“Nursing is in your DNA. We’re called to serve,” said Lorie Brown, the president-elect of the nurse-attorney association. Brown, who works as a nurse-attorney at Brown Law Office in Indianapolis, couldn’t leave her law practice to go back to nursing. But she did devote time preparing a guide about self-care and mental health for nurses, covering such things as mindfulness, meditation and yoga. [Read Full Article]
Nursing And The Coronavirus
A nurse working at Kaiser in California took care of a patient who was positive for the coronavirus. She volunteered to care for this patient because she had training on the recommended protective gear. Her assumption was that should something happen to her, she would be cared for.
Unfortunately, after a few days passed, the nurse became ill. She put herself on a 14-day self-quarantine period. However, she could not get tested to confirm whether she had contracted the coronavirus. At that time, she was put on some type of list.
The United States has the lowest number of tests conducted for the coronavirus as compared to the rest of the world. It goes without saying that if we cannot get tested, how do we know who has it and then how can we limit the spread of the coronavirus?
Fortunately, this nurse had the support of her union, National Nurses United, which hosted a press conference on this matter at 11:00 A.M. PDT on March 12, 2020. You can listen to it here.
What concerns me about this situation is that this nurse took care of a patient with confirmed coronavirus and became ill. My issue with this nurse who became ill after she cared for the patient is that if it is not proven that she contracted the coronavirus during her treatment of the patient, her employer would have grounds to deny any workers compensation claim she might make.
It is very important that nurses who are exposed to the coronavirus get the proper documentation, so they not only get their time off but also for any medical care co-pays and any other sequelae.
I hope nothing like this happens to you, but it possibly could. Approximately 65 employees from the nursing home where many of the deaths from coronavirus are now ill but unable to get confirmatory testing. It’s scary that all these people are getting infected and I am hopeful they can contain the virus.
In the meantime, do whatever you can do to keep yourself healthy including taking vitamin C, exercising, drinking plenty of fluids, get adequate sleep and taking probiotics.
What has your facility done in light of the coronavirus outbreak? Have any specific precautions been put in place there to protect you?
Please share in the comments below.
Nursing Scope Of Practice
Have you ever worked somewhere and your supervisor says, “Just write an order for that. We always do that to help out the physicians.”
In that situation, you feel like you’ve been put between a rock and a hard place. Your supervisor is telling you one thing and your gut is saying, “Hey! Wait a minute! I don’t have an order. I don’t have a policy and procedure and the physician is not available for me to ask.” Your gut tells you that this is something you should not do yet your Supervisor is ordering you to do exactly that.
This is a dilemma in which nurses frequently find themselves.
If you are asked to do something outside of the scope of your practice … trust your gut … don’t do it! The physician just might not cover you for what you did.
In addition, know your facility’s standing orders which are those that you can adjust medications based on labs and things like that. But they must be in the actual order or in the policies and procedures.
Taking it upon yourself to adjust or order medications or order labs is improper without the protection of a standing order or a policy and procedure. This would be called practicing medicine without a license and exceeding your scope of practice.
In addition, as nurses, we know too much. Sometimes when we have a pain, we are inclined to take a pain medication that we had around for a long time that was prescribed for another purpose or a previous episode of the same event. This also is considered practicing medicine without a license and exceeding your scope of practice.
It is really important that as nurses, we set the example. We cannot borrow a pain medication from someone else because we hurt our back. We have to go through the proper procedures as we are held to a higher standard than the general public and need to go through the same channels that the general public goes through. When we are sick, we go to the doctor, emergency room or urgent care to get a prescription.
If you are asked to take a drug test and have a positive urine for a medication for which you don’t have a prescription or a medication that has expired or prescribed for another reason, it is very difficult to protect and defend yourself.
When you take an expired medication or one borrowed from someone else, you are self-prescribing and practicing medicine without a license and exceeding the scope of your practice. It also is considered diversion because the medicine was not prescribed specifically for you or for that reason. Diversion simply means taking something from where it was supposed to go and moving it to another place.
This is such a big issue in healthcare.
Although you may not feel well, go to the doctor who knows the best way to help you. In this way, it is documented that everything was properly prescribed.
When you are faced with these difficult ethical dilemmas and you don’t have policies and procedures to support you, stand in your power and tell your supervisor that you do not feel comfortable doing something which is outside the scope of your practice.
Although you may fear you might lose your job, as I often say, you can always get another job but not another license.
In a Gallup Poll, nursing has again been voted as the most trusted profession for the 18th year in a row.
One of the reasons it has been so long acclaimed is because of nursing ethics. However, anything that nurses do that may not put our profession in the most favorable light, can be detrimental.
In an MTV reality TV show “Scrubbing In”, they portrayed nurses going to bars in their scrubs. This negatively portrayed the nursing profession. We are held to high standards, just like a physician. Because we are a nurse 24/7, If we go out and drink, we should not wear our hospital attire, nor should we get behind the wheel of a car.
Be careful of any behavior which could be negatively interpreted by the public. As stewards of health, let’s do our part to put our best foot forward in all situations whether or not we are at work.
Having a criminal matter can reflect negatively on the profession. Because we are nurses 24/7, having a positive urine test even with a valid prescription, the Board cannot tell when you took that medication, even if you did take it after work.
Just remember, as a nurse, we are under the public spotlight. Ask yourself if you would have judgement toward a nurse engaging in certain behaviors. If the answer is “Yes,” then don’t do it! For example, if you take controlled substances off work, and the same medication you took comes up missing or a patient says they never received it, it will be difficult to defend yourself.
As nurses, we want to help. But sometimes, helping can mean crossing the line. One nurse went to the ATM for a patient across the street and the patient now claims she never received the money.
I am proud to be a member of the most trusted profession. Hopefully it offsets the reputation of some attorneys! Please join me in continuing to make nursing the most trusted profession and being professional even when you’re not at work.
Top 10 Blogs Of 2019
This is one of my favorite things with each New Year. I look at my top 10 blogs to see which ones you really enjoyed. In 2018, the favorite ones were based on license protection so in 2019, I chose to do more articles on that same subject.
Just like with the New Year’s Eve countdown, let’s go down the list starting with number 10 and head to number 1. By the way, you can read the original blog by clicking on the bolded number for each one.
NUMBER 10: PYXIS AND YOUR NURSING LICENSE – Probably among the most important of my videos because day after day I see where nurses are not properly following policy with medication management which is of concern to administration due to our opiate crisis.
NUMBER 9: THE PERILS OF TRAVEL NURSING – This blog discussed the top 8 ways travel nurses can get into trouble and advises how they can protect themselves.
NUMBER 8: WILL NURSES BECOME OBSOLETE – Is new and advancing technology creating a more automated world that is taking the place of nurses?
NUMBER 7: MED ERRORS AND CRIMINAL CHARGES – Tennessee nurse RaDonda Vaught accidentally gave a patient vecuronium instead of Versed resulting in the patient’s death. Vecuronium is used to intubate patients by repressing respiration. While in a PET scan, the patient arrested and died. The issue was not identified until an audit by the Center for Medicaid and Medicare Services (CMS) was done over a year after the incident. After the investigation, nurse Vaught was charged criminally in this matter. While she did commit malpractice, it is my opinion that it should not have risen to the level of a crime albeit for making a horrible mistake.
NUMBER 6: REFUSAL TO DRAW BLOOD – Jonathan Moore was involved in an auto crash killing a former city council woman and her daughter. When Moore was hospitalized, police wanted the nurse to draw blood without an order and without patient consent. The nurse told the officer that a warrant would be needed to make the draw. Crystal clear policies should be in place so nurses know when they can do certain activities.
NUMBER 5: FATAL MEDICATION ERROR UPDATE – This was another article dealing with of nurse RaDonda Vaught who accidentally administered vecuronium to a patient [See NUMBER 7]. Criminal charges were filed against nurse Vaught and the Tennessee Board had initially excused her actions but then decided to take action against her license.
NUMBER 4: NURSES IN TROUBLE WHEN PHYSICIAN OVERPRESCRIBES – A physician was actually practicing “end of life” measures by prescribing 20 times the normal dosages of fentanyl. Nurses who carried out those orders were all fired and reported to the Board. There was one wrongful death lawsuit that settled for $4,500,000.
NUMBER 3: NURSES WITH ADDERALL – This item discusses a Louisiana Board’s concerns about nurses who take the controlled substance Adderall. In fact, it shows a statement by the Board about how Adderall is the most widely abused prescription drug in America and how Boards can take action if a nurse takes any controlled substance.
NUMBER 2: UNUSUAL NURSING BOARD CASE – A nurse received an unfavorable decision by the Delaware Division of Professional Regulations to the Supreme Court which overturned the Delaware agency’s ruling. Two nurses were on duty and required to count medications just as if they were controlled substances. During the count, the supply of hepatitis C medication, costing $1,000.00 per pill, was accidentally spilled to the floor. The nurse put the 12 pills in the sharps container, but the pharmacy ordered them to be retrieved for later distribution to this patient/prisoner. The nurse’s license was placed on probation for 90 days and required her to take continuing education. But she disagreed with the decision and took the matter to the Delaware Supreme Court … and WON! It is unusual for nurses to appeal a case, let alone be successful.
NUMBER 1: PATIENT KILLS NURSE – A nurse accosted by a patient who, before others could restrain him, violently slammed the nurse’s head onto a desk. Lynne Truxillo subsequently succumbed to blood clots in her leg leading to a pulmonary emboli. Though the patient was charged with manslaughter, the obvious truth was that the charge could never bring back nurse Truxillo.
MY PERSONAL FAVORITE: My personal favorite blog was an interview with nurse Yolene Lofton who lost her license simply for recording the wrong date on some documents. It was sad that she lost her license over that error. But it does show just how important your license is and how even a minor error could result in loss of your license and livelihood.
My hope is that you can learn from these blogs and do everything you can to protect your most valuable asset: your license.
What was your favorite blog in 2019? Was it any of the above or perhaps a different one? Let me know in the comments below.