The new year always is a perfect time to focus upon commitment and responsibility. And for registered nurses, that means a fresh look at practice “DOs” and “DON’Ts.”
The “DOs” we all should know: Follow those good habits we’ve been taught, complete our continuing education requirements, practice good common sense.
It’s the “DON’Ts” that sometimes confuse us. Unfortunately, the medical field is complicated and cumbersome. Sometimes we’re not sure of what is proper and improper. We have too many patients and too little time. How do we balance the competing needs for our time, all the while ensuring that we follow protocol?
Basic procedural foundation is laid for us in the law and in the Alabama Board of Nursing’s administrative procedures. See Code of Alabama, Section 34-12-25(b) (just after the section stating that you can be fined for poor practice):
“(b) The board (Alabama Board of Nursing) may also deny, revoke, or suspend any license issued by it or otherwise discipline a licensee upon proof that the licensee: is guilty of fraud or deceit in procuring or attempting to procure a license; has been convicted of a felony; is guilty of a crime involving moral tuipitude or of gross immorality that would tend to bring reproach upon the nursing profession; is unfit or incompetent due to the use of alcohol, or is addicted to the use of habit-forming drugs to such an extent as to render him or her unsafe or unreliable as a licensee; has been convicted of any violation of a federal or state law relating to controlled substances; is guilty of unprofessional conduct of a character likely to deceive, defraud, or injure the public in matters pertaining to health or has willfully or repeatedly violated any of the provisions of this article, as defined by board rules and regulations. The board may refrain from or delay taking disciplinary action under this subsection if a licensee can be voluntarily treated or rehabilitated…”
The Code section goes on to provide for the procedure for administrative hearings for persons accused of violating BON procedures.
“Suspension” and “revocation” are dreaded terms for registered nurses. After all, good nurses don’t get into trouble with the Board of Nursing. Right?
Wrong. The best-educated and most competent nurses can and do make mistakes, just as the best lawyers, physicians and architects can and do. But we can minimize the chances of mistakes by practicing good, time-honored procedures and using common sense.
Nurses often confide that they thought what they were doing may not be strictly proper, but it was on doctor’s orders. No physician has the authority to give a nurse an order which violates the practice act. If you fear the order is improper, question it and report it to a supervisor. Call the Board of Nursing and report it. If you’re a member of the Alabama State Nurses Association, by all means call ASNA where you will always find support and comfort.
Board of nursing staff are not the villains some nurses perceive them to be. Yet BON staff have the prosecutor’s mentality. They seem to believe that you’re guilty until proven innocent. And they have such a heavy load that they have to dispose of cases as quickly as possible.
The typical procedure for this early resolution is to have the investigator call the nurse in and push a consent decree in his/her face, stating that the matter will be all over with if they only sign. Often execution of a consent decree is the preferable procedure – is in the nurse’s best interest. But a registered nurse, whose hard-earned license is at issue, should never sign a consent decree without first obtaining competent legal representation. Consult an attorney before you go to the Board of Nursing or sign any document.
The conduct proscribed in the BON regulations largely is conduct we know nurses shouldn’t be involved in: diversion or illegal drug use; abandoning or neglecting patients; “documenting” something that was not done; violating nurse-patient boundaries; etc. Yet simple negligence – just making a mistake – can be the source of a complaint too.
But regardless of the source of the complaint, DON’T view a board investigation as an end-of-practice occurrence. DO stay calm, seek legal help and rely upon your powerful advocate, the Alabama State Nurses Association.
by Don Eddins, BS, MS, JD
Attorney at Law
Don Eddins is a practicing attorney in Auburn, Alabama, and serves as a legal counsel to the Alabama Nurses Association. Every member is entitled to a one-hour free consultation on any legal matter by calling the ASNA office.
Copyright Alabama State Nurses’ Association Dec 2003-Feb 2004
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