Wednesday, August 29, 2007

DWI and Nursing

The Board's new proposed rules (due to the most recent legislative session) puts into writing what has been informal for a while: the Board does not typically take action unless a nurse has two DWIs. §213.28(5)(a)(ii).Licensure of Persons with Criminal Offenses. This helps for those cases when people have bad judgment. The rationale for the rules is interesting: "DWI offenses involve the use and/or abuse of mood altering drugs while performing a state licensed activity affecting public safety; repeated violations suggest a willingness to continue in reckless and dangerous conduct, or an unwillingness to take appropriate corrective measures, despite previous disciplinary action by the state."

Even though the Board does not prosecute for one DWI, I still advise all health care providers to never drink (even one drink) and drive. The ramifications are too great: You can hurt or kill someone or hurt yourself, criminal prosecution, monetary costs (estimates can be $25,000 to $50,000 for the costs associated with defending the DWI and the probation costs). If you drink and drive with children in your vehicle, you may face felony child endangerment charges which will get the Board interested in your case.

It is too easy to get a taxi or have a designated driver or walk or take public transportation or drink at home, just don't drink and drive.

Thursday, August 9, 2007

Reporting Nurses to the Board

Due to the recent Legislative session, there were some significant changes to the rules at the Texas Board of Nursing and they are currently posted as proposed rule changes:

§217.11.Standards of Nursing Practice.
(K) Comply with mandatory reporting requirements of Texas Occupations Code ch. 301, Subchapter I, which include reporting a nurse :

(i) who violates this chapter or a board rule and contributed to the death or serious injury of a patient;

(ii) whose conduct causes a person to suspect that the nurse's practice is impaired by chemical dependency or drug or alcohol abuse;

(iii) whose actions constitute abuse, exploitation, fraud, or a violation of professional boundaries; or

(iv) whose actions indicate that the nurse lacks knowledge, skill, judgment, or conscientiousness to such an extent that the nurse's continued practice of nursing could reasonably be expected to pose a risk of harm to a patient or another person, regardless of whether the conduct consists of a single incident or a pattern of behavior.

I am waiting to see how this change plays out because it seems to finally get rid of all of those minimal violations that seemed to plague nurses working in a shortage situation (documentation errors, delay in administering medication etc.). Now the violation must have resulted in Death or serious injury to a patient or the nurse is suspected of substance abuse or the nurse violated boundaries or committed abuse, exploitation or fraud or the nurse shows incompetence to a level that could harm a patient.

I think it is going to be hard to punish a nurse currently in the system for documentation issues or something likewise minor, when the Board knows that the Legislature is wanting nursing discipline to actually protect the public. For more information about the problems that have been plaguing regulatory actions and nursing see More Nurses in Trouble with the Board.

Restarting the Information Roll

I gave it a month to see if having too many blogs affected our website ranking and I have seen no difference, so I am restarting my postings to this site. This site is used to give insight into Texas laws, rule changes, and policy changes that affect nurses. Watch for new postings to come.

I have two other blogs that each focus on different areas: Information for Nurses is a blog used to inform nurses of issues, changes, and important news. A Nurse Attorney's Thoughts focuses on my opinions and views of what I see as a nurse attorney representing nurses and other health care providers before regulatory boards in Texas.