Another burden for Disciplined Nurses

Every nurse used to be worried about their name showing up in the Board's newsletter. That worry is still present, but now there is an additional burden for the disciplined nurse to endure; their Agreed Orders are available online for all to review. No more just seeing numbers and wondering what the nurse did, but now the facts are available for review.

My hope is that there will be positive outcomes from this additional information. I hope that nurses will recognize how vulnerable they are while practicing and become more involved in advocacy for nurses to limit disciplinary actions against nurses for minor violations. I also hope that nurses will realize that another nurse that has been disciplined by the Board is not a "bad" nurse and that after reviewing the facts, they realized that they have also been in the same situation and that only luck prevented them from ending up with disciplinary action. Just a note - I am not saying that there should not be regulation because there are often valid reasons to discipline licensees; my concern has always been a just review of the facts of the case and if the FACTS show a valid concern for the public's safety, then the application of appropriate discipline to protect the public.

My hope is always that nurses band together to provide a united front against those that are a danger to the nursing profession. Too many nurses are leaving nursing because of unjust actions and non-support from their fellow nurses. Nursing is a grand profession and nurses deserve respect from everyone including fellow nurses.

Justice for a Nurse

Back in December I posted a message about the Texas Board of Nursing Investigator who refused to obtain documents that would help show my client's innocence in a case. I had to request a subpoena in order to get the needed documents and when I received the records and reviewed them---the records support exactly what my client said happened!!! The issue is that if the investigator was being non-biased and fair, she would have obtained the records when requested rather than having me request a subpoena to obtain the information. This situation makes me worry about nurses that do not know to hire an attorney and when faced with similar circumstances, give in and accept discipline when they are in fact, innocent.

I also want to point out that my experience with this investigator is not universal at the Texas BON. I have dealt with several investigators over the years, including one today, that are extremely helpful in obtaining information that the nurse needs. They understand that their role is to be open to both sides of the story and to obtain all necessary information prior to forming an opinion. They truly investigate a case. But, until the BON makes all investigators adhere to a non-bias, fact finding method of investigation, the potential remains for an innocent nurse to be wrongly disciplined.

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.

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.

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.