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It Can Happen to You

Nurse Attorney Article Magazine   (991 Views 6 Replies 799 Words)
by Lorie Brown RN, MN, JD Lorie Brown RN, MN, JD (Advice Column) Writer Expert Verified

Lorie Brown RN, MN, JD has 30 years experience and works as a Nurse Attorney.

10 Followers; 7 Articles; 5,013 Visitors; 90 Posts

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I’ve represented over 500 nurses in dozens of states (I work with co-counsel in states where I am not licensed) and every one of them has said, “I never thought I would be called before the Board.” Yet, here they are sitting across from me feeling very scared and vulnerable that they will not get to continue in the profession that they love. Anyone can report you (file a complaint) to the Board and once the Board receives a complaint, they are required by statute to investigate the allegation(s).

It Can Happen to You

Here are a few ways in which nurses can be called before the Board and how you can protect yourself.

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1. The first and obvious the Board feels that you are a nurse 24/7 and anything that you do that could look bad on our profession or be a concern for your judgment, they will take action.  This means any criminal matter where you are arrested, charged or convicted such as a DUI.

2. Do not use controlled substances, illegal substances, marijuana or alcohol.  If you take a controlled substance and do not have a valid prescription and you have to take a drug test that shows positive, it does not look good for you.  And don’t take medications without a valid, current prescription or borrow medications from someone else as this would be considered practicing medicine without a license by self-prescribing and it is also called diversion.  In addition, do not give a medication to someone else even if they’ve had a valid prescription for that medication in the past. This also is considered practicing medicine without a license and diversion.

3. Do not cross professional boundaries.  Nurses are required to care of patients during the time that they are assigned to the patient’s care.  Do not come to visit patients after hours and do not continue a relationship with patients after the nurse/patient relationship is concluded.  I’ve seen nurses who subsequently marry patients and then, if they divorce, the ex-spouse then files a complaint against the nurse’s license. I have seen nurses who, trying to be nice, will conduct banking chores for the patient.  Taking the patient’s debit card and PIN, they do the transaction only to find that the patient then alleges the nurse stole money. Don’t become involved with patients after the nurse/patient relationship has ended and only provide activities within the scope of your practice.

4. Be mindful of HIPAA.  Talking about a patient outside of their room, even without using names, can be a HIPAA violation.  You never know who might be listening. And don’t access patients’ records if you are not providing care for that patient and have no reason to access the patient’s records.  One nurse’s adult son was in the emergency room. She could not leave her position but looked at his chart to get his information. She had no business checking the chart which was a violation of HIPAA.  Don’t talk about patients except for treatment purposes and only in a secure area and do not access any other patients’ charts unless you are providing care or have a legitimate reason to do so.

5. Make sure you use due care in administering and signing out narcotics.  With the opiate crisis these days, there is software in the Pyxis machine to see who is giving more medications than the others who are on the unit.  Don’t be an outlier. Discuss the medication strategy with your coworkers and make sure that everyone is on the same page. When I went to nursing school, pain was considered the 5th vital signs and we always wanted to stay on top of pain.  However, things are changing. In fact, sometimes they don’t even give narcotic pain medication, even after surgery. If you do give pain medications, make sure you administer them as soon as they are removed from the Pyxis. Do not carry it in your pocket except to go directly to the patient’s room. I have seen it argued before the Board that by waiting too long to administer injectable narcotic medication, the nurse had an opportunity to take some or all of the medication and replace it with saline. Also, make sure you waste medications right away for the same reason and make sure the witness actually sees the waste and cosigns it. Going to a coworker after you wasted the medication and asking a coworker to cosign the waste without witnessing is in violation of your facility’s policies and procedures. So, make sure you follow all the facility’s policies and procedures. If you do get reported to the Board, my experience has been that if there are discrepancies with narcotics given, the Board will think that you are using them and if you aren’t using them for your own use then you are selling them.  They can be very unforgiving. Protect yourself by following your policies and procedures to the letter.

The above-mentioned tips may seem obvious but you would be surprised how many nurses are called before the Board for these types of issues.  The best protection against a Board Complaint is to be proactive and follow the rules.

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Lorie A. Brown is a Nurse Attorney representing nurses before the licensing board and founder of EmpoweredNurses.org. Empowering Nurses at the bedside and in business.

10 Followers; 7 Articles; 5,013 Visitors; 90 Posts

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2 Followers; 5,903 Visitors; 1,049 Posts

I left hospital nursing 25+ years ago after we could not offer patients narcotics after surgery.

Never would I participate in such barbarism again. Thankfully, I have been able to make a living elsewhere.

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1 Article; 16,218 Visitors; 973 Posts

Ahh, #3. Every few months we have a slew of nurses on these forums asking if it’s a bad idea to date their former psych patient (or worse, lecturing us on why it’s a good idea to do this but asking if their coworkers will judge them). 

I always think back to a post I saw a few years ago on this site: an angry ex-spouse (not a nurse) asking if she could report her ex-husband’s new girlfriend (a Peds NP) to the BON because she knew the girlfriend had written the ex-husband an antibiotic RX even though he wasn’t her patient. People do some crazy, petty things that can ruin your career. It’s unfortunate, but we definitely work in a ‘CYA mentality’ healthcare system. 

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Daisy4RN has 20 years experience.

1 Follower; 1 Article; 6,028 Visitors; 917 Posts

I dont like the idea that the board considers that you are a nurse 24/7. This is a ridiculous outdated idea that should change. Employer's do not pay me 24/7 so it should not be their, nor the Board's, business what I am doing if it is not directly hurting them.

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beachynurse has 33 years experience as a BSN and works as a School Nurse.

934 Visitors; 93 Posts

When I read articles like this, it really frightens me. I am a contientious nurse, but a human one. I am terrified to make a mistake of any kind. The thought of having to go before the board is both intimidating, and horrifying. When I think of the board, I think, career ending. I realize that they are there to protect the public, but, I also think that as an entity, they should also be looking out for nurses as well. In some instances, I see where compromise, retraining, educating, and or supporting can be more of a benefit to a nurse rather than just taking, or suspending a license. I often wonder, who looks after us??

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KCMnurse has 33 years experience as a BSN, MSN, RN and works as a Registered Nurse.

1 Article; 7,145 Visitors; 221 Posts

On 5/10/2019 at 7:14 AM, beachynurse said:

When I read articles like this, it really frightens me. I am a contientious nurse, but a human one. I am terrified to make a mistake of any kind. The thought of having to go before the board is both intimidating, and horrifying. When I think of the board, I think, career ending. I realize that they are there to protect the public, but, I also think that as an entity, they should also be looking out for nurses as well. In some instances, I see where compromise, retraining, educating, and or supporting can be more of a benefit to a nurse rather than just taking, or suspending a license. I often wonder, who looks after us??

Malpractice insurance is a must. Also, as someone else said, you need to practice CYA at all times.

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beachynurse has 33 years experience as a BSN and works as a School Nurse.

934 Visitors; 93 Posts

On 5/13/2019 at 1:07 PM, KCMnurse said:

Malpractice insurance is a must. Also, as someone else said, you need to practice CYA at all times.

Believe me, I do. But it is still potentially a daunting experience.

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