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.

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.

 

ADVANCED PRACTICE REGISTERED NURSES: New Legislation to take Effect on April 4, 2017

On January 4, 2017, Governor Kasich signed Ohio Substitute House Bill 216 into law.

Effective April 4, 2017, there will be new licensing criteria for advanced practice registered nurses (APRNs).  A new APRN license will replace the current “Certificate  of  Authority” and “Certificate  to Prescribe”.

The APRN license will also authorize a Certified Nurse-Midwife (CNM), a Certified Nurse Practitioner (CNP), and a Certified Nurse Specialist (CNS) to prescribe.  In order to obtain the new APRN license, CNPs, CNSs, and CNMs must have either a current Certificate to Prescribe or Certificate to Prescribe Externship, or have completed a 45-hour course in advanced pharmacology within five years of the application date.

Additional information is available from the Ohio Association of Advanced Practice Nurses here: http://c.ymcdn.com/sites/www.oaapn.org/resource/resmgr/hb_216/HB_216_Signed_Revised_-_Effe.pdf

A FAQ from the Ohio Association of Advanced Practice Nurses is here: https://oaapn.site-ym.com/page/HBFAQ

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 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 Under Probation May Not Be Able To Travel Outside of the United States Without Risking Disciplinary Action

If you are a nurse who is under disciplinary action with the Ohio Board of Nursing that requires you to submit to random drug testing, you may not be able to travel outside of the United States without risking disciplinary action.

Ohio nurses who are under probation with the Nursing Board are required to strictly comply with all terms and conditions imposed in their Consent Agreement or Adjudication Order.  While under probation, some nurses are subjected to:

  • random drug or alcohol screens;
  • AA or NA meetings; and/or
  • counseling with a chemical dependency or mental health professional.

Traditionally, when a nurse is subjected to random drug testing, they are required to notify FirstLab (the Nursing Board’s contracted screening provider) and their  Monitoring Agent at the Nursing Board if the nurse is going to travel so that an alternative screening site can be located for the nurse.  However, this notification alone DOES NOT EXCUSE THE NURSE FROM THE DRUG TESTING REQUIREMENT!

In some cases, nurses have requested to be excused from the random drug testing  requirement while on vacation.  In very limited instances in the past, the Nursing Board has excused nurses from the drug testing requirement.  However, these were extremely limited circumstances and compliance with all other probationary terms including abstinence was nevertheless requiredMore recently, the Board has denied requests to be excused from drug testing while on vacation.

If you are subjected to Nursing Board random screens, it is recommended that you first verify with FirstLab whether there is an approved testing site at your vacation destination (which also has weekend hours) prior to booking your vacation.  If no approved testing site is available, you may request to be released from random drug testing while on vacation. However, based on our recent experience, you should anticipate that the request may be denied.  If the Board denies your request, you may be subjected to discipline if you fail to provide a screen on a day you are selected to do so.

It is our understanding that FirstLab only has testing sites in the continental U.S., Alaska, and Hawaii and that there are no FirstLab locations on cruise ships or outside of the U.S.

Merely notifying your Monitoring Agent of your vacation dates does not excuse or waive any of the requirements of your Consent Agreement or Board Order.  You must comply with all probationary terms while on vacation, unless you have been given specific written approval in advance by the Board.

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

 

 

Ohio Nurses: New way to update your address with the Nursing Board

Moved? Changed your Name? Manage your Nursing License/Certificate Online

As a nurse licensed to practice in Ohio, it is your responsibility to notify the Nursing Board of any changes to your address or your name.

Beginning July 1, 2016, all name and address changes must be performed on-line by accessing the Nursing Board’s new eLicense 3.0 licensure system. (Simply sending an email or letter to the Board with your new address will NOT be sufficient to update your address.)

Listed below are the steps to register as a new user on the Nursing Board’s eLicense 3.0 licensure system. This information was obtained on the Nursing Board’s website under the section “Forms and Applications.”

Failure to notify the Nursing Board of a change in name and/or address could cause an issue for a potential employer performing on-line licensure verification. By not updating your name and/or address, it could hinder the Nursing Board’s ability to provide you with written notification in a timely fashion.

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

 

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

Many nurses who realize they have a chemical dependency problem consider applying for the Ohio Board of Nursing’s Alternative Program for Chemical Dependency. The Alternative Program is a program designed as an alternative to public discipline for the Board to monitor nurses who suffer from chemical dependency issues who want to obtain treatment.

The Alternative Program could be an excellent option for nurses who know they need treatment in which to obtain treatment and not have it publically registered as “discipline” on their Ohio license. However, nurses should be aware of the following:

Limited Eligibility

Ohio Administrative Code 4723-6-02(B) prohibits a nurse from participating in the Alternative Program if the Board determines that the nurse’s compliance cannot be effectively monitored. This rule also specifies at least 12 different reasons why the Board can refuse to permit a nurse to participate in the Alternative Program.

Limited Admission

As of June 30, 2014, there were only 73 active cases in the Alternative Program (source: June 30, 2014 Nursing Board Annual Report). In Fiscal Year 2014, the Board reported that it mailed out 41 applications, received 32 completed applications, and admitted only 14 applicants.

License Inactivation

Most nurses are not aware that to even be considered for admission to the Alternative Program, they must inactivate their nursing licenses. Unfortunately, being denied admission to the Alternative Program does not automatically reactivate the nurse’s license. Instead, the nurse must request that his or her license be reactivated, a process for which there is also no timeline imposed on the Board. In our practice, we have seen nurses wait for months after having been denied admission to the Alternative Program before the Board re-activates their license.

Application Process

Alternative Program applicants must also complete a rigorous application detailing their chemical dependency history, including diagnoses and treatment, relapses, and related agency or law enforcement involvement. In addition, the applicant must undergo a complete chemical dependency evaluation and authorize the disclosure of all records related to the evaluation to the Board. There is no timeline imposed upon the Board for deciding whether to admit an applicant to the Alternative Program. Many applicants are denied admission without explanation.

Limited Confidentiality

In our experience, if a nurse is denied entry into the Alternative Program or is terminated from the Alternative Program, the Board uses the information that the nurse disclosed to the Board in the Alternative Program application to form the basis of a public disciplinary action against the nurse. Although the Alternative Program is described as a confidential program, there are limits to this confidentiality and many nurses are unaware of these limitations.

Rigorous Requirements

Based on the Alternative Program agreements we have reviewed, the Board imposes rigorous requirements on the nurse participating in the Alternative Program, including but not limited to monitoring periods sometimes in excess of monitoring periods we have seen in public disciplinary matters.

Conclusion 

Prior to even requesting an Alternative Program Application from the Ohio Board of Nursing, consider obtaining the advice of experienced legal counsel to help you determine how best to proceed in your case.

As always, if you have any questions about this post or about the Ohio Board of Nursing in general, please feel free to contact one of the attorneys at Collis Law Group, LLC at 614-486-3909. You may also look for more information at http://www.collislaw.com.

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.

Alternative Program for Chemically Dependent Nurses

In Ohio, nurses who suffer from drug or alcohol addiction or abuse should immediately seek treatment at an authorized chemical dependency treatment facility.  However, nurses are often concerned about voluntarily seeking treatment because they do not know what effect, if any, treatment will have on their nursing license.

Fortunately, for Ohio nurses, the Ohio Board of Nursing has established the Alternative Program for Chemically Dependent Nurses.  This is a confidential program that allows eligible nurses to enter into a monitoring contract with the Nursing Board. Under the contract, the nurse is required to complete the recommendations of a treatment program, completely abstain from drugs and alcohol and submit to random drug screens generally for a period of five years.     A full outline of the program can be found at: http://codes.ohio.gov/oac/4723-6

Not all impaired nurses are eligible for the program. To be eligible, a nurse must hold a valid Ohio nursing license, submit an application for enrollment in the Board’s confidential program, submit to a chemical dependency assessment, and then follow all treatment recommendations. http://codes.ohio.gov/oac/4723-6-02 Eligible nurses may be required to place their nursing license on inactive status for six months at the beginning of treatment and they will be required to submit to random drug screens and attend weekly AA or NA meetings for five years.  This may seem like a long period of time to submit to monitoring, a chemically impaired nurse, is permitted to return to the practice of nursing while participating in the confidential program after six months of clean screens.

What can make a nurse ineligible for the program?  Nurses who are prescribed controlled substances by their physicians; who have a dual diagnosis with another medical or psychiatric condition; or who have completed drug and alcohol treatment two or more times in the past, may not be eligible for this program. http://codes.ohio.gov/oac/4723-6-02

The Alternative Program is confidential. If you are accepted, your participation will not be considered “discipline” by the Nursing Board. There will be no notation on the Board’s website that you are participating in the program and you will not be listed in the Nursing Board’s Momentum publication as a participant in this program. In addition, if you successfully complete the program, you will not be reported to the National Practitioner’s Data Bank . http://codes.ohio.gov/oac/4723-6-04

As always, if you have any questions, please feel free to email me at beth@collislaw.com or call me at 614-486-3909.