Tag Archives: substance abuse

Ohio Nurses with Narcotic Restrictions: You CANNOT Observe Waste

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A nurse who is the subject of a disciplinary action by the Ohio Board of Nursing may, in certain instances, have one or more restrictions placed on their nursing license.  One type of restriction is a narcotics restriction.

Although the language of a narcotic restriction can and does vary depending on the facts and circumstances of each case, the Ohio Board of Nursing’s narcotic restriction typically provides:

“Unless otherwise approved in advance, in writing, by the board or its’ designee, NURSE shall not administer, have access to, or possess (except as prescribed for NURSE’s use by another so authorized by law who has received a complete copy of this Consent Agreement prior to prescribing for NURSE) any narcotics, other controlled substances, or mood-altering drugs in which NURSE is working in a position that requires a nursing license. In addition, NURSE shall not possess or carry any work keys for locked medication carts, cabinets, drawers, or containers. NURSE shall not count narcotics. NURSE shall not call in or order prescription refills for narcotics, other controlled substances, or mood-altering drugs.”

As stated noted above, a nurse with a narcotics restriction may not count narcotics.  Counting narcotics includes, but is not limited to, observing the waste of unused narcotics by another nurse because observing waste is considered part of the counting process.  If you have a narcotics restriction on your license, you may not observe waste and you should ensure that your employer is aware that your narcotic restriction prohibits you from observing waste before you are in a situation where you are asked to witness another nurse wasting.

Narcotic restrictions can be permanent or temporary.  If the narcotic restriction is permanent, the nurse must comply with the narcotic restriction on a permanent basis, unless the narcotic restriction includes the language, “Unless otherwise approved in advance, in writing, by the board or is designee”.  This language permits the nurse to request the Nursing Board’s approval for a specific exception to the permanent narcotic restriction.

If the narcotic restriction is temporary, the nurse must comply with the narcotic restriction during their entire probationary period or, in certain cases, for a shorter period.  If the temporary narcotic restriction includes the language, “Unless otherwise approved in advance, in writing, by the board or its’ designee”, the nurse may request the Nursing Board’s approval for a specific exception to the temporary narcotic restriction.

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

Nurses who enter into a Consent Agreement with the Ohio Board of Nursing MUST complete all conditions OR negotiate terms to modify to the Agreement.

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A Consent Agreement with the Ohio Board of Nursing is a negotiated contract between the nurse and the Board that specifies the terms and conditions under which a nurse on probation may continue to practice as a nurse and/or seek reinstatement of their license, if suspended. By signing the Consent Agreement, the nurse agrees (among other things) to waive their right to a hearing and to comply with the terms in the Consent Agreement.

Failure to comply with the terms of the Consent Agreement can result in the Nursing Board automatically suspending a nurse’s license to practice in Ohio.

Typically, a Consent Agreement which includes a suspension will outline conditions for a nurse to seek reinstatement of their license or, for a Consent Agreement that includes probation, will place conditions on a nurse’s license. Often, nurses are subjected to random drug testing, are required to attend weekly AA/NA meetings, or complete additional continuing education courses. In some cases, a nurse may have a license limitation that does not allow them to work in certain settings or dispense medications.

Actions including, but not limited to, missing a mental health or chemical dependency examination, failure to check in daily for alcohol or drug screens, or failure to submit to a screen when selected are a few examples of a breach of the Consent Agreement.

Even when unemployed as a nurse, the nurse is still required to comply with the Consent Agreement. For Consent Agreements that include a probationary period, the nurse must actually work in a nursing position for the probation period to count down.

Compliance with a Consent Agreement can be time-consuming and costly. Nurses are often unable to afford the random screens or become frustrated with the lengthy probationary period, especially if they are not working as a nurse.

I am often contacted by nurses who want to stop compliance with the terms of their Consent Agreement because they can no longer afford the random screens or are no longer interested in completing all compliance terms.

A Consent Agreement is a negotiated contract between a nurse and the Nursing Board.  The nurse MUST negotiate alternative terms in writing with the Nursing Board. If the nurse simply stops complying with the Consent Agreement, without first negotiating a written amendment or modification to the Consent Agreement, their license will likely be automatically suspended by the Nursing Board for failure to comply with the Consent Agreement.

To seek an amendment or modification to the Consent Agreement, the nurse must be in full compliance with all probationary terms. Even if in full compliance, the Nursing Board may only agree to place the nurse’s license on indefinite suspension. And if the nurse wants to seek reinstatement of their license in the future, the nurse may be required to complete most if not all of the probationary terms again.

In summary, in order to cease having to comply with the terms and conditions of a Consent Agreement, the nurse must re-negotiate the terms of the Consent Agreement with the Nursing Board and must continue to comply with their Consent Agreement until the Nursing Board agrees in writing to the modified Consent Agreement.

All Consent Agreements must be approved by the full Board, which only meets six times a year. The nurse should expect that it could take up to 8 weeks before the Nursing Board will approve a new Consent Agreement or a modification to a Consent Agreement.  The nurse must continue to comply with their existing Consent Agreement until a new Consent Agreement or modification has been approved in writing by the Nursing Board.

Before making the decision on whether to stop complying with the terms of a Consent Agreement with the Board of Nursing, it is recommended to consult with an attorney. Factors such as the nurse’s financial condition and their desire to practice nursing in the future should be considered.

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

 

Nurses: Marijuana is still Illegal in Ohio, and a Positive Drug Screen could lead to Discipline

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Marijuana for medical or recreational purposes is now legal in some states, such as Colorado and Oregon. However, use of marijuana is still illegal in Ohio. If employed as a nurse, you can be subjected to pre-employment, for cause, or random drug tests. If you test positive for marijuana, you may be terminated from your job and may be subjected to discipline by the Ohio Board of Nursing. Chemicals in marijuana, mainly THC, can show on a urine, blood, saliva or hair follicle drug test after 120 or more days, based on usage and other personal factors. (See Samhsa.gov for guidance on drug testing).

According to RC 4723.28(B)(8), it is a disciplinable offense for a nurse to be self-administering or otherwise taking into the body any dangerous drug, as defined in RC 4729.01, in any way that is not in accordance with a legal, valid prescription issued for that individual, or self-administering or otherwise taking into the body any drug that is a Schedule I controlled substance. (Marijuana is defined as a Schedule I substance.)

Courts have held that an employee is not protected from a wrongful discharge even if they are lawfully taking medical marijuana, and test positive at work. (Coats v. Dish Network). This is because marijuana is unlawful under Federal Law, which the court determined prevails in this situation.

The Ohio Board of Nursing routinely takes disciplinary action against a nurse who tests positive for marijuana, even in cases where the nurse has consumed marijuana in a legal jurisdiction. Therefore, it is important for Ohio nurses to be aware of the risks they take if consuming marijuana, whether it be legally or illegally. Testing positive on a drug screen may result in a disciplinary action against your nursing license.

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

 

Ohio Nurses: Failure to Document May Result in Disciplinary Action Against Your Nursing License

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The importance of documentation in the nursing field cannot be underestimated.

The Ohio Board of Nursing is authorized to discipline a licensee for (among other things) failure to practice in accordance with acceptable and prevailing standards of safe nursing care.  Failure to document the administration or otherwise account for the disposition of controlled substances that the Nurse removed from the Pyxis, or other place where controlled substances are stored, may also be the basis for the Nursing Board to discipline a nurse.

In certain cases, the Nursing Board will offer the Nurse a Consent Agreement as an alternative to an Administrative Hearing.  A Consent Agreement allows the Nurse to avoid the time, worry, and expense of an Administrative Hearing.  Nurses do not need to sign a Consent Agreement. It is always a good practice to read a proposed Consent Agreement very carefully.  We have seen Consent Agreements that are based on allegations of failure to document the administration or otherwise account for the disposition of controlled substances. In many cases, the Consent Agreement requires  (in some cases, lasting years)  random drug screening, narcotic restrictions, and practice restrictions, even when there was no history of drug use or abuse by the Nurse.

If the nurse does not sign a proposed Consent Agreement, he or she always has the right to go to an Administrative Hearing.  The nurse can present evidence that there is no history of drug use or abuse and that the nurse has an otherwise excellent history of employment.  The Board’s attorney is going to present its evidence that the nurse failed to document the administration or otherwise account for the disposition of controlled substances that were removed.

It is imperative to completely, accurately, and timely document the administration or disposition (waste) of controlled substances or other drugs! The Nursing Board may place a nurse on probation and subject them to multiple probationary terms, even if there is no evidence that they suffer from chemical dependency and even if there is no evidence of diversion.

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

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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 – time to renew your license!

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This month, Ohio LPNs will be mailed instructions by the Ohio Board of Nursing on how to renew their LPN license on-line.  The Board will mail the instructions to the address that you previously provided to the Board as your address of record. If you do not timely receive the instructions, you should contact the Board immediately.

If you do not want to renew on-line, you may request to have a paper renewal form mailed to you. To be sent a paper renewal form:

  • send a written request to: Ohio Board of Nursing, 17 S. High Street, Suite 400, Columbus, Ohio 43215, attn: Renewal; or
  • fax a request to the Board at 614-466-0388, attn: Renewal;
  • or, email the Board at renewal@nursing.ohio.gov

Renewal applications received after July 1 will be assessed a $50.00 late fee. If you do not renew by August 31, the license will lapse.http://codes.ohio.gov/oac/4723-7-09

Whether you choose to renew online or to complete the paper renewal form, it is important that you take a few quiet minutes to complete the form on your own!   Allowing others to renew your license for you or not taking the time to carefully read and accurately and completely respond to the questions on the renewal can be a costly mistake.

By signing the renewal application you are certifying to the Nursing Board that all information contained in the application is correct and complete. The Nursing Board reviews all original applications for licensure and renewal applications very seriously and will take a disciplinary action against a licensee who fails to provide the Board with correct and complete information.

In addition, any questions in which you have to answer “yes” to will require you to provide a short written explanation. You should take time to provide a clear and careful response. Don’t minimize the incident or fail to take responsibility for your actions, as this could be to used as an aggravating factor if the Board chooses to impose a discipline.

The Nursing Board routinely suspends or revokes licensees who provide  a false response to a renewal question.  It is always better to provide clear, honest responses to the questions than to provide information that might be misleading or may lead to more questions by the Board.   If you do not understand a question, you may call the Nursing Board staff and ask  – however, the staff is unable to give legal advice.

As always, if you have any questions about this post or another question involving the Ohio Board of Nursing, feel free to email me at Beth@collislaw.com.