California Governor Gavin Newsom proposes that nurses be trained in ICU care in just 48 hours.  Maybe they can be trained in 2 days but certainly not sufficiently enough to do things safely or within the standard of care.

A nurse with only 48 hours of ICU training may end up being more of a danger to a COVID 19 patient than the virus itself.

But what difference does that make when hospitals cannot be sued for malpractice involving COVID related cases?

I would like to be standing alongside Governor Newsom while he learns to become proficient as an ICU nurse in a mere 2 days.  Of course, it will not happen and, in fact, can NOT happen!  Even if he had a medical background to start with, it just is not feasible for such a Herculean feat, even by a Governor.

To become an effective and safe nurse requires years of practice and continued education for one “to get their nursing legs.”

More precisely, the assumption that one can go from a different type of nursing care to learn ICU practices in 48 hours is also ridiculous!

Many nurses have spoken up saying Newsom’s whimsical idea will not work.  They have talked about how they themselves had 6 months of training before they were allowed to take patients on their own without the support of other already professionally trained medical personnel.

I caution any California nurse to think again if they believe they can become a proficient ICU nurse in less time than it takes to drive from Los Angeles to New York City.

You may not be sued for malpractice because of the laws protecting COVID 19 healthcare providers from legal action but, nevertheless, your LICENSE IS STILL ON THE LINE.

Do not make the mistake of trusting a politician’s statement over the most basic reality of what is known by essentially every person in the healthcare profession.  Which do you believe provides a more trustworthy educated and work-experienced opinion?

2 days?  The idea would be laughable if it did not involve the life-and-death issues accompanying the COVID pandemic.

I strongly encourage you to invite your legislators to shadow you in the ICU so they can see what you are dealing with and decide for themselves if someone can be trained in 2 days.

Let me know below your thoughts on Governor Newsom’s statement.

 

A Minnesota emergency room nurse was concerned about having to wear his own scrubs to work during COVID and returning home to his wife and children wearing those potentially contaminated scrubs.  He worried about bringing the virus home and passing it on to his family.

Scrubs were available in the emergency department and healthcare workers at other hospitals in the same system were allowed to wear the scrubs provided by the hospital.

However, at this particular hospital, he was told he could NOT use the hospital scrubs.  He continued to wear the hospital acquired scrubs rather than his own and, as a result, was terminated.  Since then, he received a letter from the Board.

It is so aggravating to learn that nurses, who are trying to protect their families, cannot wear hospital provided scrubs but are forced to wear their own scrubs and to wear home after working with possible COVID patients at the hospital.

However, I do not condone violating hospital policy and he did receive a warning after which he continued to disobey the hospital policy and continued using the hospital provided scrubs.

The nurse felt he was forced to decide whether the most important point was the policy or the safety of his workplace, public health, and family.

There is an appropriate way to make change and there are appropriate channels for this.  If you cannot make change, then you can decide if you want to leave.

There are also other ways to protect your family’s health.  I know of nurses who brought an extra set of scrubs and changed clothes in the hospital before leaving.  I know nurses who, on arriving home, have changed in the garage and immediately took their potentially contaminated scrubs to their washing machines for cleaning.

Unfortunately, this particular nurse who chose to violate hospital policy has now received a complaint from the Board.

Anyone can file a complaint against a nurse and the Board will subsequently investigate to determine whether the file should be closed or the action on the complaint should proceed.

I have represented nurses who have taken from their hospital IV supplies for hydration and the Board considers that as theft.  Just borrowing hospital-provided scrubs which you don’t take home and are still laundered by the hospital … well, I’m not sure what the Board will think.

Unfortunately, this nurse now is unable to get a new job.  He believes he has been “blackballed.”  However, this nurse has been very vocal in publicizing his case on a website and on Twitter.

Hospitals do check you out and especially so with social media.  Would they want to hire a nurse who knowingly violated hospital policy?

If you want to make change, make it the appropriate way and be careful what you put on social media.  What are your thoughts about this matter?  Comment below please.

 

An Oregon oncology nurse posted a video on Tik Tok saying that she does not wear masks in public, continues to travel and allows her children to have playdates. Someone who viewed the video reported her to her employer.  She was placed on administrative leave.

In the video, this nurse apparently is in the break room at work and wearing scrubs with a stethoscope around her neck.  The hospital felt the nurse displayed “cavalier disregard for the seriousness of this pandemic and her indifference towards physical distancing and masking outside of work.”

Her employer responded with a statement saying that the video does not speak for the health system: “We also want to assure you that this one careless statement does not reflect the position of Salem Health or the hardworking and dedicated caregivers who work here.”

I have several thoughts on this issue.  The first is to advise you to be very careful of what you put on social media.  Do not do a Tik-Tok video in scrubs in your break room.  Even though you are on break, you are still on hospital property.  Even if you were not at work, you are considered a nurse 24/7 and while you may not like this, if your statement can impact your employer, that is not being professional as a nurse. Before doing a video or putting something on social media, ask yourself, “What is the purpose?”  I am not sure what this nurse’s purpose was in posting her video.  If your purpose is to educate the public that is one thing but if it is to create controversy or show your hospital or health facility is doing something wrong, that is another thing.

But my biggest concern is freedom of speech.  This nurse should be able to speak her mind regardless of whether or not it’s in line with company policies.

While there are very strong feelings on both sides of this pandemic, including whether to get vaccinated, whether to wear a mask, whether to travel, whether to allow your children to have playdates … all of these are very polarizing issues.  However, I do believe every nurse, just like every person, has the right to free speech and should not have his or her job placed on the line because of it. Check out these related blog posts.  https://empowerednurses.org/beware-of-using-social-media-as-a-nurse/  https://yournurseattorney.com/speech-is-not-always-free/

What are your thoughts?  Let us read your comments below.

 

Every nurse I have ever represented said, “I am a good nurse.  I never thought I would have to appear before the Board.”  But here they are caught in the administrative quagmire.  There are a myriad of ways a nurse can get in trouble with the Board. I wanted to share common ways I have seen in my practice to put you on alert so you can avoid these issues.  Here are ten possible ways, in no particular order, that might get you in trouble with the Nursing Board.

1. DRUG DIVERSION AND/OR SUBSTANCE ABUSE:

A large percentage of the number of cases that come up before a Board fall into this group.  If you develop a substance use or abuse problem, I suggest contacting your peer assistance program as this is the best way to protect your license.  If you know of someone who needs help, I highly recommend that you insist that your colleague protect their license by also contacting the peer assistance program.  This could save their life and their license.

2. CRIMINAL ACT OR CONDUCT:

This could also relate to drug diversion or substance abuse but sometimes it does not.  It could be an ethical issue that the Board is concerned about for which they would like to take action.  Whether you agree with it or not, the Board views you as a nurse 24/7.

3. SCOPE OF PRACTICE:

This violation occurs when a nurse acts outside the scope of their practice.  It happens when, say, a nurse fails to get a doctor’s order for something.  Many times, it happens when a nurse does something thinking the physician will cover them later and then he/she doesn’t.

4. HIPAA VIOLATION:

This is self-explanatory.  Any time you breach a patient’s confidentiality or have some other HIPAA violation, the Board can take action against you.

5. FRAUDULENT OR FALSIFIED PATIENT CARE OR BILLING RECORD:

It is unfortunate that should you fail to document the administration of a narcotic, the Board seems to believe that you took the medication or, if you didn’t take the medication, then you sold the medication or, in a third hypothesis, if you administered the medication and just forgot to document it, then you are incompetent.  This seems like a no-win situation.

6. FAILURE TO MAINTAIN MINIMUM STANDARD OF NURSING PRACTICE:

Such allegations include incompetence or negligence.  This can include medication errors or failing to identify a change in patient condition.  Sometimes it can even include concerns due to terminations from multiple jobs in a short period of time.

7. RECIPROCAL ACTIONS:

Did you know that if you have an action against your license in another state, you also can have an action in all states in which are or have ever been licensed?  Therefore, it is very important to fight such claim at the outset, even if you no longer practice in that state.  Otherwise, the other states in which you hold a license can take action leaving you with no defense if you resolve the matter in just one state.

8. RENEWAL FRAUD:

If a nurse fills out a license renewal application or an employment application but does not tell the truth, it can be considered fraud and material representation in obtaining a license. This includes omitting jobs from an employment application.

9. FAILURE TO PROPERLY DOCUMENT:

This is when your documentation does not accurately reflect the patient care and services rendered.  Late entries can be a red flag for these types of claims especially if they were not properly made. Sometimes facilities have cameras in the hall and can show that you did not check on the patient as required or only were in the room such a short period of time, you could not have possibly rendered the care you said you did.

10. FAILURE TO ADHERE TO FACILITY POLICIES:

It is very important that you know the policies at your facility.  Facility policies and procedures can change often.  You may have been at one place where, say, it was proper for a nurse to draw blood from a Quentin catheter and then go to another place where it is not acceptable.

By sharing with you these ten areas in which nurses are frequently called before the Board, I hope that you will be on high alert to avoid such situations in your daily practice.

A couple of weeks ago, I shared about a scam taking place against nurses in Idaho and which now has spread to Missouri.  What is happening is that nurses are alerted by a phone call and letter purportedly from the state Board of Nursing telling the nurse that they are being investigated and required them to provide a payment in the form of a bond to keep their license active during the investigation.

The premise on this scam is that someone had used an advanced practice nurse’s NPI number to write prescriptions in another state and that they were under investigation for allegedly trafficking in illegal drugs.

The letter looks official and much of what is in the letter, such as the nurse’s home address, state license number and NPI number, are real.  However, keep in mind that no nurse should be required to pay upfront any monies like a bond for an investigation.

You can confirm your license at www.nursys.com.  It also advised that the nurse could enroll in nurses enotify to receive notifications such as license renewal reminders, verification when the license is renewed and notification of any change to their license or discipline status.

While it is certainly scary that nurses are being scammed, be very cautious if you receive such a phone call or letter from the Board.  It also may be worthwhile to contact an attorney.