Tag Archives: impaired nurse

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

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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: New way to update your address with the Nursing Board

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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.

 

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

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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.

 

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

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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.

Ohio Nursing Board imposes Permanent Practice Restrictions

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In our practice at Collis, Smiles and Collis, we have the privilege of representing not only Nurses before the Ohio Board of Nursing but also other professionals before their licensure Boards.  This has given us the opportunity to see how various licensure Boards in Ohio handle disciplinary matters.

Each licensure Board in Ohio has its own rules and regulations and has the authority to take any action including but not limited to revocation, suspension, and/or probation of a license.  Under Ohio Revised Code Chapter 119, licensees in Ohio are entitled to an administrative hearing, which allows the licensee to introduce evidence in their defense.

Despite the similar due process that is afforded to most licensees facing a disciplinary action in Ohio, we have seen that many licensure Boards in Ohio (Nursing Board, Medical Board, Psychology Board, Board of Education, Counselor, Social Work and Marriage and Family Therapist Board) impose very different sanctions, despite the relatively similar nature of the offense.

In our experience, we have seen that, generally, licensure Boards in Ohio can be more strict/punitive than licensure Boards in other States in terms of sanctions.

Even within Ohio, based on our experience, the Ohio Board of Nursing imposes permanent practice restrictions on its licensees to a far greater extent than other licensure Boards in Ohio.  Generally, a permanent practice restriction limits a Nurse’s ability to work in the following settings: hospice, home health, as an independent provider for an Ohio agency, as a private duty nurse, as a volunteer, as well as any position involving management of nursing or supervision or evaluation of nursing practice, including but not limited to Director of Nursing, Assistant Director of Nursing, or Nursing Supervisor.  In certain instances, the Ohio Board of Nursing will include language in a Consent Agreement or Order that allows a Nurse to request on a case-by-case basis approval to work in an otherwise restricted position, however, such requests are given close scrutiny and are often denied.

Permanent practice restrictions are often imposed in cases in which a Nurse has been convicted of a crime, found to be addicted to drugs or alcohol, or where a Nurse has practiced below the standard of care.  In certain cases, the Ohio Board of Nursing imposes practice restrictions that prohibit a Nurse from working in any position that would require a Nurse to have oversight or control over financial dealings.

Permanent practice restrictions place a significant hardship on a Nurse’s employment opportunities.  Although we have seen Nurses with permanent practice restrictions on their license obtain employment, permanent practice restrictions create an enormous hurdle to overcome in terms of obtaining meaningful employment because, in our experience, many employers will simply not consider any Nurse who has permanent practice restrictions on their license.

Historically, it has been our experience that the Ohio Board of Nursing imposed permanent practice restrictions on a Nurse in cases where the facts of a case fully justified doing so based on significant practice or impairment issues, or in cases where a Nurse had been repeatedly disciplined.  Presently, however, we are seeing the Ohio Board of Nursing impose permanent practice restrictions on Nurses in greater numbers and on their first disciplinary action.

While there are cases in which permanent practice restrictions are justified to protect the public, obtaining the advice of experienced legal counsel before you sign a Consent Agreement containing permanent practice restrictions or before undertaking to represent yourself at an Administrative Hearing (which could result in a Ohio Nursing Board Order imposing permanent practice restrictions) is recommended.

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

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Who Monitors the Ohio Board of Nursing?

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The Ohio Board of Nursing’s mission is to “actively safeguard the health of the public through the effective regulation of nursing care.” http://www.nursing.ohio.gov/ The Board is responsible for issuing licenses to nurses, to regulate the education of nurses, and to discipline nurses who have violated the provisions of the Ohio Nurse Practice Act. (R.C. 4723). However, most nurses are surprised to learn that the Nursing Board is not created to “protect” nurses but has been created to “protect the public”.

In its role as an administrative licensing agency, the Board holds immense power. The Board has the power to license, deny a license, suspend or revoke a license. The Board can initiate an investigation, may order a licensee to a psychiatric or chemical dependency evaluation. (R.C. 4723.28(G)). However, the Board is not required to complete investigations in any time frame (no statute of limitations) and the Board is NOT REQUIRED to notify a nurse if and when an investigation has been closed. I often contact the Board after an investigation has been pending for months (or even years) to learn that the investigation has been closed and that the nurse was never notified that it was closed.

There is a check and balance system in place for the Nursing Board. Prior to denying an applicant a nursing license, or taking an action against a nurse (ie. suspending or revoking their license) the nurse is entitled under the U.S., Ohio Constitutions and Ohio State law (R.C. 119) the right to due process of law. This means that prior to denying a license or disciplining a nurse, the Board is required to provide the nurse with notification of the charges and a right to be heard (a hearing). Failure to timely request a hearing may bar the nurse from providing any evidence on their behalf.

An adverse decision of the Board may also be appealed to the local Court of Common Pleas. However, most nurses have neither the money, time nor inclination to appeal an adverse decision of the Board to the Courts. This is an expensive process that can take years to complete. In addition, the Courts are reluctant to reverse a decision of the Board and have shown that it will NOT reverse a sanction of the Board simply if it feels the sanction is too harsh.

A second check on the Nursing Board is the Office of the Ohio Inspector General. The Inspector General’s office is the Watchdog that is responsible for investigating state employees and state agencies. Complaints may be filed with the Inspector General by going to their website at: http://watchdog.ohio.gov/FileaComplaint.aspx

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 Collis, Smiles and Collis 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

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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

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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.

Permanent Practice Restrictions on Nursing Licenses

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For violations of the Nurse Practice Act in Ohio, the Nursing Board can impose a range of sanctions against a nurse which can include (but are not limited to) any of the following sanctions: revocation, suspension, reprimand, temporary or permanent practice restrictions.

Prior to the Board imposing a sanction against a nurse’s license, the Board is required to provide the nurse with a written Notice of the alleged violation and an opportunity to request a hearing.  If the nurse properly and timely requests a hearing, the nurse can attempt to negotiate a Consent Agreement with the Board (similar to a plea bargain in a criminal case) or they are entitled to a hearing where the Board would be required to prove the alleged violation of the Nurse Practice Act.

The sanction that the Board imposes in each case is strictly dependent on the individual facts and circumstances that gave rise to the alleged violation.  However, in most cases, the Board attempts to impose similar sanctions on similar cases.

Many nurses are surprised that in addition to a suspension of a nursing license, in many instances the Board will impose temporary or even permanent practice restrictions on the nurse’s license.  The restrictions generally limit the nurse’s ability to pass narcotics or to work in certain settings such as home care or home hospice, through an agency, as an independent provider, as a volunteer or to contract individually with a patient.  The Board also typically restricts the nurse’s ability to work as a nurse manager, DON, ADON or nursing supervisor.

If the Board places temporary practice restrictions on a nurse’s license, typically the restrictions will be lifted when the period of suspension and probation ends.  However, in certain serious cases, the Board will impose permanent practice restrictions that will permanently bar the nurse from working in certain settings. Occasionally, the Board will include a statement that says that the practice restrictions are permanent “unless otherwise approved by the Board.”  This specific language allows the Board to lift a permanent restriction in certain circumstances and for certain specific positions.

If a nurse has a permanent practice restriction on their license without the “unless otherwise approved” language, the permanent practice restrictions can NEVER be lifted.  This is generally reserved for the most serious violations of the Nurse Practice Act, generally resulting from cases of significant impairment (drug or alcohol abuse) by the nurse.

Nurses are often disappointed that they may complete a period of suspension or probation but still have permanent limitations on their license.  While the Board is one of only a few professional licensing agencies that will impose permanent restrictions on a professional license, it is a routine practice of the Board and is even imposed against a nurse who may have never been disciplined by the Board in the past.

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 Collis, Smiles and Collis, LLC or email me at beth@collislaw.com

National Prescription Drug Take-Back Day October 26, 2013

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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.