Nurses who enter into a Consent Agreement with the Ohio Board of Nursing MUST complete all conditions OR negotiate terms to modify to the Agreement.

A Consent Agreement with the Ohio Board of Nursing is a negotiated contract between the nurse and the Board that specifies the terms and conditions under which a nurse on probation may continue to practice as a nurse and/or seek reinstatement of their license, if suspended. By signing the Consent Agreement, the nurse agrees (among other things) to waive their right to a hearing and to comply with the terms in the Consent Agreement.

Failure to comply with the terms of the Consent Agreement can result in the Nursing Board automatically suspending a nurse’s license to practice in Ohio.

Typically, a Consent Agreement which includes a suspension will outline conditions for a nurse to seek reinstatement of their license or, for a Consent Agreement that includes probation, will place conditions on a nurse’s license. Often, nurses are subjected to random drug testing, are required to attend weekly AA/NA meetings, or complete additional continuing education courses. In some cases, a nurse may have a license limitation that does not allow them to work in certain settings or dispense medications.

Actions including, but not limited to, missing a mental health or chemical dependency examination, failure to check in daily for alcohol or drug screens, or failure to submit to a screen when selected are a few examples of a breach of the Consent Agreement.

Even when unemployed as a nurse, the nurse is still required to comply with the Consent Agreement. For Consent Agreements that include a probationary period, the nurse must actually work in a nursing position for the probation period to count down.

Compliance with a Consent Agreement can be time-consuming and costly. Nurses are often unable to afford the random screens or become frustrated with the lengthy probationary period, especially if they are not working as a nurse.

I am often contacted by nurses who want to stop compliance with the terms of their Consent Agreement because they can no longer afford the random screens or are no longer interested in completing all compliance terms.

A Consent Agreement is a negotiated contract between a nurse and the Nursing Board.  The nurse MUST negotiate alternative terms in writing with the Nursing Board. If the nurse simply stops complying with the Consent Agreement, without first negotiating a written amendment or modification to the Consent Agreement, their license will likely be automatically suspended by the Nursing Board for failure to comply with the Consent Agreement.

To seek an amendment or modification to the Consent Agreement, the nurse must be in full compliance with all probationary terms. Even if in full compliance, the Nursing Board may only agree to place the nurse’s license on indefinite suspension. And if the nurse wants to seek reinstatement of their license in the future, the nurse may be required to complete most if not all of the probationary terms again.

In summary, in order to cease having to comply with the terms and conditions of a Consent Agreement, the nurse must re-negotiate the terms of the Consent Agreement with the Nursing Board and must continue to comply with their Consent Agreement until the Nursing Board agrees in writing to the modified Consent Agreement.

All Consent Agreements must be approved by the full Board, which only meets six times a year. The nurse should expect that it could take up to 8 weeks before the Nursing Board will approve a new Consent Agreement or a modification to a Consent Agreement.  The nurse must continue to comply with their existing Consent Agreement until a new Consent Agreement or modification has been approved in writing by the Nursing Board.

Before making the decision on whether to stop complying with the terms of a Consent Agreement with the Board of Nursing, it is recommended to consult with an attorney. Factors such as the nurse’s financial condition and their desire to practice nursing in the future should be considered.

As always, if you have a question about this post or the Ohio Board of Nursing in general, please feel free to contact one of the attorneys at the Collis Law Group, LLC at 614-486-3909 or email me at



Ohio nurses: Watch when your Certificate to Prescribe Externship (CTP-E) and CTP expire!

As a registered nurse in Ohio, it has become routine to timely submit a complete RN renewal application at the same time every two years. However, a CTP-E is issued for one year and expires one year from the date of issuance, NOT one year after you start working as a nurse. In addition, once a CTP is issued, the renewal date may be different from the date the nurse renews their license. It is imperative that you know when you need to renew your license, CTP-E and CTP.  You will not receive a letter or notification from the Nursing Board to remind you to renew your certificate to prescribe.  It is illegal to continue to prescribe on a lapsed CTP-E or CTP!

The Ohio Board of Nursing requires advanced practice nurses who have had no prior experience prescribing medications or therapeutic devices to obtain a Certificate to Prescribe-Externship (“CTP-E”).  The purpose of the externship is to create a period during which the nurse’s prescribing activities are reviewed and evaluated by a supervising professional for the purpose of ongoing improvement of the nurse’s competence, knowledge, and skill in pharmacokinetic principles and the application of these principles to the nurse’s area of practice.

In order to apply for a CTP-E, the applicant must hold a valid Ohio R.N. license as well as a current Certificate of Authority to practice as a certified nurse midwife, nurse practitioner or nurse specialist.  In addition, the applicant must have completed required coursework on advanced pharmacology.  Once all materials have been submitted and reviewed by the Board of Nursing, the CTP-E will be issued for one year.  The year begins on the date the CTP-E is issued by the Board.  It is critical to remember this date.

During this year, the advanced practice nurse is required to complete 1,500 hours of supervised prescribing (500 hours under the direct supervision of a supervising professional).  Direct supervision means that the supervising professional is on-site when the nurse is prescribing.  300 of the 500 direct supervision hours must be supervised by a physician; the remaining 200 hours may, with the collaborating physician’s permission, be supervised by an advanced practice nurse with prescriptive authority, not a CTP-E.  The remaining 1,000 hours may be indirectly supervised.  This means that a physician, in accordance with a schedule documented in the standard care arrangement, regularly and timely reviews the nurse’s prescriptions and prescribing practices.

Once the advanced practice nurse has completed the required supervision hours through the CTP-E, the supervision must be documented by the collaborating physician and submitted directly to the Board of Nursing on Form B.  PLEASE NOTE that Form B must be submitted well prior to the end of the expiration date on the CTP-E to allow the Board time to review it and issue the advanced practice nurse applicant a Certificate to Prescribe.  Even if Form B is submitted timely, it is illegal to continue to prescribe after the year for the CTP-E has expired unless the nurse has received the Certificate to Prescribe.  Advanced practice nurses may face discipline if they continue to prescribe once the CTP-E has expired if they have not been issued a Certificate to Prescribe.

A CTP-E cannot be renewed.  It can be extended for a one-time period of 2 years, if a request to extend is timely received by the Board before the CTP-E expires.

As always, if you have any questions about his post or about the Ohio Board of Nursing in general, please contact one of the attorneys at the Collis Law Group LLC at 614-486-3909 or email

46 Ohio nurses did not defend themselves?!


Yesterday, I attended the January meeting of the Ohio Board of Nursing.  On the morning agenda, the Members of Nursing Board voted to issue a Notice of Opportunity for Hearing, Notice of Immediate Suspension, or Notice of Automatic Suspension to over 60 nurses.

Additionally, the Nursing Board voted to impose a final disciplinary sanction (suspension, revocation, or limitation) on over 100 nurses’ professional licenses in Ohio.  I was struck and saddened to learn that in 46 casesthe nurse failed to request a hearing and never introduced ANY evidence in their defense.

If a nurse fails to request a hearing, the Nursing Board is authorized to impose any sanction from dismissal of the case to permanent revocation of the nurse’s license.  If a nurse fails to request a hearing, the nurse may not submit any evidence in their defense.

It cannot be understated the positive effect that can result when a nurse presents “their side of the story”, explains what happened, and puts the Nursing Board’s allegations into context.  The Nursing Board members like to see that the nurse understands the gravity of the allegations, accepts responsibility (where warranted), and fights for their license.  In certain instances, where the nurse presents evidence rebutting or refuting the Nursing Board’s charges, the Nursing Board has been known to dismiss certain counts in the Notice or dismiss an entire case against the nurse.

At the meeting yesterday, based on mitigating evidence that was introduced in one case, the Nursing Board modified the recommendation of the Hearing Examiner from a 6 month suspension to no suspension and simply placed the nurse on probation.

As a nurse, you have worked hard for your professional license.  If you are notified by the Nursing Board that they propose to take an action against your license, request a hearing and defend yourself.  While you may represent yourself before the Nursing Board, please note that the Nursing Board will be represented by an attorney from the Office of the Ohio Attorney General who will prosecute the case on behalf of the Nursing Board.  It is recommended that you should also have experienced counsel to represent you in this stressful and difficult process.

If you have any questions about this blog post or the Ohio Board of Nursing in general, please feel free to contact one of the attorneys at the Collis Law Group, LLC at 614-486-3909 or email me at

Ohio RNs and APNs, time to renew your license!

If you are licensed as a Registered Nurse or Advanced Practice Nurse in the State of Ohio it is time to renew your professional license.

As part of its electronic renewal system, the Ohio Nursing Board assigns each nurse a unique User ID and Password.  You can access this information through the Board’s website at:

You can save money by renewing your license before July 1, 2015.  Registered nurses who renew before July 1, 2015, must pay Sixty Five Dollars ($65.00).  After July 1, 2015, the cost goes up to One Hundred Fifteen Dollars ($115.00).

Advanced practice nurses (APRN) must renew their RN license and each of their Certificates of Authority (COA).  Before July 1, 2015, the renewal fee is Eighty Five Dollars ($85.00) for each COA.  After July 1, 2015, the renewal fee goes up to One Hundred Thirty Five Dollars ($135.00) for each COA.

APRNs with prescriptive authority must renew their RN license, their COA, and their Certificate to Prescribe (CTP).  The renewal fee for the Certificate to Prescribe (CTP) is Fifty Dollars ($50.00) through August 31, 2015.

APRN’s must provide the name and address of their collaborating physician as part of the renewal process.

Maintaining an Active nursing license is your responsibility. Failure to renew your RN license, COA, and CTP (as applicable to you) by August 31, 2015 will result in your RN license, COA, and/or CTP to automatically lapse.  Practicing under a lapsed license, COA, and/or CTP is a disciplinable offense.

As always, if you have any questions about this post or the Ohio Board of Nursing in general, please feel free to contact one of the attorneys at Collis, Smiles and Collis, LLC at 614-486-3909. You may also look for more information at