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.