Tuesday, October 30, 2007

The Boards Need Changes To Be Fair

If you want to listen to the broadcast of the Appropriations subcommittee regarding the Texas Medical Board, go to the Texas House of Representatives and click on the 10/23/07 link. My law partner, Tim Weitz, chose to testify and you can hear his comments at about 6:64. Tim's comments are appropriate not only for the Medical Board, but also other regulatory boards such as the Texas Nursing Board.

For example, currently if a nurse(or doctor) goes to a contested case hearing with the Board at the State Office of Administrative Hearings (SOAH) and the Judge finds in favor of the nurse, the case still goes back to the Board for final determination. It has happened many times that the Board imposes their determination for that of the SOAH Judge, which means that the nurse spent money and time for the same result. The nurse's only recourse is to take the case to District Court. The fair way of resolving these cases as Tim explains to the Subcommittee is to have SOAH be the final decision maker and then either party (the health care provider or the Board) can appeal.

Another problem specific to the Texas Nursing Board is that the Board files "Formal Charges" within their agency, but this does not mean that the Board has submitted the case to SOAH and the procedure rules do not apply until the case is filed with SOAH. The main problem is that once these Formal Charges are filed, the charges are published online in the verification system. The problem with this is that the matter has not been resolved, it has not been submitted to SOAH, but it is now public knowledge.

Tim also points out ideals for regulatory agencies to follow. One of those is his statement that "Regulation does not always mean punishment." The idea that not every violation deserves regulatory action. Nurses need to pay attention to what is going on with the Medical Board because it may end up impacting nursing practice as well and if there are some legislative changes to improve the regulation of physicians, nurses need to be ready to request those changes for their agency as well.

Remember that knowledge is power and the first step for nurses to gain power in their occupation is to become knowledgeable about the laws governing the practice and then to join together to make the changes needed to fix the problems.

Monday, October 22, 2007

Meeting Involving the Texas Medical Board

The meeting scheduled for tomorrow at 10 am is turning out to be much more than originally thought. I received an email from the Medical Board's Public Information Director. Ms. Wiggins provided the following article involving the meeting, "Texas Medical Board to be Questioned at Hearing." This really seems to be shaping up to be an interesting meeting that all doctors and anyone else interested in the Texas Medical Board should consider attending.

Friday, October 19, 2007

Texas Medical Board House Committee Meeting Scheduled

I just found this upcoming committee meeting which is scheduled for next Tuesday. It is interesting that the committee is going to take testimony about the Texas Medical Board when it is outside the Legislative Session. Sounds interesting, let your physician friends know that this may interest them.


Appropriations-S/C on Regulatory


10:00 AM, Tuesday, October 23, 2007




Rep. Fred Brown

The Subcommittee will meet to take invited and public testimony regarding
the Texas Medical Board.


The Texas Board of Nurses has adopted the new CEU rules I warned you about in a June posting. The new rule allows the Board to refuse to renew a license if the nurse does not comply with continuing education requirements. Besides the complaints I had in that posting, I also question the legality of taking away a license without notice and a hearing. Since there were no comments about the proposed law and there were no complaints about the broad application of section 301.303(a) Nurse Practice Act, the rule will stand until there is a rule challenge.

The lessons to be learned here are to join organizations that monitor proposed rules and legislation and be sure that those organizations reflect your concerns about nursing practice AND be sure that your address is current with the Board so that you get all notices AND be sure to keep up with your continuing education credits and any audits.

Wednesday, October 17, 2007

The Nurse Police

Be sure to check out my new article "The Nurse Police". I explain the role of Nursing Boards and some basic steps nurses can take to protect themselves.

Friday, October 5, 2007

Think for Yourself!

I was driving home last night listening to a talk radio show. On the show the host was discussing whether a woman that had a mastectomy due to a misdiagnosis should be allowed to sue the doctor for a simple error. The host continued his discussion stating that simple errors should not be cause for litigation and that since the doctor did not intend to misdiagnose the woman, the doctor should not be sued. The host was getting very animated with each caller, discussing how he never sues anyone and that we are all litigation happy. The various callers were discussing how they would either only give the woman the cost of a "boob job" or give her nothing. The host was using all of this to continue to project how we need reforms and that lawsuits cost us all. He would spend a great deal of time with the callers that were agreeing with his premise of too many lawsuits, continuing to ask them questions to draw out more discussion about how this woman deserved no or little money.

I had heard the woman earlier that day describing what had happened and knew that the talk show host had key facts wrong. I called in and waited to talk to the host.
Since there had been discussion about the most this woman should expect to compensated was for the cost of a simple "boob job," I felt compelled when I FINALLY got on the air to discuss this misconception. I explained that the woman was facing extensive reconstructive surgery , not a simple breast enlargement and that her breasts would never be the same as they were before. I explained that women can have significant complications after reconstructive surgery so there was nothing simple about it.

I then proceeded to tell the host that this was not a simple error involving a doctor, instead it was a lab cutting corners and performing multiple tests at once to save money. And that due to the cutting corners, two women have been injured - the one who had the mastectomy and did not have cancer and the woman who did have cancer and has gone untreated for many months. The host then made a statement that surely I was in favor of cutting costs. When I replied, No, not when it ends up inflicting damage on people and I also added that there are continued cost cutting even when the corporate revenues are up and that patients are the ones being harmed and they have no recourse in many situations, but I was hung up on so that it seemed that my last statement was No, not when it ends up inflicting damage on people.

So, the radio station/host was editing people's comments to promote their agenda of too many lawsuits. Instead of allowing me to discuss the issue completely, they hung up on my call. I continued to listen and noticed that I could often pick out exactly when they hung up on other callers that disagreed with the host.

I thought here is another example of how the media is crafting what we hear and see to lead us to their ideas. They are not interested in the truth, but rather what makes better entertainment. I have been present when a person was interviewed for a story, yet when I watch the interview on TV the context is vastly different than what the reality was.

Once again, as nurses you have a scientific mind and you should utilize that mind to question what you are told and shown. Be an individual and investigate the truth. Make up your own minds and take action based on what you know to be right. Others are looking to you to be a leader or at least completely informed. Just because a co-worker, or administrator, or physician or a talk show host tells you something, you must decide for yourself what is correct. If you do not have enough information to determine what is the truth, investigate it until you are an informed nurse.

Just my Thoughts. You don't have to agree and that is the point of this entry.

Monday, October 1, 2007

Nurses! Please help each other

I saw something the other day while I was waiting at a stop light. Off to the side, a man was jogging and he stopped to move a large tire that was in the middle of the access road. It was not his responsibility, he was not hired to move tires. It was not his tire, he was just jogging by the tire. But, he took it upon himself to protect others, to ensure safety.

That is the type of mindset all health care providers (and really, all of humanity) should have - if you see something that requires action, just do it. I have seen people waste more time complaining about a situation or trying to find out who is responsible than if they had just taken the initiative to fix the problem. This would also help morale. It is proven that people get a rush when helping others (there is more of a rush, if the help was given and not asked for).

So, Just DO It! And maybe start decreasing errors and start increasing job satisfaction.