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Found 8 results

  1. I received an email from the BON compliance officer about wanting me to participate in an investigation. When I spoke with them, they stated it was about a med error for suboxone many months prior that 15 other nurses at the facility made. They stated it was minor and wouldn't result in suspension or loss of license, just disciplinary action at the very most. I told them I was concerned and may seek legal counsel. They continued to state that it was minor and they just wanted to get my take on the situation regarding safe medication administration. They want to schedule a time to interview. Do I accept the interview or consult an attorney? Should I speak to my unit first? Nobody has written me up or informed me of any med error regarding this. I also have not heard of our entire unit being under investigation, either. I have only been a nurse for 3 years and have never had this happen. My state nursing board has a reputation for being notoriously aggressive. What's the best way to proceed?
  2. So about a month ago I came here looking for advice about being suspended for a co-sign waste discrepancy. I just got an email from HR saying they need to meet with me this is the email i copied the email... “As you were informed by your manager, ***** **** on Date deleted..., HR, Management and Pharmacy are conducting an investigation into your medication handling and administration practices. We need to meet with you in connection with the investigation. Please contact me at your earliest convenience. Failure to contact me or otherwise cooperate with the investigation will result in the termination of your employment. If you’re employment is terminated, we will be obligated to report you to the State of Michigan Licensing Bureau.” this happened a month ago, I’m contingent so I started looking for work right away. I secured a job. I feel like this is a trap and I was under the impression they are required to the state anyways. I talked to a lawyer when this all went down and he said, hospitals usually don’t let lawyers attend internal meetings. any advice would be great appreciated
  3. Dear Nurse Beth, I hope your day is going well. My dilemma is as follows: I am to apply to a nursing program in the state of Georgia on May 1st of this year. I was arrested on January 8th of this year for first time DUI also in Georgia. I currently have a DUI attorney looking into my case. He says that I could put that I have not been convicted of any Misdemeanors or Felonies on my application. I do NOT have any prior record whatsoever. Do you think this is a good idea? Also, if I do indeed end up being convicted AFTER I got accepted (if I got accepted), could this be an issue? Thank you for your time and have a wonderful day! Dear Georgia, I'm sorry to hear this. A DUI can affect your ability to get into nursing school, your ability to take the NCLEX, and your employment. The good news is you have an attorney- that would have been my first piece of advice. The biggest problem for you is the timing and uncertainty. A DUI from your past does not carry as much weight as a recent DUI. Proof of recovery and rehabilitation takes time. Misdemeanors are far less damaging than felonies, and you don't know the outcome yet. Hopefully, your BAC will lend more towards a misdemeanor, and you have no priors. It is very important to answer the questions on your nursing school application exactly as asked. But you see the problem- you could technically and truthfully answer "No" to "Do you have any convictions?" full well knowing that you have a pending conviction. So you could take the technical truth road, and not disclose. Or you could pre-emptively address the situation. I would be inclined to talk to the school, find out how a DUI affects your nursing school application, and go from there. Keep in mind that even if you get into nursing school you will still have to apply for eligibility to take the NCLEX. Unlike nursing schools and employers, the BON conducts an FBI level background check. Even expunged records are revealed, so never conceal an expungement to the BON. Here's some advice for writing a letter of explanation to the BON when the time comes. Best wishes, Nurse Beth
  4. Kastiara

    Putting in orders without an order.

    Do you ever or have you ever put in orders without actually getting an order from the doctor? The other nurses on my unit do it all the time. Lab orders, restraints, modifying medication orders, and I've seen some even put in medication orders. I can't bring myself to do it, mainly because I'm worried it will land me trouble both at work and with the BON. The other nurses say I'm too cautious.
  5. nurseinthecity11

    Recently terminated- being reported to state BON

    I was recently terminated from my position in a hospital. I was accused of making 2 errors during my care for patients. I don’t want to give too much detail, but one was forgetting to document something properly and another was related to assessment. These 2 incidences occurred within a few day of each other unfortunately and my job terminated me. I recently became pregnant and honestly was feeling a little more tired and foggy to begin with. Now I’m worried something will happen to my license. Anyone else have experience with this? None of my patients had any effects from either situations.
  6. Just over a year ago, in April of 2018, RN Carolyn Strom lost her court appeal contesting disciplinary action that was taken by her regulatory body (the Saskatchewan Registered Nurses Association “SRNA”) for a comment she posted on Facebook about the care her dying grandfather received in a hospital. Strom’s Facebook post read as follows: “My Grandfather spent a week in “Palliative Care” before he died and after hearing about his and my family’s experience there (@ St. Joseph’s Health Facility in Macklin, SK) it is evident that Not Everyone is “up to speed” on how to approach end of life care ... Or how to help maintain an Ageing Senior’s Dignity (among other things!) So ... I challenge the people involved in decision making with that facility, to please get All Your Staff a refresher on the topic AND More. Don’t get me wrong, “some” people have provided excellent care so I thank you so very much for YOUR efforts, but to those who made Grandpa’s last years less than desirable, Please Do Better Next Time! My Grandmother has chosen to stay in your facility, so here is your chance to treat her “like you would want your own family member to be treated”. That’s All I Ask! And a caution to anyone that has loved ones at the facility mentioned above: keep an eye on things and report anything you Do Not Like! That’s the only way to get some things to change. (I’m glad the column reference below surfaced, because it has given me a way to segway into this topic.) The fact that I have to ask people, who work in health care, to take a step back and be more compassionate, saddens me more than you know” While Strom was not employed by the facility and was, in fact, not practicing nursing at all (she was on maternity leave), the nurses at the care facility took notice to these comments and filed a formal complaint against Strom with the SRNA. The SRNA launched an investigation and found Strom guilty of professional misconduct, namely that Strom engaged in “conduct that is contrary to the best interests of the public or nurses or tends to harm the standing of the profession of nursing” and “not following the proper channels”. Strom appealed this decision to the Court of Queen’s Bench for Saskatchewan where Currie, J. upheld the administrative decision of the SRNA. In his judgement, Currie, J. holds that the judgement by the SRNA was “reasonable” and ordered Strom to pay the costs of the investigation, as well as a disciplinary penalty totaling $26,000 CAD. It is likely that Strom will appeal this decision; however, as it stands now, this rests as valid case law and sets a precedent for nurses to be charged and disciplined for “off-duty” misconducts. Removing our Constitutional Rights to Freedom of Speech The precedent set in this case permits a regulatory body (such as a BON) to limit one’s constitutional right to freedom of expression. In his judgement, Currie, J. acknowledges that this was a breach of Strom’s constitutional rights to freedom of expression, but holds that, so long as a regulatory body “proportionately balanced the right to freedom of expression with the objectives of the [Nursing Act], in the context of Ms. Strom’s circumstances”, it is acceptable to limit freedom of expression. Currie, J. goes on to state that “The [SRNA’s] balancing of the rights and objectives is not required to be correct. It is required to be reasonable.” So what makes it reasonable? Currie, J. holds that the decision was reasonable because Ms. Strom was granted other avenues of expression, namely, she was able to report the nurses providing inadequate care to the SRNA or the hospital administration. This is in fact what is recommended in the code put forth by the SRNA. Omitting Pivotal Case Law While Currie, J. holds that Ms. Strom was able to express herself in other avenues, he ignores holdings from previous case law where the form of expression (or the avenue chosen for expression) can only be limited if the location or method of expression removes the protection of freedom of expression (see: Montréal (City) v. 2952-1366 Québec Inc., [2005] 3 S.C.R. 141;). While Currie, J. and the SRNA holds that Ms. Strom should have followed the methods outlined in the Code, Currie, J. and the SRNA did not apply the test as outlined in the case of Montreal v 2952-1366, where the method or location of expression can only be limited if it conflicts with one of the three values of freedom of expression (i.e. Self-fulfillment, truth-finding and/or democratic discourse). Currie, J. and the SRNA omitting this vital aspect of freedom of expression analysis has paved the way for bad precedent. Therefore, Currie, J. did not address whether the SRNA could in fact limit one's freedom of expression by law, as this step of the analysis was overlooked. Implications We now have this precedent standing that will for sure give a carte blanche to regulatory bodies to arbitrarily discipline their members for expressing anything that the regulatory body opposes. This will only hamper the ability of professionals (the ones arguably best suited to advocate for change in a system they are fluent in) to advocate for change and to speak out against bad public policy and other ill-doings, for risk of being reprimanded by their regulatory bodies.
  7. A criminal history does not mean that you cannot become a nurse, but it may mean extra work and extra expenses. If you have a previous offense, maybe you, like Ashley, must now write a letter of explanation regarding your offense or DUI to the BON. Your Letter of Explanation is highly important. It determines your future. You will be judged as to your level of remorse, insight, and personal responsibility for the incident. It must be genuine, concise and honest. STEP 1 Factual Start with the incident. State what happened simply, factually and chronologically. Do not offer excuses or cast blame, but do include underlying circumstances. It's in your favor to describe the conditions in your life that affected your decisions and behavior at the time. Most bad choices don't come out of nowhere, and the people who will be reading your letter understand that. It's important to convey that you are not making excuses for your behavior. You are simply describing the circumstances that contributed to your choices. STEP 2 Personal Insight Perhaps the most important and the key to success is showing insight into your own behavior. Everyone makes mistakes...but have you learned from your mistakes? Tell the BON exactly what you've learned about yourself, and how your values have changed. Maybe you were impulsive and immature at the time, but now you value long-term gratification over instant gratification. STEP 3 Rehabilitative lifestyle changes Show the BON without a doubt that you have taken responsibility. What have you changed in your life to ensure that this behavior would not happen in the future? List everything you've done to prevent future occurrences. Did you receive counseling, attend a recovery program, do community work? Include compliance with terms of probation, restitution, or parole. You may live in a different location with positive influences now, or maybe you've joined or even lead support groups. Show that you are not the same person who committed the offense. You have different friends and you make good choices. STEP 4 Show remorse You are genuinely sorry for what you did. You now understand that you could have harmed yourself, or other people. You can't change the past, but you can control your future behavior. You have grown from this and regret the choices you made in the past. You are remorseful. STEP 5 Enlist help It's best to get help from someone to write this, unless you are very confident in your writing skills. At the very least, have your letter proofed for grammar and spelling by 3 separate individuals who will be honest with you. Some applicants find it helpful to retain a lawyer during the process, to ensure that the licensing process goes smoothly. This can be expensive, and not all attorneys accept payments over time. Start saving for legal expenses in advance if you anticipate a problem,. STEP 6 Letters of Reference Letters of reference should be on official letterhead from employers, nursing instructors, health professionals, professional counselors, parole or probation officers, or other individuals in positions of authority who are knowledgeable about your rehabilitation efforts. They must be signed and dated within the past year. What to expect You may face probation, a conditional license with probation terms, a fine, or citation. If your DUI was a fairly low BAC, you may only face a letter of reprimand or a citation and fine. Do not ignore any mail from the BON or Attorney General's office. Make sure your current address is on file at all times. Your failure to respond to the Statement of Issues will result in the denial of your license application by a default process. Cases are decided on an individual basis, and may take some time. Be patient and persevere.
  8. travelNP

    Nurse Practitioner Restrictions

    I decided to become an ARNP because I knew it would be an empowering career. Although the work of an ARNP and Physician is similar, there are many differences. Physicians tend to use a scientific approach when addressing their patients, due to their rigorous science-based education. ARNPs approach the patient holistically. When I diagnose a patient with Diabetes Mellitus Type 2, I explain what this disorder is and the causes; I explain the treatment plan; I discuss nutrition and physical activity changes; I assess the patients comfort level with their treatment; I encourage the patient to discuss their feelings upon finding out they have this new chronic disorder; and I reassess the patient within a 2-4 week timeline. I am interested in making sure the patient understands their disorder and how they can manage it. Unfortunately, in Florida there are some limitations on the ARNP that allows physicians to have more power. For example, Physicians can order home health treatment,controlled substances, and open their own practices without having a supervisory protocol. It is frustrating that Florida is one of the few states that has such strong limitations on ARNP scope of practice. For example, ARNPs cannot order durable medical equipment for Medicare patients in Florida. This means I cannot order a low back brace for my patient with chronic low back pain; I cannot order diabetic shoes for my patient with DM Type 2; I cannot order a cane for my patient with Parkinson's. Moreover, ARNPs cannot prescribe controlled substances, including benzodiazepines that so many of my patients take for their anxiety or insomnia. Currently, I write out the prescription and my supervisory physician will sign the prescription. The only people suffering are my patients because this delays access to their medications. Recently,Tramadol was added to the controlled substance list. I had previously prescribed this medication frequently for my patients with chronic low backpain and severe osteoarthritis. I was not thrilled the day I received a phone call from the pharmacist telling me that tramadol was effectively now a controlled substance. In addition, ARNPs cannot order home health treatment. This does not make sense to me since I am the primary care provider for many patients and oversee their medical care. So if I have a patient with history of a stroke and hemiparesis, I believe I should be able to order home health physical therapy for them. If I have a patient with dementia and uncontrolled hypertension, I believe I should be able to order home health blood pressuremonitoring for them. Lastly, I do not like that ARNPs have to have a protocol with a supervising physician. It's as if the physician defines our scope of practice and not the state board of nursing. If I wanted to open up my own practice, I would need a physician to be the medical director. This means I would have to waste a few thousand dollars a month just to pay the physician for having their name on the wall of my clinic. I would be seeing the patients, overseeing the clinic, and reviewing charts, but would still have to pay my supervising physician to do nothing except 'supervise me'. I am hoping with the Affordable Care Act and the abundance of new people seeking primary health care, that Florida will increase the scope of ARNPs. Working with the ANA, FNA, and other nursing organizations, I plan to fight for these rights. I see myself having my own practice where I see a variety of illnesses and ages. I hope that the care provided will not be based as much on cost as it is today. We already know ARNPs will be a forefront to help with the primary care shortage.

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