Murphy Jones LLP has filed a civil complaint in the District Court of Nevada on behalf of nurse Jessica Rice, RN against Sunrise Hospital Medical Center, et. al., for Defamation, Wrongful Termination, Intentional Infliction of Emotional Distress, Negligence, Conspiracy, Civil RICO violations and Fraud in relation to an ongoing dispute arising from Sunrise Hospital’s allegations of “intentional patient harm” against infant patients in the Neonatal Intensive Care Unit (NICU).

On July 2, 2010, two-month old baby Miowne Obote died from complications stemming from a disrupted catheter line. Sunrise Hospital requested that the Las Vegas Metro Police Dept. investigate fourteen (14) incidents of disrupted catheters, and the subsequent police investigation has not led to any criminal charges being filed. The Clark County Coroner has admitted that his initial determination that the death was a homocide was not supported by any County Coroner investigation and instead he relied on the conclusion of the allegedly flawed analysis by an expert that Sunrise Hospital hired.

Subsequently, both Ms. Rice, and another NICU nurse were summarily suspended from nursing practice by the Nevada Board of Nursing. After an independent investigation, the Nevada Board of Nursing found no evidence of wrongdoing and reinstated both nurses’ licenses. (“Fired Sunrise nurse files suit,” Harasim 5/31/12, Las Vegas Review-Journal.)

Sunrise Hospital terminated the employment of both of nurses based on an alleged policy violation. The nurses’ union, (Service Employees International Union of Nevada; i.e., SEIU NV), filed a grievance against the hospital for wrongful termination. In December 2011, the Federal Arbitrator found in favor of Ms. Rice and issued an Order requiring Sunrise Hospital to reinstate Ms. Rice to her former position in the NICU and awarded her back pay. To date, Sunrise Hospital has refused to comply with the Arbitrator’s decision. The nurses’ union (SEIU) has filed a lawsuit in Federal Court seeking to enforce the Arbitrator’s decision.

The civil Complaint filed by Murphy Jones LLP on behalf of Ms. Rice on May 29, 2012, alleges that Sunrise Hospital was made aware of “at least thirteen (13) incidents involving intravenous catheter lines, in which the catheters became separated in two (2) of the incidents…interrupting the flow of fluids through the catheter. After two (2) catheter incidents resulted in harm or potential harm to infants in May 2010, Defendants intentionally, and/or with reckless disregard for the truth and/or negligently began a course of conduct that focused aggressively on employee Plaintiff Jessica Rice as the presumed suspect for the cause of the catheter incidents, labeled her as a ‘person of interest,’ terminated her from her employment without just cause, exposed her to public contempt, ridicule and disgrace and induced evil opinion of her.”

Democrat and Republican senators are seeking a national investigation regarding state medical boards' disciplinary actions. Senators Max Baucus (D-Mont), Orrin Hatch (R-Utah) and Charlie Grassley (R-Iowa) have submitted a request letter to the director of the Office of the Inspector General for the Dept. of Health seeking a federal investigation into state medical boards.

The senators' letter states, "With the adoption of advanced medical technologies...and an increase in physicians holding licenses in two or more states, it is becoming increasingly important that states issue timely board actions and coordinate licensure actions to protect the public from unqualified or marginally proficient practitioners." (Walker, MedPage Today 2/21/12). The senators cite a Public Citizen, a consumer organization, report which finds that less then one-half of the 10,672 doctors listed in the National Practitioner Data Bank (NPDB) have been disciplined by their licensing state medical board.

A federal investigation could have wide ranging ramifications relating to increased disciplinary actions being filed and increased delays in state medical board administrative proceedings. The attorneys at Murphy Jones LLP are monitoring the situation and will continue to report on the investigation request as new information becomes available.

Governor Jerry Brown will speak at the National Nurses United (NNU) union's convention this evening, Lieutenant Gov. Gavin Newsom is scheduled to address the organization tomorrow morning, and filmmaker Michael Moore is slated to speak to at the conference on Friday.  Over 1,000 nurses are scheduled to attend the convention in San Francisco.

NNU is also actively engaged in a "campaign for a tax on Wall Street financial speculation in order to provide revenue for  Main Street reforms, including jobs at living wages, guaranteed healthcare for all, and freedom from hunger, homelessness, and retirement insecurity." (NNU, Media Advisory, 9/13/11)

The California Board of Chiropractic Examiners has recently adopted Informed Consent requirements which compel chiropractors to obtain patients' consent after being fully informed of any potential risk of harm to the patient in relation to medical treatment. The new legislation takes effect on October 7, 2011, and will require informed consent both orally and in writing prior to the performance of chiropractic clinical care. Violation of the new law will constitute unprofessional conduct which will very likely lead to the Board of Chiropractic Examiners to initiate disciplinary proceedings against practitioners who fail to adhere to the requirements. (Dynamic Chiropractic, California Board of Chiropractic Examiners, 9/12/11)

On September 7, 2011, the National Union of Healthcare Workers (NUHW) filed a notice of intent to strike with Kaiser Permanente on September 21 - 23, 2011. NUHW issued a statement stating that it intends to have union members strike "should management continue to refuse to bargain in good faith." There are rumors that the California Nurses Association (CNA) will participate in the strike demonstrations, but no notice of intent to strike has been filed yet. The two unions represent over 21,000 Kaiser Permanente employees, with NUHW representing approx. 4,000 Kaiser employees.     (Rauber, San Francisco Business Times, 9/8/11)

A recent study in the Archives of Internal Medicine determined that elderly heart failure patients who completed an Advanced Practice Nurse transitional care program while hospitalized, which entailed various pre-discharge procedures and post-discharge house calls, had a 48% lower readmission rate compared with other seniors who did not complete the program. An additional study of 257 seniors found that 12.8% of seniors who participated in the transitional care program required readmission hospitalization compared with 20% of elderly patients who did not participate in the program. Healthday News. 

The California Board of Chiropractic Examiners has revised the Rules and Regulations governing chiropractors as of June 2011. The rules are located in Title 16 of the California Code of Regulations, Division 4, section 301 et. al. The updated rules can be found here.

Attorney Kathleen Jones is presenting an informative educational seminar on Alternative Discipline Programs at the National Council of State Boards of Nursing's Attorney/Investigator 2011 Conference in Chicago, IL. Mrs. Jones will be discussing confidentiality, administration, due process concerns, and various other issues before the NCSBN membership.

The Nat. Council of State Boards of Nursing is an organization which provides education, service, and research to state nursing regulatory boards.

1,100 Los Angeles nurses stage "walk out" to protest unsafe staffing ratios at Kaiser Permanente's L.A. Medical Center. The nurses were joined by 1,400 other Kaiser employees who oppose long wait times patients face and proposed cuts to Kaiser employees' healthcare and retirement benefits. Kaiser Permanente nurses stage one-day walkout over working conditions (Helfand, 5.18.11 Los Angeles Times.)

The healthcare attorneys at Murphy Jones LLP successfully represented their client, Mrs. Marilyn W., in a personal injury accident stemming from a fractured ankle occurring at a dog park in Las Vegas, NV. Mrs. W. was walking in the enclosed area when two large dogs barreled into her knocking her to the ground breaking her ankle and hitting her head. Mrs. W. was referred to Murphy Jones LLP and they assisted her in representing her interests and securing $30,000 compensation for her broken ankle injuries.

"The attorneys at Murphy Jones LLP are outstanding. They responded to me in a timely manner and provided excellent legal services! I know that this was a small case for them, but they prosecuted it like it was the most important case in the world. I am so grateful and satisfied with the outstanding results! Thank you Kathleen and Kevin!!!" - Mrs. Marilyn W.

On 4/20/11 the Medical Board of California, along with local Los Angeles law enforcement agencies, raided three medical marijuana dispensaries in the Venice Beach area. Investigators raided facilities connected with Medical Kush Doctor, and the Medical Board of California's spokesperson declined to discuss the basis for the raids but did disclose the locations of the targeted facilities.

"Venice pot doctors shut down after raid by state medical board and police" (Hoeffel, L.A. Times 4/20/11)

Both political parties are joining forces to oppose one of the key features of President Obama's deficit reduction plan, the Independent Payment Advisory Board. US Dept. of Health & Human Services Services Secretary Kathleen Sebelius has described the purpose of the IPA Board to "ensure that health costs are reduced." However, several large groups, including AARP, oppose creation of the Board and claim that arbitrary spending targets do not lead to good healthcare policy.

"Obama Panel to Curb Medicare Finds Foes in Both Parties," (Pear, NY Times 4/19/11)
 

 The Supreme Court of the United States has taken no action on Virginia Attorney General's request to expedite the resolution of the pending Healthcare Reform Legislation litigation, in attempt to skip appellate judicial review despite President Obama's objection. "High court takes no action on Va. health care case" (Associated Press, 4/19/11)

The California state Senate has approved a $600,000 settlement agreement resulting from the termination of Catherine Hayes four years ago. Ms. Hayes was the Executive Officer of the California Board of Chiropractic Examiners at that time. The lawsuit arose from a disagreement about whether California chiropractors could legally perform a technique known as "manipulation under anesthesia."  

Calif. Senate OKs chiropractic firing settlement (The Associated Press, 04/14/2011)

Recent high profile media attention has been focused on Sunrise Hospital’s allegations that two nurses were intentionally “disrupting catheters” in the Neo-natal Intensive Care Unit of Sunrise Children’s Hospital. Murphy Jones LLP successfully defended one of the accused nurses, Jessica Rice, who voluntarily placed her nursing license on “Inactive Status” during the investigation by Las Vegas Metro Police and the Nevada State Board of Nursing. Subsequently, the investigation has failed to produce any evidence of wrongdoing of any nurses, both nurses have had their licenses reinstated and the police have not filed any criminal charges. 

For further information relating to the case, please see:

Las Vegas Channel 8 News story wherein Attorney Kathleen Jones is interviewed and speaks about her client, Jessica Rice, who was wrongfully accused of cutting catheters in the Neo-natal Intensive Care Unit of Sunrise Children’s Hospital, the inadequate investigation by Sunrise Hospital and the wrongful termination of the nurses.

Las Vegas Channel 8 News story describing that the accused nurses had their licenses reinstated after the Nursing Board’s investigation, and the police investigation, because their was no evidence of wrongdoing of either nurse.

Las Vegas Channel 8 News story explaining that the Sunrise Hospital investigation of the ‘disrupted catheters,’ and the report that prompted the criminal investigation, was inadequate and failed to produce any conclusive findings. Sunrise Hospital hired a “metallurgist” (specialist in metals) to examine the rubber catheters. The investigation did not examine whether a product failure was the cause, and the hospital requested the expert to state whether or not the lines could have been cut and not to determine the cause of the catheter failures. The Las Vegas Metro Police investigation into ‘intentional disruption’ was based in part on the findings of Sunrise’s investigation.

Las Vegas Review Journal newspaper Nov. 7, 2010 ”Babies’ deaths haunt Sunrise nurses” wherein Attorney Kathleen Jones is quoted regarding Sunrise Hospital’s failure to properly investigate.

Las Vegas Review Journal newspaper Nov. 21, 2010 article “Safety shortcomings spotted in Sunrise catheter case” wherein Debora Simmons, head of the Houston-based National Center for Cognitive Informatics and Decision Making in Healthcare said, ”This is a failure of hospital leadership…We’re talking about a culture where tolerance of patient harm was allowed to develop…You have to fix a problem before you kill somebody.” Ms. Simmons went on to say, “They (Sunrise officials) should have recognized that they didn’t have the expertise to deal with this right away…The way they handled this was a tragedy.”

Las Vegas Review Journal newspaper Jan. 17, 2011 article “Hospital Warned about evidence in catheter case” describing that Sunrise Hospital officials have been warned not to ”destroy, conceal, and/or alter any evidence” surrounding catheter failures at the institution.” The catheter failures led to one infant’s death and another infant patient needed a life-saving operation as a result of a separate catheter failure. Attorney George Kelesis was quoted as saying, ”Unfortunately, Sunrise has been known to get rid of evidence that may hurt them before they go to court” in reference to a 2004 $5 million medical malpractice lawsuit which made it to the Nevada Supreme Court in which Sunrise Hospital “had a duty to preserve anesthesia equipment used in patient’s surgery” and sold the equipment in question instead of preserving it for inspection.
 

The California Board of Medicine makes Accusations against physicians available to the public. Check Doctor License status here. The Medical Board's search system has been touted as one of the best in the country [Dahlberg, Sacramento Bee 7/12/10]. Patients seeking to learn more about their doctors/potential doctors can easily view discipline Accusations lodged against physicians, which can lead to a more informed decision.

However, medical professionals, healthcare practitioner advocacy groups and defense attorneys protest the disclosure of Accusations prior to any final action being taken against a physician. The exposure of Accusations, prior to any final action being taken, creates a situation where a doctor can be judged on the basis of unproven complaints or allegations.

The ultimate goal is to protect the public, and allow patients to access a practitioners' history, while simultaneously protecting physician privacy and due process rights under the law. The disclosure of unsubstantiated Accusations has the potential to mis-inform patients and ruin reputations of healthcare professionals, but also allows patients to make more informed decisions based on the nature of the allegations. It is a "Catch 22" for everyone involved, but the physicians bear the brunt of the detriment to their careers and profession if patients make judgements based on untruthful accusations.

Nurse Practitioners prime candidates for Primary Caregivers in the face of Dr. Shortages:

Nurse practitioners are going to play an integral role as primary caregivers, filling the void left by massive physician shortages throughout the United States. (Stuart, 4/28/10). The Association of Medical Colleges reports that the U.S. may be facing a 150,000 doctor shortage by 2025. (Chapman, 4/18/10 Chicago Tribune "Nursing our way out of a doctor shortage"). The American Medical Association estimates the doctor shortage to equal a deficit of 85,000 by the year 2020. Regardless, the data is evident that doctors are facing extraordinary understaffing difficulties at the same time they are facing astronomical increases in their patient loads.

28 States currently have introduced legislation designed to expand the role of advanced practice nurses to that of Primary Caregiver. ("Fewer doctors may lead to more patients seeing nurse practitioners") Several states already allow independent advanced nursing practice, and many other states are currently seeking to fill the void left by a lack of physicians. Oklahoma is currently seeking to expand nurse practitioners' roles (Coburn 4/21/10 "Officials look to PAs, nurse practitioners for aid in physician shortage"), as well as Oregon, Washington, California. (Johnson AP 4/14/10 "Shortage may mean a bigger role for nurse practitioners"), New York (Gordon 4/25/10 "Take advantage, New York, of our nurse practitioners)

Nurse practitioners, or "advanced practice nurses," are highly trained registered nurses who usually possess a masters degree or a doctorate in a specialized nursing discipline. Nurse practitioners have advanced education, experience and training in the diagnosis, treatment and management of common illnesses (Parker, ehow "Nurse Practitioners & Patient Education). The American Academy of Nurse Practitioners indicates that 95% of advanced practice nurses already prescribe medications, writing an estimated 19 prescriptions per day.  

Healthcare Reform impact on doctor shortages:

32 Million more Americans are anticipated to be included in the healthcare patient pool as a result of the recently passed healthcare reform legislation. (4/14/10 "Use nurse practitioners to reduce doctor shortage") This large number of additional patients will further exacerbate physician shortages across the country. Medicare typically reimburses nurse practitioners at a lower rate than doctors are reimbursed, which could end up saving millions of dollars at a time when our economy is in dire need of reducing government spending. Maryland columnist Jay Hancock explains that nurse practitioners should be allowed to practice completely independently from physician supervision, and that they are already allowed to practice independently in Washington, Oregon, Alaska, Washington D.C. (Hancock, The Baltimore Sun "Md. should make nurse practitioners independent").(Stuart, 4/28/10 "Nurse practitioners key to unlocking healthcare access").

Doctors are beginning to mount opposition to such measures arguing that allowing nurse practitioners to usurp physicians' roles will place patients at risk. Dr. Daniel Carey, President of the Medical Society of Virginia, has stated, "When you talk about increasing the scope of practice of nurse practitioners...we have problems with that. They are not acknowledging the significant difference in training." (Smith 4/26/10 "Health reform may expand non-physician roles") The American Medical Assoc. (AMA) President James Rohack has said, "increasing the responsibility of nurses is not the answer to the physician shortage." (Bagg, 4/19/10) "Doctors have shown up in white coats to testify against nurse practitioner bills. The AMA, which supported the national health care overhaul, says that a doctor should supervise an NP at all times and in all settings. Just because there is a doctor shortage, the AMA argues, is no reason to put nurses in charge and endanger patients." Associated Press; Maher 4/19/10 "Hey Nursie!" The Battle over Letting Nurse Practitioners Provide Primary Care"). One critic claims "doctors went to their medical schools for a reason, and allowing a nurse to take over their roles is a short-sighted way of solving these shortages." (Joyner, 4/18/10 "Let doctors, not nurses, doctor")

Nurse practitioners have accumulated their own support, and are beginning to form their own professional associations across the nation. (Gallaher, 4/22/10 "Whatcom County nurse practitioners form new professional association"). Univ. of Southern Indiana Professor Daniel Lucky describes the difference between Nurse Practitioners and Physicians as not being education or professional qualifications but instead it is their healthcare approach, "NP practice is based on the nursing model of care -- not the medical approach...Nursing teaches us that we should not reduce human beings to mere signs and symptoms, place a disease on someone, give them a pill and send them off. As nurses we are trained to look at the entire patient from a holistic perspective and then, actively partner with the patient and family to not only correct problems, but also enhance optimal health. Nursing care places the patient -- not the provider -- as the central focal point." (Beaulieu, 4/14/10 "Expanding roles of nurse practitioners stir controversy"). In fact, the Josiah Macy, Jr. Foundation recently released a report recommending immediate removal of legal and financial barriers preventing advanced practice nurses from providing primary care. (Glenn, 4/20/10 "Nurse practitioners new primary care providers?") Nurse practitioners assert that they are not trying to infringe on doctors' specialities, but are a critical resource in providing patient care in this time of dire need. (West, 4/27/10 "Not looking to replace doctors") In actuality, nurse practitioners do not commit malpractice as often as physicians or, at least, they are not sued as often -- only 1.4% of Nurse Practitioners are named as a primary defendant in medical malpractice lawsuits. (Stuart, 4/28/10 "Nurse practitioners key to unlocking health care access")

Conclusion -- Let the Nurses Doctor!

Murphy Jones LLP represent nurses in licensing, discipline and malpractice matters and are intimately familiar with the nursing profession, and have full confidence in nurses' abilities to render superb healthcare to patients.As healthcare attorneys, we support the expansion of nurse practitioners' primary care roles provided that they do not usurp the proper functions of physicians. Physicians are adept with dealing with advanced diseases and treatments for complex disorders; whereas advanced practice nurses are more than capable of diagnosing common diseases and disorders, and prescribing medications to treat patients. A 2000 study published by the Journal of the American Medical Association reported that patients of nurse practitioners recovered as well or better than patients under the supervision of a primary care physician. A main benefit of expanding nurse practitioners' roles is that they manage patients with current illnesses and simultaneously teach patients how to stay healthy. This is exactly the type of care America needs if we are going to improve the overall health of our citizens and simultaneously lower health care costs. Often times, patient satisfaction is higher among patients receiving care from an advanced practice nurse as opposed to a licensed physician. (British Medical Journal 4/6/10 "Systemic review of whether nurse practioners working in primary care can provide equivalent care to doctors") So with happier and healthier patient results coupled with reduced costs and government spending, allowing nurse practitioners to use their knowledge helping patients while reducing the doctor shortage voids is common sense and good business judgment. 

As the old adage says, "Doctors diagnose, Nurses HEAL!" So why not let nurse practitioners do both?!

View related videos:

• "Doctor of Nursing Degree Changes Healthcare"
• "The Congressional Report: Health Care and the Nursing Shortage"
• "Nurse Practitioners look for a bigger role in health care" Feb. 10, 2011

California Assemblywoman Mary Hayashi has publicly criticized the California Board of Pharmacy for supporting legislation that allegedly conflicts with the Board of Pharmacy’s duty to regulate pharmacy operations and it’s duty to protect the public. As healthcare attorneys who defend pharmacists in disciplinary investigations and proceedings before the Office of Administrative Hearings, we are very concerned and interested in preserving impartiality of the Board of Pharmacy during the development of legislation making it easier for the public to get flu shots.

The Board of Pharmacy is endowed with the power to regulate the profession, discipline pharmacists who violate their duties, and to protect the public. The legislation in question is designed to expand the ability of pharmacists, especially independent operators, to provide flu vaccinations to Californians. Assemblywoman Hayashi has publicly stated, “Their (the Board of Pharmacy) legislative actions on behalf of the profession they are supposed to regulate have raised questions about industry influence, which compromises their role as a regulator.” Assemblywoman Hayashi has introduced legislation, Assembly Bill 2104 (AB 2104), designed to require the California Board of Pharmacy to secure approval from the California Department of Consumer Affairs before sponsoring legislation.

Currently, none of the California Boards (Board of Medicine, Board of Registered Nursing, Board of Dental Examiners, Board of Occupational Therapy, Board of Vocational Nursing and Psychiatric Technicians, Board of Chiropractic Examiners, etc.) are required to seek approval by the Dept. of Consumer Affairs prior to sponsoring legislation. Other lawmakers criticize Assemblywoman Hayashi”s AB 2104 for only focusing on the Board of Pharmacy. “What’s good for one board should be good for all the boards.” said Bob Stern, President of the Center for Governmental Studies.

Assemblywoman is a former member of the California Board of Registered Nursing, which opposed the flu vaccine legislation, Assembly Bill 977 (AB 977) in 2009. Many nurses are still worried about the procedures for providing flu vaccinations to the public. AB 977 passed the California State Assembly in January 2010 and is currently pending action in the California State Senate.

For a full account see: Sacramento Bee article

Review legislation at: California State Assembly legislative inquiry

Murphy Jones LLP has created a Facebook Page generating posts providing up to the minute news and developments relating to professional practice of medicine, the nursing profession, State Licensing Boards (Medicine, Nursing, Dental Examiners, Vocational Nursing and Psychiatric Technicians, Occupational Therapy, Chiropractic Examiners, and all other state healthcare licensing agencies) medical malpractice litigation impacting professionals’ rights and responsibilities, and other interesting legal developments in the healthcare industry. Our administrative law healthcare attorneys staying informed of trends, changes in the law, case precedence, and post information relevant to medical practitioners and the legal industry.

Visit us at https://www.facebook.com/HealthcareLicenseDefenseAttorney , and start following today to keep informed about recent developments.

Aspiring nurses must complete fingerprinting with LiveScan, and the board must receive the results from the Dept. of Justice and the Federal Bureau of Investigation which can take 3 – 6 weeks. As of August 10, 2009, the Board is no longer issuing interim or temporary licenses prior to the completion of the fingerprinting process. This process can be lengthy and should be prepared in advanced to ensure timely licensing and/or certification. If you need help with the licensing process, contact our attorneys for a consultation.

http://www.rn.ca.gov/

National Nurses United will be comprised of the merging of the 3 existing unions: Cal. Nurses Assoc., Massachusetts Nurses Assoc. and United American Nurses. The 3 unions, already powerhouses among legislative organization for nursing professionals, plan to combine forces and unite under the new National Nurses United (NNU) title. Each member union will hold a national convention to ratify the merger, and the NNU will hold its founding convention in December 2009.

Modern Health Care

Texas nurse downloaded entire computer hard drive (over 3,000 pages of patient files) after being fired because she told supervisors she was going to file written report about patient care violations.  The Texas court of Appeals upheld her conduct under whistleblower laws, over objections based on medical confidentiality. Whistleblower laws not only permit but require nurses to report abuse, neglect and other illegal and wrongful acts.

Westlake Surgical vs. Turner, 2009 WL 2410276 (Tex. App., August 7, 2009).

Murphy Jones Law healthcare attorneys are interested in the development of Texas’ case-law relating to nurses’ duties to patients and their protection from liability for acts relating to protection of patient interests. Recently in Nevada nurses have continued to be disciplined for conduct similar to that in issue in the Westlake Surgical v. Turner. The judicial development may provide a basis for Nevada and California nurses, and other healthcare professionals, to protect their licenses in jeopardy of professional discipline for actions relating to “unauthorized removal of medical records.” We follow case law, and state legislation, closely to ensure efficient protection of our clients right to practice medicine.

California Board of Nursing replacements were elected August 12, 2009, and discussed raising licensing fees in 2010 and addressing the backlog of disciplinary actions. New Board members meet with the committees today in Sacramento.

Nursing Licensure fees have not been altered for the past 18 years, and will be increased by almost 50%. The increase in fees is necessary to fund the 63 positions created to handle complaints and investigate disciplinary actions. Renewal rates will increase to $150 (+ an additional $10 for the RN Educational Fund), interim & temporary license fees will rise to $50, and initial fees for NPs, nurse midwives, CNAs and clinical nurse specialists will also cost $150. The Board moved to support the increase of fees and will set a public hearing date shortly. The soonest the Board could vote on the increased fee schedule is November 2009.

Gov. Schwarzenegger appointed Brian Stiger as the new director of the Dept. of Consumer Affairs. Stiger has ordered an internal review of the Cal. Board of Nursing disciplinary process, and reform is a top priority. Stiger’s goal is to streamline the process so that complaints are investigated, prosecuted and resolved within a 12 – 18 month timeframe.

http://nursing.advanceweb.com/Editorial/Content/Editorial.aspx?CC=205077

When Gov. Schwarzenegger promised “sweeping changes” he failed to appreciate the amount of time it will require to overhaul the Cal. State Board of Nursing disciplinary process. Delays and inefficiencies in the disciplinary process, that healthcare attorneys at Murphy Jones LLP have been dealing with increasingly, are now becoming more apparent to the state legislature and analysts waiting for reform.

Julie Fellmeth, Admin. Director of the Center for Public Interest law, said, “For some reason, [the State Board of Nursing staff] seem to feel their system is just fine, that it just needs a little tweaking around the edges here and there…There needs to be a significant blowing up of the system.”

As administrative law attorneys who routinely interact with State Boards in both California and Nevada, Murphy Jones LLP lawyers are eager to see reform of the California State Board of Nursing disciplinary process. With some disciplinary actions taking in excess of thirty-six (36) months to resolve, we hope to see the discipline process adhere to the anticipated eighteen (18) month resolution time-frame goal.

To read the L.A. Times article visit: http://www.latimes.com/news/local/la-me-nursing-reform18-2009aug18,0,4778533.story

Calif. to start dropping children from state plan – Modern Healthcare

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South Dakota class action similar to Las Vegas endoscopy clinic suit. http://bit.ly/xNbS8. The recent Las Vegas endoscopy clinic practice of re-using syringe vials which led to a Hepatitis outbreak among patients has a sister personal injury medical malpractice legal action stemming from similar practices in a South Dakota facility.

The recency of the lawsuits make for interesting ongoing comparisons in the cases’ developments.  The healthcare attorneys at Murphy Jones LLP will keep you informed as to the respective outcome in each matter, the similarities and differences in each states’ action, and the impact on local Nevada legislation and medical practices.

Aspiring nurses must complete fingerprinting with LiveScan, and the board must receive the results from the Dept. of Justice and the Federal Bureau of Investigation which can take 3 – 6 weeks.

http://www.rn.ca.gov/

CMS reports that Scripps Memorial La Jolla and Scripps Mercy Hospital in San Diego, CA, boast the highest survival rates for pneumonia and heart failure patients. The data reflects info. gathered from patient discharges between July 2005 – June 2008.

ADVANCE article: http://nursing.advanceweb.com/Editorial/Content/Editorial.aspx?CC=203928

Full CMS Report: www.hospitalcompare.hhs.gov.

CMS published an announcement 7.20.09 describing regulatory changes that will impact standards for Medicare reimbursement starting 2010. The press release articulated the definition of “direct supervision” of an physician who is supervising nurse practitioners, clinical nurse specialists and/or certified nurse midwives as,”For services provided in the hospital, direct supervision means that the physician must be present in the hospital or on campus and immediately available to furnish assistance and direction throughout the performance of the procedure. For services furnished in an off-campus outpatient department, direct supervision means the physician must be present in the off-campus department and available to furnish assistance and direction throughout the performance of the procedure. In or out of the hospital, the physician need not be present in the room when the procedure is performed.” FEDERAL REGISTER July 20, 2009 Pgs. 35424 – 35425

Murphy Jones LLP healthcare attorneys stay informed of medical industry developments, such as this, which may affect a practitioner’s ability to successfully protect her license in disciplinary hearings before State Boards. Our administrative law practice incorporates information from all arena’s affecting the healthcare industry and our clients’ rights.

Teamsters have filed an additional charge of Unfair Labor Practices with the National Labor Relations Board for alleged retaliatory conduct against employee Dale Slover, RN. Nurse Slover testified in May 2009 against the hospital and has filed a subsequent quality review report. See: http://www.lasvegassun.com/news/2009/jul/04/teamsters-boulder-city-hospital-retaliated-/

Dr. Howard Dean wants to speak directly with nurses and doctors about the role they must play during this critical phase in new healthcare system legislative process. The conference, which is co-sponsored by the American Nurses Association, is intended to discuss elements of the House and Senate bills and how they will impact health care professionals.. Murphy Jones LLP healthcare attorneys will attend the tele-conference in effort to contribute to the development of legislation that furthers interests of the nursing profession. All nurses and people wanting to learn more about the actions each individual can take to make nurses’ needs a legislative and national priority are encouraged to attend and contribute.

The conference call will take place July 22, 2009, at 6:30 pm EST. In order to complete registration and review additional details related to the national conference call visit:

http://www.rnaction.org/site/PageServer?pagename=EmergencyCallwithDrDean

Murphy Jones LLP has created a Twitter account generating tweets providing up to the minute news and developments relating to professional practice of medicine, the nursing profession, State Boards of Nursing, medical malpractice litigation impacting professionals’ rights and responsibilities, and other interesting legal developments in the healthcare industry. With our administrative law healthcare attorneys staying informed of trends, changes in the law and case precedent, we post information relevant to medical practitioners and the legal industry.

Visit us at http://twitter.com/NurseAttorneys , and start following today to keep informed about recent developments.

Did you know that in Nevada and California a first time criminal conviction for driving under the influence, or other misdemeanor, can lead to disciplinary action by the State Board of Nursing?

Both the State Boards of Nursing in Nevada and California may view a conviction of D.U.I., and certain other misdemeanors, as "unprofessional conduct" under each state's Nurse Practice Act. [Nev.: NRS 632.120, 632.320, NAC 632.890; Cal.: Bus. & Prof. Code 2761(f), et. al.]. Both Nevada and California have adopted regulations requiring nurses to submit fingerprints when applying for, or renewing, a nursing license. The State Boards are now receiving information regarding prior convictions of licensees. The Boards review matters on a case-by-case basis, and consider several factors when evaluating an appropriate course of action, including, but not limited to: the nature and severity of the act; the harm to public; the harm to patient; the prior criminal &/or disciplinary history; any time elapsed between convictions &/or Nurse Practice Act violations; any mitigating circumstances; and any, rehabilitation evidence.

Often times criminal attorneys, under a mistaken impression, instruct a nurse that he/she need not disclose misdemeanor convictions on their RN License/Renewal Application -- this is incorrect. Nevada and California require nurses to disclose all "criminal convictions"  which include misdemeanors such as D.U.I. If a nurse is convicted of a misdemeanor and fails to disclose that on the License Application, the Board of Nursing may Deny or Revoke a license for fraudulent application. [N.R.S. 632.320; Cal.: Bus. & Prof. Code 2761(b)].

Other states have legal precedent indicating that a D.U.I. is not "unprofessional conduct relating to the practice of nursing" based on the particular facts of a nurse's situation, which may be utilized by an attorney to help protect a nurse's license after a conviction. [See: In the Matter of Charles S. Phillips, Docket No. 507-05-6929 [Texas]; Ross v. State Board of Nurse Examiners, Docket No. 507-06-0911 [Texas]. You should consult a nurse-attorney regarding the specific facts of your matter, and the laws of your state, to determine the best course of action for your particular situation.

What should a nurse who is convicted of a D.U.I., or other misdemeanor, do? Consult an attorney specializing in State Board of Registered Nurses licensing & disciplinary matters. Depending on the time, type and factual basis of a conviction, various options are available to the nurse. The worst thing a nurse can do is fail to disclose a criminal conviction and hope that the Board does not find out.