Why Did I Quit Nursing?

I was asked a few days ago why I quit nursing and went into law. The simple answer is that law fits my personality better. I have always had a difficult time remaining quiet when something happens that "'taint fair". When I was in nursing school, I took up the cause of an LVN that had returned to school to obtain her BSN. She was brilliant, but had a horrible case of test anxiety. She knew everything and could explain in person, but the minute she was placed in a test situation, she froze up. So, she was failing. I went to the professors to plead that they find a way to help her overcome the anxiety because society was going to miss out on a great nurse. I compared her to another classmate that made all "A"s, but had no common sense at all. I told them that she was going to graduate, but that she was going to be a dangerous nurse [about 2 years later, I saw that her license had been revoked]. I was told that it was none of my business and to stop interfering. I told them that I had to intervene because the LVN was too scared and embarrassed to step forward and speak for herself.

Even when I was a child, I could never keep myself from stepping forward to advocate on behalf of someone that could not argue for themselves. What my Mom used to call being a "busybody" has now grown into a well suited career. As for quiting nursing, I didn't really quit. What I have done is to channel my work into a way to help nurses. That is why I call myself a "Nurse Attorney."

The Most Aggressive Board

The Star-Telegram has written an article about the Texas Board of Nursing. The article states that "The board is perhaps the most aggressive healthcare regulator in Texas, taking patient safety to heart." I have represented nurses before the Board for over 10 years and before that I interacted with the Board while I worked at the Texas Medical Board, so I have seen the Board change over the years. What I have seen is that the Board has become much more conservative and much more punitive.

Complaints against nurses that used to be dismissed if the nurse could show knowledge of the incident and remediation of the issue. For several years now, those same types of complaints have resulted in increasingly harsher actions by the Board. Whenever the public sees the number of disciplinary orders increasing, they assume that the public is being protected. That is an illusion. Public Safety and high numbers do not go hand in hand. To obtain those numbers, many good nurses that were forced to choose between violating the Nurse Practice Act and caring for their patients are finding themselves under disciplinary sanctions. Yes, they violated the law, but the reality of nursing practice (too many very sick patients and too few nurses) is the cause of the violation, not the competency of the nurse.

I have always believed that all regulatory Boards need to focus on true public safety issues, which means discipline of those licensees that are truly a threat: incompetent without remediation potential, addicts that are not in recovery (although I do believe there needs to be a non-disciplinary, non-public method of monitoring all addicts), and those missing core ethical boundaries. SB 993/HB 2158 seems to be a step in that direction. this legislation defines what conduct by a nurse is subject to reporting. The requirements for reporting are:
1. Violating the law AND contributing to the death or SERIOUS injury of a patient;
2. Substance abuse impairment;
3. Intentional or knowing abuse, exploitation or fraud, violation of boundaries;
4. Incompetency where the nurse's continued practice could harm a patient.

This legislation should stop all the minor reporting of documentation issues and simple medication errors that are not due to incompetency. Perhaps this legislation will slow the reporting of nurses for minor, non-public safety issues and the Board can focus on those nurses that require monitoring by the Board to ensure public safety.

First Impressions

I was sitting in the waiting room of the Texas BON today waiting to present a client's case. The room was full of individuals seeking licensure as either a registered nurse or licensed vocational nurse. When one young lady was called back to meet with the Board, as soon as she left the waiting room, the other people in the room began to comment on her appearance. The applicant had shown up to meet with the Board dressed in casual pants, a tight fitting shirt made of t-shirt material, and flip flops. One of the other applicants commented, "She is sending the Board a message that she does not take them or her license seriously." Everyone noticed that when the Board staff member called the girl back to meet with the Board members, that the staff member's face showed that she thought the exact same thing as the other people in the waiting room.

First impressions count so much when meeting with the Board of Nurses. It is important to look and act professional. The Board members/staff do not know the applicants/licensees and so they rely upon information gathering to determine which course is the best for the Board to take. A person's appearance becomes part of that information gathering, even if it is done on a subconscious level.

The girl left in tears and they were not tears of joy, so I would surmise that she was denied licensure.

My Aunt, the Nurse

My aunt Mary Lou died recently and at her funeral a slide show was presented. Her career as a Nursery Room Nurse was presented and this photo of her LPN graduation was shown. It was not until after I went to nursing school that I learned that my aunt was also a nurse (we lived across the country from them and so I did not know very much of their lives). I enjoyed looking at the new nurses in this photo and thought I would share it.

Good Nurses Don't Need Malpractice Insurance

Wrong, Wrong, Wrong. "Good" nurses get sued or reported to the Nursing Board all the time. The biggest excuse I hear from nurses as to why they do not carry malpractice insurance is that they did not think they needed it. Every nurse that does any kind of patient care needs to carry their own malpractice insurance that also covers license defense before the Nursing Board. Once an incident happens it is too late to obtain insurance, so take care of yourself and your career - get malpractice insurance today.