And if the nurse wants to seek reinstatement of their license in the future, the nurse may be required to complete most if not all of the probationary terms again.

In summary, in order to cease having to comply with the terms and conditions of a Consent Agreement, the nurse must re-negotiate the terms of the Consent Agreement with the Nursing Board and must continue to comply with their Consent Agreement until the Nursing Board agrees in writing to the modified Consent Agreement.

All Consent Agreements must be approved by the full Board, which only meets six times a year. The nurse should expect that it could take up to 8 weeks before the Nursing Board will approve a new Consent Agreement or a modification to a Consent Agreement. The nurse must continue to comply with their existing Consent Agreement until a new Consent Agreement or modification has been approved in writing by the Nursing Board.

Before making the decision on whether to stop complying with the terms of a Consent Agreement with the Board of Nursing, it is recommended to consult with an attorney. Factors such as the nurse’s financial condition and their desire to practice nursing in the future should be considered.

As always, if you have a question 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, LLC at 614-486-3909 or email me at beth@collislaw.com.

Nurses: Marijuana is still Illegal in Ohio, and a Positive Drug Screen could lead to Discipline

Posted on November 10, 2017 by Beth Collis

Marijuana for medical or recreational purposes is now legal in some states, such as Colorado and Oregon. However, use of marijuana is still illegal in Ohio. If employed as a nurse, you can be subjected to pre-employment, for cause, or random drug tests. If you test positive for marijuana, you may be terminated from your job and may be subjected to discipline by the Ohio Board of Nursing. Chemicals in marijuana, mainly THC, can show on a urine, blood, saliva or hair follicle drug test after 120 or more days, based on usage and other personal factors. (See Samhsa.gov for guidance on drug testing).

According to RC 4723.28(B)(8), it is a disciplinable offense for a nurse to be self-administering or otherwise taking into the body any dangerous drug, as defined in RC 4729.01, in any way that is not in accordance with a legal, valid prescription issued for that individual, or self-administering or otherwise taking into the body any drug that is a Schedule I controlled substance. (Marijuana is defined as a Schedule I substance.)

Courts have held that an employee is not protected from a wrongful discharge even if they are lawfully taking medical marijuana, and test positive at work. (Coats v. Dish Network). This is because marijuana is unlawful under Federal Law, which the court determined prevails in this situation.

The Ohio Board of Nursing routinely takes disciplinary action against a nurse who tests positive for marijuana, even in cases where the nurse has consumed marijuana in a legal jurisdiction. Therefore, it is important for Ohio nurses to be aware of the risks they take if consuming marijuana, whether it be legally or illegally. Testing positive on a drug screen may result in a disciplinary action against your nursing license.

As always, if you have a question 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 LLC at 614-486-3909 or email me at beth@collislaw.com.

Ohio Board of Nursing – Mandatory Disqualifying Offenses

Posted on January 24, 2017 by Beth Collis

Prior to going through the time, effort and expense of attending nursing school you should know if you are eligible to be licensed as a nurse if you have convicted of a crime.

Under Ohio Revised Code (“ORC”) Section 4723.092, there are certain offenses, for which individuals are ineligible for licensure. ORC Section 4723.092 provides:

“An individual is ineligible for licensure under section 4723.09 of the Revised Code or issuance of a certificate under section 4723.651, 4723.75, 4723.76, or 4723.85 of the Revised Code if a criminal records check conducted in accordance with section 4723.091 of the Revised Code indicates that the individual has been convicted of, pleaded guilty to, or had a judicial finding of guilt for either of the following:

(A) Violating section 2903.01, 2903.02, 2903.03, 2903.11, 2905.01, 2907.02, 2907.03, 2907.05, 2909.02, 2911.01, or 2911.11 of the Revised Code;

(B) Violating a law of another state, the United States, or another country that is substantially similar to a law described in division (A) of this section.”

Licensure under ORC Section 4723.09 applies to licensure by examination to practice as a registered nurse or as a licensed practical nurse, or (ii) by endorsement to practice nursing as a registered nurse or as a licensed practical nurse. The certificate referred to in ORC Section 4723.651 is a medication aide certificate. The certificate referred to in ORC Section 4723.75 is a certificate to practice as a dialysis technician. The certificate referred to in ORC Section 4723.76 is a certificate to practice as a dialysis technician intern. The certificate referred to in ORC Section 4723.85 is a community health worker certificate.

An individual who has been convicted of, pleaded guilty to, or has a judicial finding of guilt for violation of any of the following offenses, or for violating a law of another state, the United States, or another country that is substantially similar to any of the following offences, is ineligible for licensure by examination or by endorsement to practice nursing as a registered nurse or as a licensed practical nurse in Ohio, or for a medication aide certificate, a dialysis technician certificate, a dialysis technician intern certificate, or a community health worker certificate in Ohio:

ORC Sections:

2903.01 – Aggravated Murder

2903.02 – Murder

2903.03 – Voluntary Manslaughter

2903.11 – Felonious Assault

2905.01 – Kidnapping

2907.02 – Rape

2907.03 – Sexual Battery

2907.05 – Gross Sexual Imposition

2909.02 – Aggravated Arson

2911.01 – Aggravated Robbery

2911.11 – Aggravated Burglary

If you have been convicted of a crime that is Not on this list, you will still be required to disclose the conviction on your application for licensure. The Nursing Board will review each application on a case by case basis and determine if you will be granted a license.

Even if you have been convicted of a crime NOT listed above, the Nursing Board may choose to deny you an Ohio nursing license or may issue you a license on probation or require you to submit to a period of random drug testing when first licensed. Unfortunately, the Nursing Board will not determine if your license will be denied or limited until you complete nursing school and submit an application. So, if you have a conviction on your record, you should carefully consider whether you want to attend nursing school.

As always, if you have any questions about this post or the Ohio Board of Nursing, contact one of the attorneys at the Collis Law Group LLC at 614-486-3909 or go to our website at http://www.collislaw.com for more information.

How a DUI may affect your Ohio nursing license

Posted on January 1, 2017 by Beth Collis

Happy New Year!

Over this holiday weekend, I have received calls from several health care professionals who have been charged with a DUI inquiring how or whether a criminal charge may affect their license to practice as a nurse in Ohio.

First, it is important to understand that the Ohio Nursing Board may take a disciplinary action against a nurse for certain criminal convictions, even if the charge does not relate to the practice of nursing. Second, it is important to understand that a DUI is not considered a “minor traffic violation”. A DUI, even if reduced to a lesser offense, such as disorderly conduct or reckless operation of a vehicle, is still of concern to the Nursing Board and may result in a sanction to the nurse’s professional license.

If you have been charged with a DUI, you should seek competent legal counsel to assist you through the criminal case process. In certain instances, you may be accepted into a treatment program which, if successfully completed, may result in no criminal conviction or the charges may be reduced to a less serious offense.

A conviction for a DUI or certain other criminal offenses may result in negative consequences for your professional license. While you are not required to immediately notify the Ohio Nursing Board that you have been charged with or convicted of a criminal offense, you may need to disclose the criminal matter when you renew your professional license, depending on the matter. At the time you renew your license, you should consider hiring legal counsel to assist you to accurately respond to the questions on the renewal application and to prepare any documents necessary or required by the renewal application.

The way in which the Ohio Nursing Board handles your criminal case will depend on a variety of factors. In determining what sanction, if any, that the Ohio Nursing Board might impose, the Ohio Nursing Board will consider factors including but not limited to the following:

the seriousness of the matter;
whether the matter relates to your professional practice;
whether the matter is your first criminal matter; and
whether you fully cooperate and complete any requirements of the Court.

Depending on the circumstances of your matter, the Ohio Nursing Board can order the nurse to submit to a chemical dependency assessment to determine if treatment is needed and/or can require the nurse to submit to a period of random drug testing. Additionally, the Ohio Nursing Board has the authority to suspend a nurse’s license and/or can place the nurse on probation.

If you need treatment, you should obtain comprehensive treatment. The Ohio Nursing Board does not maintain an approved list of treatment providers. The nurse may choose any treatment center that will provide them with the treatment needed for their addiction.

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 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.

Alternative Program for Chemically Dependent Nurses

Posted on February 13, 2012 by Beth Collis

In Ohio, nurses who suffer from drug or alcohol addiction or abuse should immediately seek treatment at an authorized chemical dependency treatment facility. However, nurses are often concerned about voluntarily seeking treatment because they do not know what effect, if any, treatment will have on their nursing license.

Fortunately, for Ohio nurses, the Ohio Board of Nursing has established the Alternative Program for Chemically Dependent Nurses. This is a confidential program that allows eligible nurses to enter into a monitoring contract with the Nursing Board. Under the contract, the nurse is required to complete the recommendations of a treatment program, completely abstain from drugs and alcohol and submit to random drug screens generally for a period of five years. A full outline of the program can be found at: http://codes.ohio.gov/oac/4723-6

Not all impaired nurses are eligible for the program. To be eligible, a nurse must hold a valid Ohio nursing license, submit an application for enrollment in the Board’s confidential program, submit to a chemical dependency assessment, and then follow all treatment recommendations. http://codes.ohio.gov/oac/4723-6-02 Eligible nurses may be required to place their nursing license on inactive status for six months at the beginning of treatment and they will be required to submit to random drug screens and attend weekly AA or NA meetings for five years. This may seem like a long period of time to submit to monitoring, a chemically impaired nurse, is permitted to return to the practice of nursing while participating in the confidential program after six months of clean screens.

What can make a nurse ineligible for the program? Nurses who are prescribed controlled substances by their physicians; who have a dual diagnosis with another medical or psychiatric condition; or who have completed drug and alcohol treatment two or more times in the past, may not be eligible for this program. http://codes.ohio.gov/oac/4723-6-02

The Alternative Program is confidential. If you are accepted, your participation will not be considered “discipline” by the Nursing Board. There will be no notation on the Board’s website that you are participating in the program and you will not be listed in the Nursing Board’s Momentum publication as a participant in this program. In addition, if you successfully complete the program, you will not be reported to the National Practitioner’s Data Bank . http://codes.ohio.gov/oac/4723-6-04

As always, if you have any questions, please feel free to email me at beth@collislaw.com or call me at 614-486-3909.

Ohio Legal Counsel to Professionals

advocating for nurses and other licensed professionals in Ohio

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