Lorie Brown, Nurse Attorney, and Marc Lopez, Indiana Criminal Attorney, discuss what happens when a Nurse has been arrested, disciplined and/or investigated by an employer. They also discuss the best steps to take to avoid or lessen criminal charges as well as appearing before the Board of Nursing. Some of the other topics include controlled substances diversion, criminal diversion, Office of the Inspector General (OIG) Exclusion List, Nursys.com, ISNAP, Indiana Professionals Recovery Program (“IPRP”), expungement.
As you know, marijuana is legal in 9 states for recreational purposes and in 30 for medical purposes. However, even if it is legal where you live or visit, it may not be legal for you to use as a nurse.
Unfortunately, it stays in your system for a long time and there is no good way to detect marijuana usage. Frequently, I get calls from nurses who had a positive pre-employment screen and subsequently they lost their chance for a job and were reported to the Board.
The best advise that I can give is for you not to use marijuana in any form at all. Your licenses and your livelihood are too important to put at risk for this substance.
Other nurses have claimed they were at a party and unknowingly happened to ingest something like a brownie laced with marijuana. But, to tell the Board that you did not know they contained marijuana “is not a defense.” In fact, “I didn’t know is never a good defense” in any such situation.
If you don’t know for sure what is in an item or who made it, I would advise against having it.
As nurses, we are held to a higher standard than the rest of the public. Even if you go on vacation, don’t partake because it could likely still be in your system upon your return to work.
Marijuana has been touted to be a great stress reliever and nurses certainly have their share of stress. It also can help you sleep. Be careful even with CBD oil, make sure you use only the oil which does NOT have THC in it. There is CBD oil that contains only hemp, the female part of the marijuana plant, which has no THC.
I hope this information helps you to protect your license. I believe that Boards look at the use of marijuana by a nurse is like it being used by an airline pilot. Would you really want to get on a plane knowing that the pilot was using marijuana? Would you trust your child’s safety to a school bus driver or daycare teacher who you knew used marijuana?
This may be opening a proverbial “can of worms” but let me know your thoughts on this topic in the comments below.
Are you required to do mandatory overtime at your hospital? In Ohio, lawmakers are trying to ban mandatory overtime as a condition of employment. Nurses are very scared that if they say “no” to mandatory overtime that they will be fired.
Due to the nursing shortage, hospitals feel they have no choice but to have nurses work longer hours to cover more shifts. But, unfortunately, this creates a danger to the patients and to those who care for them because the nurses will be exhausted. Interestingly, Ohio was the state where a nurse was killed in an auto accident when she fell asleep at the wheel after working mandatory overtime. Her husband filed a lawsuit against the hospital.
It is sad that laws need to be put into place to make sure nurses are not working unusually long shifts. Laws are in place that limit work hours for airline pilots, truck drivers and others. Nursing should be one of those professions with limited work hours.
Minimum mandatory staffing would go a long way, however, under such a directive, hospitals may require having nurses work over to fill that minimum requirement.
Minimum staffing requirements were recommended to improve patient care but, if nurses are working longer hours to fulfill that minimum mandatory requirement, then that is not helping patients because the nurse will become exhausted.
Measures need to be taken to have an on-call system or other protections in place so that adequate staffing is maintained but not at the expense of nurses working mandatory overtime.
What are your thoughts? Does your hospital have mandatory overtime? Please let me read your thoughts in the comments below.
As nurses, while we really want to help our patients, we sometimes find that our being helpful can get us into trouble. As you know, we are required to follow tons of rules. We have to watch our professional boundaries to make sure we are not overstepping.
For example, if you work at an assisted living facility where one of your patients needs help getting groceries and you agree to get the items for the patient. This is crossing the line. You are there to provide nursing care and not help the patient with something like that.
I’m aware of what you’re thinking, “You know, I’m just trying to help her out.” But still, that crosses the line and can lead you to trouble.professional boundaries nurses nursing patients
Another scenario is you have a patient who perhaps is constipated and requires Milk of Magnesia. The physician normally prescribes that for all his postop patients but let’s say that, for whatever reason, this order got missed. You go ahead and give the Milk of Magnesia to the patient while fully intending to get an order to cover you.
As much as you wanted to help the patient and relieve their suffering from constipation, this would be practicing medicine without a license.
Don’t fall into the trap; your license is too valuable. It’s a true privilege to be a registered nurse but don’t mess up your career because you felt compassion toward a patient.
Here’s another example: your boyfriend is in pain and you give him one of your own pain medications left over from a surgery you had. As much as you would like to ease his pain, this too is considered practicing medicine without a license.
How about if you were working on a cancer unit and when a patient passes away, the medications are left and not wasted. If you save these for other patients who may not be able to afford these medications, even if ordered, is considered diversion.
If any of these situations cause you concern, I would suggest taking continuing education on ethics and professional boundaries to make sure you are complying with the law. Each one of these nurses thought they were helping people and it turned out to hurt them. Have you run across similar situations? What did you do? I would love to here your thoughts below in the comments.
You’ve heard of the “never” events where the government will not pay for certain things that happen in a hospital that shouldn’t have happened. This list includes things such as decubitus ulcers (stage III and IV), vascular catheter associated infection, catheter associated urinary tract infections, administration of incompatible blood, falls, air embolism and foreign object intentionally retained after surgery.
I decided to come up with my own NEVER-DO list in nursing.
- NEVER pre-chart anything in the medical records. You can never know what will happen. I’ve seen so many nurses get in trouble with the Board because they pre-charted and then something different happened to the patient.
- NEVER prearrange medications and take them out of the packaging if you are not going to administer them right away.
- NEVER remove medications from the Pyxis early and carry them around with you. While it’s great to think ahead, the delay in administration is a red flag.
- NEVER keep medications in your pocket if you find the patient is asleep or if they refuse to take the medication. Always make sure you return it.
- NEVER sign that you witnessed a waste of narcotics if you actually did not do so.
- NEVER document anything that you did not do.
- NEVER omit any of the jobs you’ve held when applying for a job on an employment application.
- NEVER forget to document the name of anyone else who provides care to a patient, such as starting an IV, inserting a catheter or calling a physician.
- NEVER act outside the scope of your practice. If the policies and procedures does not support your actions, then don’t do it. For example, nurses in one hospital may be allowed to draw blood from the Quinton catheter but those in a separate hospital may not be allowed to do that same task. A hospital may allow a nurse to remove a central line but denied doing that at another facility.
- NEVER forget to renew your license. Practicing nursing without a license is a criminal event.
This is not meant to be a complete list but only as a starting point.
What other things can you think of that nurses should never do? I would love to read your list in the comments below.