Help! Hospice RN under investigation for diversion

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Hey guys,

I’m an experienced RN-BSN nurse with about 10 years of experience. I am a hospice nurse, mainly seeing patients who live at home or with family. I received a letter from the BON regarding an investigation for “unethical conduct” in April of this year, I immediately called a nurse attorney who instructed me not to speak with the BON investigator.
Long story short-I had a patient who’s daughter was very anxious, and also the primary caregiver of my patient. She was constantly changing her mind about the plan of care/ medications she wanted or didn’t want for her mother. Anyway I just got a letter today that the BON is pursing my RN license for med diversion! Apparently this daughter has reported that I removed medications from the home. I have never diverted meds, nor do I have any history alcohol or drug abuse. Has anyone been in similar circumstances and faced the BON? I’m freaked out!

Thanks

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Specializes in LTC, assisted living, med-surg, psych.

First thing you do is lawyer up. You do not want to face the BON alone. Preferably, you'll get one who has extensive knowledge of nursing practice. There's a group called TAANA which can refer you to experienced attorneys who know what BONs can do to a nurse's license and reputation. I wish you best of luck, I've never been in your position but I feel for you and your situation. Please keep us posted.

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You’ve done the right thing by lawyering up..

The next part is probably the worst part though.. the waiting with a cloud over your head.

In my state, complaints are “triaged” by the board, and cases that are immediate-jeopardy and easy-to-prove end up at the front of the line. There’s a “goal” that something like 80+% of cases get resolved in a year, and some take a couple years.. (usually DUI’s and such where people have attorneys who are going back and forth with the board)..

A nurse that’s found with a needle in their arm in a patient bathroom will get a speedy “trial”, and a speedy hanging in the public square. The board can literally meet telephonically and suspend a license the same day..

A situation like you’ve laid out- where a family member claims without proof that you might have taken something - is weak, unsexy and requires work on the part of the investigator. They’ll definitely be looking at your record of complaints with them, they might pull criminal history on you, and they might even have to contact other patients that you’ve cared for and previous employers - and get interviews with them. But - in a he-said, she-said, the shortcut is to get you to admit that you did it, or cast doubt on yourself in some other way.. in an interview with you.

If your attorney cut-them-off-at-the-pass, they still might demand that in-person interview.. but your attorney can probably force them to show their hand a little- and if the complaint is weak, it’ll be easier to push it to the back of the queue and go after easier prey.

As hard as it is, the longer the board delays things, the better it is for you. If the patient’s family had you on tape dumping gramma’s Percocet’s down your gullet & washing them down with a bottle of Jim Beam, you’ld already be in jail, and your license would have been suspended.

good luck.

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Specializes in Psych (25 years), Medical (15 years).

Sorry this happen to you, Rohr, and I hope the best for you.

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On 6/6/2020 at 6:27 AM, rzyzzy said:

You’ve done the right thing by lawyering up..

The next part is probably the worst part though.. the waiting with a cloud over your head.

In my state, complaints are “triaged” by the board, and cases that are immediate-jeopardy and easy-to-prove end up at the front of the line. There’s a “goal” that something like 80+% of cases get resolved in a year, and some take a couple years.. (usually DUI’s and such where people have attorneys who are going back and forth with the board)..

A nurse that’s found with a needle in their arm in a patient bathroom will get a speedy “trial”, and a speedy hanging in the public square. The board can literally meet telephonically and suspend a license the same day..

A situation like you’ve laid out- where a family member claims without proof that you might have taken something - is weak, unsexy and requires work on the part of the investigator. They’ll definitely be looking at your record of complaints with them, they might pull criminal history on you, and they might even have to contact other patients that you’ve cared for and previous employers - and get interviews with them. But - in a he-said, she-said, the shortcut is to get you to admit that you did it, or cast doubt on yourself in some other way.. in an interview with you.

If your attorney cut-them-off-at-the-pass, they still might demand that in-person interview.. but your attorney can probably force them to show their hand a little- and if the complaint is weak, it’ll be easier to push it to the back of the queue and go after easier prey.

As hard as it is, the longer the board delays things, the better it is for you. If the patient’s family had you on tape dumping gramma’s Percocet’s down your gullet & washing them down with a bottle of Jim Beam, you’ld already be in jail, and your license would have been suspended.

That’s is what I’ve been hoping, that maybe the longer the wait by the board, the better. But yes, the waiting is the worst part (besides facing losing my license by here-say.)

I’ve retained a lawyer who was an MSN nurse before becoming a judge and now a defense attorney. I’m hoping my past if no criminal record, and a majority of happy patient families will all be cause to help my case, plus the face I didn’t divert anything.

I will keep everyone posted as to how this plays out. Thanks

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Can’t help but wonder how much of the meds were stolen by the family member. She’s only trying to destroy you in order to distract anyone from investigating her.

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That’s what I was thinking too.. she was very anxious, constantly calling all hours of the day/ night wanting help with behaviors- but then refusing the options we had available after the MD had already ordered them. It was a messy situation, as they had a caregiver in the home too, that was not licensed, who would rearrange Med planner- change dosages of medications. What’s to say she didn’t take them? I’m just hoping the board will see the holes in this complaint. I’ve never been stressed like this!

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On 6/6/2020 at 8:50 AM, Rohr.RN1990 said:

That’s what I was thinking too.. she was very anxious, constantly calling all hours of the day/ night wanting help with behaviors- but then refusing the options we had available after the MD had already ordered them. It was a messy situation, as they had a caregiver in the home too, that was not licensed, who would rearrange Med planner- change dosages of medications. What’s to say she didn’t take them? I’m just hoping the board will see the holes in this complaint. I’ve never been stressed like this!

The holes will be easier for an attorney to find than for you to find yourself.

my board investigation experience was different, but similar - in that it was just an unsupported patient complaint.

I think it took eight months to actually get to that interview with the investigator, at which point I wasn’t even asked any questions, the investigator told *me* that the complaint was bull, and that’s when I was told that the patient was a serial complainer that had made multiple false claims, tried to blackmail a CNA after sexually assaulting her, yadda yadda..

I could have buried myself if I had chatted with the board at the first opportunity without an attorney, or if I hadn’t had an attorney’s help in crafting my response to their written questions.

The waiting is agonizing and terrifying if you’re actually innocent. And they didn’t provide me with any actual details of the complaint until they were dismissing it.

I thought multiple times about just turning my license in and walking away - and I hadn’t actually done anything wrong..

I feel you, I been there, stay strong..

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Specializes in NICU/Mother-Baby/Peds/Mgmt.
2 hours ago, Rohr.RN1990 said:

That’s what I was thinking too.. she was very anxious, constantly calling all hours of the day/ night wanting help with behaviors- but then refusing the options we had available after the MD had already ordered them. It was a messy situation, as they had a caregiver in the home too, that was not licensed, who would rearrange Med planner- change dosages of medications. What’s to say she didn’t take them? I’m just hoping the board will see the holes in this complaint. I’ve never been stressed like this!

Start writing down everything you remember. Of course you'll have to correlate with doctor's orders but you can start now to get your thoughts on paper. Don't tell anyone but your lawyer you're doing this.

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I have been documented everything I can remember, including medications tried/refused/ disposed of, MD orders, calls from the state BON, notes about specific charting I remember doing about the instability in the home. I no longer work for this company that I was seeing the patient at- the turn over rate was incredible, without very productive leadership, so that makes things a bit more challenging too. I did go up the chain of command about this particular family- I intent to inform my attorney about that as well. Thank for your response.

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11 hours ago, Rohr.RN1990 said:

she was very anxious, constantly calling all hours of the day/ night wanting help with behaviors- but then refusing the options we had available after the MD had already ordered them. It was a messy situation, as they had a caregiver in the home too, that was not licensed, who would rearrange Med planner- change dosages of medications.

For the future, consider removing yourself from these situations. Sometimes challenging behaviors are primarily due to the acute stress under which good people find themselves, but sometimes behaviors are just part of lifelong toxic patterns and the people don't care who they hurt. These latter instances are not worth tolerating just so your employer can have a client/continue the case. If they want that particular client that bad they can put someone else on the case.

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Yes, you’re so right, I should have done that sooner. That’s ultimately what made me submit my resignation at that company. I never dreamed this would be happening now, a year later. But, here we are- hindsight is 20/20.

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