Tuesday, February 26, 2008

In Celebration of Nurses and Black History Month:

In 1793, a yellow fever epidemic gripped Philadelphia, PA (at that time, the temporary capital of the newly established US). The cause of yellow fever was unknown and it was laughable at the time that something as small as a mosquito could kill a human. Many thought it was contagious and they isolated the infected. The citizens left Philadelphia in droves, which left many desperately ill with no one to care for them or increasingly when they died, no one to bury them or care for their orphaned children.

Yellow fever patients in advanced stages would bleed from their nose and gums and because their intestines would also bleed, the patients would vomit noxious black bile. This presentation made it difficult to care for the sick.

“The vomit that yellow fever patients spewed forth, as well as the blood and offensive odors, were particular horrors to most people, even those medically trained. Young Dr. Isaac Cathrall found these bodily discharges disgusting: ‘The matter ejected [from the stomach] was of a dark color, resembling coffee grounds, sometimes mixed with blood; great flatulency; hemorrhages from different parts of the body; tongue frequently covered over with blood... urine very offensive.’” [An American Plague: The True and Terrifying Story of the Yellow Fever Epidemic of 1793, by Murphy, Jim. Scholastic, Inc. 2003, p. 53.]

Although subjected to slavery and discrimination by those now needing help, the members of the Free African Society stepped forward and cared for the people of Philadelphia. During the yellow fever outbreak, the black nurses, male and female, out numbered the white nurses. “Since the people they helped were usually poor, the black nurses often stayed and helped a person for no money at all.” [An American Plague: The True and Terrifying Story of the Yellow Fever Epidemic of 1793, by Murphy, Jim. Scholastic, Inc. 2003, p. 51.]

“Dr. Cathrall flatly refused to touch the vomit of a patient for any reason, as did most other people; the black nurses, however, had o choice. Their job, after all, was to care for and clean up the patients.” [An American Plague: The True and Terrifying Story of the Yellow Fever Epidemic of 1793, by Murphy, Jim. Scholastic, Inc. 2003, p. 54.]

I read about the yellow fever epidemic of 1793 in a intriguing book An American Plague: The True and Terrifying Story of the Yellow Fever Epidemic of 1793, by Jim Murphy. This book describes the progression of the epidemic and the huge impact it had on the entire town and even those towns surrounding Philadelphia. Within the book are descriptions of selfless individuals that stepped forward to help when it was unknown whether their kindness would be rewarded with their own development of yellow fever. With all the current discussions about potential pandemics, I found this book very interesting.

Tuesday, February 19, 2008

Texas Nursing Board Attorney

I just spoke with a nurse that had hired a lawyer from her hometown to represent her before the Board. The attorney had never been before the Board, but assured the nurse that her that "it could not be too hard" and that he would have no problem. The disciplinary sanctions the nurse agreed to based on the advice of the attorney were not in line with what the incident warranted. It was obvious that the attorney did not understand what information must be presented to the Board. The attorney told the nurse to sign the Order (agreeing to the disciplinary sanctions)and that they could negotiate the terms afterwards. This was bad advice because it is difficult to modify an Order once it has been agreed upon. The nurse also stated that it was difficult to speak to the attorney and that when she did speak to him it was as though he did not remember her.

The nurse was distraught and asked how was she supposed to know the difference in attorneys. I explained that attorneys can specialize much in the same manner as doctors. While obtaining a law license enables a person to practice in any area, most attorneys focus on one or just a few specialties in order to gain expertise. Each area of law has constant changes due to case law, new rules, new regulations, new policies and new statutes being put in place, so attorneys must maintain their education. If an attorney focuses on too many areas of law, it becomes difficult to stay current in all of the areas.

Administrative law has another level of specialty in that lawyers also need to know the various state agencies, their procedures and their staff. Inexperienced lawyers frequently underestimate the importance of this knowledge. So, how does a nurse determine whether a lawyer is experienced? Look at the attorney's background. Look for a lawyer that is focused on the Board of Nursing. Ask what other areas of law they practice. Ask if they are Board Certified in Administrative Law. Go to the State Bar website and look up information about when they graduated and what area they indicate as their area of practice. Ask how many years they have been representing nurses before the Board.

Another area of distress for the nurse that I spoke with. She asked what I charged to represent nurses before the Board and she said that she paid $1500.00 more for the attorney she chose. Be an informed consumer and check out your attorney's credentials and chose wisely.

Tuesday, February 12, 2008

Maybe I am Naive

I just read an article about Firefighters being attacked in England. Maybe I am naive, because I was shocked to read that some people are even starting fires and then attacking the firefighters when they show up to respond to the fire. I have heard about EMS, fire and other emergency workers being threatened when they arrived to provide care to a crime victim, but this article talks about situations that have increased in violence. Scary read for those in health care.

Saturday, February 2, 2008

Do You Need an Attorney for the BON?

I just received a call from a nurse in another state. She asked if she needed an attorney to represent her before the Board of Nurses in her state. She said that she thought if she just told the Board everything that she would be okay. Just in the short amount of time she took to explain her situation, she brought up several areas that would cause the BON concern and several things she brought up had nothing to do with the allegations against her. She was also very angry and then started crying.

I explained that almost every case a nurse going before the BON (in any state) should at least consult with an experienced attorney and in most cases, the nurse should hire an experienced attorney to assist with the BON. I told her that the Board is not there to protect or assist her, but to protect the public. I told her that an attorney can watch out for areas that have nothing to do with the allegations, but that are issues the nurse should not bring up; that an attorney can help the nurse in understanding the process and the easiest way to navigate the system and address the allegations; and since the attorney is not emotionally involved in the situation, the emotions do not become an issue.

I gave the nurse a couple of names of attorneys that I knew represented nurses in her state and then told her that she could contact The American Association of Nurse Attorneys or her state Nursing Association or the State's Bar Association for a referral. I also told her that doing an online search can give her some information as well. I told her to be sure that the attorney she hires is experienced in representing nurses before the BON (look at my other blogs for more info on how to do this).

Just like the disclaimers on TV: DO NOT ATTEMPT THIS ON YOUR OWN!