My Nursing License Is At Risk - Or Is It? - page 7
by TheCommuter Senior Moderator | 39,496 Views | 68 Comments
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. 的知 putting my license on the line by dealing with that difficult... Read More
- 0Mar 21, '13 by pmax57Diversion can be the outcome of forgetting to chart a Narc on a busy unit. If you test clean on a drug test there is a good chance you we be assumed to have diverted for a loved one. The BON must do what they have been hired to do (protect the patient). However there is a chance that if you have angered someone you will be reported even if others on the unit have committed the same offense. Can you use this to excuse yourself or to state existing prejudice? I wouldn't. On the other hand this is how petty managers get away with unethical behavior which appears to be rampant in business ( yes you can call hospitals a business now ) today. Please don't judge each other without full knowledge.
- 0Jun 29, '13 by TheCommuter, ASN, RN Senior ModeratorQuote from JericaLYour viewpoint on this issue is interesting. Thanks for taking the time to share.Your nursing license should be in jeopardy if you diagnose someone in your family, give them your own prescription pills and then threaten them if they don't want to take them (and against your doctor's wishes). That really should be against the law if it isn't already.
- 0Jun 29, '13 by JericaLSomething like that isn't minor, and I would think that a nurse would have been trained to understand something that simple. It's common sense. Would like to see an article that goes more deeply into the issue because losing a license is losing a livelihood and something you have put years into studying. Your life can be ruined by these missteps. I doubt that nurses are all addicts but some may have other problems that they're keeping hidden. Would be interesting to explore some of the other things that can threaten a license. It was interesting to see how a lot of comments found more small/petty infractions not to be punishment worthy, though losing your license should be the ultimate punishment (besides jail if that's necessary).
- 1However, I do personally know of a case where a nurse who (perhaps foolishly) commented on some questionable practice by a nursing home where she went via a staffing agency--and had her license tarnished forever in retaliation.
She was "caught" the next day and reported to the BON for doing something almost universally done in those days--such as pre-pouring meds prior to an evening med pass. Meanwhile, every other nurse there was doing the same, but someone just "happened to notice it" in her case and make an issue of it, while everyone else scuttled away with their own med carts and "pre-poured" meds. (This was in the days when bubble packs were used in ECFs, vs. individually-labeled blister-wrapped pills, so pre-pouring meant actually popping them out of a big weekly bubble card into the med cup.)
She didn't have her license revoked, of course, but she did suffer a BON hearing, a formal reprimand for the breach of regulations in pre-pouring ("setting up" meds in advance) and the nursing home got away with punishing her for expressing concern about poor care! Thus she is ow the one with the "history, and even though the nursing home still has a crummy record, no one there had their licenses sullied in any way.
I have also talked at length with a pharmacist at a hospital where I worked, who had perosnally seen a peer fired for reporting missing drugs; they were being diverted by a nurse relapsing into addiction, but the hospital was angry he documented it and reported it properly, vs. sneaking under the table to help the hospital just let her go quietly and hide the whole event. In this case, a pharmacist lost his job, the public and BON didn't hear about a dangerous nurse, and his advice to me to keep quiet when I found something questionable in the narcotics wastage record was pretty compelling. (That dilemma resolved itself, I was very relieved to see.)
"Reporting you to the Board" is a fairly common threat from the very people and agencies who need reporting themselves, and it is used as retaliation against a potential whistle-blower.
It's not hard to catch most nurses taking shortcuts to cope with lack of resources. They should not take them, it's true; neither should the Board ignore such mistakes because the reporting person or facility might have ulterior motives.
But the "report you to the Board" threat and punitive action should be more openly discussed and acknowledged as one too-effective way of keeping nurses quiet about substandard care--especially outsiders such as traveling nurses, student nurses, etc.
- 0Oh, and, a footnote, in case anyone is tempted to say, "just a reprimand?"
That nurse spent money for legal representation at the BON hearing, but could not have afforded an appeal. Her attorney told her afterward, too, that, "If your case is held before a class of nursing students..."--and hers was--"...they throw the book at you, to make a lasting memory for the students about cutting corners...and you're lucky they didn't do worse, for that reason", after initially telling her the charges were so ridiculous and lacking in evidence, and her actual real offense of pre-pouring medications so common and relatively minor she'd likely be "in and out of there in 10 minutes!"
She lost her job (making legal funds further out of reach, no doubt), and was turned down by others. She would have had trouble joining the military, adopting a child, working for the actual government, for a VA hospital or clinic, or an agency such as the BON, and (ironically) any inspection organization for facilities.
The higher-up the position, or the more important the need for "relationships" with other agencies in a job role, the more weight any disciplinary history would have, too, of course...so there might be no problem working as a staff nurse, but as a manager or representative? Well. She might be denied entrance to a higher school of nursing, too.
She would always be of limited value as a "whistle-blower" witness, because it could seem she had a vendetta against employers or providers, if she complained or provided evidence in another case.
Regardless, forever after she is required to let every employer know who cares to ask. If she were to apply for licensure by an endorsement to another state, it would take time, money, and embarrassment to gather the necessary extra information. Sometimes this would including multiple letters of reference from supervisors and other professionals who "know her history" attesting to her "rehabilitation".
There could always be a question in employers' minds, too, of whether the Board suspected (but lacked proof of) more than what was she was finally reprimanded for. Why? The Board has the discretion to decide the correct action based on circumstances surrounding the basic facts, and yet apparently decided to set a firm example with her case.
(I say this because others "only" reprimanded, per the disciplinary records on state BON sites, have done some pretty shocking things to "only" be reprimanded!) For that reason, some will wonder, understandably, what else she REALLY did to be judged harshly, and presume there just must not have been quite enough evidence.
In responding to probing questions, if there are any, there's another a lose/lose risk: If she went into too much detail about the retaliation aspect of what happened, instead of focusing on the lesson she learned, or if she mentioned that the nursing home was substandard, etc.,and she had foolishly tried to effect changes, she might leave a worse impression. Not only will she be seen as lacking in adequate remorse for what she did undeniably do--pre-pour medications--and lacking in improved judgement, but some employers would be scared to hire a potential whistle-blower.
So even a seemingly small "tarnish" on a nurse's license is no small thing, and it is all too easy to set someone up for one. That's pretty ironic when you know that some employers will let a criminal or addict go quietly (and unreported) to protect themselves.
It is easy to say "Do everything right, and you'll have nothing to worry about." True, except that not only are people human enough to make relatively minor procedural slips (especially smaller than pre-pouring medications) even when usually quite conscientious, but when errors are made, it's often the "why?" that determines whether a nurse was negligent or careless, vs. simply making a mistake. Isn't it?
I'm not sure of the solution, but maybe a healthy skepticism about complaints to the BON in some situations is called for. Spending much time setting examples for students of what happens when you violate procedure might be important. But for other, much more serious types of cases (mentioned in the media), oversight and control is inadequate due to lack of time, resources, personnel, and probably due to legal limits to investigation and tracking. Perhaps more of these scarce resources might be used for tracking those nurses, and investigating those major offenses.Last edit by unplannedRN on Sep 11, '13 : Reason: many typos