Nursing & Healthcare Provider License Law Blog

Polarity Between Medical and Nursing Boards

June 17, 2021 by LORIE A BROWN, R.N., M.N., J.D. 2 Comments

In California, there was a proposed legislation that would add 2 seats so that a majority of members for the Medical Licensing Board would be consumers rather than doctors.

This is an interesting proposition. However, in my experience, the consumer Board member does not contribute as much because they haven’t worked in the nurses’ or the doctors’ shoes.

Evidently, the public is very suspicious of the Medical Board in California because of several complaints by patients against doctors that seemed substantial where the doctor received no disciplinary action.

In fact, one member of the public stated, “My husband lost his hands and feet, and this physician has a spotless record.”

Adding more public members or making a public member majority would, “Obtain more transparency and data with regard to the Board’s enforcement process, and how it makes decisions.”

However, I do not think that this legislation was enacted.

Apparently, the Board settles 84% of its cases and 54% of those stipulated settlements failed to meet the disciplinary guidelines, yet no action is taken.

There was also another allegation against a former chief pediatrician over some 20 years as the pediatrician allegedly had sexually abused boys. No action was taken against this physician.

What is so interesting is the California Board of Registered Nursing and the Medical Board are polar opposites. The Medical Board is “the good old boys’ club” whereas the BRN is eating their young.

It would be interesting to see in the states that have medical boards oversee nurse practitioners, if it would make a difference in the outcomes. Would nurse practitioners be part of the medical board’s good old boys’ club or treated just as harshly as they are by many of the nursing boards?

I suspect this issue is not over in California.

There was a shakeup in California several years ago when Arnold Schwarzenegger was Governor, where the California Board of Registered Nursing delayed taking action against nurses accused of misconduct. The then Governor Schwarzenegger replaced most of the BRN members. The BRN has been much more aggressive because they don’t want to be removed as in the Schwarzenegger era. Yet recently the former director of the BRN, Joseph Morris, resigned after there were allegations of sexual harassment from state employees.

What else is new? It’s California!

NURSES’ REFUSAL OF COVID VACCINES

June 9, 2021 by LORIE A BROWN, R.N., M.N., J.D. 18 Comments

I had great trepidation to write this article because it is so controversial among many nurses. However, in my desire to share with you real world happenings, I chose to go ahead to write about this subject.

Houston Methodist Hospital’s Jennifer Bridges, R.N., has worked with COVID patients since the pandemic began. She would assist patients to a window to see family members and at times hold a phone to their faces while family members spoke with them, many for the last time. She suffered numbness in her arms from holding up iPhones or iPads for hours. She risked infection, experienced the psychological toll of witnessing firsthand families in trauma.

She a times would find herself drenched in sweat and light-headed at the end of shifts. Helping her patients was a task in which she went above and beyond.

Last month, her hospital became the first hospital in the country to require mandatory COVID vaccinations for all employees. Those employees who did not comply and failed to provide proof of vaccination by this past Monday, June 7^th, were suspended without pay for 2 weeks. After that, they would be subject to termination.

Nurse Bridges, by no means an anti-vaxxer, received her annual flu inoculations as well as all the other recommended vaccines. However, she did have concerns about taking the CV-19 vaccines because they were rushed onto the public with Federal Drug Administration (FDA) “emergency use authorization” rather having gone through the normal prescribed testing protocols previously required for vaccines prior to it going to the public. Essentially, rather than the vaccines first being tested on animals, the public itself became the testing subjects.

She since has encountered dozens upon dozens of patients who experienced adverse reactions to the vaccines such as blood clots, heart arrhythmia, swollen appendages, etc.

Altogether, she does not feel comfortable at this point with the vaccines but maybe after they have been evaluated more in depth or even properly tested by the FDA, she would be more agreeable to accepting the vaccines.

In her home state of Texas, apparently only 33% of the residents are fully vaccinated meaning that two-thirds of the population has not received the full vaccination treatments.

That may reflect how the vaccine issues have split our nation into an “us vs. them” society. I’ve seen the opinions and responses on social media of the 2 camps: those who believe in protecting themselves and others with the vaccines and those who are hesitant or even refuse to participate in the vaccination programs. Most believers shun those that don’t want to get vaccinated but, interestingly, I have not seen many non-vaccinated who choose to shun their inoculated counterparts.

This is typical of the profession where “nurses eat their young” … shunning your brothers and sisters for choosing what they would like or not like to put in their bodies.

Ms. Bridges said, “This is supposed to be America! You’re supposed to have civil rights and constitution rights, your freedom of choice. … Nobody should be forced to put anything into their body if they are not okay with it.”

While many health care facilities have mandatory flu vaccines, if one chooses not to take the inoculation, you can wear a mask. But this is not so with the COVID vaccines.

According to the Health Law & Policy Institute at the University of Houston Law Center, an at-will employee of a private institution which has medical and religious exemptions in place, is not forcing her to take the vaccine.

With the support of other nurses, receiving signatures of more than a hundred co-workers, Ms. Bridges has filed suit against the hospital. Will the courts allow her to have a choice of what goes in her body or err on the side of public health? We shall see.

A HUGE NURSING SHORTAGE

June 3, 2021 by LORIE A BROWN, R.N., M.N., J.D. 3 Comments

Anyone interested in making money in Georgia?

Piedmont Healthcare is offering sign-on bonuses of up to $30,000 to attract nurses to their employ. That hospital system has been relying on expensive travel nurses to treat their patients but instead is now making a concentrated effort to put together their own staff.

Many other health systems are offering sign-on bonuses such as Penn State Health’s offer of $15,000; and Baptist Health Systems which is presently offering a $20,000 enticement.

Nurses are more in demand now than ever throughout the country. The shortage is resulting from many who have left the profession due to being “burned out” with the demands of health care during the pandemic.

Specifically, there is a crucial need for med/surg and ICU nurses and even operating room nurses as health systems try to recoup lost revenue from earlier during the pandemic when elective surgeries were placed on hiatus.

Interestingly, there currently is less of a demand for specialties like pediatric care as well as labor and delivery.

If you decide to apply for a new position that offers a sign-on bonus, be careful because if you are later terminated, or the position does not work out for any reason, you will have to pay back that bonus, usually pro rata.

You will want to negotiate very carefully a contract with a sign-on bonus as there can be many strings attached. Having an attorney review the contract before you sign would be prudent.

While it’s great that “money talks,” I really would like to see the loss of nurses curbed by being treated better so that they will want to stay with their job. Some things to help are assisting nurses decrease burn out, having adequate staffing and showing appreciation to the nurses for their service.

The culture in many of today’s healthcare facilities needs to change if they wish for their nurses to stay.

Though it may sound great to move to Georgia and get a sign-on bonus, do your homework, make sure the unit you are signing onto values and appreciates their nursing staff. And of course, carefully negotiate your sign on agreement so that you can avoid paying back a lot of money if things don’t work out and you choose to leave.

Should It Take 30 Weeks For A License?

April 8, 2021 by LORIE A BROWN, R.N., M.N., J.D. 2 Comments

Imagine having your military serving spouse transferred in the middle of a pandemic and you are an Advanced Practice Nurse then having to wait 30 weeks before you can be licensed in your new state?

Well, that is exactly what happened to Courtney Gramm of California, board-certified and a member of the American Association of Nurse Practitioners.

Mrs. Gramm’s husband, serving with the U.S. Air Force, was ordered to move from Florida to California. But when she applied for her Registered Nurse license in California, she had to be fingerprinted, submit transcripts of her education, and pay a required $350.00 fee as well as $30.00 for a license verification check.

Altogether, she emptied her bank account of more than $900.00 to finally get her nurse practitioner license.

Now, compare these to my home state of Indiana which requires a $50.00 application fee for a Registered Nurse and another $50.00 for an APRN.

However, Mrs. Gramm’s issues did not end there! She submitted everything as required only to have to wait and wait and wait.

She knew she had valuable skills to help during the pandemic in California but couldn’t even work because she was unable to be licensed.

Finally, 6 months later, after contacting her California State Assembly member, Mark Stone, who then contacted the Board of Registered Nursing in California on her behalf, was she able to get her Nurse Practitioner license.

Imagine, a nurse in overall good standing professionally yet not being able to work for more than 30 weeks because she was unable to get licensed.

Something needs to change!

Some states have COVID exceptions where a nurse can get a temporary permit to work right away … but apparently that is not in California.

It is sad that so many people around the nation need the help of nurses but are being denied because of these unreasonable bureaucratic constraints on a nurse’s ability to practice. Unlike nursing where you can get a compact license in 34 states, there are no compact licenses for Nurse Practitioners.

Are there delays in getting a license in your state? I would love to hear your comments below.

What Happened To Nurse Do No Harm?

April 1, 2021 by LORIE A BROWN, R.N., M.N., J.D. 2 Comments

52-year-old Connie Sneed is charged with a Level 5 felony for practicing medicine without a license in Indiana. Ms. Sneed, who had been with the nursing home for 15-years, posted a comment on a Facebook page which caused her to be charged criminally. Her comment was, “I just want y’all to know the hardest thing I’ve ever done in 28 years start a patient on O₂ for 4 days 12 LPM. with a non-rebreather mask … I asked him on day 4 if he’s tired he said yes I said do you want me to take all this off for you and let you go and fly with the angels and he said yes.” She unhooked the oxygen from the resident, and he succumbed a few hours later.

This man did have a diagnosis of COVID and his oxygen saturations were 64%. Ms. Sneed never contacted the doctor to ask for an order.

Nursing is not an independent practice. There must be physician orders or a policy and procedure that protects us for everything that we do.

Ms. Sneed did talk to the daughter who told her, “She could remove it but try to put it back on him later when he calmed down.” Apparently, the daughter did not understand that removing the oxygen mask would cause his demise. The daughter cannot give physician orders.

In an interview with state health inspectors, Ms. Sneed said that it was a terrible week. She had been caring for more than 40 COVID-19 patients at the facility when she forgot to notify the resident’s physician of his decline in condition.

While she may have thought what she was doing was in the best interest of the patient, she did not go through the proper process. She had a duty to pick up the phone to tell the physician about his declining condition and let the physician determine what the best plan of action would be.

Indiana is not a “right to die” state. Physician assisted death or “medical aid in dying” is legal in 10 jurisdictions: California, Colorado, District of Columbia, Hawaii, Maine, Montana, New Jersey, Oregon, Vermont, and Washington state.

Fortunately, Ms. Sneed was not charged with manslaughter as she could have faced a possible death penalty.

So, sometimes caring for patients may not be in alignment with what you believe but we are here to serve the patients and not ourselves

I did have the opportunity to look on the Indiana Professional Licensing Agency website and Ms. Sneed is listed as having an active license as well as a pending compact license application. It appears that she wanted to practice in other states as she lived near the Kentucky border.

While it is unfortunate that Ms. Sneed was so busy with 40 COVID patients, no nurse has the right to take a patient’s life in their hands. [Indianapolis Star article]

Let me hear what you think of this in the space below.

Until next time, happy nursing.

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