Ohio Nurses: Failure to Document May Result in Disciplinary Action Against Your Nursing License

The importance of documentation in the nursing field cannot be underestimated.

The Ohio Board of Nursing is authorized to discipline a licensee for (among other things) failure to practice in accordance with acceptable and prevailing standards of safe nursing care.  Failure to document the administration or otherwise account for the disposition of controlled substances that the Nurse removed from the Pyxis, or other place where controlled substances are stored, may also be the basis for the Nursing Board to discipline a nurse.

In certain cases, the Nursing Board will offer the Nurse a Consent Agreement as an alternative to an Administrative Hearing.  A Consent Agreement allows the Nurse to avoid the time, worry, and expense of an Administrative Hearing.  Nurses do not need to sign a Consent Agreement. It is always a good practice to read a proposed Consent Agreement very carefully.  We have seen Consent Agreements that are based on allegations of failure to document the administration or otherwise account for the disposition of controlled substances. In many cases, the Consent Agreement requires  (in some cases, lasting years)  random drug screening, narcotic restrictions, and practice restrictions, even when there was no history of drug use or abuse by the Nurse.

If the nurse does not sign a proposed Consent Agreement, he or she always has the right to go to an Administrative Hearing.  The nurse can present evidence that there is no history of drug use or abuse and that the nurse has an otherwise excellent history of employment.  The Board’s attorney is going to present its evidence that the nurse failed to document the administration or otherwise account for the disposition of controlled substances that were removed.

It is imperative to completely, accurately, and timely document the administration or disposition (waste) of controlled substances or other drugs! The Nursing Board may place a nurse on probation and subject them to multiple probationary terms, even if there is no evidence that they suffer from chemical dependency and even if there is no evidence of diversion.

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.

 

 

 

Ohio Board of Nursing – Mandatory Disqualifying Offenses

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 licensureORC 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

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.

Ohio Nurses: Things To Consider If You Receive a Notice of Opportunity for Hearing from the Ohio Board of Nursing

Last week, I attended the Ohio Board of Nursing’s bi-monthly meeting where the members of the Board issued final sanctions against dozens of Ohio nurses.  At that meeting, the members of the Board also authorized the issuance of over sixty Notices of Opportunity for Hearing to Ohio licensed nurses.  The Notice of Opportunity for Hearing (or Notice of Automatic Suspension or Notice of Immediate Suspension) outlines specific charges against the nurse, which, if proven, can form the basis for the nurse to have their license revoked, suspended, placed on probation or reprimanded.

There are legal timelines that must be followed for a nurse to request a Hearing in order to defend their professional license.  Failure to timely request a Hearing can bar the nurse from presenting ANY defense to the Board.

There is no routine disciplinary matter when it comes to a nurse’s professional license.  Disciplinary sanctions imposed by the Board may affect a nurse’s ability to practice nursing in the short-term and can also impose permanent practice and/or narcotic restrictions.

If you receive a Notice of Opportunity for Hearing (or Notice of Automatic Suspension or Notice of Immediate Suspension), it is highly recommended to obtain experienced legal counsel to assist you before the Board.  When hiring legal counsel, here are a few things to consider:

EXPERIENCE:

  • Does the attorney have experience with the type of matter for which you need representation?
  • Is this type of matter a usual part of the attorney’s practice?
  • Has the attorney handled any cases similar to your particular matter?
  • If it is a matter where a settlement or hearing may be involved, how many of those matters has the attorney handled?
  • In general for this type of matter, what does the attorney consider to be a good result?
  • Can the attorney explain the process to you?

ACCESS:

  • What is the best way to communicate with the lawyer and how will he or she communicate with you?
  • When can you expect to hear from the attorney?
  • Are there other people in the attorney’s office who can assist you should an emergency arise while your attorney is unavailable?
  • How will you know what work the attorney has done or will be doing on your matter?

COMPATIBILITY:

  • Will you be comfortable sharing your information with the attorney?
  • Do you understand the information the attorney is telling you?
  • Are there different approaches to your situation, and if so, how will the attorney decide which to take or recommend to you?

FEES:

  • How does the attorney charge you?  Based on hours worked?  Fixed fee?  Or some other method?
  • Is payment required up front?  If so, how and when is that money applied to your account?
  • Will you receive statements for the work performed?
  • Will you be charged for expenses (ex:  travel, hotel, postage, copy charges)?
  • Does the attorney accept credit card payments?

This is a general guide and is not legal advice.  Of course, there may be other questions or concerns you may want to discuss with a potential attorney based on your individual circumstances or issues.

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 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.

 

 

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.

 

Alcohol Prohibitions – Be Aware of the Things You Eat and Drink As Well As the Products You Use and the Medications You Take

In alcohol impairment cases before the Ohio Board Of Nursing resulting in Consent Agreements, the Alternative Program, Board Orders, or otherwise requiring nurses to undergo screening for alcohol, nurses are typically required (among other things) to abstain completely from the use of alcohol or any products containing alcohol.

It is critically important to avoid beverages, foods, hygienic and beauty products, household products, over the counter medications, and prescription medications which contain alcohol.

BEVERAGES: Beverages, including but not limited to, distilled spirits, beer, ale, malt beverages, wine, and cider contain alcohol.  Additionally, beverages such as Communion Wine or beverages labeled “Non-Alcoholic” or “NA” also can contain alcohol.

FOODS: Foods prepared with cooking wine, sherry, wine vinegar, soy sauce and items containing flavoring extracts (such as vanilla extract), can contain alcohol.  Additionally, certain cooking sprays contain alcohol.

HYGENIC AND BEAUTY PRODUCTS: Certain hygienic and beauty products can contain alcohol, including but not limited to certain:

Perfumes, colognes, and after shaves

Lotions and balms

Body sprays and mists

Makeup removers

Hand sanitizers

Antiperspirants

Deodorants

Mouthwashes

Hair Products

Cosmetics

HOUSEHOLD PRODUCTS: Certain household products can contain alcohol, including but not limited to certain:

Antibacterial products including antibacterial gel, dishwashing liquid and hand soap

Cleaners

Detergents

Dishwashing liquids

Air fresheners

Insect repellents

Disinfectant sprays

Sanitizing wipes

Liquid bandages

OVER THE COUNTER MEDICATIONS: Certain over the counter medications can contain alcohol, including but not limited to certain:

Cough suppressants

Expectorants

Nasal decongestants

Oral antiseptics

Anti-asthmatics

Antihistamines

Bronchodilators

Decongestants

Mouthwashes and gargles

Laxatives

Analgesics

Supplement

Vitamins

Anti-diarrheas

PRESCRIPTION MEDICATIONS: Certain prescription medications, including but not limited to certain asthma inhalers, contain alcohol or ethanol.

CONSULT YOUR PHYSICIAN: If you are unsure whether a particular food, beverage, product, or medication contains alcohol, read the label and consult your physician prior to eating, drinking, using, or taking it.

This article provides general guidance and is not a substitute for the advice of your physician.

As always, if you have any questions about the Ohio Board of Nursing or this post, please feel free to call one of the attorneys at Collis, Smiles and Collis at 614-486-3909 or check out our website at http://www.collislaw.com.

Ohio Nursing Board Investigations of Nurses during Inpatient or Intensive Outpatient Treatment

Tackling addiction to drugs or alcohol is a difficult decision to make and a lifelong challenge to maintain. It is important that you make this decision without jeopardizing your professional license.

Frequently, a nurse will enter a drug or alcohol rehabilitation program due to employer discipline or termination from employment. In certain instances, both the Nursing Board and law enforcement will be notified about the employment action.

Because of its responsibility for patient safety, the Nursing Board can and should take these situations very seriously. Nursing Board investigators frequently contact nurses who are participating in intensive rehabilitation programs to question them about their addiction and employment issues. As part of the investigatory process, nurses are often requested to place their license on inactive status as a “sign of cooperation with the Board investigation” or as a “good faith commitment to their sobriety”.

There are certain times when going on inactive status is the right choice. It allows the nurse time to obtain treatment and often provides more time for the Nursing Board investigation, which gives the nurse more time to strengthen his or her sobriety. In certain instances, a nurse can also be given credit by the Nursing Board for the period of time during which the nurse was on inactive status towards any period of license suspension imposed by the Nursing Board in a disciplinary action.

However, prior to making the decision to go on inactive status, a nurse should make sure they are in the correct mental or emotional state.  Going on inactive status is a very serious decision.  When a nurse is in treatment, quality of thought may not be at its best and, as with other important family or career matters, it is often not the best time to be making serious, long lasting decisions. A nurse should also be aware that the Nursing Board can impose significant requirements on a nurse in order to have a license reinstated, including but not limited to undergoing evaluation and/or treatment for drugs or alcohol or psychological condition, successfully completing negative urinalysis for a period of time determined by the Board, completing additional continuing education, and/or completing a practice improvement plan. Each situation is different and will be handled on a case by case basis by the Nursing Board.

Once the intensive portion of the treatment program is completed, there will be time to decide whether to communicate with a Nursing Board investigator and/or whether to voluntarily do anything regarding the status of your license. Such decisions should be made with a clear mind and after a careful consideration of the facts in your case. The recommendations of experienced nursing license defense legal counsel can be of assistance.

As always, if you have any questions about the Ohio Board of Nursing or this post, please feel free to call one of the attorneys at Collis, Smiles and Collis at 614-486-3909 or check out our website at http://www.collislaw.com.

Nursing license suspension can result from a conviction

Under the Ohio Nurse Practice Act, R.C. 4723, the Ohio Board of Nursing can take an action against a nurse for criminal convictions, even if they are NOT related to the practice of nursing.

R.C. 4723.28 (B)(3) allows the Nursing Board to take an action against a nurse who has been convicted of a misdemeanor in the course of practice. This seems obvious. However, under R.C. 4723.28(B)(4) the Nursing Board may take a disciplinary action against a nurse who has been convicted of any felony or a “crime involving gross immorality or moral turpitude.” So even crimes that are not related to the practice of nursing can result in a sanction on your nursing license.

Crimes involving gross immorality or moral turpitude are generally defined as crimes of violence or that “shock the conscience.” Crimes such as for assault or child neglect, easily come to mind as crimes that would involve “gross immorality”. However, crimes involving financial dealings (passing bad checks, bank fraud, tax evasion) have also been found to meet this standard.

The Nursing Board also has the authority to take a disciplinary action against a nurse if they do not have a conviction, but are otherwise permitted to enter into a pre-trial diversion program or are found judicially eligible for a treatment in lieu of conviction program. So, even when they don’t have a formal conviction, the Nursing Board is still authorized to take a disciplinary action against the nurse.

The Nursing Board meets six times per year at monthly meetings where it decides, after an investigation, if a disciplinary action should be taken against a nurse. The Nursing Board met last week and sent letters to over eighty (80) Ohio licensed nurses proposing to take a disciplinary action against them. For many of these nurses, the Board is proposing to discipline them for criminal convictions.

If the Board chooses to discipline a nurse, the nurse will be sent a Notice and given a right to a hearing. It is important that the nurse respond to this Notice in a timely fashion to request a hearing. The Board handles each case on an individual basis and the sanction it chooses to impose on a nurse is often dependent on the information the Nursing Board learns from the nurse or their legal counsel.

As always, if you have any questions about the Ohio Board of Nursing or this post, please feel free to call one of the attorneys at Collis, Smiles and Collis at 614-486-3909 or check out our website at http://www.collislaw.com.

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.