Death and dying, from a nurse’s perspective

Since a close relative of mine passed away a little over a year ago, I have been fascinated with reading stories and articles related to end of life issues. So often in America, death and dying is a taboo subject that everyone dances around and which no one seems to be willing to openly and honestly discuss. As we are all going to die one day, I find it rather amazing that people really don’t want to discuss it.

Because I regularly represent nurses who are seeking initial licensure or are the subject of an investigation by the Ohio Board of Nursing, I was curious to see what type of training nurses receive related to end of life issues and how nurses deal with the death of their patients.

I recently came upon two books by a nurse, Theresa Brown, who is an oncology nurse from Pittsburgh, who addresses death and dying from a nurse’s perspective. In her recent book, The Shift, Brown follows the lives of four cancer patients over a 12 hour shift. Brown raises many important issues related to providing nursing care to patients in their homes, listening to patients and family members deal with their fears, and helping her patients deal with the inevitable future.

In her previous book, Critical Care, A New Nurse faces Death, Life and Everything in Between, Brown highlights her first year as a nurse. This book has been used by many nursing schools as part of their curriculum.

A story highlighting Brown and her books can be found on NPR at:

I highly encourage all nurses (and others interested in end of life issues) to listen to the NPR story and consider reading Brown’s books or other literature on end of life issues.

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

When the Ohio Board of Nursing can automatically suspend a license

The Nurse Practice Act in the State of Ohio (R.C. 4723) sets out certain instances when the Nursing Board can take a disciplinary action against a nurse. In most instances, the Nursing Board will issue a Notice of Opportunity for Hearing to the nurse that addresses the allegations against the nurse, note the Code section that the nurse is alleged to have violated, and offer the nurse an opportunity to request a hearing prior to the Nursing Board issuing any sanction against a nurse.

However, in instances when the Nursing Board believes that allowing the nurse to continue to practice presents danger of “immediate and serious harm to the public,” the Nursing Board can suspend the license prior to offering the nurse a hearing. In previous blog posts, I have noted instances when a nurse has been convicted of a serious crime (aggravated murder, murder, gross sexual imposition, etc.) in which the Nursing Board automatically suspended a license prior to offering the nurse a hearing.

The Nursing Board has automatically suspended a nursing license prior to offering the nurse a hearing though in less seriously instances. For example, if a nurse is under probation with the Nursing Board and subject to terms in an Adjudication Order or Consent Agreement and violates any terms of the Agreement the Nursing Board will automatically suspended their nursing license prior to offering them a hearing. Violations of Consent Agreements (such as testing positive on a random drug test or failing to notify the Nursing Board of their employment) has triggered an automatically suspension.

Once the license has been automatically suspended, the nurse can request a hearing and present evidence in their defense. However, during the hearing process or while negotiating terms of an Amended Consent Agreement, the nurse’s license remains suspended. It is imperative when entering into any Consent Agreement with the Nursing Board that the nurse understands the terms of the Consent Agreement, because failure to comply with the terms, limitations or conditions of the Consent Agreement can result in an automatic suspension of their nursing license.

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 the Collis Law Group at 614-486-3909 or email me at

Ohio RNs, if you waited to renew your license at the last minute it may have expired!

If you are a Registered nurse in Ohio, you were required to renew your nursing license by August 31, 2015. This year, all renewals are required to be filed online. This caused many problems for nurses who could not access the Board’s online renewal system, did not have their access code and password,  or who responded “Yes” to any of the renewal questions.

Nurses who responded “Yes” to any of the renewal questions were not renewed by the Board, but were requested to supplement their renewal with a written explanation and documents to support the affirmative response. Until the nurse submitted the supplemental information to the Nursing Board, their renewal was considered “incomplete” and their license was not renewed.

On September 1, 2015, if your nursing license was not renewed, it expired. You May NOT work as a nurse until your nursing license has been renewed!

As you can imagine, in the days leading up to the August 31 expiration date, the Nursing Board was swamped with nurses attempting to renew their licenses. Given the volume, many licenses were not renewed. This is the message that was issued by the Nursing Board:

From the OBN website:

ALERT: eLicense Renewal System, August 31, 2015

Due to an Ohio eLicense systems issue, some registered nurses who submitted renewal information on or about August 31, 2015, have not been processed. If a license credential indicates “ACTIVE IN RENEWAL – INCOMPLETE”, the license renewal application should be processed by 5:00 pm on September 2, 2015. If you have questions about a license in this status after August 31, please email: The State IT group is working diligently to resolve this system issue. We regret the difficulties you are experiencing.

In the future, we highly encourage nurses to complete their renewals in June or July and not wait until the week their license is set to expire.

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

You have a right to counsel when meeting with a Nursing Board investigator

The role of the Ohio Board of Nursing is to regulate the practice of nursing. This entails issuing professional licenses to nurses and also investigating and imposing discipline on nurses who violate the Ohio Nurse Practice Act.

Often, a nurse first learns that a complaint has been filed against them with the Nursing Board when they are contacted by a Nursing Board investigator. The Nursing Board has “field” investigators who work throughout Ohio and are each assigned to various geographic regions of the State.  Once a complaint has been filed or initialed against a nurse, an investigator is assigned to conduct the investigation. This may include collecting records from the nurse’s employer or from the Court. It may also include contacting the nurse for a personal interview.

Prior to meeting with the Nursing Board investigator, please understand that under Ohio law, (R.C. 9.84) you have the right to be accompanied, represented and advised by an attorney and you are also required to be advised of the right to counsel BEFORE you are interrogated.

Unlike in a criminal proceeding, you will not be assigned legal counsel for your defense. You are required to seek your own legal counsel to assist in your defense before the Nursing Board or any other administrative agency. However, you have a right to have counsel present.

Many nurses have asked me whether they “look guilty” by attending the meeting with legal counsel or if it “appears that they are hiding something” if they take legal counsel with them to the meeting. Nothing could be farther from the truth. Meetings with investigators can be intimidating, overwhelming and threatening. Any information that is obtained by the investigator can and will be used against you before the Nursing Board. In addition, if the investigator believes that the nurse’s conduct violates the law, they can also alert the local sheriff’s department or criminal Prosecutor, and in certain instances, criminal charges can be issued against a nurse.

While I often encourage nurses to fully cooperate in an investigation, including meeting with the investigator, I highly encourage nurses to retain legal counsel to assist them throughout the investigative and disciplinary process. You have a right to counsel under Ohio law and it is in your interest to exercise this right to protect yourself.

As always, if you have any questions about this post or the Ohio Board of Nursing in general, please contact one of the attorneys at the law firm of Collis, Smiles and Collis, LLC at 614-486-3909 or you may email me at

Ohio Nursing Board imposes Permanent Practice Restrictions

In our practice at Collis, Smiles and Collis, we have the privilege of representing not only Nurses before the Ohio Board of Nursing but also other professionals before their licensure Boards.  This has given us the opportunity to see how various licensure Boards in Ohio handle disciplinary matters.

Each licensure Board in Ohio has its own rules and regulations and has the authority to take any action including but not limited to revocation, suspension, and/or probation of a license.  Under Ohio Revised Code Chapter 119, licensees in Ohio are entitled to an administrative hearing, which allows the licensee to introduce evidence in their defense.

Despite the similar due process that is afforded to most licensees facing a disciplinary action in Ohio, we have seen that many licensure Boards in Ohio (Nursing Board, Medical Board, Psychology Board, Board of Education, Counselor, Social Work and Marriage and Family Therapist Board) impose very different sanctions, despite the relatively similar nature of the offense.

In our experience, we have seen that, generally, licensure Boards in Ohio can be more strict/punitive than licensure Boards in other States in terms of sanctions.

Even within Ohio, based on our experience, the Ohio Board of Nursing imposes permanent practice restrictions on its licensees to a far greater extent than other licensure Boards in Ohio.  Generally, a permanent practice restriction limits a Nurse’s ability to work in the following settings: hospice, home health, as an independent provider for an Ohio agency, as a private duty nurse, as a volunteer, as well as any position involving management of nursing or supervision or evaluation of nursing practice, including but not limited to Director of Nursing, Assistant Director of Nursing, or Nursing Supervisor.  In certain instances, the Ohio Board of Nursing will include language in a Consent Agreement or Order that allows a Nurse to request on a case-by-case basis approval to work in an otherwise restricted position, however, such requests are given close scrutiny and are often denied.

Permanent practice restrictions are often imposed in cases in which a Nurse has been convicted of a crime, found to be addicted to drugs or alcohol, or where a Nurse has practiced below the standard of care.  In certain cases, the Ohio Board of Nursing imposes practice restrictions that prohibit a Nurse from working in any position that would require a Nurse to have oversight or control over financial dealings.

Permanent practice restrictions place a significant hardship on a Nurse’s employment opportunities.  Although we have seen Nurses with permanent practice restrictions on their license obtain employment, permanent practice restrictions create an enormous hurdle to overcome in terms of obtaining meaningful employment because, in our experience, many employers will simply not consider any Nurse who has permanent practice restrictions on their license.

Historically, it has been our experience that the Ohio Board of Nursing imposed permanent practice restrictions on a Nurse in cases where the facts of a case fully justified doing so based on significant practice or impairment issues, or in cases where a Nurse had been repeatedly disciplined.  Presently, however, we are seeing the Ohio Board of Nursing impose permanent practice restrictions on Nurses in greater numbers and on their first disciplinary action.

While there are cases in which permanent practice restrictions are justified to protect the public, obtaining the advice of experienced legal counsel before you sign a Consent Agreement containing permanent practice restrictions or before undertaking to represent yourself at an Administrative Hearing (which could result in a Ohio Nursing Board Order imposing permanent practice restrictions) is recommended.

As always, if you have any questions about this post or the Ohio Nursing Board in general, please feel free to contact one of the attorneys at Collis, Smiles & Collis, LLC at 614-486-3909 or email








Be honest when filing an application or renewal with Ohio Board of Nursing

Honesty is always the best policy when working with the Ohio Board of Nursing.

Professionals should know that before submitting information to a licensing authority the information must be accurate. Whether it is submitting the responses on an initial application for a license, or answering the questions on the bi-annual renewal of a license, the responses must be truthful.

However, I am often asked, “how will the Board know if I answer a question on my renewal application or original application incorrectly?” We never know how the Board may be notified of a violation of their laws and rules. Complaints to the Nursing Board can be anonymous, and the complainant is immune from liability (absent a finding of bad faith in their report). This means that you can be reported to the Board without your knowledge and you will never been provided with a copy of the complaint or the name of the complainant. (O.R.C. 4723.28(H) and (I)(1))

You may have a neighbor, employer or co-worker file a complaint against you with the Board alleging that you had a DUI that you failed to disclose to the Board or violated a section of the Ohio Nurse Practice Act. If you have reported this infraction on your application and/or on your renewal, it goes a long way to possibly having the investigation closed with no disciplinary action. However, if the Board goes back and pulls your application or renewal form and finds that you failed to disclose this information to the Board, the Board has the authority under O.R.C. 4723.28(A) to take an action against your license for providing false or fraudulent information to the Board.

Even without a formal complaint, the Board has the authority to open its own investigation if it learns of a violation of the Nurse Practice Act. If a Board investigator reads a news article about a nurse who has been charged with a DUI or is admitted into a diversion program by the Court, these types of actions can lead the investigator to open an investigation against the nurse. (Please note, that the nurse does not need to self report convictions or violations to the Board until the time of renewal of the license. However, on the renewal application responses need to be truthful and accurate.)

So, when applying for a license or completing a renewal application never ask yourself,”how will the Board ever find out?” The question you should ask yourself is, “what is the right answer and how can I best provide that information to the Board.”

While I encourage nurses to be honest with the Board, I always encourage the nurse to seek experienced legal counsel to assist them if they have any questions about how to respond to specific questions or if they are called to attend a meeting with a Board investigator.

As always, if you have any questions about the Ohio Board of Nursing or this post, please feel free to contact one of the attorneys at Collis, Smiles and Collis at 614-486-3909 or email me at

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




Hair Products


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

Antibacterial products including antibacterial gel, dishwashing liquid and hand soap



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


Nasal decongestants

Oral antiseptics





Mouthwashes and gargles






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