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 Board discipline .. when to take the deal

Each year, hundreds of nurses face a possible disciplinary action by the Ohio Board of Nursing.  Sanctions can include a reprimand, probation, suspension, license limitations, and even license revocation.  In many cases, the nurse is offered a Consent Agreement, which is similar to a plea bargain in a criminal case, in which the nurse can agree to the terms of discipline.  I am often asked by my clients, “Should I accept the Consent Agreement or should I reject the offer and proceed to a Hearing?”

It is important to first note that whether the nurse enters into a Consent Agreement or proceeds to a Hearing, the Board will issue a final Order against the nurse and that the Order and the sanction imposed against the nurse is a public record which will be on the Board’s website, reported to the National Practitioner Data Bank and www.nursys.com, and published in the Nursing Board’s quarterly magazine, Momentum.

There are pros and cons to accepting a negotiated Consent Agreement.  By entering into a Consent Agreement, the nurse often has the ability to negotiate what factual information concerning the disciplinary action will be included in the Consent Agreement.  Because a disciplinary action is open and available to the public, being able to negotiate the wording of the Consent Agreement is important.  Additionally, the nurse can often negotiate WHEN the sanction will take place or when they will start the conditions for reinstatement of their license (if their license is suspended).  Also, the nurse avoids the stress, expense, and uncertainty of a Hearing.  If a nurse proceeds to a Hearing, nurse has no ability to negotiate the factual summary that is included in the Order or negotiate the sanction to be imposed. The Board has the sole discretion to issue any sanction as noted above.

However, there can be drawbacks to accepting a Consent Agreement. Consent Agreements are negotiated by only one Board member.  In negotiating a Consent Agreement, the nurse waives their right to a Hearing and often regrets not having their “day in court” to tell their “side of the story.”

In determining whether to negotiate a Consent Agreement or proceed to a Hearing, the nurse should consider all options and potential outcomes. These options and potential outcomes, as well as the nurse’s final decision, should be carefully considered, taking into account how the Board has handled similar cases in the past.  Whether through a Consent Agreement or a Hearing, the sanction that is imposed in each case depends on the individual facts and circumstances of the matter.

As always, if you have any questions related to this post or the Ohio Board of Nursing in general, please feel free to contact one of the attorneys at Collis, Smiles in Collis, LLC at 614-386-3909 or email me at beth@collislaw.com

Ohio Nurse Applicants – The NCLEX Program Is Going Paperless in 2014

The Ohio Board of Nursing recently announced that starting January 2014, the NCLEX program will transition to a paperless program. The Nursing Board’s website located at http://www.nursing.ohio.gov/index.htm provides further information regarding the transition to a paperless program. Highlights from the Nursing Board’s website announcement include:

NCLEX Examination Candidate Bulletin: The NCLEX Examination Candidate Bulletin will no longer be distributed in a hard copy version. Boards of nursing, candidates and education programs will access the Candidate Bulletin via the NCSBN website.

Eights Steps of the NCLEX: This Candidate Bulletin insert will no longer be distributed in a hard copy version. This abbreviated reference guide to NCLEX processes will be enhanced to include additional information and will also be available on the NCSBN website. The name of this document will be changed to the NCLEX Information flyer.

Candidate Bulletin At-A-Glance: Due to the enhancements of the Eight Steps of the NCLEX, as well as the continued accessibility of the Candidate Bulletin, the At-A-Glance piece will no longer be published as either an electronic or hard copy version.

Money Order, Certified Check and Cashier Check Payments: Money order, certified check and cashier check payments will no longer be accepted. Beginning Jan. 1, 2014, all candidates and third parties will be required to register and pay for exam registrations through the Pearson VUE website or over the phone (866.496.2539) with a credit card, debit card or prepaid card.

Authorization to Test (ATT) Letter: Once the board of nursing makes a candidate eligible, that candidate will receive their ATT by email. The ATT continues to serve as the candidate’s notice that they may schedule their NCLEX at a Pearson Professional Center. Beginning Jan. 1, 2014, the paper copy of the ATT letter will no longer be necessary for test admittance. To gain access to the NCLEX, candidates must present one form of acceptable identification that matches the name exactly as the candidate provided when registering. If the candidate’s ID does not match the name exactly as they registered with, the candidate will not be admitted to test and will have to reregister and pay another examination fee.

“You’ve Completed the NCLEX Examination but Still Have Questions” Brochure: This brochure is currently given to candidate’s at the test center on the day of their exam. Beginning Jan. 1, 2014, this information will be sent to a candidates email address shortly after they have completed their exam and will also be available on the NCSBN website.

For additional information see http://www.nursing.ohio.gov/index.htm

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.

It’s That Time Again (RN licensure renewal)

Has it really been two years already? Yes! It is time to renew your RN and APRN licenses!

If you renew before July 1st, the renewal fee is $65.00. If you renew between, July 1st-August 31st, the renewal fee is $115.00. After August 31st, your license is deemed lapsed and you must request, complete, and submit a Reinstatement Application from the Board.

Many RNs who submit their renewal application before the final deadline are concerned that their license will not be renewed before August 31st and that they will not be able to work. This is not the case. As long as you renew your license prior to August 31 the Nursing Board will renew your license and will not allow your license to lapse.

Many Nurses are also concerned that their license will not be renewed by the Board in a timely manner if they answer “Yes” to any of the compliance questions on the renewal application. However, a “Yes” response to any of the questions on the renewal application will not prevent the Nursing Board from timely renewing your nursing license. It is imperative that you answer all renewal questions honestly and accurately. Providing the Board with false information my lead to the Board taking a disciplinary action against you.

However, all renewal applications that include YES responses to questions related to your conduct since the last renewal (such as convictions, DUI, etc) will result on your license being sent to the Compliance Unit of the Nursing Board for further review and investigation. Then, even if your license is renewed, this does not mean that the Nursing Board has closed the investigation.

If the Board chooses to open an investigation based on any of your affirmative responses on the renewal application, you may be notified by a Board investigator by phone or mail to provide further information or documentation to the Board.

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

Yes, you can find a nursing job even if you have been disciplined by the Nursing Board

Each year, hundreds of nurses in Ohio face discipline to their nursing license based on a variety of circumstances ranging from violations of the Nurse Practice Act (R.C. 4734) to being found guilty of a criminal offense (such as a DUI) or for being diagnosed with drug or alcohol abuse or addiction. Often nurses face a temporary suspension of their license or are required to submit to random drug screens or other probationary monitoring terms once their nursing license is reinstated during a probationary period.

Under the Ohio public records law, an Order of the Nursing Board or a Consent Agreement that is negotiated between the nurse and the Nursing Board is a matter of public record. The sanction is noted on the Nursing Board website and the actual Order or Consent Agreement is often loaded on the Nursing Board website for anyone to download and read.

Based on the public nature of Nursing Board disciplinary actions, I am often asked “Will I ever find a job as a nurse in Ohio if I have a disciplinary action against my license?” In general, the answer is “Yes!”

Over the past fifteen years, I have represented hundreds of nurses before the Nursing Board. Based on my experience, even nurses who have received treatment for drug or alcohol abuse or who have been found to have violated the Ohio Nurse Practice Act, which has resulted in suspensions of their licenses, eventually can find employment in the field of nursing once their license has been reinstated. However, it is important to note that securing employment can be more difficult for a nurse who has a limited or restricted license.

I typically find that nurses who are honest with employers and clearly and accurately explain the basis for their disciplinary action, as well as the steps that they have taken to remediate the situation have the best chance of finding employment as a nurse. Employers are generally willing to give disciplined nurses a chance at employment if they believe that the nurse has remedied their situation, that they have taken responsibility for their actions, and that they are honest about their conduct.

To prepare to discuss a Board disciplinary matter with an employer, I always advise clients to prepare a “one minute elevator speech” in which the nurse discloses and addresses the disciplinary action taken. I have found that employers do not like to be blindsided about a disciplinary action after they have already employed an individual or to learn of a disciplinary action in a background check. It’s best to head off any questions that an employer might have about your past and tell them yourself up front.

This blog is intended as general guidance and may not fit your particular situation. As always, if you have any questions about this post or about the Ohio Board of Nursing in general, please email me at Beth@collislaw.com or call me at (614) 486-3909.

Three Days in the ICU

Last week I was not in my office. I flew to the west coast to be with a relative who had been taken to the hospital.  When I arrived, I found the relative had been taken to the ICU at their local small community hospital. For the next three days and nights, I stayed with the relative in the hospital.  What I found was really quite amazing.

I was raised in a family of medical professionals and I have spent the better part of twenty years representing medical professionals before their professional licensure boards. I have been to the hospital before, for simple trips to the ER for stitches or a simple fracture. I also spent two nights in the hospital after the births of my children. Nothing in my past prepared me for the time I spent with my relative in the ICU.

I was thoroughly amazed at the level of care that was provided to my relative. I had always known that nurses provided the bulk of the care to patients, but to see it first hand was awe-inspiring. While it was a small hospital, all records were maintained electronically and all medications dispensed were logged into the record. However, since my relative did not have a local physician, they were cared for by the in-house “hospitalists”. Specialists were called in throughout our time at the hospital to evaluate various aspects of the patient’s care, however, it was the nursing staff who provided the constant care to the patient, advocated for the patient, and updated the physicians of the patient’s current medical condition.

Given the fact that the patient did not have an internist who coordinated care, they saw a different hospitalist at each shift. Over the three days that the patient was in the ICU and the other days that they were on a med/surgical floor, they never once saw the same hospitalist. However, the nursing staff provided the continuous care and continuity of treatment to the patient by updating each hospitalist who examined the patient and each specialist as to the patient’s medical history, demeanor and current medical condition. It was a great relief that I did not have to continue to update each physician as to the patient’s condition since they had been prepped daily by the nursing staff.

As a nurse, never under-estimate the superior service and value that you provide to patients and to their families.  To the nursing community at large, this blog post is a huge “thank you” to your service to the community.

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

Who makes decisions at the Ohio Board of Nursing?

It’s Board week at the Ohio Board of Nursing. This means that Board members from around the state will meet at the Board offices in Columbus on Thursday, September 20 and Friday, September 21, 2012 to review the official business and make decisions regarding such matters as the implementation or change to a Board rule, granting licenses to nurse applicants, closing or continuing investigations, issuing citation letters to nurses, and ruling on final disciplinary matters against nurses. Ohio Revised Code §4723.06.

The Nursing Board is governed by the Nurse Practice Act, which outlines the powers and duties of the Board members. R.C.§4723. The Board is composed of thirteen Board members: eight are licensed RNs, 4 are licensed LPNs and one is a public member. Board members are not compensated but are reimbursed for their expenses. Board Members are appointed by the Governor and serve four-year terms. O.R.C. §4723.02.

Under the Board’s rules, the Board is only required to meet as often as necessary to carry out its duties. O.A.C. 4723-1-01(D). The Ohio Nursing Board has six regularly scheduled meetings each year. Meetings are typically held the third week in January, March, May, July, September and November.

While the Board members make all final decisions, the daily operations of the Board is managed by an Executive Director, who is also an RN. The Board also has a bevy of attorneys, investigators, licensure specialists, and support personnel that work at the Board office on a daily basis and carry out the daily operations of the Board. In addition, any disciplinary matter that proceeds to an administrative hearing, is prosecuted by an Ohio Assistant Attorney General.

The Board is not governed by a statute of limitations. Therefore, if an investigation is initiated against a nurse or nurse applicant, the Board has no time limit in which it must begin or complete the investigation or license (or deny) the application of an applicant. Investigations and applications for initial licensure can take months before the individual is notified if they will be granted a license or subjected to discipline by the Board.

I am always asked “who makes all the decisions at the Nursing Board?” and “why does it take so long to get through the application or investigation process?”  The short answer is that the Board members make all final decisions.  However, since the Board only meets six times a year, official Board decisions are only issued at those Board meetings.   Therefore, if your case is not presented by the staff to the Board Members to review at a Board meeting, your case will not be acted on until the next board meeting.

The Ohio Nursing Board licenses and monitors thousands of nurses each year. For the vast majority of nurses, they will be issued a license or their license will be renewed quickly and without delay. However, if your license application is subjected to additional scrutiny because of a prior conviction, prior impairment, or action by an other state agency, it can take months to be licensed. Similarly, if you are the subject of a Board investigation, even if your license has been summarily suspended by the Board, it can take months to work through the Board investigative and disciplinary process.

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