Nurse Practitioners

Most of my clients that are nurse practitioners are in trouble before the Board of Nurses not because of patient care issues, but rather because of a failure to follow (and usually understand) the rules and regulations governing their nursing practice. It is crucial that nurse practitioners take a copy of the rules and regulations and use them as a check sheet. These rules apply even if a NP is only covering for a colleague.

The American Association of Nurse Attorneys has a book available regarding the law and nurse practitioners (click on marketplace, then on online store:TAANA products). I have not personally seen the book, but it may be worth looking into. It is also very important for NPs to be a member of nurse practitioner associations so that the NP will be informed of any new laws.

Nurses on TV

Just a quick note: I found a great discussion on the history of nurses on TV at Nurse Ratched's Place. It brought back great memories and I thought some of you might like to see it.

The Best Attorney for the Job

A previous post explained why nurses should never represent themselves before the Board of Nurses and that they should hire the best attorney available. Now, what is meant by "the best attorney?" Whenever hiring an attorney for any legal work (Board, malpractice defense, real estate, family law etc.), a person should look for an attorney that is knowledgeable and experienced in the particular area of law involved.

Board Certification in the particular area is a good indicator of experience and knowledge. However, when it comes to representation before regulatory boards, it is important to inquire as to whether the lawyer has experience before that particular board and how much experience (how many years have they been practicing before the Board, how many of their clients are nurses). Success with administrative boards often depends on knowing the staff, the policies, and their usual methods.

Be sure to talk to the attorney you are thinking of hiring. Do they return your calls or emails? Do you only get to speak to their secretary or assistant? Do they seem to know the law involved or do they always tell you that they will have to "research" a particular issue? Do they seem to know the people that work at a Board and the ways in which the Board functions? You may want to speak to 2-3 different attorneys because everybody has a different personality and approach to practice. The key is that you want to be able to trust your attorney and have confidence in their representation of you. Because you will be working together for a while, you should also like your attorney and feel comfortable with them.

Hint: Cost is no indication of quality. Attorneys charge different fees based on their experience, education, certifications, overhead and caseload. A good lawyer could be expensive, moderate or inexpensive. The key is to find someone that meets your needs, that is experienced, and knowledgeable. But above all -- DO NOT REPRESENT YOURSELF!

There are some areas of caution to be aware of:
I received several phone calls last year from an attorney Board Certified in Administrative Law (the type of law involving regulatory boards) asking questions about the Board of Nurses and how they functioned. Although this attorney was Board Certified in the particular area of law, he stated that he dealt with real estate and did not have any experience before the Board of Nurses. He was calling for a friend that needed representation before the Board and he was going to refer him to me once he convinced the friend to hire an attorney. The friend never contacted me and now this same attorney is advertising that he is a specialist in occupational licensing defense.

With tort reform changes, there have been many attorneys leaving or branching out from malpractice defense work. Several of these attorneys are looking to administrative law as a new practice area. These may not the best attorneys to choose because of their perceived lack of knowledge and experience before the Board. The only way to determine, is to talk to whomever you are thinking of hiring and decide if this is the attorney you want to hire.

Representing Yourself Before the Board of Nurses

I heard from a nurse who is facing possible action before the Board. She had asked a nurse friend about hiring an attorney and was told that the Board of Nurses is nothing to worry about, that they will understand what happened and because she is a good nurse nothing will result from the complaint. A quick look at the newsletter shows that this is not true. Many "good" nurses receive disciplinary action by the Board. Some of those actions were not deserved and some may have received harsher restrictions than what was warranted. How can this happen?

The Board's mission is to protect the public, not the nurse. For more on this read "The Nurse Police." Since the Board is not responsible for protecting the nurse, they are interested in resolving complaints against nurses in the fastest way that also protects the public. The Board is not in a position to tell nurses the best ways to defend themselves. The Board is not the nurse's friend, that is not their role. So, who is available to advocate for and protect the nurse? Administrative Law Attorneys with experience before the Board of Nurses.

Nurses that would never think of representing themselves in a malpractice lawsuit will think nothing of going on their own before the Board of Nurses. While a lawsuit can cost you money, losing with the Board can cost your career. There is also the issue of time and knowledge. Nurses are busy working, taking care of their families, and living their lives, they do not have the time to learn administrative law (the type of law involved with regulatory agencies) and to deal with the Board. I attend many hours of continuing education a year in order to remain current with Administrative Law issues and there are even attorneys that cannot keep up with the changes in all the areas of law, so how can a nurse be expected to have the time? A survey was conducted with nurses that had been through disciplinary actions and they highly recommended that nurses not represent themselves and that they spare no expense in hiring the best attorney. Many of my clients are nurses that are under their second investigation and because of the problems they encountered with the first investigation, they decided that they learned from the first time and that it was in their best interest to hire an attorney this time.

Coming next: What is the "best attorney"?