Dear How Do you Lose Your License,
Management is a tough job, kudos to you. You are smack in between administration and staff nurses, trying to get staff nurses to do what administration wants/needs, and trying to get administration to hear what staff nurses want/need.
Losing Your License
Losing your nursing license is generally the result of willful misconduct, negligence, or acting outside of the scope of your license. Mostly it is about not complying with ethical and legal standards.
Typical reasons include addiction to alcohol, prescription or illegal drugs; falsifying a medical record; patient abuse or neglect; patient abandonment; sexual misconduct; or unprofessional conduct.
Each state regulates the practice of nursing, and a nurse could lose his/her registered nurse license for different reasons in different states.
According to Lorie Brown RN, MN, JD, there are 5 main reasons nurses lose their license.
- Failing to keep the Board apprised of your current address (remember to do this when you move)
- Having sex with a patient
- Being impaired
- Fraud or dishonesty Fraud is intending to mislead, for example, charting vital signs that weren't taken. Never document a treatment or meds that you didn't give; never document anything early†(didn't happen yet)
- Acting outside the scope of your licensure
What They Are Really Saying
As a manager, you have to hear what the nurses are really saying and respond to that.
Maybe they are genuinely afraid of losing their license (in which case, educate your staff and and encourage them to educate themselves about the responsibilities of licensure).
But maybe it's more that they are angry about their workload and know they can't get everything done. Try to get to the bottom of their concerns.
What Makes Nurses Angry?
- Work overload
- Feeling of powerlessness (maybe the worst)
- Frustration at not being able to provide good care
Management's Job
You have a challenging job, because you are responsible for the overall patient care on your units; you have to portray your employer positively; and you have to validate your staff nurses and help them to do a good job.
Can you help your nurses to feel more in control by giving them tools to prioritize care? Nurse always have 5, or 10, or 20 things to do at the same time. So they are always choosing one to the delay or exclusion of other tasks.
For example, a decision to do one thing (say, pass meds) is also a decision to not do something else at the same time. The key is for them to have a basis for their choice that they can speak to.
Do they have a rationale for prioritizing patient care, and can they speak to it? Patient safety? Time sensitive events, like medications and diagnostic procedures?
Help them to see what things can be re-scheduled or delayed. For example, there is a window of two hours around routine medications before they are considered late.
Never condone documenting things that weren't done, or working off the clock. Know what is reasonable and doable for the average nurse to accomplish, and that becomes the yardstick for you as manager to measure the productivity of other nurses and interpret their concerns.
Staffing Ratios in Sub Acute
Specific nurse to resident ratios are not federally mandated in Sub Acute/LTCs, except for mandating the presence of a Registered Nurse. Know your own state's regulations, and your facility's policies on staffing, and make sure you follow them.
If minimum staffing levels are violated, the LTC would lose its license, not the nurse.
It is up to management to allocate resources, including nurses, wisely. Readers, what do you think the nurses in this facility are really saying to their manager?
Best wishes,
Nurse Beth
LadysSolo
411 Posts
Why? Corporate puts pressure on management in search of the almighty dollar, don't care that real human beings' lives are involved. It's all about the money, and as long as they can keep people working and trying to do so much with so little, they profit and don't care about the workers and patients/residents. And management is squeezed, they (sometimes) care about their employees but they have families to feed too, and if they don't do what corporate says they are out too.