Thursday, October 30, 2008

The MERCI project

Nursetogether has an article about MERCI, Medical Equipment Recovery of Clean Inventory, a program developed by Helen French. This program gathers clean medical waste and donates the "waste" to needy areas. The MERCI project's website has more information about what they do.

I love this project. When I worked in surgery, I hated to see good supplies be discarded just because they were "opened". I worked for a physician who would collect this medical waste and ship it to a third world country where they had limited supplies, but not everyone was doing this. I knew of nurses that would collect the suture packs that were removed from their outer wrapper, but that had the inner wrapper unopened and instead of throwing them away would give the packs to Veterinarians to use. What great "recycling" ideas. So, if your facility is throwing away good supplies, look into setting up a MERCI project.

Myths that harm nurses

Be sure to check out my new article, Malpractice Insurance: The myths that harm nurses located at This website is full of useful information for nurses including forums, chat rooms, job information and hints, articles, and much more.

Thursday, October 2, 2008

"SOAH" State Office of Administrative Hearings

The State Office of Administrative Hearings ["SOAH"] is where contested cases are tried between a nurse and the Texas Board of Nursing. An administrative law judge (ALJ) is assigned to the case and the proceeding is like a judge-alone trial without a jury. Witnesses are called to testify, records are put into evidence, and legal argument entertained. A transcript or recording is made. After the hearing, the ALJ may take weeks or months to issue a Proposal for Decision (PFD) analyzing the evidence and recommending a decision to the Board. The nurse’s attorney and the agency staff attorney exchange exceptions and replies about the PFD – essentially objections and argument either for or against the PFD. The PFD is then presented to either the full Board or the Board’s Eligibility and Disciplinary Committee for approval. If presented to the full Board, they will hold a hearing on the PFD in which the ALJ presents the PFD and counsel for both sides argue their positions. The Board may ask questions, review the pleadings and the record, and deliberate at length. When all is said and done, the Board either votes to adopt the PFD, adopt something different than the PFD, or dismiss the case even if the PFD recommends action. (this is taken from information contained on my firm's website)

Very few nurses ever have to go to SOAH, which is good news considering the potential pitfalls discussed above and in an earlier blog. An experienced attorney can negotiate a resolution with the BON that addresses the Board's concerns for public safety and that is acceptable to the nurse. SOAH should be reserved for those times where a satisfactory resolution cannot be reached with the Board by way of negotiation.

Nurses need to beware of attorneys that use SOAH as a means to churn fees by creating unnecessary litigation. When I worked for the Medical Board, we were well aware that certain attorneys when hired would never negotiate and the case would end up in litigation at SOAH. To us it always seemed like such a shame that a licensee would be subjected to the stress and expense of a hearing when the Board was willing to negotiate. By failing to negotiate, the licensee is subject to a drawn out process that may generate unnecessary fees and expenses and the licensee potentially risks receiving more severe restrictions. Hearings should be reserved for those special cases where negotiation fails to reach a fair conclusion to the claim.

Wednesday, October 1, 2008

Maybe It's Just Me

I could not believe this story when I read it so I had to share it.

According to Denver News 7, "The Denver police union is selling T-shirts that poke fun at protesters at last month's Democratic National Convention." "The back of the shirts reads, "We get up early to beat the crowds" and "2008 DNC," and has a caricature of a police officer holding a baton. The front has the number 68 with a slash through it, a reference to the Recreate 68 Coalition, which organized several demonstrations during the convention."

Maybe it's just me, but making fun of a serious situation always makes me cringe. I think this is even more heinous because the people being made fun of are protesters voicing their opinions. No matter what actually happened, this "joke" makes it appear that the people were being beaten by the Police because they were expressing their views.

I have always thought that those in "power" need to be very cautious with how they are perceived because if actions are not viewed as fair and just, the system will break down (and if their actions are not actually fair and just, the system needs to be broken down and repaired). I find this every day in my practice - if the Board's action is perceived as fair and just, the licensee accepts or at least understands the action, but if there is any aspect that is unfair, the licensee believes that the Board is "out to get them."