Mississippi Board of Nursing

Mississippi Board of NursingLynn Langley, DNP, FNP-BC, ANP-BC, CPHQInterim Executive DirectorMississippi Board of Nursingllangley@msbn.ms.govPhone (601) 957-6289

Objectives1. Explain role and function of the Mississippi Board of Nursing.2. Understand the function of the Nurse Recovery Program and the Office of Nursing Workforce. 3. Identify grounds for disciplinary actions and duty to report.

Mississippi Nurse Practice LawMississippi Board of Nursing

Legally charged to protect the public by Regulating the practice of Nursing.

Mississippi Nurse Practice Law defines the practice of nursing; (73-15-5)

Administrative CodeMississippi Board of NursingMississippi Administrative CodeTitle 30: Professions and OccupationsParts 2801 2900The authority of the Mississippi Board of Nursing is to promulgate rules and regulations for the licensure of registered nurses, advanced practice registered nurses, licensed practical nurses, expanded role licensed nurses and certified hemodialysis technicians as provided for in the laws of the Miss. Code Ann. Sections 73-15-17 (a), &73-15-101.

Purpose and FunctionThe Mississippi Board of Nursing is authorized by Miss. Code Ann., 1972 Chapter 15, to protect the public through the process of licensure and regulation of nursing practice.

Functions of the BoardEstablish standards of nursing practice through rules and regulations.Regulate the practice of nursing.Approve applicants for licensure examinations.License qualified applicants.Certify qualified applicants to function in the expanded role.Discipline those associated with practice violations.Support effective relationships within the healthcare community.Provide educational resources relative to licensure and practice.Consider public opinion, responses and relationships.

Composition of the BoardThere shall be at least one (1) board member from each congressional district in the state.However the physician member, consumer representative member and one (1) registered nurse shall be at large always.

Composition of the BoardThirteen (13) membersTwo (2) nurse educationsThree (3) registered nurses in clinical practiceTwo (2) associate or diploma degreeOne (1) basic nursing preparation a baccalaureate degreeOne (1) registered nurse at largeFour (4) licensed practical nursesOne (1) licensed physician who is member of the State Board of Medical LicensureOne (1) consumer of health services

Appointment of MembersMembers (exception of the physician) is appointed by the Governor with advice and consent of the Senate from lists of nominees submitted by any Mississippi nursing organization and/or association.

Mississippi Nursing Practice Law ~73-15-9 (1), (2), & (3)

Qualifications of MembersCitizen of the United States and resident of the State of Mississippi

Qualifications - Registered NurseGraduation from an approved educational program.At least five (5) years of nursing experience.Employed for at least the past three (3) years.Currently registered to practice in Mississippi.

Qualifications - Licensed Practical NurseGraduation from an approved educational program.At least five (5) years of nursing experience.Employed for at least the past three (3) years.Currently registered to practice in Mississippi.

Accountability Each Member ShallPossess a current, active and unencumbered Mississippi nursing license.Protect the public.Make responsible and educated decisions and be accountable for such decisions.Maintain the integrity of the board.Participate actively in business meetings, assigned hearing panels and committees.Collaborate with other board members.

Accountability: Each Member Shall NotDisclose confidential information gained by reason of his/her official position or authority on the board.Use his/her official position on the board to secure unwarranted privileges or exemptions for self or others.Use confidential information for private or public gain.Incur more than two consecutive absences from meetings.TermsMembers are appointed in staggered terms for four (4) years. No member may serve more than two (2) consecutive full terms.

OfficersPresidentSecretaryTreasurer

Mississippi Nursing Practice Law ~~73-15-11 (1)

Presidents DutiesPreside over all meetings of the board.Make decisions for the board, between meetings, which require immediate action.Gain consent and appoint all members of ad hoc and standing committees..Remove any member not fulfilling obligation to a committee.Oversee presentation of boards annual budgetPresent to Personnel Board any changes in status of executive directorServe as the boards official representative to legislative groupsRetain the right to vote on all board issuesSign appropriate legal documentsServe as counselor and advisor to executive directorServe as ex-officio member of all standing and special committees.Oversee presentation of executive directors annual evaluationPrepare and present report at annual meeting.Secretarys DutiesPreside and make decisions for the board, between meetings in absence of president.Sign all board minutes.Keep the official tally of all board actions.Prepare and present report at annual meeting.Treasurers DutiesWork with executive director and accountant on budgetary matters.Assist with boards annual budget presentation to appropriate commissions and committees.Present report at annual meeting.Perform secretarial duties in absence of secretary.MeetingsAt least once every four (4) months for the purpose of transacting business.

Disciplinary hearings and business meetings are open to the public.

QuorumOf the thirteen (13) board members, seven (7) members including at least three (3) registered nurses and two (2) licensed practical nurses shall constitute a quorum.

Mississippi Practice Law ~~73-15-11 (4)

Standing CommitteesExecutive CommitteeNominating CommitteeNursing Practice CommitteeAdvanced Practice CommitteeCompliance CommitteeOther Committees

Parliamentary ProcedurePublished February 1876 by then U.S. Army Colonel Henry Martyn Robert (18371923) with the short title Robert's Rules of Order placed on its cover.

Roberts Rules of Order, Newly RevisedGoverns the board, published 2011

Programs Under the Auspice of MS Board of NursingNurse Recovery ProgramOffice of Nursing Workforce

Nurse Recovery ProgramOperates within the Board of NursingApproximately workload annually .318 participants signed 5 year monitoring affidavits.50% of those completed the five year program with no relapse or non-compliance.10% relapsed or engaged in noncompliance necessitating a second affidavit.40% were unable to maintain sobriety and were referred to the disciplinary division for further action.RecidivismOut of the 60 percent who successfully completed the program, 7.5 % of them violated following completion.

RN AND LPN Patterns of AbuseCases involving RNs and LPNs most often involve the diversion of wastes of opiate medications.Pre-charting and excessive administration of controlled substances.Doctor shopping to obtain more medication than prescribed.Prescription forgery.

APRN Patterns of AbuseWriting and filling prescriptions for self administration using patients or family members names.Doctor shopping to obtain excessive amounts of medications.Use of anesthesia agents.Diversion of fentynal, versed and other anesthesia medications.SIGNS AND SYMPTOMS OF IMPAIRMENTOBVIOUSSUBTLESlurred speechSleeping while on dutyLack of coordinationUnexplained absences from the unitFrequent bathroom breaksSmelling of alcoholGlassy red eyes, or pinpoint dilated pupils

Pulling and administering more controlled medications than other nurses.Patients complaining of untreated pain.Preferring night shifts or unsupervised settingsNever wasting with a witnessNever taking vacationVisiting home health patients when not on dutyTHE IMPAIRED NURSE

Board InterventionThe MS Board of Nursing intervenes on a nurses practice when that nurses addiction has caused violations of the nursing practice law and administrative code to occur.

Investigative cases that involve diversion, doctor shopping, prescription forgery, and other drug related offenses are referred to the Recovering Nurse Program.

Nurses Monitoring Programs1982 International Conference on the Addicted Nurse launched a call to action to all states to create board based programs for substance dependent nurses.The resolution was grounded on research showing that having programs specifically for nurses resulted in earlier identification of the disease, timely removal from the work place, appropriate monitoring and safer return to practice.

Nurses Monitoring ProgramsThe National Council of State Boards of Nursing took up the cause and began promoting the formation of advocacy programs to the boards of nursing.Mississippi created the RNP in 1982, the RNP is a disciplinary program that results in action similar to an administrative felony. While many of the other states created programs based on a non-disciplinary model, the Board in Mississippi felt that diversion and similar violations of the NPL needed to be recognizable and did not want impaired untreated nurses moving from state to state anonymously.

Components of MonitoringProfessional assessment conducted by a masters or doctorate level individual utilizing collateral information provided by supervisors, co-workers, and family members.

A substance dependency diagnosis.

Admission by the nurse of violation of the nursing practice law and administrative code as well as an expressed desire to receive help.Components of MonitoringPrompt removal from the workplace.Referral and admission to the correct treatment modality.Signing a monitoring affidavit with the board.Return to work agreementMonitoring with random drug screens, reports, prescription use and medical treatment documentation.Aftercare treatment to include groups, counseling and medication management where appropriate.

Components of MonitoringParticipation in 12 step groups and recovery activities.Routine group meetings with RNP staff.AccountabilityRepetitionFive year monitoring agreement

Office of Nursing Workforce

Provides: Educational programs.Determine continuing education needs of nursing workforce.Promote and coordinate schools of nursing opportunities.Apply for grants for developmentData collections on adequate nurses in Mississippi.

Office of Nursing WorkforceThe Mississippi Office of Nursing Workforce (ONW) is dedicated to furthering research and analysis of solutions to nursing workforce issues for purposes of public information.

Mississippi Code 1972, 75-15-18

Duty to ReportFailure to report to the Board facts known regarding incompetent or illegal practice of any RN or LPN

Filing a Complaint Source of information will be kept confidential.Report suspected problems at once to your immediate supervisor.Do not discuss your suspicions with others.Write a comprehensive report as soon as possible.If you are not certain it has been reported to the Board, you can make a report yourself directly to the Board.

Conspiracy to and illegally dispensing and distributing controlled substancesMD, age 76, of Metairie, LA, pled guilty in federal court to four counts of dispensing Schedule III and Schedule IV controlled substances outside the scope of professional practice and not for legitimate medical purposes; and one count of conspiracy to illegally dispense and distribute Schedule III and Schedule IV controlled substances and mixtures of Schedule III and Schedule IV controlled substances outside the scope of professional practice and not for legitimate medical purposes.MD was employed by Advanced Pain Management at clinics located in Metairie, Slidell, and Gretna, LA. During his employment, MD knowingly used his DEA registration to issue controlled substance prescriptions that were not medically necessary or were issued for overlapping treatment periods for the same medical condition.Sentenced to ten months in federal prison followed by three years of supervised release and ordered to pay a fine of $40,000 and an assessment of $500.00.Misprision (concealment) of a felonyAccording to court documents, MD was employed by Advanced Pain Management at clinics located in Metairie, Slidell, and Gretna, LA. During her employment, MD was aware of the clinics operations and practices including the issuance of controlled substance prescriptions without medical necessity or not in the course of usual medical practice and the scheduling and treatment of hundreds of patients per day, often seen by one doctor, and the clinics failure to comply with medical standards applicable to pain management.Despite this knowledge, MD failed to notify any authorities or to disclose the information in meetings with agents of the Drug Enforcement Administration.MD was sentenced to six months in federal prison followed by one year of supervised release and ordered to pay a fine of $5,000 and an assessment of $100.00.

Grounds for Disciplinary ActionPossessing, obtaining, furnishing or administering drugs to any person, including self, except as legally directed.

Failure to report to the Board facts known regarding incompetent or illegal practice of any RN or LPN.

Grounds for Disciplinary ActionHad disciplinary action in another jurisdictionFailed to meet generally accepted standards of practiceViolated order of the boardFalsified or failed to make essential entries on recordsAddicted to habit-forming drugs/alcoholMisappropriated any medication

Grounds for Disciplinary ActionPhysical, mental, or emotional disability that renders licensee unable to perform nursing with reasonable skill and safetyEngaged in conduct that constitutes a crimeEngages in conduct likely to deceive, defraud or harm the publicEngages in unprofessional conductViolated any provision of the nurse practice law

Grounds for Disciplinary ActionUnprofessional conductViolating confidentialityWillful alteration of medicationsObtaining controlled substances by unauthorized meansForging a prescription for medicationPassing a forged prescriptionSelling a controlled substance

Questions??? How far we have come.