My Nursing License Is At Risk - Or Is It? - page 2
I often listen as certain coworkers, usually the nurses with zero to two years of experience, chime about the dangers to their hard-earned nursing licenses. "I'm putting my license on the line by... Read More
Nov 1, '12 by Susie2310monkeybug said what I was just thinking. My malpractice policy exclusions include: Injury that a reasonable person would expect, along with criminal acts. As nurses we are held to the "reasonable nurse" standard. So my understanding is that if I am determined to be responsible for my patient's injury because of my breach of the Standards of Care, then my malpractice policy exclusions are invoked. I am familiar with the Nurse Practice Act, standards of practice, HIPAA, Nurse's Code of Ethics, Patient's Bill of Rights, and more, including risk management information for practicing nurses provided by my malpractice insurer. All of this is a lot of reading. The difficulty as I see it is that employers sometimes make it very difficult for nurses to practice safely and to fulfill their legal requirements, eg. as monkeybug mentioned, understaffing. A personal example is lack of support staff to assist with a family member with acute diarrhea (yes, as family I was very glad to help, but no further staff were provided). As I understand it, one's legal duty as a nurse in these situations is to fill out an incident report, and report the situation to their manager explaining why the staffing is insufficient to meet their patient's needs, and request more help. The problem, as I see it, is often having to do these things in order to be able to give safe care. The nurse is often put in these highly risky situations by their employers, where the patient's safety is risked and the nurse's license (along with their finances and future ability to support their family) is put at risk through the risk of poor patient outcomes that invite malpractice claims.
If one has not already done so, I recommend reading risk management information provided by one's malpractice insurer, and learning what actions one can take to protect oneself. Some of the case studies where legal judgements have found against the nurses are quite frightening.
I believe these situations are of much greater real risk to the nurse than the ever present risk that we may be reported to the BON.
Nov 1, '12 by BuckyBadgerRN, RNWow, that's a great reminder to pay back those loans!!
Quote from dudette10I looked over my state's report for September. Here's the breakdown.
Documentation re: patient care and policies (5): 5 reprimands
Drugs (6): 4 indefinite suspensions, 1 indefinite probation, and 1 refusal to renew
Failure to Report (6): 1 reprimand for false information on application, 1 fine for failure to report another state's disciplinary action, 1 reprimand for failure to report termination and unprofessional conduct, 1 indefinite suspension and 1 reprimand for late reporting of felony convictions, 1 indefinite probation for being audited w/ no CEs
Actual Patient Care (1): 1 reprimand for failing to notify physician of a change in patient status
And, drumroll please...
THIRTY refusals to renew and FOUR indefinite probations for defaults on student loans
Nov 1, '12 by FivetenThere's no need to be hostile. I can tell you from looking up other nurses licenses in my state that most revocations are narcotic-abuse related. Mistakes in nursing judgement happen, and these may result in losing a job or reprimands. Revocation is the last straw.
Nov 1, '12 by VICEDRN, BSN, RNQuote from TheCommuterNoted that you don't disagree that you can lose your license for something other than narcotics abuse and criminal activity. Further, the vast majority is not all license revocations.I agree with the theme that is developing on the thread. While license revocations are rare, it is not difficult to imagine being in a indefensible situation when one has too many patients on one shift or does not give needed care. Suspensions and lawsuits are equally scary and impact the ability to collect pay checks profoundly.Well, I'll bite back because I'm not your sister and that's not my theory. . .Anyhow, it would be nice if the nurse who has lost his/her license for dealings with difficult families, short staffing in nursing homes, or giving meds late would come forward and share his/her story. However, I kinda suspect that nurses who lose their licenses for minor issues are rare. My point is that the vast majority of license revocations in my state of residence occur due to issues with impairment or diversion. I regularly read the disciplinary web pages on the website of my state's BON.
Nov 1, '12 by Mulan10 Ways to Lose Your Nursing License - Nursing Link
"9. Patient Abuse and Neglect
Sadly, this is quite obvious and, even worse, happens more often than we’d like to admit. Patient neglect and abuse can happen because a nurse is intentionally causing pain and/or suffering, or because of a simple mistake because a nurse is over-worked or has too many patients. One of the most serious offenses, patient neglect and abuses affects more than just the nurse, and even more than just the patient. The patient’s friends and family must also suffer alongside him/her, making this grave offense even worse.
Unfortunately, this happens all too often. Many times, a nurse doesn’t neglect a patient on purpose, but her forgetfulness can cause more damage than imagined and result in the loss of her license."
Nov 1, '12 by FLmedQuote from TheCommuterThank you for sharing this. :-)By the way, the following is a link to the recent disciplinary action page on the BON website for the state where I live. Just click on any license number to read the stories that led up to disciplinary action being taken against the licensee (nurse).
Nov 1, '12 by MotherRNQuote from TheCommuterDo you think for the minor stuff (compared with narcotics stuff) like giving a med late or staffing issues, that the nurse loses her job, not her license first?Well, I'll bite back because I'm not your sister and that's not my theory. . .
Anyhow, it would be nice if the nurse who has lost his/her license for dealings with difficult families, short staffing in nursing homes, or giving meds late would come forward and share his/her story. However, I kinda suspect that nurses who lose their licenses for minor issues are rare.
My point is that the vast majority of license revocations in my state of residence occur due to issues with impairment or diversion. I regularly read the disciplinary web pages on the website of my state's BON.
And the narcotics stuff leads to a revoked license?
Nov 1, '12 by dirtyhippiegirl, BSN, RNQuote from TheCommuterReading through the remedial education, deferred postings is cringe-worthy to me. Proof that you can get hauled in front of the BoN for simple mistakes in med administration/nursing judgment, even if you're basically found not guilty. That's still time, money, and god-knows-what-sort-of-behind-the-back-gossip for the nurse involved.By the way, the following is a link to the recent disciplinary action page on the BON website for the state where I live. Just click on any license number to read the stories that led up to disciplinary action being taken against the licensee (nurse).
Nov 1, '12 by musingmomThis is an interesting article, because (as PP have said) those of us still in school and newly out of school have heard over and over again about the numerous risks to our license.
I took a cursory glance at the public records of license revocations in my state of California, for the month of September 2012. 2/3 are for narcotics use or diversion. One RN turned out to be a pedophile (off the clock) and was sent to jail. One home health RN was found guilty of Medicare Fraud. One RN was convicted by a criminal court for battery on a patient as a result of unwanted touching. He was acquitted of sexual assault. The BON revoked his license for the battery conviction.
I found one that was for negligence... however this particular nurse had 7 documented instances of negligence over a 2 year period, at 2 different employers, both of whom terminated her and reported her to the BON. Some of her issues included giving insulin without an order, failing to take a blood glucose level prior to giving insulin, falsifying patient records, and many other issues. I have to admit, my favorite part is that she seems to have taken a patient medical record from the facility, altered it, and submitted it directly to the BON at her hearing as part of her defense. It was then determined that she did not have the patient's consent to disclose their records (so an additional HIPPA violation), plus the BON determined she falsified information in it.
That's all for September 2012. It does seem that you need to do/not do something VERY serious to lose your license, and in most instances a pattern of behavior is established, not just a one time offense. Also, it's worth noting that most of the narcotics related offenders were put on probation first, and continued to test positive for narcotics and so were now finally losing their licenses.
Nov 1, '12 by nurseprnRNQuote from VICEDRNUm, not really. The point is that this is the level of offense that gets your license jeopardized, not mouthing off to the staffing clerk when you refuse to work extra or doing a late med pass. And yes, it does take something illegal or very serious to have your license acted upon. I think since most of them are diversion-related that's the easiest (and most instructive) thing for most of us to cite, but there are clearly others.I'll bite...
So your theory is that because the nurses that you know that got their licenses revoked all did something illegal/ very serious that all nurses who have their licenses revoked did something implicitly illegal and/or very serious?
Think that logic is a little faulty there sister!Last edit by nurseprnRN on Nov 1, '12
Nov 1, '12 by Oldest&Ugliest, BSN, RNQuote from dirtyhippiegirlI agree, it is really scary.Reading through the remedial education, deferred postings is cringe-worthy to me. Proof that you can get hauled in front of the BoN for simple mistakes in med administration/nursing judgment, even if you're basically found not guilty. That's still time, money, and god-knows-what-sort-of-behind-the-back-gossip for the nurse involved.
Nov 1, '12 by CauliflowerThanks for posting this. I am a new-ish nurse and am constantly worried about "losing my license." I'm glad to hear that it's more major infractions.
Nov 1, '12 by Susie2310Cauliflower, those major infractions can be committed quite easily. If you accept an assignment with insufficient staffing, and you cannot provide safe care to your patients, and you do not request more help and insist that you receive it, and there is a bad patient outcome (as would have likely happened to my family member with acute diarrhea where the nurse came in to hang fluids and antibiotics, and the aide came in to take vital signs, and no-one had time to assist a patient having frequent diarrhea), had I not been there to give the care myself my family member with sepsis and acute renal failure would likely have suffered a very bad outcome. And yes, I would have held someone accountable for insufficient staffing and a breach in the standard of care if I found out that my family member suffered unduly and deteriorated partly due to the fact that their acute diarrhea was not attended to properly when they were struggling to cope with sepsis and kidney failure.