Published May 24, 2009
We had our nursing school's "field trip" to the BON this week. I have to say it was so disappointing. I went in with the idea in my head that it would be fair and professional, but in fact it just seemed like the board was very biased against anyone with legal representation, and like their rulings were very arbitrary.
The first case we heard was a new RN who had recieved a DUI 2yrs prior to starting nursing school. It was a misdemeanor and she had fully completed her sentence before nursing school. The BON put her on 6mo of drug/ETOH testing when she earned her license. So she had to call daily to find out if it were her day to test. Each of the first 4mo she was in full compliance and had two drug tests each month, all negative. On the fifth month she tested twice, the last time on a Friday. It was the last week of the month. Over that weekend she moved, she was 8mo pg, and that Mon. she forgot to place her call into the testing system. As soon as she realized (with a couple minutes of it shutting down) she called those she was working with at the BON, but it was too late. She was given a "positive" drug test even though her number didn't necessarily come up. Her argument was that she was under the impression that she had to take two per month, and that she just completely forgot but thought she was fine since she'd already done two clean tests that month.
The BON suspended her license for 3mo, gave her a $1000 fine, and reinstituted 6mo of drug/ETOH testing.
The next case was an LPN who worked at a hospital and told the RN that pt x needed his demerol from the pyxis and the RN retrieved it for her. The following day the same thing happened except shortly afterward the LPN started acting intoxicated, making odd statements, and threw up. She tested pos. for demerol. Turns out there was no order for demerol at all.
The BON did not suspend her license, didn't fine her, nothing. She got put into PEER assistance. That's it.
To me it was just shocking that a nurse could lie to the RN to get the drugs, and take them ON HER SHIFT, clearly putting pts in real harms way and she just got put into PEER, and this other nurse has not had a single instance r/t drug/ETOH use/abuse as a nurse, or even in the couple years leading up to her licensure and she actually got a suspension with a big fine.
Do you think it was because she was an RN and the second was an LPN? It just seemed like the rulings were completely arbitrary and so unequal I was honestly really disappointed because I expected the board to be tough, and after the first case I thought "wow, they really are tough" but I expected them to be tough on everybody. It seemed like if you tried to make a case, your penalty was very harsh, but if you just worked out a deal, you got off easier. Some people seemed to get off with a slap on the wrist, and others more harsh, but they were all lighter than the cases that were fought by the nurses. But what if you actually feel the charges by the BON are unfounded? You just take a deal anyway?
Many of these folks are just politicians and bureaucrats, so why would you expect logic or consistency?
When applying for my endorsement in a second state (had my RN from my primary state of residence and practice) my license was held up for weeks because of a 26 year old DUI arrest, which I duly disclosed on the application. Same disclosure I included to my original state of licensure, which had no problem, my record being clean for the quarter century since then
The board "investigator," who would never return phone calls, wanted documents from the municipality that no longer existed, as well as my driving record for 26 years since. Many years of those records no longer existed either.
I asked what about if the arrest had happened 10 years ago, would I have to supply 26 years of driving records, since I could lie as easily about things that happened before as well as after. No cogent response, to my complete lack of surprise.
I ended up hiring a lawyer to move the BON off its fat you know what.
There are BONs that do a good job, I'm sure, but they are first and foremost bureaucracies, and their overriding goal, as Weber noted, is the propagation and expansion of itself.
I do find that a bit unfair. For cryin't out loud, the DUI happened two years ago.
Lacie, BSN, RN
Excellent reason to have your own Liability Insurance. Those lawyers cost $ and most people are already suspended by thier jobs or on hold by the BON therefore no income no $ to pay the attorney. I couldnt afford the $2500.00 retainer fee and this was in 1989! Imagine what they want now. I had 4 month suspension and 2 years probation not to mention a $500.00 civil penalty fee. Additional ceu requirements and quarterly drug testing. For what you may ask?
As the only RN in a Burn ICU on nights, I brought a patient thier "MYLANTA". When the patient in the next cubicle pulled his trach out, I set the Mylanta down on the bedside table and asked the tech if she would be sure Mr. So So took his mylanta so I could tend to the other patient. lol, they turned me into the BON for this!!!! Here it is 20 years down the road and I still have to explain this little mark on my license everytime I go to an interview! Yep it's very unfair and why I preach and preach to my new nurses "Get and keep liabilty insurance and never allow it to lapse". If I had it back then I could have had that attorney at my side.
Play the game the way TPTB want and you do ok, stand up for yourself and you get slammed. Same thing happens at work, no reason to expect anything different here.
Daytonite, BSN, RN
I think you are being much harsher than the BON. In the first case you have a known user of alcohol who had a DUI on her public record. She was given rules to follow and didn't. So, she has consequences for that. Alcoholics are manipulators and will lie and twist the truth to suit their own purposes. When they drink they get forgetful. Maybe that is why she forgot to phone in and not the reason she gave. Now, none of us knows if this nurse is an alcoholic or not, but she was convicted of a DUI so why should the BON believe she isn't? You want to make it a case of bias because she was an RN? She broke the law by driving drunk and endangering people's lives! How do any of us know she doesn't still have an alcohol problem even if she is pregnant?
The second person had no criminal record and this was the first time she was found taking a narcotic substance and abusing it herself. BONs have recognized for some time that before they turn these people over to the authorities for civil punishment that because we are exposed to these drugs we have a responsibility as peers to first attempt to help them if the nurse is willing to cooperate.
None of this was arbitrary. They are sentencing guidelines laid down and followed by the BON in case after case. Judges do the same things in civil and criminal law. Believe me, the first time you make an error and get written up for something you do wrong as an RN on the job, and it will happen because no one is perfect, you will be glad someone doesn't throw the book at you and fire you for it.
I was wondering, is it required that if a nurse is let go because they abused a patient that management has to report that nurse to the BON? I worked with a nurse who was verbally abusive and very rough with a patient, she was reported to management and her contract was cancelled. She wasn't reported though, so I'm curious if it is mandatory.
Valerie Salva, BSN, RN
I think the RN with the DUI was treated fairly. I think that the LPN who lied to get Demerol then used on the job was let off with a slap on the wrist.
From the cases I am aware of, I do think BONs deal with RNs more harshly.
The ruling on case 1 seems a little harsh. But in reality life is harsh like that and you can miss the mark by just one small thing. e.g., You can fail an exam by one point (or less). It is possible to go into default on a loan by paying ten minutes too late. So that's life and the RN has to accept that and be more diligent going forward if she wants to keep her license.
IMO case 2 sounds like a slap on the wrist. Stealing drugs and using on the job is a big deal from the patients' point of view. I'm surprised at how many nurses don't seem to get this. There's a small chance that peer assistance might ensure that she doesn't do it again but we all know this is not likely (how many people are able to give up addictions because of a little on the job peer counseling??). It sounds to me like the system may actually be encouraging the behavior since it has little interest in nipping it in the bud.
don't think it should be any of the bons business if you got a dui or any other crimes that is not related or affects your work as a nurse.
I have really mixed feelings about the first case. I can certainly see the side that addicts tend to be manipulative etc, but it still seems really harsh.
I have no doubt about the second case - abusing drugs while on duty, regardless of the source, is not okay. Stealing drugs from work, even if they weren't actually diverted from a patient, is also significant.
I'm also surprised that the RN who gave the LPN the narcotic did so without seeing the order. Man, that's just asking for trouble,
VICEDRN, BSN, RN
Thank you for sharing your experiences with me. I learned a lot.
I do agree with BOTH decisions. In Case #1, the BON had established boundaries with the nurse and then she broke them. (albeit with seemingly no bad intent) The punishment fit both her circumstances and the consequences of non-compliance.
The second nurse is just now entering the "system." She is getting a good opportunity to get help. I will pray for her that she finds the help she needs.
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