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.

It’s That Time Again (RN licensure renewal)

Has it really been two years already? Yes! It is time to renew your RN and APRN licenses!

If you renew before July 1st, the renewal fee is $65.00. If you renew between, July 1st-August 31st, the renewal fee is $115.00. After August 31st, your license is deemed lapsed and you must request, complete, and submit a Reinstatement Application from the Board.

Many RNs who submit their renewal application before the final deadline are concerned that their license will not be renewed before August 31st and that they will not be able to work. This is not the case. As long as you renew your license prior to August 31 the Nursing Board will renew your license and will not allow your license to lapse.

Many Nurses are also concerned that their license will not be renewed by the Board in a timely manner if they answer “Yes” to any of the compliance questions on the renewal application. However, a “Yes” response to any of the questions on the renewal application will not prevent the Nursing Board from timely renewing your nursing license. It is imperative that you answer all renewal questions honestly and accurately. Providing the Board with false information my lead to the Board taking a disciplinary action against you.

However, all renewal applications that include YES responses to questions related to your conduct since the last renewal (such as convictions, DUI, etc) will result on your license being sent to the Compliance Unit of the Nursing Board for further review and investigation. Then, even if your license is renewed, this does not mean that the Nursing Board has closed the investigation.

If the Board chooses to open an investigation based on any of your affirmative responses on the renewal application, you may be notified by a Board investigator by phone or mail to provide further information or documentation to the Board.

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

National Prescription Drug Take-Back Day October 26, 2013

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.

If you received a Notice for Opportunity for Hearing .. request a hearing

On Friday, July 27, the Ohio Board of Nursing held its bi-monthly meeting. At that meeting, the Board voted to take disciplinary action against dozens of nurses in the state of Ohio. Nurses who face discipline by the Board will be mailed a Notice of Opportunity for Hearing, Notice of Summary Suspension or Notice of Automatic Suspension of their nursing license by certified mail.  This is not a final decision by the Board.  These Notices outline the charges that the Board has alleged against you.

If you receive notification from the post office that you have a certified letter from the Nursing Board, immediately go to the post office and collect the letter as there are important time sensitive deadlines which, if not met, can have a permanent effect on your license.

If you want the Board to hear “your side of the story” you must request a hearing in writing to request a hearing by the deadline in the Notice. This can be done by following the instructions in the Notice. A request for a hearing is a simple letter sent to the Board stating that you would like a hearing. You do not need to list your defenses or reasons why you want a hearing. You simply need to state in the letter that you would like a hearing.

You only have thirty (30) days from the date the Notice was MAILED to you to request a hearing.  The 30 day time frame starts on the date that the letter was mailed to you and not on the date that you received the letter. Failure to request a hearing will prevent you from providing any evidence on your behalf to the Board.

I am often asked “why should I even request a hearing … the Board has already made a determination.” This is not correct.  These Notices only list allegations raised against you.  While the Board has conducted an investigation prior to issuing the Notice, in most cases they have only considered one side of the evidence. By requesting a hearing you will be able to present your side of the story.

Even in cases where the nurse has violated the Ohio Nurse Practice Act, by presenting your side of the story and explaining what challenges you faced or what you were thinking when the error occurred, you increase the chances of getting a lighter sanction from the Board than if you simply do not even request a hearing.

You worked hard for your nursing license. There are always two sides to any story. If you receive a Notice of Opportunity for Hearing, a Notice of Summary Suspension, or a Notice of Immediate Suspension, request a hearing within the deadline and make sure the Board hears your side of the story before they make a final determination.

You should also consider hiring experienced legal counsel to defend you before the Nursing Board. When considering how to hire an attorney, check out my previous post on “How to Hire an Attorney”.  Your livelihood depends on you finding experienced legal counsel that you trust to help in your defense.

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

What part of NO ALCOHOL don’t you understand?

Nurses who suffer from substance abuse or substance addiction and who are monitored by the Ohio Board of Nursing in either the confidential Alternative Program for Chemically Dependent Nurses Program or pursuant to a Consent Agreement or other public disciplinary action, are typically required to submit to random (often observed) toxicology drug screens. The screens will detect not only alcohol content in the body but can even detect the metabolites of alcohol (evidence that the body is processing or breaking down alcohol). The tests are very sensitive virtually any consumption or exposure to alcohol  in the 3-4 days proceeding such consumption or exposure will be detected.

Prior to initiating the screening process, nurses are advised that they may not consume any alcohol or any substances that may contain alcohol. They are clearly warned to not consume any alcohol, including: beer, wine, liquor, “non-alcoholic” beers and cooking wines. They are also warned to stay away from topical ointments that may contain alcohol and to stay away from cleaning products or aerosols that may contain alcohol. Nurses are usually surprised to learn that many cleaning products contain alcohol and they do not realize that hand sanitizers (the same kinds routinely used in hospitals, nursing homes, schools, etc.), aftershave, air fresheners (Febreze), contain some amount of alcohol.

Despite this requirement, nurses routinely test positive for alcohol or for the metabolites of alcohol in their system (positive ETG test).   Ethyl Glucuronide (ETG) is a direct metabolite of alcoholic beverages (ethanol).  Its presence in urine may be used to detect recent alcohol consumption, even after ethanol is no longer measurable.  The presence of ETG in urine is a definitive indicator that alcohol was ingested.

When questioned, many will initially deny use. Then, they will try to argue that they used a hand sanitizer or over the counter medications, which may have resulted in a positive alcohol or ETG drug screen.

However, while the tests (specifically the ETG test) are very sensitive and can detect consumed alcohol, the cut off for the screening is above the level that would test positive in an “accidental” exposure. Generally, merely cleaning your house with Lysol or spraying your couch pillows with Febreze should not result in a positive screen. However, consuming Nyquil for a cold will result in a positive screen.

As always, if you have any questions about the Ohio Board of Nursing or this post, please feel free to email me at beth@collislaw.com or call me at 614-496-3909.

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.

How to request a hearing with the Ohio Board of Nursing

On November 20-22, 2013, the Ohio Board of Nursing met for its bi-monthly meeting. At that meeting, the Board voted to issue Notices of Opportunity for Hearing to over 80 nurses in Ohio.  The Notices either proposed to take a disciplinary action against a nurse for an alleged violation or Automatically or Immediately suspended certain nurses’  licenses based on an alleged violation of the Board’s laws and rules.  If you received a Notice of Opportunity for Hearing or a Notice of Suspension  from the Nursing Board, there are important deadlines, which if missed, can have significant consequences.

First, whether the allegations in the Notice are true or not, in order to preserve your right to a hearing, you must request a hearing in writing. The Notice contains instructions on how to request a hearing. It is imperative that you request a hearing in writing within 30 days of the mailing of the Notice to you (not from the date you receive the Notice)  If you do not request a hearing in writing within such period you will be prevented from providing any information or evidence on your behalf.   In the request for the hearing, you simply need to state “I am writing to request a hearing.”  It is also a good idea to follow-up with the Board via phone to ensure that they received your request for a hearing within the required time frame.

Then, you should consider hiring experienced legal counsel to defend you before the Board. The Nursing Board is represented by the Office of the Ohio Attorney General and also employs several in-house enforcement attorneys. In addition, all hearings are held before attorney hearing examiners. So, if you choose to represent yourself at a hearing, you may be the only non-attorney who participates in the hearing process. It’s your professional license at stake. It is important to find experienced counsel to assist in your defense.  Check out earlier posts where I provide guidance on how to hire experienced legal counsel to assist you.

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

 

What do I do when contacted by a Nursing Board Investigator?

In my practice I receive calls each week from nervous and frightened nurses who have been contacted either by telephone or letter from a Nursing Board or even Pharmacy Board investigator.  The question I am always asked is:

Do I have to talk with the investigator?

First, never speak with investigators without competent legal counsel. Anything you tell an investigator can be used in a disciplinary action against you by your licensing board and/or by the police in a criminal investigation.

Depending on the facts in your case, sometimes I advise clients to speak with investigators or to provide a written statement to their licensing board regarding an alleged complaint. However, I never have my clients meet with investigators without legal counsel and I never allow my clients to submit written statement that I have not had a chance to review.

Also, don’t allow the investigator to set the timing for when you will respond to them. I am often contacted by nurses who have been contacted by an investigator from the Ohio Board of Nursing and advised that they need to meet with the investigator or submit a written statement to the investigator within 24 or 48 hours.  These deadlines or almost always negotiable. Do not allow the investigator to rush you into providing them with the statement until you have had a chance to meet with legal counsel.