Ohio Nurses with Narcotic Restrictions: You CANNOT Observe Waste

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

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.

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

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

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.

The Ohio Board of Nursing’s Practice Intervention and Improvement Program

The Ohio Board of Nursing is the state agency that regulates the practice of nursing in Ohio. The mission of the Nursing Board is to protect the public by ensuring that nurses have the skills to provide care to patients. In instances where a nurse has violated the Ohio Nurse Practice Act, the Nursing Board has the authority to take a disciplinary action, such as to suspend or revoke a nurse’s license to practice in Ohio. However, in instances where the Nursing Board has reason to believe that a nurse has a deficiency in their practice that may be corrected, the Board may require the nurse to seek additional education and/or training.

The Nursing Board’s Practice Intervention and Improvement Program (“PIIP”) permits the Nursing Board to offer a nurse an opportunity to seek remedial education and training in a specific area instead of taking disciplinary action against a nurse who has a practice deficiency. The PIIP program is considered non-disciplinary and does not constitute a restriction or limitation on a nurse’s license. Participation in PIIP is confidential.

The criteria the Nursing Board uses to identify an individual’s practice deficiency includes, but is not limited to:

(1) Whether the public will be adequately protected from unsafe practice if the individual enters PIIP;
(2) Whether the individual’s practice deficiency resulted in harm to the patient;
(3) The likelihood that the identified practice deficiency can be corrected through remediation;
(4) The frequency of the occurrence of the practice deficiency;
(5) Whether the individual is eligible for participation in PIIP under 4723-18-03 of the Administrative Code; and
(6) Whether the individual has a mental or physical impairment that contributed to the practice deficiency.

If the supervising member believes, after investigation and review, that the individual’s practice deficiency can be successfully corrected through participation in PIIP, the Nursing Board may choose to take no disciplinary action. This decision is generally reached, if the individual enters into a Participatory Agreement with PIIP, complies with the terms and conditions of PIIP, and successfully completes PIIP.

The PIIP Participatory Agreement includes, but is not limited to, provisions that:

(1) Identify the practice deficiencies and the specific remediation (including educational interventions) the participant must complete;
(2) Require the participant to pay all expenses for the required remediation;
(3) Require the participant to provide the Participatory Agreement to a manager of the participant’s employers;
(4) Require the participant to participate in workplace monitoring;
(5) Require the participant to cause all workplace monitors to provide remediation and to send written progress reports regarding the participant’s progress to PIIP at specified intervals;
(6) Require the participant to submit a written personal progress report containing the information required by PIIP to PIIP at specified intervals; and
(7) Specify the terms and conditions the participant must meet to successfully complete the remediation, including the time frames for successfully completing both the educational intervention and workplace monitoring components of the remediation.

Generally, to comply with PIIP, the nurse will identify a nurse educator who will prepare an individualized course of study for the nurse. The course may include a series of written materials to review or a list of on-line continuing education courses that must be completed. The course of study is almost always tailored to the individual need of the nurse and generally does not require the nurse to return to complete coursework in a nursing school setting or to repeat an entire nursing course. The educator will generally meet individually with the nurse to evaluate their skills to determine if the deficiency in their practice has been remediated. In most instances, the nurse can complete the remedial education in a matter of weeks.

A PIIP participant can be terminated from PIIP for reasons including, but not limited to, the failure to: 1) comply with the Participatory Agreement; 2) progress through or successfully complete the educational intervention in the manner and time frame required; or 3) incorporate learned knowledge and skills into practice.

In addition to avoiding public discipline, a participant who successfully completes PIIP will not be reported to the National Council of State Boards of Nursing disciplinary data bank or the National Practitioner Data Bank (NPDB) unless the Nursing Board imposes disciplinary action against the participant.

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 Nurses and Social Media

Social media is a prevalent and common form of communication in society today.  Although social media offers benefits of faster and broader delivery of information, Ohio nurses should be aware of legal requirements and best practices in connection with the use of social media.

Ohio Administrative Code 4723-4-03(H) and 4723-4-04(H) prohibit all nurses from accessing patient information or disseminating 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.  Ohio Administrative Code 4723-4-06(Q) specifically prohibits nurses 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.

Violation of these rules may result in disciplinary action by the Ohio Board of Nursing.

The Ohio Board of Nursing website (http://nursing.ohio.gov/Practice.htm) has the following from the National Council of State Boards of Nursing:

NCSBN Offers Helpful Resources on Using Social Media

Nurses need to be aware of the potential ramifications of disclosing patient-related information. You are invited to use and share these resources:

-Take A Quiz – https://www.qzzr.com/c/quiz/157691/nursing-and-social-media-quiz-copy

-Watch A Video – https://www.ncsbn.org/347.htm

-Order Free Printed NCSBN Resources – A Nurse’s Guide to the Use of Social Media at https://www.ncsbn.org/3739.htm; Poster: Social Media in Nursing: Understand the Benefits and the Risks at https://www.ncsbn.org/6842.htm; Poster: Common Myths and Misunderstandings of Social Media at https://www.ncsbn.org/6843.htm

Do not indiscriminately use social media, texts, emails, or any other form of communication.  Be mindful of your legal obligations and follow best practices.  Take the quiz, watch the video, and review the guide!  These resources are informative and helpful.

As always, if you have any questions about this post or the Ohio Board of Nursing, contact one of the attorneys at the Collis Law Group LLC at 614-486-3909 or go to our website at http://www.collislaw.com for more information.

How a DUI may affect your Ohio nursing license

Happy New Year!

Over this holiday weekend, I have received calls from several health care professionals who have been charged with a DUI inquiring how or whether a criminal charge may affect their license to practice as a nurse in Ohio.

First, it is important to understand that the Ohio Nursing Board may take a disciplinary action against a nurse for certain criminal convictions, even if the charge does not relate to the practice of nursing. Second, it is important to understand that a DUI is not considered a “minor traffic violation”.  A DUI, even if reduced to a lesser offense, such as disorderly conduct or reckless operation of a vehicle, is still of concern to the Nursing Board and may result in a sanction to the nurse’s professional license.

If you have been charged with a DUI, you should seek competent legal counsel to assist you through the criminal case process.  In certain instances, you may be accepted into a treatment program which, if successfully completed, may result in no criminal conviction or the charges may be reduced to a less serious offense.

A conviction for a DUI or certain other criminal offenses may result in negative consequences for your professional license.  While you are not required to immediately notify the Ohio Nursing Board that you have been charged with or convicted of a criminal offense, you may need to disclose the criminal matter when you renew your professional license, depending on the matter.  At the time you renew your license, you should consider hiring legal counsel to assist you to accurately respond to the questions on the renewal application and to prepare any documents necessary or required by the renewal application.

The way in which the Ohio Nursing Board handles your criminal case will depend on a variety of factors.  In determining what sanction, if any, that the Ohio Nursing Board might impose, the Ohio Nursing Board will consider factors including but not limited to the following:

  • the seriousness of the matter;
  • whether the matter relates to your professional practice;
  • whether the matter is your first criminal matter; and
  • whether you fully cooperate and complete any requirements of the Court.

Depending on the circumstances of your matter, the Ohio Nursing Board can order the nurse to submit to a chemical dependency assessment to determine if treatment is needed and/or can require the nurse to submit to a period of random drug testing.  Additionally,  the Ohio Nursing Board has the authority to suspend a nurse’s license and/or can place the nurse on probation.

If you need treatment, you should obtain comprehensive treatment. The Ohio Nursing Board does not maintain an approved list of treatment providers.  The nurse may choose any treatment center that will provide them with the treatment needed for their addiction.

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

Ohio LPNs experience difficulties renewing licenses with new online system

LPNs who are renewing their nursing licenses in Ohio this year are required by the Ohio Board of Nursing to renew online. The Ohio Board of Nursing will no longer accept paper renewal or initial licensure applications. All applications must be submitted online.

However, as WSYX Channel 6 Investigative Reporter Brooks Jarosz discovered, the new online application process has not been without problems. See Jarosz’s report: http://abc6onyourside.com/investigators/technical-problems-persist-for-nurses-license-renewal

In order to start the renewal process, each nurse should have received a letter from the Nursing Board with their Log In ID. If a nurse moved since their last renewal and has not updated their address with the Nursing Board, the nurse may not have received their Log In ID. In Ohio, nurses are required to maintain a current address with the Nursing Board. Nurses can update their address at the Nursing Board’s website. The Nursing Board will not accept emails or a letter advising of a new address.

There are 58,000 licensed LPNs in Ohio. Ohio LPN licenses which have not been renewed timely lapse on November 1, 2016. If you have not timely renewed your Ohio LPN license, you MAY NOT WORK ON AN EXPIRED OR LAPSED LICENSE.

Do not wait until the last minute to attempt to renew your license. After September 15, you will be charged a late fee in connection with your renewal application.

To check on the status of your license, visit the Nursing Board’s online license verification page at: https://elicense.ohio.gov/oh_verifylicense

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 email me at beth@collislaw.com.

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

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

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

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

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

EXPERIENCE:

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

ACCESS:

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

COMPATIBILITY:

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

FEES:

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

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

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