Ohio Nurse Applicants – The NCLEX Program Is Going Paperless in 2014

The Ohio Board of Nursing recently announced that starting January 2014, the NCLEX program will transition to a paperless program. The Nursing Board’s website located at http://www.nursing.ohio.gov/index.htm provides further information regarding the transition to a paperless program. Highlights from the Nursing Board’s website announcement include:

NCLEX Examination Candidate Bulletin: The NCLEX Examination Candidate Bulletin will no longer be distributed in a hard copy version. Boards of nursing, candidates and education programs will access the Candidate Bulletin via the NCSBN website.

Eights Steps of the NCLEX: This Candidate Bulletin insert will no longer be distributed in a hard copy version. This abbreviated reference guide to NCLEX processes will be enhanced to include additional information and will also be available on the NCSBN website. The name of this document will be changed to the NCLEX Information flyer.

Candidate Bulletin At-A-Glance: Due to the enhancements of the Eight Steps of the NCLEX, as well as the continued accessibility of the Candidate Bulletin, the At-A-Glance piece will no longer be published as either an electronic or hard copy version.

Money Order, Certified Check and Cashier Check Payments: Money order, certified check and cashier check payments will no longer be accepted. Beginning Jan. 1, 2014, all candidates and third parties will be required to register and pay for exam registrations through the Pearson VUE website or over the phone (866.496.2539) with a credit card, debit card or prepaid card.

Authorization to Test (ATT) Letter: Once the board of nursing makes a candidate eligible, that candidate will receive their ATT by email. The ATT continues to serve as the candidate’s notice that they may schedule their NCLEX at a Pearson Professional Center. Beginning Jan. 1, 2014, the paper copy of the ATT letter will no longer be necessary for test admittance. To gain access to the NCLEX, candidates must present one form of acceptable identification that matches the name exactly as the candidate provided when registering. If the candidate’s ID does not match the name exactly as they registered with, the candidate will not be admitted to test and will have to reregister and pay another examination fee.

“You’ve Completed the NCLEX Examination but Still Have Questions” Brochure: This brochure is currently given to candidate’s at the test center on the day of their exam. Beginning Jan. 1, 2014, this information will be sent to a candidates email address shortly after they have completed their exam and will also be available on the NCSBN website.

For additional information see http://www.nursing.ohio.gov/index.htm

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.

Three Days in the ICU

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

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

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

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

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

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

Who makes decisions at the Ohio Board of Nursing?

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

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

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

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

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

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

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

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

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

At the start of this holiday weekend, I wanted to reach out to Ohio medical professionals and remind them that their behavior is of concern to the Ohio Board of Nursing whether at work or at home. If you venture out this weekend to an end of summer holiday party and knock back a few beers or a couple of jello shots, take a cab home.

Each year, dozens (if not hundreds) of nurses receive alcohol related traffic violations. DUIs, OVIs, reckless operation charges, and any alcohol related misdemeanor may lead to discipline taken by the Ohio Board of Nursing against your nursing license. You don’t have to be “drunk at work” or fail a breathalyzer test on the way to work for the Nursing Board to be concerned about your ability to practice safely as a nurse in Ohio. Alcohol related traffic violations can lead to your nursing license being placed on probation and may subject you to random drug screens and Nursing Board monitoring for lengthy periods of time. The severity of the charges may also lead to suspension of your Nursing license.

I have written about this issue in the past. See my June 11 post about the requirement to disclose alcohol related convictions on your renewal application; my May 25 post about not being able to consume alcohol in ANY form if you are being monitored by the Board, and my April 30 post featuring the top three reasons the Nursing Board takes disciplinary action against a nurse (alcohol and drug usage being one of the top three reasons for Board discipline).

If you are going to “party” this weekend, be smart about it. Don’t get behind the wheel of the car if you have been drinking. Don’t risk your professional license.Take a cab home.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Yes, you must disclose your DUI on your nursing license renewal form

This spring, all LPNs will renew their licenses in Ohio. To renew your license, you should have been sent information by mail that will allow you to renew your license on-line. If you have not received renewal information, you can contact the Nursing Board at renewal@nursing.ohio.gov and you will be mailed a paper renewal form.  All renewals must be submitted by the deadline (June 30) to avoid a late fee. For renewal instructions go to: http://www.nursing.ohio.gov/PDFS/Licensure/2012_LPN_Renewal_Instructions.pdf

On the renewal form, you will be asked a series of questions. One question that seems to concern many nurses that I am routinely asked about is the following question:

Yes or no. Do you have a  “misdemeanor in Ohio, another state, commonwealth, territory, province or country. This does not include traffic violations unless they are DUI/OVI. (Ohio Board of Nursing 2012 Renewal application, emphasis add)

If you have a DUI, even if it was reduced to a reckless operation of a vehicle, you must check YES. Even if your case has been sealed or expunged or is in another state,  … you need to check YES. A DUI or reckless operation charge is a misdemeanor and is not a simple traffic violation. Traffic violations that do not typically have to be disclosed are things like “rolling a stop sign” or “going 45 in a 35 mph zone”. However, any DUI/OVI related traffic violation should be disclosed to the Nursing Board at the time of renewal.

If you have been convicted of a misdemeanor DUI or alcohol related reckless operation of a vehicle, the Board has the authority to take a disciplinary action, including suspending your nursing license, placing your license on probation,  or placing a restriction on your license.

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

What is a Nursing Board Consent Agreement?

Under the Ohio Nurse Practice Act, R.C. 4723.28, the Nursing Board can deny, revoke, suspend, reprimand, impose a fine or place limitations on a nursing license.

To take disciplinary action against a nurse, the Nursing Board first must  charge the nurse with violating some provision of the Ohio Nurse Practice Act. Notice is usually provided to the nurse in a citation letter, entitled, “Notice of Opportunity for Hearing.”  The Notice letter outlines the alleged misconduct (the basis for the action), specifies the section of the Nurse Practice Act that the nurse has allegedly violated, and provides the nurse with an opportunity to request a hearing before the Nursing Board concerning the allegations.

However, in some instances, the Nursing Board will send a nurse a document called a “Consent Agreement” without issuing a Notice.  The Consent Agreement is a contract between the nurse and the Nursing Board in which the nurse agrees that the specified violations of the Nurse Practice Act occurred, agrees to accept a specified discipline, and waives his or her right to a hearing. While signing a Consent Agreement may be the best route for the nurse, there are issues that should be considered before entering into a Consent Agreement with the Nursing Board.

A Consent Agreement is a formal disciplinary action of the Nursing Board and is a public document under the Ohio Public Records law (R.C. 149). As a public record, the Nursing Board must make the document available to the public and may post the actual agreement on their website. The Board will also list the name of the nurse and the discipline imposed in the Board ‘s quarterly Momentum magazine in the Disciplinary Actions section.

Negotiating the terms and condition of the Consent Agreement can result in changes and/or clarifications.  As with any legal, binding agreement, prior to signing the Consent Agreement, it is recommended to have it reviewed by experienced legal counsel so that you clearly understand what you are agreeing to in the document.

In addition, even after you complete any discipline imposed by the Consent Agreement, the Consent Agreement will always remain as a part of your professional record with the Nursing Board. Unlike some criminal cases, there is no way to seal or expunge a disciplinary action taken by the Nursing Board. Therefore,  it is important that you understand and agree to all the terms in the Consent Agreement and that the Consent Agreement accurately reflects the facts 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 email me at beth@collislaw.com or call me at 614-486-3909.

What the Nursing Board really cares about ..addiction, lies and convictions

I had the opportunity to speak to a nursing school last week about the role of Ohio Board of Nursing. In preparing for the talk, I knew I would be asked “What is going to get me in trouble with the Nursing Board?”.  I have a pretty good idea of the types of actions that I regularly see investigated by the Board, but I also did a little research and reviewed the last few months’ list of disciplinary actions or proposed actions so I would be ready for this question.

I found, generally, the Nursing Board receives 3000 complaints each year. While the Board investigates all complaints, they only take action against approximately 600 nurses each year.

Half of the nurses disciplined or monitored by the Nursing Board involve cases of nurses who suffer from drug or alcohol abuse or dependency. (see my former post The Alternative Program for Chemically Dependent Nurses)   Many nurses voluntarily seek treatment and then are entitled to participation in the Board’s confidential monitoring program.

But, some nurses find themselves the subject of Board discipline after being found guilty of a DUI, or testing positive on a drug screen through their employer. Last month, the Nursing Board cited several nurses who tested positive at work for illegal street drugs or for medications for which they could not produce a valid prescription (ie. they had been given a prescription drug from a friend or family member)

In addition to actions against nurses who suffer from substance abuse, the Board also takes actions against nurses who have felony convictions and misdemeanors involving moral turpitude.  The Nursing Board recently cited nurses who had been charged with numerous crimes including: child endangering; Medicaid fraud; transporting or possessing a semi-automatic handgun; stealing narcotics; misdemeanor assault; illegal processing of drug documents; theft by deception, just to name a few.

The Board also takes action against nurses who have been disciplined by other state agencies (other state Nursing Boards) and they take actions against nurses for practicing outside of the scope of their license or for failing to disclose to the Board a disciplinary action or conviction from another agency or district (lies).

Most nurses are surprised to learn that the Nursing Board is genuinely concerned about conduct both at work and also outside of work. In addition to discipline related to practice, nurses can be subjected to disciplinary actions for “bad behavior” outside of the work setting. Nurses are routinely the subject of discipline by the Board for DUIs, assault, child abuse, neglect, passing a bad check and other crimes. As professionals, nurses are held to a high standard by the Board while at work and after work.

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