NurseDiane

If this "manager" was so concerned about you going into the separate break room, why didn't she go in the room when you were there to see what you were doing? "Managers" love to exert their "power" any way they know how. Since there is obviously nothing wrong with your clinical performance, this is what the "manager" decided to make up. Nurses, in general, think nurses that don't share every personal detail of their life with everybody are "suspicious" or hiding something. You go into the alternate break room for the peace and quiet. In the regular break room, that's where everyone spills the details about their marriage, children, families, friends, and gossip about others. There is nothing wrong with staying out of the "gossip station". "Because no one else does it" is totally irrelevant----you are not doing anything wrong. Not spilling the details about your personal life has no effect on your clinical performance. If that "manager" wants to act like a b*tch, let her. Keep doing what you're doing. Don't quit because of one stupid remark that bears no relevance to your performance.

This is not the end of the world, but I would strongly advise that you retain an attorney for any board hearing, any board questioning and any document signing. The BON's goal is to scare you into signing a consent order before speaking to an attorney. The Florida BON is ruthless and the IPN is nothing more than a giant profit-driven organization that makes a crap ton of money from board-ordered "evaluation" by unqualified practitioners that are not addiction specialists. Forcing you into an IPN contract before an adequate investigation is done should be illegal. A thorough investigation will show that this was a documentation error, and not an issue of diversion or addiction. By telling you that they will turn you over to the DOH, it's nothing but a threat. Who cares if you get turned over to the DOH? At least the DOH will conduct an investigation before any hearings regarding your nursing license are conducted. The BON knows that the vast majority of nurses panic at the thought of any disciplinary action because they do not understand the process, and often just "submit" to whatever the BON wants them to do. DON'T DO THAT. So what if they turn you over to the DOH? At least then an investigation will be done. The BON cannot justify forcing you into an IPN contract when there is no evidence of diversion or drug use. They just don't want to have to spend any money on handling something like this properly. If you consent to an IPN contract, you all be their b!tch for the next 5 years. Do not agree to enter IPN before a complete investigation is done on this incident. The penalty for a documentation error is far less than the penalty for entering IPN. Tell the BON that you are respectfully declining their offer because you do not have a drug problem, you did not divert any narcotics, your drug screen was totally negative and they have nothing to support the necessity for you to be in a monitoring program. Threatening nurses to consent to a 5 year monitoring contract with IPN is a bottom-feeder behavior. Let them do some work for their salary. The Florida BON tries to throw every nurse into IPN no matter what the offense is or if it involves drugs or it doesn't. IPN is a profit-driven monster. Remember that consenting to join IPN doesn't automatically assure that something won't be slapped onto your license if somebody at IPN or BON feels that you haven't done enough to "participate" in the program. The BON can unilaterally extend your contract for no reason. They have total control over you. It is not the end of the world if you get a mark against your license for a documentation error, but you can be guaranteed that you will never work as a nurse again if you get a mark against your license for a drug-related offense. You will not lose your license for a documentation error. This is exactly the reason why you need an attorney. One thing you definitely do not want to do is be questioned by the BON or DOH without an attorney present, or without being prepped by an attorney before the questioning. As soon as the BON & DOH know you have an attorney, their demeanor will change because they know they can't threaten you anymore. Talk to a lawyer. Be honest. Try to get all the documentation you can, including the results of your drug test for the attorney. An attorney can request all of the documents that the BON has in its possession---if you requested those records, your request would be refused. You have to consent to entering into an IPN contract---the BON cannot order you into it. That's why they throw ultimatums in your face--the less time a nurse has to think about it, the more likely it is that they'll agree to it. The BON or DOH cannot take any action against your license without a full investigation and hearing. The BON wants to make "turning you into the DOH" sound really scary, but it's not. An attorney can negotiate with the DOH much better than you can. There is no way a documentation error should turn into a drug offense without an investigation. You will likely not get out of this scot-free, but agreeing to enter into a 5 year IPN contract is ridiculous. You will probably have to take some type of course on proper documentation, and maybe get a strike against your license, but that's it. Maybe a small fine, too. Fight for your license. Don't let the BON scare you into something that is totally unnecessary and which will cost you tens of thousands of dollars over the course of 5 years. Use that money to retain an attorney.

It depends on where you live & what you need an attorney for.

Get a job while you're in nursing school to help pay expenses & stop relying on the school loans to fund your lifestyle. Bad decisions put you in the financial mess you're in now. Loans have to be paid back. Start living frugally, start paying the loans back NOW, before they start building up interest. If you're moving back in with your parents, there is no reason why you can't pay $2,000/month working one nursing job. At this point, don't worry about working 2 full time jobs---worry about getting one job & doing that job well. Don't get your heart set on working in a pediatric ER from the get-go. You need experience before you go to a setting like that. Your idea of a "sustainable lifestyle" will have to change---you will have to drive a used car instead of a new car, make do with an older cell phone instead of getting a new one every other year, & curb your spending habits. The only way to not accumulate $200,000 in school loans is to start working to pay your living expenses NOW so you don't depend on loans to fund your "lifestyle". I think $200K is WAY TOO MUCH for a nursing degree. I can't see how transferring back in state would be more expensive than what you're doing now. It might even be worthwhile to take a break from school, or drop to part-time, work for a while to make some money that you can put toward school instead of taking out all that money on loans. Don't worry about what's going to happen AFTER you have over $200k in loans---start being proactive NOW in order to reduce the amount of loan money you need.

While doing a GYN case in the OR while I was a student nurse anesthetist, I was trying to give the patient a bolus of propofol in the IV, but I didn't realize the stopcock was turned the wrong way. So I pushed the plunger on the 60cc syringe as hard as I could, and it popped out of the line, spraying the surgeon's head with propofol!!! That was pretty embarrassing.

I don't have a nightmare interview to report, but I wanted to comment on interviews for clinical nursing positions. Places treat interviews for staff nurses like they are interviewing for C-level positions, which is absurd. When I was hired for my first RN job out of college, it was at a major NYC medical center---I was hired over the phone, after a phone interview!! How interviews for staff nursing positions have turned into some ridiculous affair, I don't know. If a nurse has just graduated & passed the board exam, then they are going to need a longer orientation period than a seasoned nurse that's been doing it for a couple of decades. The most important thing is whether the nurse interviewing for the job is going to be reliable, professional & pull their weight. Their "personal interests" don't matter. I think a good answer to the question of "Why do you want to work here" is "Because I need a job to pay my bills". That's as good an answer as any, because it's the truth. Putting someone on the spot with ridiculous questions, "panel" interviews & multiple interviews with different people is ridiculous.

"Hematuria" is not a diagnosis. It is a symptom. Blood in urine is a symptom of whatever condition is causing blood in the urine. Your DON needs to go back to clinical practice for a couple of years to learn what correct clinical practice is. It sounds to me like the DON didn't want any notation of hematuria or blood in the urine in the patient's medical record, because that would raise eyebrows with the state if it was not addressed promptly (or at all). (I am assuming this occurred in a LTC facility.). Did you ask the DON what you should write instead of hematuria? Most LTC facilities don't want to address any medical issues because they don't want to lose money. If a patient had blood in their urine, the LTC facility would have to collect a urine specimen to be sent out to a lab, get the results back and possibly send the patient out to a urologist or to the emergency room to get a diagnosis & treatment, which could possibly affect their profits.

You're right---the BON is not your friend & they attempt to get nurses to implicate ate themselves instead of having adequate evidence to prove their case. I believe it is a violation of an individual's right to due process, even though dealing with the BON is technically "administrative", to be accused of something without a shred of evidence to support the allegations. This is why BON's need an independent, unbiased & neutral organization to govern their operations instead of being "self governing". However, the BON's must change the way they handle nurses with substance abuse issues. Instead of treating their illness as a character flaw & intentional act for which they punish those nurses, not only by mandating them into a "contract" that they must comply with whether they can afford it or not, but by not humiliating & shaming them by publication of their "offenses" on a website for the entire world to see. There is no reason why a nurse's family, neighbors & friends should have access to humiliating & intimidating information that has nothing to do with them at all. I find that to be the most offensive thing of all. Your story made me smile---I like hearing about nurses that have successfully battled the BON, and won. BON's base things largely upon the fear of the nurses they are pursuing and not the actual facts of the matter.

Whether they still worked at the facility at the time the complaint was filed makes a difference. If they did not work at the facility at the time they submitted the complaint to the BON, the facility has no responsibility over them as far as "vicarious liability" and you can sue them individually. If they still worked there at the time the complaint was submitted to the BON, the facility could have vicarious liability in a lawsuit since the manager was an employee of the facility. DO NOT MEET WITH THE BON ALONE. Make sure your attorney is with you, or someone as your representative. Record the meeting in its entirety. Do not sign anything, do not admit to anything, do not agree to a "plea" or consent agreement. If what was filed is 100% false, fight it with all you've got. Do not just "talk"---demand to see whatever documents the BON has in their possession. If they threaten you in any way, such as saying if you don't submit to a consent agreement you will have to face a hearing with the BON, make sure you record that statement or have them sign something stating the same thing. If they still want you to submit to a consent agreement, decline the offer & tell them you want to proceed to a hearing. At the hearing, the manager that submitted the complaint has to show up to testify. If they don't, the complaint that they submitted can't be accepted as legally sworn information & the BON have nothing to prosecute. The person that submits the complaint has to testify to the BON---without a witness to substantiate the statements in the complaint, whatever is in the complaint cannot be taken as fact. If your lawyer is with you, let him/her do the talking & don't say anything. The BON wants you to implicate yourself & admit to just a teeny little thing that might be fact in the complaint so that they can proceed with a disciplinary action. If the BON was dropping the charges, they wouldn't want to meet with you---their investigation would have shown that what was in the complaint was false. They are trying to push you into a corner & get you to trip up & admit to something in the complaint. "I don't recall", "I'd have to see the records" and "I can't answer the question as asked" are great answers to questions. Good luck.

If what was stated in the complaint is absolutely, 100% untrue, you can sue the hospital/facility and name the manager individually in the lawsuit for defamation, slander & libel---what she wrote (and likely stated) to the BON has affected your livelihood, and this is the key point in slander/libel/defamation lawsuits. The hospital would likely deny any liability & throw the nurse under the bus, distancing itself from her actions as much as possible. This is much different than a medical malpractice lawsuit, where a facility's insurance would cover a staff member. A facility's malpractice insurance wouldn't cover a nurse manager's actions as far as defamation, slander & libel--she'd have to hire her own attorney, pay her own legal fees & deal with the consequences of her actions. Even if she had her own malpractice insurance, it wouldn't cover something like this. "Reporters" are not protected by law when they submit a complaint to a licensing board containing untrue claims that defame someone & negatively affect their livelihood, even if they are that person's supervisor/manager. At the very least, you should sue for lost wages, potential lost wages, emotional distress, legal fees/costs and punitive damages for the manager's egregious actions that hurt your career/livelihood. At the very least, she will probably lose her job. And make sure that you notify the media about this---the public needs to be made aware that nurses are being reported by their peers/supervisors/managers with false information, resulting in the nurses losing their jobs, having to pay attorneys to fight the allegations & unnecessary emotional distress. I would also report this manager to the BON for submitting a complaint that included totally false claims & allegations, as honesty & integrity are a requirement of being a licensed nurse. I would be interested to know what that manager put in the complaint about you, and whether the complaint was made before or after you left your job. People that file false complaints, whether they are strangers, superiors, another nurse, your neighbor or ex-spouse, can be sued for making false statements that negatively affect your livelihood, especially to an administrative board. As far as potential employers finding out about an investigation, as far as I understand, pending investigations/actions with the BON cannot be revealed or published. Only when there is action/discipline against a nurse's license can it be made public.

How would it be more expensive to transfer to a community college at home for two more years? If you live at home, that saves you a crap ton of money. "Time consuming"? Do you know what time consuming is? Time consuming is working 7 days a week to pay off school loans. The school you're going to isn't the only nursing school in the country. I cannot see how pre-reqs wouldn't transfer to another college. I don't know what "they don't transfer well" means. They either transfer or they don't. Pre reqs are pre reqs, no matter where you take them. Anatomy & physiology is the same no matter where you take it. Pharmacology is the same no matter where you take it. Statistics is the same no matter where you take it. Inorganic & organic chemistry is the same no matter where you take it. I don't want sound mean, but it seems to me that you would rather just stay in the situation you're in than put in the time & effort to figure this out. If you have to forego a semester to move back home, get your credits transferred to another college, find a job, then that's what you have to do. $200,000 is one HELL OF A LOT OF MONEY. And that is without interest. You can buy a home with that kind of money. If you are saddled with that kind of debt right out of school, you can forget about buying a new car, or a place to live, or living anywhere else but a studio apartment on the bad side of town for 10 or so years. And nurses are having hard times finding jobs these days. You shouldn't count on being able to even get 2 full time jobs. There isn't any nursing degree worth $200k. You already have close to $100k in debt. If you put your nose to the grindstone, do what you have to do---which means getting a job, learning to live frugally, taking as little loan money as possible, living with your family---you can get away without having to take any student loans. You can't do anything about the past, but you can control your future.

Why can't you get a job now? You can certainly work at least a part time job while going to school. $200K for a nursing degree is ridiculous. Get a job, and transfer to a school that is cheaper. Try to get into a school near your family so you don't have to pay for room & board. There are tons of ways to lower college costs--the problem is that many college students don't want to make sacrifices to do it.

And here is a perfect example of absolute & total waste of health care dollars. If you're laying there eating a bag of Cheetos, your belly pain can't be too bad. No million dollar workup--in fact, it should be immediate discharge with a referral to a clinic. Why are health care costs so astronomical? Because the "You have the right to be seen & treated regardless of your ability to pay." There needs to be some sort of judgment call permitted by triage personnel because on an average day, an ED is full of non-emergencies. There is a large percentage of people without any health insurance at all that use ED's as a primary care clinic for themselves & their children & never pay the bills. Those costs are dumped onto everybody else, via higher taxes & higher costs for private health insurance. This B.S. has to stop. People have to start taking some responsibility for their own health & the system has to stop "rewarding" people for their bad choices. You're obese because you eat McDonald's every day? We've got a cure for you--bariatric surgery!!! You're a diabetic because you weigh 400 lbs. & eat a cheesecake every day? No problem---there are tons of different medications for diabetes out there!! You can keep eating that cheesecake because we can control your blood sugar with medications!!! How about rewarding those who do eat a healthy diet, stay active & take care of themselves? Those rewards can come in the form of lower insurance premiums, co-pays & deductibles. People that take care of themselves are being punished for the bad choices of others, and it is not fair. Why should my insurance premium, as someone that does not go to the doctor hardly at all, be the same as someone that goes to a doctor every other week for some health problem due to their sh***y lifestyle? Take some responsibility for yourself, for God's sake.

Good luck with the "face time" part, and I am not saying that to be snarky or sarcastic. Insurance companies & medical practices have created a "system" where it is difficult to provide the type of care that patients deserve. Your job is different than mine--I don't spend much "face time" with patients, but the "system" has forced everyone to cut corners in an effort to increase volume in order to increase reimbursements. I cannot do my job--just like you--without every other member of the O.R. team working in sync to make sure the patient is SAFE, over & above everything else. But, if I was asked what some of the other staff does on a daily basis, I honestly couldn't tell you. So, if I was asked to do a peer review of them, I wouldn't know what to say about their actual work performance. I could say that they are friendly in the locker room or that I have no interaction with them whatsoever. I know what you mean by "equal" in a team setting. Things couldn't run ANYWHERE without everyone doings their jobs to meet a common goal. My point was that if different job titles were told to do peer reviews, I don't know how that would be possible since a part of peer review, as far as I know it to be, is critiquing their work performance. While I believe it would be possible for an RN to do a peer review for an aide, I honestly cannot see how an aide could possibly do a peer review for an RN since they really don't know whether the RN is practicing safely or not. That was the point I was trying to make. I just find it strange that an aide would be expected to do a peer review for an RN, that's all. To be honest, the whole thing makes me laugh because of how the entire healthcare industry has turned into nothing more than a profit-driven business. Do you honestly think that peer reviews make any difference to a facility or how it functions? The most important thing is safe, quality patient care. Maybe nurses should be asked to do peer reviews of nursing management & administration. Now that would be interesting...................

I'm curious about a scrub tech being permitted to be a "laser operator". You don't mean that a scrub tech can actually "use" the laser, do you? I am curious because I know in some states, only MD's can use lasers for dermatology/cosmetic purposes, and in other states nurses and even "technicians" can do dermal laser procedures. There are lots of "spas" that perform laser hair removal & the person operating the laser does not have any professional license--they just took a course for a couple of days to learn how to turn on & push the laser around so the spa can charge a couple hundred dollars per procedure. I have to assume in a general O.R., you must mean nurses & ST's can turn the laser on, input settings, etc. for the surgeon to actually use. Usually---and I say usually because sometimes facilities will skate on thin ice for financial purposes---the state sets forth who can do what when it comes to clinical practice.