Lorie Brown, RN, MN, JD of Brown Law Office, P.C. discusses what can happen if you have an action or discipline against your nursing license if you have licenses in different states – even if your license is expired. This is called the “Domino Effect”.
The Joint Commission, which provides accreditation of health care organizations, issued a mandate requiring surgical/procedure teams to have a time-out prior to beginning an operation to prevent wrong site surgery. Yet, time-outs are always taken and surgical errors continue to occur.
What’s more disturbing is that a study was done prior to the time-out procedures and found at least 1 person in the operating room knew that surgery was being performed on the wrong site but was too afraid to say anything.
To me, this is unacceptable! Nurses and other health care providers need to be free to speak their mind to avoid such incidences as this.
In addition, in 2016, a study was published in the British Medical Journal reporting that the third most frequent cause of death in the United States, surpassed by only heart disease and cancer, was preventable medical errors. People do not go into the health care system as a patient to die.
There are 250,000 unnecessary deaths each year, which does not include the number of preventable medical errors where only injury occurs. None of us became health care providers to cause injury. Something is broken in our health care system that needs to be fixed. Unfortunately, given the concerns of our health care system, medical institutions are not willing to pay money for a workable solution. More staff certainly would help as well as better procedures in place and systems to prevent problems.
Health care is a high-risk business, yet so are nuclear power plants and airplane travel. Yet, neither of those other industries have the number of deaths that happen in the hospital. Why is this? And what can we do about this?
I am sure that all of us went in the profession to help people but, ironically, right now, we are helping in actually causing death.
What do we do?
What if we stand together and say that we are not willing to put our patients lives on the line and we need to find solutions to resolve this crisis.
What are your thoughts to resolving this issue? I would love to hear your comments below.
Most States are “employment at will” which means that one can be terminated for any reason or even for no reason at all! However, under Title VII of the Civil Rights Act, employers are prohibited from discriminating against applicants and employees on the basis of race, color, religion, sex and national origin.
In a recent case, a 60-year-old nurse of Chinese descent, worked at the Cleveland Clinic since 1976. Ms. Lee started over 40 years ago, when she was just 23 years old.
In 2009, she began working for a supervisor who gave her generally positive performance reviews. In 2013, with a new supervisor, Ms. Lee reported that some employees were making comments to her like, “You Chinese people eat anything that crawls and walks” and “You don’t have ‘chinky’ eyes even though you are Chinese.” She reported the incident to her then supervisor who told her that she was “overreacting” and being “sensitive.”
In 2014, she was called into the office to discuss an incident for a patient for whom a medication was prepared improperly by a student. Ms. Lee complained that she was being discriminated against by age and race. At one point, her supervisor asked when Ms. Lee would be retiring and added statements such as “Things have changed.”
She also claimed that she was given heavier loads and her unit manager would follow her around and ask her patients about her work performance, which the unit manager did not do for the younger employees.
Ms. Lee was given a performance improvement plan. Three months later, in July 2014, she was given a written warning for failing to promptly notify a physician of his patient’s elevated blood pressure despite the risk of that patient suffering an aortic aneurysm. She was placed on a 3-day suspension pending an investigation and told the patient that she was getting fired, which upset the patient.
Shortly thereafter, Ms. Lee tendered her resignation and filed a claim in Federal court alleging discrimination. After she resigned, the hospital hired several registered nurses, all below 30 years of age, including one who was a white male.
The court denied the medical facility’s summary judgment claim, a way to end litigation if a claim is determined to be without merit, and Ms. Lee’s retaliation claim was allowed to move forward.
This matter was reported on a website for human resource management. Their teaching point was that “an employer should investigate a complaint of harassment or discrimination, even if the complaint is made to avoid legitimate discipline.”
However, from my perspective, the teaching point is that you should document any negative comments directed to you. Also, if you feel like you are in a hostile work environment, report it and do not stay there. If you are thinking that you might be able to file a lawsuit afterwards, realize that it is very difficult as well as a very emotional and distressing process. It is so much easier to try to resolve things amicably.
It does seem that hospital institutions are finding ways to ask nurses who are aging and on the top of the salary range to leave. If you don’t feel like you’re getting support from your supervisor, go up the chain of command.
What are your thoughts about this? Leave your comments below.
You read and we listened! Here is a list of what you say were my top blogs of 2016. If you missed any of them, you have another opportunity to check them out by clicking on the article titles, which will take you to those writings.
I always try to balance my articles between something that is empowering and something that is protecting. Interesting though, all the top 10 blogs actually involved license protection.
This title is one of my favorite sayings and this article discusses how two long term employees sued their hospital regarding age discrimination.
I’m sure it was very difficult for these nurses, both emotionally and financially, to sue their employers. What we can take away from their case is to keep copies of ALL of employment evaluations including any time that you might have been written up.
I applaud these two nurses for speaking up against poor care in court.
This article discusses how an L.P.N. fraudulently upgraded her license to an R.N. by stealing another nurse’s identity. In Indiana, it is relatively easy to get such information on another nurse. To access your personal data online, or anyone to access your data, one needs only to provide your license number and the last 4 digits of your social security number. It would not take much effort for some nefarious person to access a nurse’s account and information.
I heard that this procedure will be changed but, yet, that revised protection for nurses in Indiana has not occurred yet.
This details a Houston lawsuit against an employer for not paying a nurse for lunch breaks during which she was forced to work.
The facility’s policy was for nurses to clock in only when they arrived and when their shift ended. The bookkeepers then deducted the ½-hour lunch break from their payable time. If your facility requires you take a lunch break and to ensure you will be paid, let your supervisor know, in writing, when you are not able to take that break.
However, it is even more important for nurses to take the breaks they need because, as health care providers, we are so busy taking care of everyone else that we don’t really take care of ourselves first. Our cup needs to be full in order to provide care for others.
Tips and strategies are provided to protect yourself regarding electronic medical records because, as the adage goes, “if it isn’t documented, it is not done.” This also is a reminder that all charting can be tracked in an audit trail. So, if think you have removed something, it STILL can be found.
A topic near and concerning to all of us, this article discusses how nurses are placed between a rock and a hard place by being denied the right to refuse assignments. If one does refuse, that’s called “insubordination” and the nurse can lose their job as well as face a possible complaint of patient abandonment.
We’re hoping that through legislative efforts that safe staffing will be mandated in both acute and long-term care.
The article discusses a medical malpractice trial in which the patient’s family won because of lack of documentation. One of the best practices to protect yourself in such a situation is to review one of your charts 6 months from now to see what you can remember about that patient’s situation and ask yourself, “Did I document everything that could have been documented to show a clear picture of my patient?”
This is another writing about documentation that discusses how copying and pasting between pages can be very dangerous as you could just be recopying what your previous colleague did. There is something to putting pen to paper and thinking through the patient’s issues to document what you see, hear, touch and smell.
Also important is to make sure all your assessments are documented rather than just checking the boxes on the listing.
Ask yourself if your documentation tells the full story of the patient’s condition, professional assessment and care.
This details how two nurse practitioners were criminally charged with 27 felony counts for prescribing phentermine, a schedule IV controlled substance, and phendimetrazine, a schedule III controlled substance, when there was an antiquated statute from the ‘70s, (before there was such a thing as nurse practitioners) saying that these medications could only be prescribed by a physician.
Unfortunately, although Kathy Lynch obtained a “not guilty” jury verdict and the case against Karen Dunning was dismissed, the Licensing Board still took action.
An update on this case revealed that following a lengthy hearing before the full Board of Nursing, Lynch’s advanced practice nurse prescriptive authority and registered nurse license were revoked. Dunning also went through an extensive hearing resulting in her advanced practice nurse prescriptive authority being revoked while her registered nurse was placed on indefinite suspension for at least 3 years.
Just because a criminal matter is resolved in your favor does not necessarily mean that the Nursing Board will not take action anyway. Clearly, they can act because violation of the Nurse Practice Act is different than violation of criminal laws.
This details how nurses, in order to participate in peer assistance programs, may need to be off all controlled substances if it’s an abstinence-based program. It also discusses how a nurse may be considered impaired if they are taking a controlled substance for something like chronic pain.
However, the most empowering part of the article is about how to create change.
- Create a petition on change.org;
- Talk to your legislators;
- Talk to your State’s Nurses Association.
These are only a couple of suggestions, but I do believe that nurses do have the answers to the problems in health care, but we need to work together to resolve these issues.
DRUM ROLL, PLEASE!
This quick easy read is about why nurses seem to get in trouble on night shifts and what they can do to avoid such problems and how to make the shift easier.
What’s so interesting in looking at these most-read blogs seems to be that they are ones related to actual cases brought by or against nurses and include practical information on how you can protect your license.
It also appears that many of you enjoyed sharing some of these articles, but did not necessary want to comment on them.
While I truly appreciate your sharing the articles, I also would love to hear your comments. Your valuable insight is reflected in what you have to say. So please keep commenting and sharing! I love to hear from you.
Thanks for being a valued reader. I look forward to continuing to provide you with very valuable information.