Alcohol Prohibitions – Be Aware of the Things You Eat and Drink As Well As the Products You Use and the Medications You Take

In alcohol impairment cases before the Ohio Board Of Nursing resulting in Consent Agreements, the Alternative Program, Board Orders, or otherwise requiring nurses to undergo screening for alcohol, nurses are typically required (among other things) to abstain completely from the use of alcohol or any products containing alcohol.

It is critically important to avoid beverages, foods, hygienic and beauty products, household products, over the counter medications, and prescription medications which contain alcohol.

BEVERAGES: Beverages, including but not limited to, distilled spirits, beer, ale, malt beverages, wine, and cider contain alcohol.  Additionally, beverages such as Communion Wine or beverages labeled “Non-Alcoholic” or “NA” also can contain alcohol.

FOODS: Foods prepared with cooking wine, sherry, wine vinegar, soy sauce and items containing flavoring extracts (such as vanilla extract), can contain alcohol.  Additionally, certain cooking sprays contain alcohol.

HYGENIC AND BEAUTY PRODUCTS: Certain hygienic and beauty products can contain alcohol, including but not limited to certain:

Perfumes, colognes, and after shaves

Lotions and balms

Body sprays and mists

Makeup removers

Hand sanitizers

Antiperspirants

Deodorants

Mouthwashes

Hair Products

Cosmetics

HOUSEHOLD PRODUCTS: Certain household products can contain alcohol, including but not limited to certain:

Antibacterial products including antibacterial gel, dishwashing liquid and hand soap

Cleaners

Detergents

Dishwashing liquids

Air fresheners

Insect repellents

Disinfectant sprays

Sanitizing wipes

Liquid bandages

OVER THE COUNTER MEDICATIONS: Certain over the counter medications can contain alcohol, including but not limited to certain:

Cough suppressants

Expectorants

Nasal decongestants

Oral antiseptics

Anti-asthmatics

Antihistamines

Bronchodilators

Decongestants

Mouthwashes and gargles

Laxatives

Analgesics

Supplement

Vitamins

Anti-diarrheas

PRESCRIPTION MEDICATIONS: Certain prescription medications, including but not limited to certain asthma inhalers, contain alcohol or ethanol.

CONSULT YOUR PHYSICIAN: If you are unsure whether a particular food, beverage, product, or medication contains alcohol, read the label and consult your physician prior to eating, drinking, using, or taking it.

This article provides general guidance and is not a substitute for the advice of your physician.

As always, if you have any questions about the Ohio Board of Nursing or this post, please feel free to call one of the attorneys at Collis, Smiles and Collis at 614-486-3909 or check out our website at http://www.collislaw.com.

Ohio Nursing Board Investigations of Nurses during Inpatient or Intensive Outpatient Treatment

Tackling addiction to drugs or alcohol is a difficult decision to make and a lifelong challenge to maintain. It is important that you make this decision without jeopardizing your professional license.

Frequently, a nurse will enter a drug or alcohol rehabilitation program due to employer discipline or termination from employment. In certain instances, both the Nursing Board and law enforcement will be notified about the employment action.

Because of its responsibility for patient safety, the Nursing Board can and should take these situations very seriously. Nursing Board investigators frequently contact nurses who are participating in intensive rehabilitation programs to question them about their addiction and employment issues. As part of the investigatory process, nurses are often requested to place their license on inactive status as a “sign of cooperation with the Board investigation” or as a “good faith commitment to their sobriety”.

There are certain times when going on inactive status is the right choice. It allows the nurse time to obtain treatment and often provides more time for the Nursing Board investigation, which gives the nurse more time to strengthen his or her sobriety. In certain instances, a nurse can also be given credit by the Nursing Board for the period of time during which the nurse was on inactive status towards any period of license suspension imposed by the Nursing Board in a disciplinary action.

However, prior to making the decision to go on inactive status, a nurse should make sure they are in the correct mental or emotional state.  Going on inactive status is a very serious decision.  When a nurse is in treatment, quality of thought may not be at its best and, as with other important family or career matters, it is often not the best time to be making serious, long lasting decisions. A nurse should also be aware that the Nursing Board can impose significant requirements on a nurse in order to have a license reinstated, including but not limited to undergoing evaluation and/or treatment for drugs or alcohol or psychological condition, successfully completing negative urinalysis for a period of time determined by the Board, completing additional continuing education, and/or completing a practice improvement plan. Each situation is different and will be handled on a case by case basis by the Nursing Board.

Once the intensive portion of the treatment program is completed, there will be time to decide whether to communicate with a Nursing Board investigator and/or whether to voluntarily do anything regarding the status of your license. Such decisions should be made with a clear mind and after a careful consideration of the facts in your case. The recommendations of experienced nursing license defense legal counsel can be of assistance.

As always, if you have any questions about the Ohio Board of Nursing or this post, please feel free to call one of the attorneys at Collis, Smiles and Collis at 614-486-3909 or check out our website at http://www.collislaw.com.

Nursing license suspension can result from a conviction

Under the Ohio Nurse Practice Act, R.C. 4723, the Ohio Board of Nursing can take an action against a nurse for criminal convictions, even if they are NOT related to the practice of nursing.

R.C. 4723.28 (B)(3) allows the Nursing Board to take an action against a nurse who has been convicted of a misdemeanor in the course of practice. This seems obvious. However, under R.C. 4723.28(B)(4) the Nursing Board may take a disciplinary action against a nurse who has been convicted of any felony or a “crime involving gross immorality or moral turpitude.” So even crimes that are not related to the practice of nursing can result in a sanction on your nursing license.

Crimes involving gross immorality or moral turpitude are generally defined as crimes of violence or that “shock the conscience.” Crimes such as for assault or child neglect, easily come to mind as crimes that would involve “gross immorality”. However, crimes involving financial dealings (passing bad checks, bank fraud, tax evasion) have also been found to meet this standard.

The Nursing Board also has the authority to take a disciplinary action against a nurse if they do not have a conviction, but are otherwise permitted to enter into a pre-trial diversion program or are found judicially eligible for a treatment in lieu of conviction program. So, even when they don’t have a formal conviction, the Nursing Board is still authorized to take a disciplinary action against the nurse.

The Nursing Board meets six times per year at monthly meetings where it decides, after an investigation, if a disciplinary action should be taken against a nurse. The Nursing Board met last week and sent letters to over eighty (80) Ohio licensed nurses proposing to take a disciplinary action against them. For many of these nurses, the Board is proposing to discipline them for criminal convictions.

If the Board chooses to discipline a nurse, the nurse will be sent a Notice and given a right to a hearing. It is important that the nurse respond to this Notice in a timely fashion to request a hearing. The Board handles each case on an individual basis and the sanction it chooses to impose on a nurse is often dependent on the information the Nursing Board learns from the nurse or their legal counsel.

As always, if you have any questions about the Ohio Board of Nursing or this post, please feel free to call one of the attorneys at Collis, Smiles and Collis at 614-486-3909 or check out our website at http://www.collislaw.com.

Do you have a prescription for that?

In most nursing positions, nurses are subjected to random, unannounced drug screens by their employer. Usually nurses are prepared to provide a drug test as a pre-condition for employment. However, once nurses have been working in a location for a while, they forget that employers may ask them to submit to a drug screen for cause (ie. if there are missing medications), when they are moved to a new unit, or just on a random basis.

If the drug test is positive for an illegal drug, the nurse may face suspension or termination from their job and the positive test result will also be reported to the Ohio Board of Nursing. However, often nurses test positive for prescription medications. If the nurse is able to provide their employer with a copy of a prescription showing that they have been prescribed the medication by their doctor, then it is not a problem. But, in many cases, nurses do not have prescriptions for medications they have taken. On occasion, nurses will take their friends’, spouse’s or kids’ medications, resulting in a positive drug screen.

Testing positive on a drug screen for a medications which has not been  prescribed,  may result in negative ramifications with your employment and your nursing license. The Ohio Board of Nursing regularly takes disciplinary actions against nurses who test positive for prescription medications, which have not been prescribed to them.

I recently spoke to a nurse who told me that her doctor told her to keep any old narcotic medications in her cabinet in case she or another family member might need the medication. This is improper advise. Medications can only be taken by the person who has been prescribed the medication. You can’t just keep a “stash” of prescription medications in your cabinet to be used by anyone who has access to the cabinet.

If you have left over medications, follow appropriate disposal procedures to discard the medication. Do not store unused narcotic medications in an unsecure location where other family members (including teenagers) may have access to the drugs.

Finally for nurses, if you have not been prescribed a medication, you should not ingest it as it may lead to a positive drug screen that may jeopardize your employment and license to practice as a nurse in Ohio.

As always, if you have any questions about this post or the Ohio Board of Nursing in general, please feel to check out my website www.collislaw.com or email me at beth@collislaw.com or call me at (614) 486-3909.

Nurses, if you drink this holiday weekend … take a cab home.

At the start of this holiday weekend, I wanted to reach out to Ohio medical professionals and remind them that their behavior is of concern to the Ohio Board of Nursing whether at work or at home. If you venture out this weekend to an end of summer holiday party and knock back a few beers or a couple of jello shots, take a cab home.

Each year, dozens (if not hundreds) of nurses receive alcohol related traffic violations. DUIs, OVIs, reckless operation charges, and any alcohol related misdemeanor may lead to discipline taken by the Ohio Board of Nursing against your nursing license. You don’t have to be “drunk at work” or fail a breathalyzer test on the way to work for the Nursing Board to be concerned about your ability to practice safely as a nurse in Ohio. Alcohol related traffic violations can lead to your nursing license being placed on probation and may subject you to random drug screens and Nursing Board monitoring for lengthy periods of time. The severity of the charges may also lead to suspension of your Nursing license.

I have written about this issue in the past. See my June 11 post about the requirement to disclose alcohol related convictions on your renewal application; my May 25 post about not being able to consume alcohol in ANY form if you are being monitored by the Board, and my April 30 post featuring the top three reasons the Nursing Board takes disciplinary action against a nurse (alcohol and drug usage being one of the top three reasons for Board discipline).

If you are going to “party” this weekend, be smart about it. Don’t get behind the wheel of the car if you have been drinking. Don’t risk your professional license.Take a cab home.

If you have any questions about this post or the Ohio Board of Nursing in general, please feel free to contact me at (614) 486-3909 or email me at beth@collislaw.com.

What part of NO ALCOHOL don’t you understand?

Nurses who suffer from substance abuse or substance addiction and who are monitored by the Ohio Board of Nursing in either the confidential Alternative Program for Chemically Dependent Nurses Program or pursuant to a Consent Agreement or other public disciplinary action, are typically required to submit to random (often observed) toxicology drug screens. The screens will detect not only alcohol content in the body but can even detect the metabolites of alcohol (evidence that the body is processing or breaking down alcohol). The tests are very sensitive virtually any consumption or exposure to alcohol  in the 3-4 days proceeding such consumption or exposure will be detected.

Prior to initiating the screening process, nurses are advised that they may not consume any alcohol or any substances that may contain alcohol. They are clearly warned to not consume any alcohol, including: beer, wine, liquor, “non-alcoholic” beers and cooking wines. They are also warned to stay away from topical ointments that may contain alcohol and to stay away from cleaning products or aerosols that may contain alcohol. Nurses are usually surprised to learn that many cleaning products contain alcohol and they do not realize that hand sanitizers (the same kinds routinely used in hospitals, nursing homes, schools, etc.), aftershave, air fresheners (Febreze), contain some amount of alcohol.

Despite this requirement, nurses routinely test positive for alcohol or for the metabolites of alcohol in their system (positive ETG test).   Ethyl Glucuronide (ETG) is a direct metabolite of alcoholic beverages (ethanol).  Its presence in urine may be used to detect recent alcohol consumption, even after ethanol is no longer measurable.  The presence of ETG in urine is a definitive indicator that alcohol was ingested.

When questioned, many will initially deny use. Then, they will try to argue that they used a hand sanitizer or over the counter medications, which may have resulted in a positive alcohol or ETG drug screen.

However, while the tests (specifically the ETG test) are very sensitive and can detect consumed alcohol, the cut off for the screening is above the level that would test positive in an “accidental” exposure. Generally, merely cleaning your house with Lysol or spraying your couch pillows with Febreze should not result in a positive screen. However, consuming Nyquil for a cold will result in a positive screen.

As always, if you have any questions about the Ohio Board of Nursing or this post, please feel free to email me at beth@collislaw.com or call me at 614-496-3909.

What the Nursing Board really cares about ..addiction, lies and convictions

I had the opportunity to speak to a nursing school last week about the role of Ohio Board of Nursing. In preparing for the talk, I knew I would be asked “What is going to get me in trouble with the Nursing Board?”.  I have a pretty good idea of the types of actions that I regularly see investigated by the Board, but I also did a little research and reviewed the last few months’ list of disciplinary actions or proposed actions so I would be ready for this question.

I found, generally, the Nursing Board receives 3000 complaints each year. While the Board investigates all complaints, they only take action against approximately 600 nurses each year.

Half of the nurses disciplined or monitored by the Nursing Board involve cases of nurses who suffer from drug or alcohol abuse or dependency. (see my former post The Alternative Program for Chemically Dependent Nurses)   Many nurses voluntarily seek treatment and then are entitled to participation in the Board’s confidential monitoring program.

But, some nurses find themselves the subject of Board discipline after being found guilty of a DUI, or testing positive on a drug screen through their employer. Last month, the Nursing Board cited several nurses who tested positive at work for illegal street drugs or for medications for which they could not produce a valid prescription (ie. they had been given a prescription drug from a friend or family member)

In addition to actions against nurses who suffer from substance abuse, the Board also takes actions against nurses who have felony convictions and misdemeanors involving moral turpitude.  The Nursing Board recently cited nurses who had been charged with numerous crimes including: child endangering; Medicaid fraud; transporting or possessing a semi-automatic handgun; stealing narcotics; misdemeanor assault; illegal processing of drug documents; theft by deception, just to name a few.

The Board also takes action against nurses who have been disciplined by other state agencies (other state Nursing Boards) and they take actions against nurses for practicing outside of the scope of their license or for failing to disclose to the Board a disciplinary action or conviction from another agency or district (lies).

Most nurses are surprised to learn that the Nursing Board is genuinely concerned about conduct both at work and also outside of work. In addition to discipline related to practice, nurses can be subjected to disciplinary actions for “bad behavior” outside of the work setting. Nurses are routinely the subject of discipline by the Board for DUIs, assault, child abuse, neglect, passing a bad check and other crimes. As professionals, nurses are held to a high standard by the Board while at work and after work.

As always, if you have any questions about this post or the Ohio Board of Nursing in general, please feel free to email me at beth@collislaw.com or call me at 614-486-3909.

Ohio LPNs – time to renew your license!

This month, Ohio LPNs will be mailed instructions by the Ohio Board of Nursing on how to renew their LPN license on-line.  The Board will mail the instructions to the address that you previously provided to the Board as your address of record. If you do not timely receive the instructions, you should contact the Board immediately.

If you do not want to renew on-line, you may request to have a paper renewal form mailed to you. To be sent a paper renewal form:

  • send a written request to: Ohio Board of Nursing, 17 S. High Street, Suite 400, Columbus, Ohio 43215, attn: Renewal; or
  • fax a request to the Board at 614-466-0388, attn: Renewal;
  • or, email the Board at renewal@nursing.ohio.gov

Renewal applications received after July 1 will be assessed a $50.00 late fee. If you do not renew by August 31, the license will lapse.http://codes.ohio.gov/oac/4723-7-09

Whether you choose to renew online or to complete the paper renewal form, it is important that you take a few quiet minutes to complete the form on your own!   Allowing others to renew your license for you or not taking the time to carefully read and accurately and completely respond to the questions on the renewal can be a costly mistake.

By signing the renewal application you are certifying to the Nursing Board that all information contained in the application is correct and complete. The Nursing Board reviews all original applications for licensure and renewal applications very seriously and will take a disciplinary action against a licensee who fails to provide the Board with correct and complete information.

In addition, any questions in which you have to answer “yes” to will require you to provide a short written explanation. You should take time to provide a clear and careful response. Don’t minimize the incident or fail to take responsibility for your actions, as this could be to used as an aggravating factor if the Board chooses to impose a discipline.

The Nursing Board routinely suspends or revokes licensees who provide  a false response to a renewal question.  It is always better to provide clear, honest responses to the questions than to provide information that might be misleading or may lead to more questions by the Board.   If you do not understand a question, you may call the Nursing Board staff and ask  – however, the staff is unable to give legal advice.

As always, if you have any questions about this post or another question involving the Ohio Board of Nursing, feel free to email me at Beth@collislaw.com.

Alternative Program for Chemically Dependent Nurses

In Ohio, nurses who suffer from drug or alcohol addiction or abuse should immediately seek treatment at an authorized chemical dependency treatment facility.  However, nurses are often concerned about voluntarily seeking treatment because they do not know what effect, if any, treatment will have on their nursing license.

Fortunately, for Ohio nurses, the Ohio Board of Nursing has established the Alternative Program for Chemically Dependent Nurses.  This is a confidential program that allows eligible nurses to enter into a monitoring contract with the Nursing Board. Under the contract, the nurse is required to complete the recommendations of a treatment program, completely abstain from drugs and alcohol and submit to random drug screens generally for a period of five years.     A full outline of the program can be found at: http://codes.ohio.gov/oac/4723-6

Not all impaired nurses are eligible for the program. To be eligible, a nurse must hold a valid Ohio nursing license, submit an application for enrollment in the Board’s confidential program, submit to a chemical dependency assessment, and then follow all treatment recommendations. http://codes.ohio.gov/oac/4723-6-02 Eligible nurses may be required to place their nursing license on inactive status for six months at the beginning of treatment and they will be required to submit to random drug screens and attend weekly AA or NA meetings for five years.  This may seem like a long period of time to submit to monitoring, a chemically impaired nurse, is permitted to return to the practice of nursing while participating in the confidential program after six months of clean screens.

What can make a nurse ineligible for the program?  Nurses who are prescribed controlled substances by their physicians; who have a dual diagnosis with another medical or psychiatric condition; or who have completed drug and alcohol treatment two or more times in the past, may not be eligible for this program. http://codes.ohio.gov/oac/4723-6-02

The Alternative Program is confidential. If you are accepted, your participation will not be considered “discipline” by the Nursing Board. There will be no notation on the Board’s website that you are participating in the program and you will not be listed in the Nursing Board’s Momentum publication as a participant in this program. In addition, if you successfully complete the program, you will not be reported to the National Practitioner’s Data Bank . http://codes.ohio.gov/oac/4723-6-04

As always, if you have any questions, please feel free to email me at beth@collislaw.com or call me at 614-486-3909.

Hello Ohio Nurses!

Hi, in my practice as an attorney I exclusively represent professionals before their state licensing boards in Ohio.  As a former Ohio Assistant Attorney General, I am familiar with the disciplinary process of Boards such as the State Medical Board of Ohio, Ohio Board of Nursing, Ohio Board of Pharmacy, Ohio Chiropractic Board and many, many more licensing agencies.

I regularly help applicants apply for a professional license in Ohio or wade through the disciplinary process. I have started this blog to answer many of the common questions that I receive in my practice on a weekly basis from nurses throughout Ohio. Such as, “should I apply for a license in Ohio if I have a criminal conviction on my record?” “what will happen with my professional license if I get a DUI?” “what should I do if contacted by a board or criminal investigator?”. I hope over  the next few months to answer many of your questions.