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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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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.

Use of Social Media by Nurses in Ohio

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The Ohio Board of Nursing’s (“OBN”) Fall 2018 edition of Momentum Magazine includes an interesting article concerning the use by nurses of social media.  The article addresses the American Nurses Association’s (“ANA”) Principles for Social Networking and the Nurse.  See: https://www.nursingworld.org/~4af4f2/globalassets/docs/ana/ethics/social-networking.pdf.

Although the ANA Principles provide useful guidance concerning the use by nurses of social media, nurses licensed in Ohio are required to observe the OBN’s laws and rules concerning use of social media which include, but are not limited to, the following:

OAC 4723-4-03(H) and 4723-4-04(H): These are OBN rules which provide in part that registered nurses and practical nurses licensed in Ohio shall not disseminate patient information for purposes other than patient care, or for otherwise fulfilling the nurse’s assigned job responsibilities, through social media, texting, emailing or any other form of communication.

These rules prohibit nurses licensed in Ohio from using social media, texting, emailing or any other form of communication to disseminate patient information for purposes other than patient care, or for otherwise fulfilling the nurse’s assigned job responsibilities.

OAC 4723-4-06(Q): This is an OBN rule which provides that, for purposes of OBN rules OAC 4723-4-06(I), (J), (K), (L), and (M), a nurse shall not use social media, texting, emailing, or other forms of communication with, or about a patient, for non-health care purposes or for purposes other than fulfilling the nurse’s assigned job responsibilities.

This rule prohibits a nurse licensed in Ohio from using social media, texting, emailing, or other forms of communication with, or about a patient, for non-health care purposes or for purposes other than fulfilling the nurse’s assigned job responsibilities, for purposes of the OBN’s requirements that a nurse licensed in Ohio:

-maintain professional boundaries;

-provide patient privacy and courtesy;

-not engage in behavior that causes, may cause, or may reasonably be interpreted as, physical, verbal, mental, or emotional abuse;

-not misappropriate a patient’s property;

-not engage in behavior for, or that may reasonably be interpreted as behavior for, personal gain at a patient’s expense;

-not engage in inappropriate involvement in, or that may reasonably be interpreted as inappropriate involvement in, a patient’s personal relationships or financial matters;

-not engage in sexual conduct with a patient;

-not engage in conduct in the course of practice that may reasonably be interpreted as sexual; and

-not engage in any verbal behavior that is, or may reasonably be interpreted as, seductive or sexually demeaning to a patient.

A nurse licensed in Ohio who is determined by the OBN to have failed to comply with any of these rules based on the improper use of social media, texting, emailing, or any other form of communication is subject to disciplinary action by the OBN.

As noted in the OBN article, “The use of social media carries with it much responsibility.  Please be aware of your responsibilities and professional obligations and how its use may impact you.”

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 Nurses with Narcotic Restrictions: You CANNOT Observe Waste

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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.

REMINDER – Ohio Licensed Practical Nurses: Renew Your Nursing License Now

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Reminder to all LPNs: Renewal of Ohio licensed practical nurse (“LPN”) licenses began on July 1, 2018 and ends on October 31, 2018.  At this time, you have less than a week left to renew your license.

It is a disciplinable offense to engage in the practice of nursing having failed to renew a nursing license.  An Ohio LPN license which is not renewed will lapse on November 1, 2018.  An Ohio LPN whose nursing license has lapsed is not authorized to work as a nurse until their nursing license is reinstated by the Ohio Board of Nursing.

The renewal fee is $65.00, plus a $3.50 transaction fee.  A late processing fee goes into effect on September 16, 2018.  An Ohio LPN who renews their nursing license on or after September 16, 2018 must pay an additional $50.00.  Fees must be paid online at the time of renewal with a credit or debit card (Master Card, VISA or Discover), or pre-paid card.  The renewal application will not be processed until all required fees are submitted.  All fees are non-refundable.

The renewal application includes, but is not limited to, questions concerning criminal, licensure, mental health matters, and alcohol/drugs matters.  All information provided in the renewal application is required to be true and accurate.  Depending on the response given to certain questions in the renewal application, uploading an explanation and Certified copies of certain specific documents is also required.

In certain cases, the renewal application may be forwarded to the Ohio Board of Nursing Compliance Unit for review and an Ohio Board of Nursing investigator may contact the LPN to obtain additional information.  In other cases, a Consent Agreement may be offered to the LPN to resolve a disciplinable offense instead of preceding to an administrative hearing.

If you do not understand a question in your LPN renewal application, or do not know what additional information to upload with your renewal application, it is recommended to obtain experienced legal counsel to assist you before submitting your LPN renewal application, speaking with an Ohio Board of Nursing investigator, or signing a Consent Agreement. Feel free to contact on of the attorneys at Collis Law Group LLC at (614) 486-3909 if you would like to schedule an appointment for a consultation for assistance to complete the renewal application.

For additional renewal application information from the Ohio Board of Nursing, see: http://www.nursing.ohio.gov/PDFS/Licensure/Renewal/Renewal_Momentum.pdf

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.

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.

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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.

 

Ohio Licensed Practical Nurses: It Is Time To Renew Your Nursing License

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Renewal of Ohio licensed practical nurse (“LPN”) licenses begins on July 1, 2018 and ends on October 31, 2018.  It is recommended to renew as soon as possible.

It is a disciplinable offense to engage in the practice of nursing having failed to renew a nursing license.  An Ohio LPN license which is not renewed will lapse on November 1, 2018.  An Ohio LPN whose nursing license has lapsed is not authorized to work as a nurse until their nursing license is reinstated by the Ohio Board of Nursing.

The renewal fee is $65.00, plus a $3.50 transaction fee.  A late processing fee goes into effect on September 16, 2018.  An Ohio LPN who renews their nursing license on or after September 16, 2018 must pay an additional $50.00.  Fees must be paid online at the time of renewal with a credit or debit card (Master Card, VISA or Discover), or pre-paid card.  The renewal application will not be processed until all required fees are submitted.  All fees are non-refundable.

The renewal application includes, but is not limited to, questions concerning criminal, licensure, mental health matters, and alcohol/drugs matters.  All information provided in the renewal application is required to be true and accurate.  Depending on the response given to certain questions in the renewal application, uploading an explanation and Certified copies of certain specific documents is also required.

In certain cases, the renewal application may be forwarded to the Ohio Board of Nursing Compliance Unit for review and an Ohio Board of Nursing investigator may contact the LPN to obtain additional information.  In other cases, a Consent Agreement may be offered to the LPN to resolve a disciplinable offense instead of preceding to an administrative hearing.

If you do not understand a question in your LPN renewal application, or do not know what additional information to upload with your renewal application, it is recommended to obtain experienced legal counsel to assist you before submitting your LPN renewal application, speaking with an Ohio Board of Nursing investigator, or signing a Consent Agreement.

For additional renewal application information from the Ohio Board of Nursing, see: http://www.nursing.ohio.gov/PDFS/Licensure/Renewal/Renewal_Momentum.pdf.

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.

Ohio Nursing Board Investigations

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A person may report to the Ohio Board of Nursing (“Nursing Board”) information the person has that appears to show a violation of a Nursing Board law or rule. The Nursing Board is required to investigate evidence that appears to show a violation of a Nursing Board law or rule.

The Nursing Board employs investigators who are located throughout Ohio. Each complaint received by the Board is assigned to an investigator. The investigator collects and reviews documents and interviews relevant parties.

In most instances, the investigator will also contact the nurse who is the subject of a complaint by phone, email, or correspondence and request the nurse to meet or speak with the investigator to address the concerns in a complaint or to give their “side of the story.”

In Ohio, a nurse’s participation in a Nursing Board investigation is voluntary, however, any information provided to the investigator may be used against the nurse in a Nursing Board disciplinary action.

Further, Ohio Revised Code Section 9.84 provides in part that a person who appears as a witness before any Nursing Board representative in an administrative investigation shall be permitted to be represented and advised by an attorney, and that the person shall be advised of the right to counsel before they are interrogated. We have seen printed on the back of a Nursing Board investigator’s business card the following statement:

“I have been advised by the OBN Agent that (i) I have the right to have an attorney present (per 9.84, ORC) and (ii) my interview is voluntary.”

However, in the stress of meeting with a Nursing Board investigator, a nurse might not take the time to read the card, and, even if they do read the card, they might feel uncomfortable requesting to postpone the meeting after they obtain legal counsel.

It is recommended to request and obtain legal counsel before speaking with or responding in writing to a Nursing Board investigator. Often, nurses are concerned that it will appear that they are hiding something or are uncooperative if they first obtain legal counsel. This is not the case. There are circumstances where it is advisable for a nurse and their legal counsel to meet with a Nursing Board investigator. Legal counsel can assist with protecting your rights, narrowing the issues, and providing guidance concerning the process.

It is also important to note that any information obtained by a Nursing Board investigator can be shared with local law enforcement if information is obtained that appears to show that a nurse has violated a criminal or other law outside of the Nursing Board’s jurisdiction.

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.

Disclosures to the Ohio Board of Nursing

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There are certain matters which must be disclosed to the Ohio Board of Nursing (“Board”) by a nurse license applicant or a nurse who is renewing their license.
The Board’s nurse license application and renewal application includes, but is not limited to, questions concerning felonies, certain misdemeanors, incompetency, professional licensure actions or investigations, mental illness, and substance abuse.
If the reply to any of the questions in the nurse license or renewal application is “yes”, then a disclosure is required. The applicant or nurse in renewal must mark “yes” to any applicable question and provide the Board a written statement of the circumstances underlying the “yes” reply and, for Court matters, Certified copies of certain court documents.
The Board is authorized to take disciplinary action against an applicant or licensee for any of the matters in Ohio Revised Code Section 4723.28. The sanction, if any, the Nursing Board imposes will depend on the individual facts and circumstances of the disclosed matter. Whether the applicant or nurse has other convictions, the acts underlying the offense, how long ago the offense occurred, and whether restitution or probationary terms were completed are typically also evaluated by the Board.

 
Except for certain limited instances, self-reporting criminal convictions prior to renewal is not required. However, criminal convictions are reported by the Court to the Board and it is recommended that a nurse consult with legal counsel to determine if it is in the nurse’s interest to self-report a conviction prior to renewal.
It is recommended to consult with legal counsel familiar with Board matters to determine if disclosure of a particular matter is required in an initial or renewal application and, if so, what information is required or recommended to be provided to the Board.
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

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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.

 

Registered Nurses: Don’t Let Your License Lapse

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Under RC 4723.24, if a nursing license is not timely renewed, the license lapses on the first day of November of the renewal year. Registered nurses must renew their licenses on odd-numbered years. Therefore, if you do not renew your RN license by October 31, 2017, it will lapse. Practicing nursing on a lapsed license is a disciplinable offense.

After you file your license renewal, it is recommended that you verify before October 31, 2017 that your license has been renewed by the Nursing Board. Verify your license renewal at: http://elicense.ohio.gov/.

RC 4723.03(A) provides that no person may practice as a registered nurse, represent themselves as being a registered nurse, or use the title “registered nurse”, the initials “R.N.”, or any other title implying that the person is a registered nurse, for a fee, salary, or other consideration without holding a current, valid license.

RC 4723.28(B)(2) provides that the Board of Nursing may discipline a nurse if they engage in the practice of nursing, having failed to renew a 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.