board of nursing Archives - Brown Law Office

Nursing And Ethical Issues

August 8, 2019 by LORIE A BROWN, R.N., M.N., J.D. 5 Comments

It is unusual for a matter before the Nursing Board to find its way into the court system primarily because of the cost. Recently, in Pennsylvania, one case did exactly that and wound up in court brought by an LPN.

In this particular case an LPN was charged on July 16, 2014 with 3 counts of drug related offenses and a count of disorderly conduct. To the charge of disorderly conduct, she entered a nolo contendere plea where a guilty plea is entered but the Defendant does not admit to the crime. She pled nolle prossed to the other 3 charges which means they were dismissed.

The LPN denied engaging in these types of behaviors but the Board believed the court documents and suspended her license for a period of 6 months. The National Council State Board of Nursing for the years 1996 through 2006, collected information showing 126,130 (more nurses than tin the entire state of Indiana!) actions were taken against nurses. 13% consisted of suspension and 7% consisted of revocation. Suspension is the second most common taken action. Probation was the most common Board action taken.

But what is interesting about this particular case is that the Board based the suspension on the conviction of a crime of moral turpitude which is an active behavior that gravely violates the sentiment of accepted standard of the community. However, the Court of Appeals stated that it was not a crime of moral turpitude and disagreed with the Board’s interpretation.

In my limited experience with these types of appeals before a court, this is a great result! I would love to see more people question the Board and appeal their actions to a regular court so that the Board can stay in check. Unfortunately, these kinds of matters are very expensive to pursue. The Boards have unbridled authority to do what they wish … and this needs to stop! This was an LPN who appealed the decision and I am so glad that the court agreed with her.

What are your thoughts? Let us know in the comments below.

25 Nurses in Trouble with Ohio Board Due to Physician Overprescribing

July 25, 2019 by LORIE A BROWN, R.N., M.N., J.D. 2 Comments

In an Ohio hospital system, a physician, William Husel, D.O, is on trial for ordering excessive and fatal doses of fentanyl. He has criminal charges pending against him and he recently pleaded not guilty to murder in 25 deaths. This is the biggest case against an American healthcare professional. (Story and Timeline). The physician ordered potentially fatal doses for 29 patients who died over the past few years. 5 might have had a chance to improve their condition with proper treatment. The defense claims that William Husel, D.O., was alleviating pain and providing comfort for dying patients. However, the fentanyl was 20 times the normal dose which is excessive. And no one questioned them.

Dr. Husel was working a critical, care intensivist at the hospital and he completed a fellowship in critical care but did not complete a required residency in internal medicine according to one source.

Five (5) managers along with 18 nurses and pharmacists were fired while the CEO of this health system stepped down. (Story). No one ever questioned the excessive doses.

Every nurse has a duty to question doses. Twenty five (25) of these nurses were reported to the Board as well. (Story).

What happened to Hippocratic Oath, physicians do no harm?

There have been several wrongful death lawsuits filed that have reached nearly $4,500,000 in settlement. It is so sad that these families trusted their loved ones to receive appropriate health care but through this doctor’s actions, they were denied.

This case is just an example of the importance of speaking up due to medical malpractice concerns, loss of your job and being reported to the Board. It is now even more important than ever that nurses speak up when the care is not appropriate.

Have you encountered any doctor like this? What would you do? I would love to hear your comments below.

Nurses And Adderall

July 11, 2019 by LORIE A BROWN, R.N., M.N., J.D. 3 Comments

Nurses work crazy shifts and can have trouble sleeping. In addition, we are being bombarded with information and get interrupted approximately every 5 minutes.

It would make sense that a nurse would go to her physician and say, “I’m having trouble focusing.” The physician prescribes Adderall and, at first, it’s amazing. You not only find that you suddenly have all this energy and are extremely focused, but you’re also losing weight as an added benefit!

Then nurses start thinking, “Oh, how could I have ever gone on without this?” Make no mistake, Adderall is an amphetamine, a controlled substance and is addictive. Some nursing students even get addicted to Adderall which they use to help them study.

If you participate in a peer assistance or substance abuse program, note that these programs are abstinence-based meaning, you will have to get off of the controlled substance it in order to participate.

It can be difficult for a nurse who has taken Adderall for a long period of time to get off that medication. The nurse may feel like they can’t focus as well and feel like they need it for their job. But, when asked to come off it, some nurses choose Adderall over their license.

In an article published by the Louisiana State Board of Nursing, “The Epidemic of Controlled Dangerous Substance Abuse,” “Adderall has been called the most widely abused prescription drug in America.” For full article, click here.

The Louisiana Board questioned whether nurses and nursing students should be allowed to practice while taking controlled dangerous substances which includes Adderall. The article goes on to state that up to 25% of college students have abused amphetamines.

According to the National Institutes of Mental Health, an estimated 4 to 5% of adults have ADHD and there are non-controlled substances which work for nearly all these patients.

“We believe that a professional who wishes to take controlled medications should make a choice between the medication and the profession. Professional Licensing Boards in all professions understand that the risk of impairment and damage to the public greatly outweighs any possible individual benefits in specific cases where practice of a profession and concurrent use of controlled medication is at issue. The overwhelming majority of such organizations choose to take the safest course and prohibit use of controlled substance medications or alcohol while practicing a profession. We agree with this policy.” [Click here to read more]

Therefore, it is a strong warning of the Boards that nurses should not take controlled substances including Adderall. Even if you have a valid prescription and your hospital may view a positive drug screen as a negative, it may come back to haunt you should you ever be called before the Board.

I would like to hear your thoughts on this topic. Please share your comments below.

Will A Criminal Record Affect My License?

June 6, 2019 by LORIE A BROWN, R.N., M.N., J.D. Leave a Comment

A guest blog by Evan Brown

Nursing boards take public health very seriously. In the interest of protecting public health, most boards take extra precautions to make sure that nurses licensed in their state have a proven track record of delivering excellent care. This includes a critical examination of nurses’ personal and professional histories.

Although you may be thinking that whatever happened was outside of work, the boards take the position that you are a nurse 24/7.

In most states, a blemish on one’s license or criminal record will not automatically bar a nurse from licensure of practice. The nursing board instead will conduct an investigation and make a decision in light of the circumstances at the time. In order to conduct an investigation, nursing boards need to be aware that an incident occurred. For this reason, nursing boards across the country have created self-reporting regulations for nurses to bring their criminal and disciplinary histories to the board’s attention.

Every nursing board asks about criminal and disciplinary history in its initial application for licensure and again on renewal. Boards differ in terms of what infractions must be reported. In general, any arrest, misdemeanor, felony, or plea of nolo contendre (an acceptance of the conviction without an admission of guilt) must be reported. Sometimes nurses must even report expunged convictions. Few require nurses to report minor traffic violations. When applying for licensure in a new state, every board also asks about prior and current disciplinary action by another board of nursing on the applicant’s license. An affirmative answer to any of these questions will often require the submission of court records and a written explanation of the event.

What about criminal convictions that occur after a nurse has received his or her license? When should these convictions be reported to the board? At minimum, every state board requires nurses to report such incidents when they renew their license. However, most states require self-reporting closer to the time of conviction. These timeframes range from “immediately” to between 10 and 90 days. One state, Arizona, requires notification of an arrest within 10 business days. Only in Massachusetts, Rhode Island, and Virginia is there no duty to self-report. These states often rely on automatic police and court reporting to the board, it is still wise to self-report.

It is always best to self-report as soon as possible, even if the board neither requires a self-report yet nor at all. Doing so demonstrates honesty and initiative, which an appreciative board may take into account when determining a response. Seeking rehabilitation or counseling, performing community service, and other voluntary measures of atonement can also help the board look more favorable on your case.

10 Mistakes That Will Get You Before the Board of Nursing

November 8, 2018 by LORIE A BROWN, R.N., M.N., J.D. Leave a Comment

Lorie Brown, Nurse Attorney, lists 10 common mistakes that nurses make that will get them before the Board of Nursing. These mistakes you may not know are violations of the Nurse Practice Act. Are you practicing medicine without a license? Are you committing fraud and material misrepresentation?

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