Use of Social Media by Nurses in Ohio

The Ohio Board of Nursing’s (“OBN”) Fall 2018 edition of Momentum Magazine includes an interesting article concerning the use by nurses of social media.  The article addresses the American Nurses Association’s (“ANA”) Principles for Social Networking and the NurseSee: https://www.nursingworld.org/~4af4f2/globalassets/docs/ana/ethics/social-networking.pdf.

Although the ANA Principles provide useful guidance concerning the use by nurses of social media, nurses licensed in Ohio are required to observe the OBN’s laws and rules concerning use of social media which include, but are not limited to, the following:

OAC 4723-4-03(H) and 4723-4-04(H): These are OBN rules which provide in part that registered nurses and practical nurses licensed in Ohio shall not disseminate patient information for purposes other than patient care, or for otherwise fulfilling the nurse’s assigned job responsibilities, through social media, texting, emailing or any other form of communication.

These rules prohibit nurses licensed in Ohio from using social media, texting, emailing or any other form of communication to disseminate patient information for purposes other than patient care, or for otherwise fulfilling the nurse’s assigned job responsibilities.

OAC 4723-4-06(Q): This is an OBN rule which provides that, for purposes of OBN rules OAC 4723-4-06(I), (J), (K), (L), and (M), a nurse shall not use social media, texting, emailing, or other forms of communication with, or about a patient, for non-health care purposes or for purposes other than fulfilling the nurse’s assigned job responsibilities.

This rule prohibits a nurse licensed in Ohio from using social media, texting, emailing, or other forms of communication with, or about a patient, for non-health care purposes or for purposes other than fulfilling the nurse’s assigned job responsibilities, for purposes of the OBN’s requirements that a nurse licensed in Ohio:

-maintain professional boundaries;

-provide patient privacy and courtesy;

-not engage in behavior that causes, may cause, or may reasonably be interpreted as, physical, verbal, mental, or emotional abuse;

-not misappropriate a patient’s property;

-not engage in behavior for, or that may reasonably be interpreted as behavior for, personal gain at a patient’s expense;

-not engage in inappropriate involvement in, or that may reasonably be interpreted as inappropriate involvement in, a patient’s personal relationships or financial matters;

-not engage in sexual conduct with a patient;

-not engage in conduct in the course of practice that may reasonably be interpreted as sexual; and

-not engage in any verbal behavior that is, or may reasonably be interpreted as, seductive or sexually demeaning to a patient.

A nurse licensed in Ohio who is determined by the OBN to have failed to comply with any of these rules based on the improper use of social media, texting, emailing, or any other form of communication is subject to disciplinary action by the OBN.

As noted in the OBN article, “The use of social media carries with it much responsibility.  Please be aware of your responsibilities and professional obligations and how its use may impact you.”

As always, if you have any questions about this post or the Ohio Board of Nursing, contact one of the attorneys at the Collis Law Group LLC at 614-486-3909 or go to our website at http://www.collislaw.com for more information.

 

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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 beth@collislaw.com.

 

Ohio Licensed Practical Nurses: It Is Time To Renew Your Nursing License

Renewal of Ohio licensed practical nurse (“LPN”) licenses begins on July 1, 2018 and ends on October 31, 2018.  It is recommended to renew as soon as possible.

It is a disciplinable offense to engage in the practice of nursing having failed to renew a nursing license.  An Ohio LPN license which is not renewed will lapse on November 1, 2018.  An Ohio LPN whose nursing license has lapsed is not authorized to work as a nurse until their nursing license is reinstated by the Ohio Board of Nursing.

The renewal fee is $65.00, plus a $3.50 transaction fee.  A late processing fee goes into effect on September 16, 2018.  An Ohio LPN who renews their nursing license on or after September 16, 2018 must pay an additional $50.00.  Fees must be paid online at the time of renewal with a credit or debit card (Master Card, VISA or Discover), or pre-paid card.  The renewal application will not be processed until all required fees are submitted.  All fees are non-refundable.

The renewal application includes, but is not limited to, questions concerning criminal, licensure, mental health matters, and alcohol/drugs matters.  All information provided in the renewal application is required to be true and accurate.  Depending on the response given to certain questions in the renewal application, uploading an explanation and Certified copies of certain specific documents is also required.

In certain cases, the renewal application may be forwarded to the Ohio Board of Nursing Compliance Unit for review and an Ohio Board of Nursing investigator may contact the LPN to obtain additional information.  In other cases, a Consent Agreement may be offered to the LPN to resolve a disciplinable offense instead of preceding to an administrative hearing.

If you do not understand a question in your LPN renewal application, or do not know what additional information to upload with your renewal application, it is recommended to obtain experienced legal counsel to assist you before submitting your LPN renewal application, speaking with an Ohio Board of Nursing investigator, or signing a Consent Agreement.

For additional renewal application information from the Ohio Board of Nursing, see: http://www.nursing.ohio.gov/PDFS/Licensure/Renewal/Renewal_Momentum.pdf.

As always, if you have questions about this post or the Ohio Board of Nursing, contact one of the attorneys at Collis Law Group LLC at (614) 486-3909.

The Ohio Board of Nursing’s Practice Intervention and Improvement Program

The Ohio Board of Nursing is the state agency that regulates the practice of nursing in Ohio. The mission of the Nursing Board is to protect the public by ensuring that nurses have the skills to provide care to patients. In instances where a nurse has violated the Ohio Nurse Practice Act, the Nursing Board has the authority to take a disciplinary action, such as to suspend or revoke a nurse’s license to practice in Ohio. However, in instances where the Nursing Board has reason to believe that a nurse has a deficiency in their practice that may be corrected, the Board may require the nurse to seek additional education and/or training.

The Nursing Board’s Practice Intervention and Improvement Program (“PIIP”) permits the Nursing Board to offer a nurse an opportunity to seek remedial education and training in a specific area instead of taking disciplinary action against a nurse who has a practice deficiency. The PIIP program is considered non-disciplinary and does not constitute a restriction or limitation on a nurse’s license. Participation in PIIP is confidential.

The criteria the Nursing Board uses to identify an individual’s practice deficiency includes, but is not limited to:

(1) Whether the public will be adequately protected from unsafe practice if the individual enters PIIP;
(2) Whether the individual’s practice deficiency resulted in harm to the patient;
(3) The likelihood that the identified practice deficiency can be corrected through remediation;
(4) The frequency of the occurrence of the practice deficiency;
(5) Whether the individual is eligible for participation in PIIP under 4723-18-03 of the Administrative Code; and
(6) Whether the individual has a mental or physical impairment that contributed to the practice deficiency.

If the supervising member believes, after investigation and review, that the individual’s practice deficiency can be successfully corrected through participation in PIIP, the Nursing Board may choose to take no disciplinary action. This decision is generally reached, if the individual enters into a Participatory Agreement with PIIP, complies with the terms and conditions of PIIP, and successfully completes PIIP.

The PIIP Participatory Agreement includes, but is not limited to, provisions that:

(1) Identify the practice deficiencies and the specific remediation (including educational interventions) the participant must complete;
(2) Require the participant to pay all expenses for the required remediation;
(3) Require the participant to provide the Participatory Agreement to a manager of the participant’s employers;
(4) Require the participant to participate in workplace monitoring;
(5) Require the participant to cause all workplace monitors to provide remediation and to send written progress reports regarding the participant’s progress to PIIP at specified intervals;
(6) Require the participant to submit a written personal progress report containing the information required by PIIP to PIIP at specified intervals; and
(7) Specify the terms and conditions the participant must meet to successfully complete the remediation, including the time frames for successfully completing both the educational intervention and workplace monitoring components of the remediation.

Generally, to comply with PIIP, the nurse will identify a nurse educator who will prepare an individualized course of study for the nurse. The course may include a series of written materials to review or a list of on-line continuing education courses that must be completed. The course of study is almost always tailored to the individual need of the nurse and generally does not require the nurse to return to complete coursework in a nursing school setting or to repeat an entire nursing course. The educator will generally meet individually with the nurse to evaluate their skills to determine if the deficiency in their practice has been remediated. In most instances, the nurse can complete the remedial education in a matter of weeks.

A PIIP participant can be terminated from PIIP for reasons including, but not limited to, the failure to: 1) comply with the Participatory Agreement; 2) progress through or successfully complete the educational intervention in the manner and time frame required; or 3) incorporate learned knowledge and skills into practice.

In addition to avoiding public discipline, a participant who successfully completes PIIP will not be reported to the National Council of State Boards of Nursing disciplinary data bank or the National Practitioner Data Bank (NPDB) unless the Nursing Board imposes disciplinary action against the participant.

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 beth@collislaw.com.

 

Ohio RNs – License Renewal Time!

On July 1, 2017, the renewal window opened for registered nurses in Ohio.  The sooner you renew, the better.

 Cost and Timing:

Prior to September 15, 2017, the fee to renew your RN license is $65.00.  An RN Renewal Application filed after September 15, 2017 will also include a $50.00 late fee.  The RN license renewal window closes October 31, 2017.  After October 31, 2017, your RN license is considered by the Ohio Board of Nursing (“Nursing Board”) to have lapsed and you are unauthorized to practice nursing in Ohio until reinstated. 

For instructions on renewing your RN license and to review the questions in the RN Renewal Application go to: http://www.nursing.ohio.gov/PDFS/Forms/Samples/SAMPLE-RN_Renewal_App-2017.pdf

 When you are ready to renew your RN license, go to: http://www.nursing.ohio.gov/forms.htm#RenewalForms

Questions on the RN Renewal Application:

The RN Renewal Application includes, but is not limited to, questions concerning your employment, residency status, Social Security number, criminal matters, medical or mental health matters, and substance abuse matters.  You are required to answer all questions on the RN Renewal Application truthfully and accurately.  Additionally, there are certain instances where you are required to upload with your RN Renewal Application specific documents and a written statement explaining your response to a particular question(s) in the RN Renewal Application.

 Based on the response(s) in your RN Renewal Application, the Nursing Board may open an investigation.  If an investigation is opened, you may be contacted by a Nursing Board investigator by phone or email requesting additional information or documentation concerning your response(s). 

If you do not understand a particular question(s) in the RN Renewal Application, or do not know what additional information to submit to the Nursing Board in support of your RN Renewal Application, it is recommended to obtain experienced legal counsel to assist you with preparation of your response or before speaking with a Nursing Board investigator. 

As always, if you have any questions about this post or the Ohio Board of Nursing, contact one of the attorneys at the Collis Law Group LLC at 614-486-3909 or go to our website at http://www.collislaw.com for more information.

Ohio Nurses: Failure to Document May Result in Disciplinary Action Against Your Nursing License

The importance of documentation in the nursing field cannot be underestimated.

The Ohio Board of Nursing is authorized to discipline a licensee for (among other things) failure to practice in accordance with acceptable and prevailing standards of safe nursing care.  Failure to document the administration or otherwise account for the disposition of controlled substances that the Nurse removed from the Pyxis, or other place where controlled substances are stored, may also be the basis for the Nursing Board to discipline a nurse.

In certain cases, the Nursing Board will offer the Nurse a Consent Agreement as an alternative to an Administrative Hearing.  A Consent Agreement allows the Nurse to avoid the time, worry, and expense of an Administrative Hearing.  Nurses do not need to sign a Consent Agreement. It is always a good practice to read a proposed Consent Agreement very carefully.  We have seen Consent Agreements that are based on allegations of failure to document the administration or otherwise account for the disposition of controlled substances. In many cases, the Consent Agreement requires  (in some cases, lasting years)  random drug screening, narcotic restrictions, and practice restrictions, even when there was no history of drug use or abuse by the Nurse.

If the nurse does not sign a proposed Consent Agreement, he or she always has the right to go to an Administrative Hearing.  The nurse can present evidence that there is no history of drug use or abuse and that the nurse has an otherwise excellent history of employment.  The Board’s attorney is going to present its evidence that the nurse failed to document the administration or otherwise account for the disposition of controlled substances that were removed.

It is imperative to completely, accurately, and timely document the administration or disposition (waste) of controlled substances or other drugs! The Nursing Board may place a nurse on probation and subject them to multiple probationary terms, even if there is no evidence that they suffer from chemical dependency and even if there is no evidence of diversion.

As always, if you have any questions about this post or the Ohio Board of Nursing, contact one of the attorneys at the Collis Law Group LLC at 614-486-3909 or go to our website at http://www.collislaw.com for more information.

 

 

 

ADVANCED PRACTICE REGISTERED NURSES: New Legislation to take Effect on April 4, 2017

On January 4, 2017, Governor Kasich signed Ohio Substitute House Bill 216 into law.

Effective April 4, 2017, there will be new licensing criteria for advanced practice registered nurses (APRNs).  A new APRN license will replace the current “Certificate  of  Authority” and “Certificate  to Prescribe”.

The APRN license will also authorize a Certified Nurse-Midwife (CNM), a Certified Nurse Practitioner (CNP), and a Certified Nurse Specialist (CNS) to prescribe.  In order to obtain the new APRN license, CNPs, CNSs, and CNMs must have either a current Certificate to Prescribe or Certificate to Prescribe Externship, or have completed a 45-hour course in advanced pharmacology within five years of the application date.

Additional information is available from the Ohio Association of Advanced Practice Nurses here: http://c.ymcdn.com/sites/www.oaapn.org/resource/resmgr/hb_216/HB_216_Signed_Revised_-_Effe.pdf

A FAQ from the Ohio Association of Advanced Practice Nurses is here: https://oaapn.site-ym.com/page/HBFAQ

As always, if you have any questions about this post or the Ohio Board of Nursing, contact one of the attorneys at the Collis Law Group LLC at 614-486-3909 or go to our website at http://www.collislaw.com for more information.