NURSE VOLUME 13 NUMBER 3 DISTRICT OF COLUMBIA JUNE 2017 R e g u l at i o n E d u c at i o n P r a c t i c e • LPN Renewal • HHA & TME Renewal • HHAs: Be Prepared for An Emergency GOVERNMENT OF THE • Medicare Fraud DISTRICT OF COLUMBIA • Meet the New Board Members MURIEL BOWSER, MAYOR eO -mF aFi Il C : I dAc L . b oPn U @dBcL. gI oCv AT• I wOeNb : ohft t pt :h/ /ed oD h . Id S c .T g oR v /IbC onT O F C O L U M B I A B O A R D O F N U R S I N G1  ADVANCE YOUR NURSING CAREER Earn your MSN or RN-to-BSN at Trinity! “The flexibility and support that Trinity offers made it possible for me to complete my RN-to-BSN while working full-time and raising my family. I valued the classroom interaction with my professors, and the knowledge and skills I gained positively influence the decisions I make in patient care. Trinity taught me leadership skills and gave me the confidence to advance my career from clinical nurse to case manager. ” - Marquise King MSN RN-to-BSN • Choose from two pathways: • For RNs holding an associate’s - Education: Be prepared to teach degree or a diploma in nursing in a nursing classroom or staff • Complete your bachelor’s degree development program and advance your nursing career - Administration: Earn a degree to advance your career as a • Classes meet on campus just one nursing manager day a week • Classes meet on campus 8 weekends a semester Trinity Washington University in D.C. is minutes from area hospitals and healthcare facilities and offers an affordable tuition, convenient class schedule, a hybrid format that blends online and on-campus learning, and faculty commited to your success. Contact us today! Call or text: 202-656-5615 [email protected] 125 Michigan Avenue NE Learn more: www.trinitydc.edu/DCNurse Washington, DC 20017 2 TRINITY WASHINGTON UNIVERSITY District of Columbia Nurse: Regulation • Education • Practice DISTRICTof c o n t e n t s COLUMBIA NURSE Message from the Chair 4 Message from Outgoing Chair 6 Message from the Executive Director 7 Edition 47 Director, Department of Health LaQuandra S. Nesbitt, MD, MPH R E G U L A T I O N Senior Deputy Director Health Regulation and Licensing Administration Nurses Rank #1 again for the 15th Straight Year! 8 Sharon Williams Lewis, DHA, RN-BC, CPM Nursing in 2017 8 Board Members Amanda J. Liddle, Dr.PH, RN, FAAN Chairperson Thank You for Your Service 10 Board Member Testifies At Council Hearing 10 Meedie Bardonille, RN, BSN, FCN Layo George, BSN, RN Margaret A. Green, LPN Elizabeth Lamme, MS, CNM Meet the New Board Members: Elizabeth Lamme 11 Vera Waltman Mayer, JD Ottamissiah Moore, BS, LPN, WCC, CLNI, GC, CHPLN COIN CONSULT 12 Laverne Plater, BSN, RN-BC Winslow B. Woodland, RN, MSN LPN Licensure Renewals Have Begun! 13 2 Vacancies (1 RN member, 1 Consumer member) Office Location IN THE KNOW15 NAP NEWS! 17 Email Address DC Board of Nursing 899 North Capitol St. NE, 2nd Floor Washington, DC 20002 • HHA and TME Renewals [email protected] Web site: http://doh.dc.gov/bon • HHAs and Patient Emergencies Office Hours • Medicaid Fraud Monday thru Friday: 8:30 a.m.-4:30 p.m. • NAP Q&A Board Staff E D U C A T I O N Karen Scipio-Skinner, MSN, RN Executive Director NCSBN NEWS 20 Concheeta Wright, BSN, RN Nurse Specialist II/Practice/COIN Nursing Schools/CNA & HHA Programs 21 Cathy Borris-Hale, RN, MHA, BSN Nurse Specialist II/Discipline Joanne C. Drozdoski, JD Investigator P R A C T I C E Health Licensing Specialists: Melondy Scott, New LGBTQ Cultural Competence 22 Supervisory Health Licensing Specialist Tanee Atwell, BS Kudos! 26 Antoinette Butler Donna Harris, BSHA, MPA Gwyn Jackson Documentation 28 Nicole Scott Antoinette Stokes Disciplinary Action 30 Nancy Kofie DC Nurse: REP Managing Editor Address Change? Name Change? Question? Please notify the Board of Nursing of any changes to your name or address. Thank you. DC BON Mission Statement: “The mission of the Board of Nursing is to safeguard the public’s health and well being by assuring safe quality care in the District of Columbia. This is achieved through the regulation of nursing practice and education programs; and by the licensure, registration and continuing education of nursing personnel.” pcipublishing.com Circulation includes over 37,000 licensed nurses, nursing home administrators, nurse staffing agencies and nursing assistive personnel in the District of Columbia. Created by Publishing Concepts, Inc. David Brown, President • [email protected] Feel free to e-mail your “Letters to the Editor” for our quarterly column. The IN THE KNOW and NAP Q&A For Advertising info contact columns include your opinion on the issues, and our answers to your questions. E-mail your letters to Dustin Doddridge • 1-800-561-4686 ext. 106 [email protected]. (Lengthy letters may be excerpted.) [email protected] ThinkNurse.com e-mail: [email protected] • web: http://doh.dc.gov/bon 3  Message from the Chair and encourage you to attend our public Board meetings so your voice can be heard on the many issues addressed. (Board meetings are open to the public DC Mayor Muriel Bowser and DC Board of Nursing Chairperson Amanda Liddle, Dr.PH, RN, FAAN. every (odd-numbered) other month (see page ???) In April of this year, I was Cathy A. Borris-Hale, RN, MHA, Further in August, I plan to appointed and sworn-in as BSN, Toni A. Eason, DNP, MS, represent us at the National a RN board member and as PHCNS, COHN-S, CEAS, RN-BC, Council of State Boards of Chairperson for the District of FAAOHN, Chioma Nwachukwu, Nursing (NCSBN) conference in Columbia’s Board of Nursing DNP, Mamie Preston, BSN, Chicago. This is an important by Mayor Muriel Bowser. As a RN, and Simmy Randhawa, opportunity for Boards of RN, licensed by the District for DNP, MBA, MS, RN, NE-BC, Nursing across the country close to 30 years, it was a proud and I would like to recognize to share information and moment. It was one that was a them for their sterling service. experiences of health care longtime coming, and I am very (See the article at the bottom delivery within their states, as honored to have the opportunity of page 10, “Board Member well as lessons learned. I look to serve the people of District as Testifies At Council Hearing,” forward to bringing those lessons Chair of the Board of Nursing. for a listing of the Board’s many back to the District so we can The District has encouraged and accomplishments during their incrementally and collaboratively supported me to professionally tenure.) build; I will brief you in my next and personally thrive; it is time Since joining the Board, I letter. to give back in such a way. have been looking at the issues Again, I am happy and excited In addition to my becoming facing the various health care to be able to serve you, and the a board member, we also have professions the Board licenses as people in the District, as we all two other new members on they deliver the highest standard work together to provide the best the Board: Meedie Bardonille, of care possible to the people health care possible. RN, BSN, FCN, and Elizabeth within the District. Over the next Lamme, MS, CNM. I think I can few months the Board will be Best, safely speak on their behalf, considering carefully how the Amanda and greatly thank the seasoned quality of the services you, our Board members and staff for licensees, provide can continue Amanda Liddle, Dr.PH, RN, the incredibly warm welcome to improve and be supported. As FAAN they extended to us. We have ever, we look forward to open, Chairperson some members stepping down: transparent dialogue with you, DC Board of Nursing 4 District of Columbia Nurse: Regulation • Education • Practice  People are our greatest resource. UMC is a great place to work. We attribute Featured Careers this to the remarkable people who work here. Nursing Careers “Putting Patients First” means having highly skilled Our commitment to recruiting the brightest to clinicians on every unit, and that means nurses. provide the best quality care is one big reason We invite you to join our nursing team and see just how that United Medical Center is transitioning exceptional working here can be. into the preferred hospital of choice. We’d be delighted to have you consider UMC as the next step in your career. united-medicalcenter.com/careers e-mail: [email protected] • web: http://doh.dc.gov/bon 5  Message from Outgoing Chair counseling nurses, as well as 8,000 home health aides (HHA) addressing concerns of those we under the board of nursing. This Cathy Borris-Hale, RN, MHA, serve. Consequently, I was fairly was a comprehensive endeavor that BSN confident this “Board thing” would included overseeing the revision be easily under control. I do not of the skills exams, monitoring the exaggerate when I tell you I was pass rate of graduated students, and Dear Fellow Nurses, Board in for a rude awakening! The tasks ensuring training facilities were Members, and Board Staff: of writing public policy, giving adhering to Board requirements. advisory opinions, addressing A most alarming concern was the THIS WILL BE MY FINAL LETTER providers, challenging educational increasing number of discipline I write you as Chair of the District institutions, and presiding over cases involving HHAs. The offenses of Columbia Board of Nursing. disciplinary hearings—well, to put ranged from false documentation After five years on the Board, the it mildly—those are tremendous and fraudulent billing to failure to time has come for me to move on responsibilities. conform to standards of acceptable to my next challenge. The message I Board members are volunteers conduct and prevailing practice. bring you today is simple, heartfelt and, while many are supported It appeared that the home health and very personal. by their organizations, some system was in serious condition. First I am proud to be a nurse are not and must arrange their It was unsettling to say the least and proud of the profession. It has work schedules in order to serve. and served as our motivation to set been a true honor to have served as Members commit to a minimum standards for improvement. chair of the District of Columbia day each month to attend It wasn’t until I was faced with Board of Nursing and I leave that meetings and give up additional my own family crisis that I realized post confident the new Board Chair private time to review materials how vital home health care is will bring her talents and wisdom and research topics prior to the for our community. Although I to lead the Board towards becoming meetings. Consumer members am a nurse with over 30 years of a transformational board. bring the perspective of the patient, experience, from bedside nursing to During my term of office, I client, family or friend to keep us the board room, I didn’t have a clue believe we successfully shared our grounded. how my family was going to meet views on many issues and had an It is astounding how much my dad’s needs. After emphatically extraordinary number of major work goes on behind the scenes telling the hospital discharge accomplishments. However, I want to license, certify and monitor the coordinator that “my father” would to break from tradition and not likes of 28,000 Advance Practice not be going to a nursing home and list all of the important work we Nurses, RNs, LPNs and nursing we would care for him at home, I did together, but rather use this assistive personnel. Before my own was left wondering—just how are opportunity to share something involvement on the Board I had you going to do that? close to my heart. no idea how labor intensive Board I was starting a new job and While preparing to write this business is and I want to personally not covered by FMLA [Family and letter, I recalled the awe that never thank the licensing specialists, Medical Leave Act]. All my siblings failed to overcome me in this attorneys and nurse specialists worked and my amazing mom was prestigious environment. Coming who work tirelessly to support that managing all of this with two bad from an administrative background, aspect of our mission. knees and torn rotator cuff that I felt comfortable writing policies One major challenge the Board she would probably never have and procedures, mentoring and faced was the effort to bring some repaired. It was in that moment 6 District of Columbia Nurse: Regulation • Education • Practice  I called a colleague and cried out entered the room, I heard this support ongoing training for our for help. A few days later, I sat warm and strong voice say, “Good nursing assistive personnel. They anxiously, pacing the living room, Morning Mr. B. My name is… and are caring for our most vulnerable arms folded, looking out of the I am here to help you feel better.” populations. I encourage you to be window to peep the glance of the I saw my father’s face light up and proud of, and want you to thank, “dreaded” home health aide. respond, “Is that so? … So nice to recognize, promote, and respect the She arrived exactly on time. meet you, darling.” thousands of women and men who Dressed in bright colored scrubs, It has now been one year since provide expert nursing care in many she extended her hand and my Dad’s HHA arrived and I can’t settings with compassion and love. introduced herself. She seemed even imagine life without her. I am Again, I thank you all for friendly enough but she wouldn’t thankful and Blessed that my family allowing me to lead this progressive pull one over on me. I began to is able to care for our dad in his board and I look forward to our tell her about my dad using every home, surrounded by the people future. medical term I could think of. who love him and without a doubt She listened intently, smiling and this wouldn’t be possible without Warmest Regards, nodding her head. Her response, our home health aide, Miss Avril. “May I meet your father?” “Sure,” So the moral of this story: the I replied as I simultaneously healthcare landscape is moving introduced her to my mom. We from the hospital to the home. We climbed the stairs silently, as we need to ensure we educate and Cathy Borris-Hale Message from the Executive Director Karen Scipio-Skinner, MSN, RN While it is sad to lose Cathy Over the coming months, you will month with an introduction to Borris-Hale as Chair of the Board, have an opportunity to hear from Dr. Elizabeth Lamme, on page 11. I am pleased to have her on staff as Liddle in these pages. Thank you again for all you do! Nurse Specialist for Discipline. Her In addition to Dr. Liddle, we And, in keeping with the theme of this presence on the staff has already have added Elizabeth Lamme and year’s National Nurses Week—take made a positive impact. I am equally Meedie Bardonille as new RN Board care of yourself as well as you care for pleased to have Dr. Amanda Liddle Members. the patients you serve. as Chair of the Board. Dr. Liddle is As is our custom, we have asked not only the new Chair, but also a Board Members to answer several Karen Skinner, MSN, RN new Board Member and has already questions to give you an opportunity Executive Director brought new energy to the Board. to know them better. We start this DC Board of Nursing e-mail: [email protected] • web: http://doh.dc.gov/bon 7 Regulation Celebrating National Nurses Week Nurses Rank #1 again for the 15th Straight Year! For the 15th year in a row, the American public has honored our profession with the ranking of the “highest honesty and ethical standards,” according to the annual Gallup poll. In Gallup’s annual poll ranking the most honest and ethical careers, nurses retain the top spot! In the 2016 poll, 84 percent of Americans surveyed say nurses have “very high” or “high” standards of honesty and ethics. Nurses have topped the honest and ethics ranking every year since they were added to the list in 1999, except for 2001, when firefighters ranked number one in response to their work during and after the 9/11 attacks. (Go to: http://www.gallup.com/poll/200057/ americans-rate-healthcare-providers-high-honesty-ethics.aspx) n Courtesy of the National Council of State Boards of Nursing (NCSBN) Nursing in 2017: Take the Time to Balance Body, Spirit and Mind! by Nancy Kofie As one of the District of Columbia’s 28,000 licensed nurses, you have accomplished a lot in the past year. The care you provide has been crucial to our efforts to continually raise the standards of care in the District. challenges, make prevention a priority, eat healthy This year, we once again celebrated National Nurses foods and make exercise a part of your self-care routine. Week, May 6-12, 2017. The theme of this year’s Balance your mind, body and spirit. As you strive National Nurses Week is “Nursing: The Balance to ensure quality care to your patients, take time to of Mind, Body, and Spirit.” The American Nurses care for yourself and get plenty of rest. The health Association designated 2017 as the “Year of the Healthy and safety of both you and your patients hangs in the Nurse.” balance. During each workday, you focus a lot of time and We value our nurses here in the District of Columbia. energy on providing quality care to your patients. Your dedication to the art of caring, and your This year, begin the habit of taking time to care for professional expertise, contribute greatly to the quality yourself. You cannot provide quality care unless you pay of life of our residents and the comfort of our visitors. attention to yourself and your well-being. The tasks you We want to take this opportunity to let you know how are required to complete, and the knowledge you must much we appreciate your work, and so do our residents continuously acquire, necessitate that you are healthy in and the millions of visitors who travel each year to the mind, body and spirit. The mission of the Department nation’s capital. of Health is to ensure a healthy citizenry—and you are Remember to take care of yourself, body, spirit and an essential part of the District’s citizenry. mind! n Make 2017 a year of wellness. Address your health 8 District of Columbia Nurse: Regulation • Education • Practice  Thomas Memorial Hospital FP ad to come e-mail: [email protected] • web: http://doh.dc.gov/bon 9  Re g u l a t i o n Farewell! Thank You for Your Service The Board of Nursing bid farewell and presented certificates of appreciation to our outgoing Board Members. We would like to publicly offer our thanks to outgoing Board Members for their dedicated service to the Board of Nursing. n Left to right: Mamie Preston, BSN, RN (Member); Simmy Randhawa, DNP, MBA, MS, RN, NE-BC (Vice Chairperson); Dr. Sharon Lewis (Senior Deputy Director of the Health Regulation and Licensing Administration); and Cathy A. Borris-Hale, RN, MHA, BSN (Chairperson). Outgoing members who are not pictured: Chioma Nwachukwu, DNP, PHNCNS-BC, RN (Vice Chairperson); Toni A. Eason, DNP, MS, PHCNS, COHN-S, CEAS, RN-BC, FAAOHN (Member). Board Member Testifies At Council Hearing on the Board of Nursing’s activities over the last year at the Oversight Hearing held in March 2017. She said, in part: “The Board has been busy. Last fiscal year we held numerous hearings and settlement conferences and imposed some 100 disciplinary sanctions. We held a Home Health Agency Roundtable focusing on submitting complaints [when to submit, and the information needed to be provided when submitting] to the board. The Board also convened a meeting between Primary Care Centers and Nursing Programs to discuss clinical placement options for nursing students. We have completed the revision of the Advanced Layo George, RSN, RN Practice Registered Nurse regulations and are currently completing the revision of the RN and LPN regulations. Board of Nursing Member Layo George, BSN, RN, The Nursing Assistive Personnel Omnibus regulations testified before the Council of the District of Columbia are currently being reviewed for legal sufficiency and we Committee on Health, Councilmember Vincent C. Gray hope that these regulations will be promulgated by the (Ward 7), Chairperson. Ms. George provided an update end of this fiscal year.” n 10 District of Columbia Nurse: Regulation • Education • Practice  Meet the New Board Members: Elizabeth Lamme This is an exciting time for the Board of Nursing! We look forward to implementing Nursing Assistive Personnel (NAP) regulations, which will allow the Board to regulate Certified Nursing Assistants (CNAs), Patient Care Techs (PCTs), Medication Aide-Certified (MA-C), and Dialysis Techs. The Board is also considering regulating non-nurse Midwives. In light of this impending challenge, we welcome new Board member and Vera Mayer, re-appointed as Consumer Member; Amanda J. Liddle, DrPH, Chairperson; Elizabeth Certified Nurse Midwife Elizabeth Lamme, RN Board Member; and Meedie Bardonille, RN Board Member. Lamme, MS, CNM. Below, is our DC NURSE interview with Ms. Lamme. In future issues we will hear from our degree at Georgetown University and Is there any aspect of your other new board members. Stay tuned! my bachelor’s degrees from Johns service as a Board member thus Hopkins University (nursing) and far that has surprised you (or has When were you appointed to the the State University of New York the experience been what you Board? at Geneseo (psychology). Before expected it to be)? I was appointed in January 2017. I became a CNM I was a labor & I was surprised to learn about the delivery nurse at MedStar Georgetown many different types of providers of What sparked your interest in University Hospital. Prior to my health care the Board regulates as service as a Board member? nursing career I worked in health well as the Board’s role in regulating Before I was a nurse I worked in policy and advocated for expanded education and training programs. health policy and was committed to provisions for women’s health in the staying involved with advocating for Affordable Care Act. What would you tell someone healthcare consumers at a systemic thinking about applying to serve level. A class in graduate school What unique perspective do you on the Board? (taught by a fellow new Board Chair, bring to the Board? Go for it! As a healthcare Dr. Amanda Liddle) introduced me to As nurse-midwife I have the honor provider you have much to offer, Boards of Nursing and encouraged me and privilege to care for women and being on the Board is a to become involved in my profession and families at the most special special opportunity to serve your even as a new advanced practice nurse. and vulnerable times in their lives. I community. understand the importance of a strong Can you tell us (briefly) about your health care workforce to support Any message you would like to background? families from the very beginning. convey to licensees? I am a Certified Nurse Midwife Thank you for providing with Women’s and Infants’ Services at What Board-related issues interest respectful, safe, and compassionate MedStar Washington Hospital Center you the most? care to the Washington, DC where I practice full-scope midwifery How best to address the obstacles community. You make our city care. I received my Master of Science that stand in the way of safe practice. stronger! n e-mail: [email protected] • web: http://doh.dc.gov/bon 11 COIN CONSULT A Resource for Impaired Nurses Letter from a COIN Participant To Whom It May Concern, COIN has been immensely helpful to me over the past few years. As well as helping keep me accountable to someone other than myself, COIN has provided me with much needed support from the nursing community. Never once did I feel judged or punished; on the contrary I felt nothing but support and respect from members of the committee; that their greatest wish was for me to succeed in both my career as well as my personal life. The past few years have absolutely flown by, and I am eternally grateful for the love and support they have shown me. Best wishes, A.B. COIN Contact Information If you are a Trained Medication Employee, Home Health Aide, Certified Nursing Assistant, Licensed Practical Nurse, Registered Nurse, or Advanced Practice Registered Nurse whose practice is unsafe due to drug or alcohol dependence, or mental illness, please feel free to contact Concheeta Wright, Nurse Specialist II, by email at [email protected]. The purpose of the COIN (Committee on Impaired Nurses) is to provide an alternative to Board discipline. The Committee monitors the recovery of participants and their practice to ensure that they practice within acceptable standards of care. All information about the participants in the program is confidential. n 12 District of Columbia Nurse: Regulation • Education • Practice  Re g u l a t i o n LPN Licensure Renewals Have Begun! Your license will EXPIRE June 30, 2017. Reason: You answered “No” to RENEW BY JUNE 30, 2017 completion of Continuing Education Licenses not renewed by June 30, 2017 will expire. Between July contact hours. 1st and August 30th you will be charged an additional $85.00 for late Your renewal will be placed on “Hold” renewal. You will have to reinstate your licensure if not renewed by if you answered “No.” August 30, 2017. Remedy: If you answered “No” you will not have completed your CE requirements by June 30, 2017; you RENEWAL TIPS DON’T will be required to submit evidence of • Wait until the last minute to renew. satisfactory completion of 18 contact DO • Let your license “expire” if you plan hours of continuing education before • Renew by accessing the HRLA to work in DC. your license will be renewed. Please website at: https://app.hpla. • Disregard the Continuing Education email evidence of your completed CE doh.dc.gov/mylicense/ audit notification if you are a requirements to [email protected]. • Read all screening questions random audit selectee. carefully before answering, Reason: You owe the District as incorrect or unintentional If your license did not renew it may Government $100 or more in fees. responses may result in a “Hold” have been for one or more of the Remedy: Provide evidence on an on your renewal application following reasons: official document from agency to even though the system will which you owe fees that you have allow you to pay and exit the Reason: You could not finish the online either paid the fee or have an approved renewal program. renewal process. payment plan. • Answer “Yes” to the continuing Remedy: Retrace your steps, and education (CE) question if you complete the process. Your renewal effort Q: What are my options if I will not are renewing for the first time. is successful once you enter payment be practicing in DC during the next • Send written explanation(s) information, press submit, and the two years? to screening questions to website processes that data and produces A: You can choose to: [email protected]. Please include a Renewal Payment Receipt for inspection your name, license number, and and printing. • Keep your license active; or the question to which you are Note: Please print receipt as evidence of • Cancel your license, in which case providing the explanation. successful renewal. you will have to apply again as a • Print out receipt after new applicant when you decide to completion of your online Reason: Your payment was not processed. resume practice in DC; or application renewal process. Remedy: Please refer to above response. • Apply for Inactive status. Your If payment information is entered and license will remain valid, but you Verify your renewal after 24 hours at submit button is pressed and that button will not be able to practice until www.hpla.doh.dc.gov/weblookup. does not depress and/or no Renewal you apply to reactivate your Allow ten (10) business days to Payment Receipt is produced, payment license. receive the renewed license in the was not processed. mail. Retrace your steps and repeat your process. Continued on page 14 e-mail: [email protected] • web: http://doh.dc.gov/bon 13  Re g u l a t i o n Continued from page 13 period is “Expired.” Nursing personnel regulated by the Board of Track Your CE with CE Broker Q: What do I need to do if I wish to Nursing (which includes registered CE Broker simplifies the place my license on Inactive status? nurses, advanced practice registered process of tracking your Can I request this on line? nurses, licensed practical nurses, continuing education with easy A: No. You will have to complete trained medication employees and reporting, digital storage for and sign a paper renewal application home health aides) who have not your certificates and licenses, (print from our website) indicating been licensed/certified by the end and a credit counting CE your desire to go on “Inactive of their renewal period will no Compliance Transcript all in one Status,”include a check or money longer receive a status of “Renewal online portal. There are three order for the fee and then mail to: Eligible.” The status will now read subscription options. “Expired.” Nursing personnel D.C. Board of Nursing will continue to have a 60-day THE BASIC ACCOUNT: This no- P.O. Box 37802 “grace period,” but their license/ cost account provides licensees Washington, D.C. 20013 certification status will show as a no-frills way to report course “expired” not “renewal eligible” completions and verify that Designation Changed from on our website. The “grace period” all completed hours have been “Expired—Renewal Eligible” to allows persons to continue to work entered into the system. “Expired” 60 days beyond the expiration The renewal status designation of their license, without being THE PROFESSIONAL ACCOUNT: for nursing personnel who have not considered by their licensing board ($29/ YR): CE Broker’s most renewed their license/ certification to be practicing without a license/ popular option is the best value prior to the end of their renewal certification, as long as they renew for professionals with several within the 60-day period after licenses or cards to keep up with. the expiration of their license/ Online Reporting—Easily report A m e m b e r o f N u r s e s S e r v i c e O r g a n i z a t i o n ( N S O**) ** N S O m a y c o v e r m o s t o f y o u r a t t o r n e y f e e s . certification and pay the late fee. your accomplishments from The law has not changed, only the your computer or phone. CE designation. n Compliance Transcript—See all Izu I. Ahaghotu, RN, JD of your requirements, what has been completed, and what CE A T T O R N E Y A T L A W What You Need to Know still needs to be fulfilled. Course about Continuing Education Search—Search for all the board- approved courses needed to fulfill • It is not required for those your requirements. Plus digital who are first time renewals certificate storage, course history but is required for all backlog, helpful tips and deadline others. notifications. • It must be obtained from THE CONCIERGE ACCOUNT: If you or a colleague is in need of an July 1, 2015 – June 30, ($99/ YR): Designed for the extra Attorney to represent you before the D.C. 2017 to satisfy the CE busy healthcare professional, Board of Nursing or FOR ANY OTHER LEGAL MATTER, Call a Nurse Attorney requirement for license this full reporting service option for a confidential consultation. renewal. provides you with a personal Please contact Izu I. Ahaghotu, RN, Esquire directly: reporting assistant. Office: 202.726.0001 DIRECT 202.361.6909 • It must be consistent with www.IZUAHAGHOTU.com your nursing position, For more info call 1-877-434- Email: [email protected] totaling 18 Contact Hours. 6323 or go to www.CEBroker. 3724 12th St NE Washington, DC 20017 com. 14 District of Columbia Nurse: Regulation • Education • Practice IN THE KNOW The Board of Nursing has established the “In The Know” column in response to the many phone calls and e-mails the Board receives regarding licensure and other issues. Please share this column with your colleagues and urge them to read it. The more nurses are aware of the answers to these frequently asked questions, the better outcomes we can expect. REGISTERED NURSE AND ADVANCED PRACTICE REGISTERED NURSE RENEWAL REMINDER Early Bird Renewals will begin March 2018 Please be informed that the 2018 RN/APRN Renewal will begin in March of 2018. As you know, we began the last renewal in January of 2016. After analyzing when nurses renew, the largest percentage, 43%, apply in June. Traditionally, we begin renewals in April, however, the 2018 renewal period will begin with “Early Bird” renewals in March and we will send RNs frequent reminders. NURSE LICENSURE COMPACT LGBTQ CONTINUING EDUCATION Q : Why isn’t DC a participant in the Nurse Licensure Compact? REQUIREMENT? Q : The new Continuing Education law A : A compact is an interstate agreement between two or more states established for the purpose of remedying a particular problem of multistate concern. The Nurse Licensure Compact (NLC) mandates that two (2) credits of CE pertinent to cultural competency or specialized clinical training that focuses on Lesbian, allows a nurse to have one compact license in the nurse’s primary Gay, Bisexual, Transgender or Questioning jurisdiction of residence (the home state) and to practice in other (LGBTQ) patients must be completed for any compact jurisdiction. Licensure fees are paid to the home jurisdiction license, registration, or certification. Can you and the nurse must follow the nurse practice act of each jurisdiction clarify? I think this is only for physicians (not in which they practice. The nurse will be subject to the discipline nurses). Is that correct? process in the jurisdiction of practice. Currently 26 jurisdictions have implemented the NLC. The traditional licensure model, used by DC, requires nurses to be licensed in the jurisdiction in which they practice. The NLC A : No. All health professionals, licensed, registered or certified by a health professional board, will need to fulfill model requires nurses to be licensed in their home jurisdiction or this requirement, however this District of primary jurisdiction of residence. Nurses in the Compact are only Columbia law will not be enforced until the required to have a license for the compact jurisdiction state in which regulations have been revised incorporating they live. But, if they choose to work in a non-compact jurisdiction, this requirement. The regulations have not yet they must apply to that jurisdiction for licensure. been promulgated for APRNs, RNs and LPNs. Although the District of Columbia has 23,673 active RN licensees; of these, only 2,673 (1%) actually live in the District. DC would RNs WITH DOCTORATES therefore lose licensure fees from 99% of our licensees if we join the Compact. During Fiscal Year 2016, the DC Board of Nursing approved 3,655 Q : I would like to get information concerning Advanced Practice Registered Nurses (APRNs) who have doctorates. I am RN endorsement applications. Although 100% of our applicants are particularly interested in the District’s law not from compact states, the vast majority of our applicants for concerning the title “Doctor” when it comes licensure by endorsement are from our neighboring jurisdictions Maryland and Virginia, which are compact jurisdictions. Continued on page 16 e-mail: [email protected] • web: http://doh.dc.gov/bon 15  Re g u l a t i o n Continued from page 15 BOARD OF NURSING ADVISORY OPINION to APRNs. Also, how does this relate AUTHORIZATION FOR USE OF RESTRAINTS AND SECLUSION to APNs that work in the federal government? A : Our legislation doesn’t make a distinction between APRNs with Q : Is it within the role and scope of responsibilities of the nurse practitioner to authorize the use of restraints and seclusion in patients or clients? or without doctorates. Q : In the District of Columbia are APRNs allowed to use the title “Doctor” in practice? Certain A : In the opinion of the Board of Nursing for the District of Columbia it is within the role and scope of practice of an Advanced Practice Registered Nurse to authorize the use of restraints and states have rules about this issue. seclusion, in emergency or other situations that necessitate their use, in Does the Board of Nursing have any accordance with federal and District laws and regulations as applicable. written policy concerning this? A : DC does not have rules regarding non-physicians using the title “Doctor.” n This statement is an advisory opinion of the Board of Nursing as to what constitutes competent and safe nursing practice. ATTENTION APRNs: DRUG ENFORCEMENT ADMINISTRATION RENEWAL NOTIFICATIONS Renewal Reminders: As of January 2017, the Drug Enforcement Administration (DEA) no longer sends its second renewal notification by mail. Instead, an electronic reminder to renew is sent to the email address associated with the DEA registration. DEA will otherwise retain its current policy and procedures with respect to renewal and reinstatement of registration. This policy is as follows: If a renewal application is submitted in a timely manner prior to expiration, the registrant may continue operations, authorized by the registration, beyond the expiration date until final action is taken on the application. DEA allows the reinstatement of an expired registration for one calendar month after the expiration date. If the registration is not renewed within that calendar month, an application for a new DEA registration will be required. Regardless of whether a registration is reinstated within the calendar month after expiration, federal law prohibits the handling of controlled substances or List 1 chemicals for any period of time under an expired registration. For more information, go online at: https://www.deadiversion.usdoj.gov/drugreg/index.html https://apps.deadiversion.usdoj.gov/webforms/jsp/regapps/common/renewalAppLogin.jsp BOARD OF NURSING MEETINGS Members of the public are invited to attend... Date: Transportation: First Wednesday of every other month. Closest Metro station is Union Station. (Red Line) Time: To confirm meeting date and time, 9:00 a.m - 11:00 a.m. (subject to change) call (202) 724-8800. Location: Meetings scheduled: 2nd Floor Board Room July 5, 2017 899 North Capitol St NE September 6, 2017 Washington, DC 20002 November 1, 2017 16 District of Columbia Nurse: Regulation • Education • Practice  Home Health Aide and Trained Medication Aide Renewals HHAs and TMEs please be reminded that your certification will expire October 31, 2017 HOME HEALTH AIDE (HHA) TRAINED MEDICATION Prior to the renewal period, you may RECERTIFICATION BEGINS EMPLOYEE (TME) be selected for audit. If selected, you AUGUST 1, 2017 RECERTIFICATION BEGINS will be asked to provide the following AUGUST 1, 2017 information: REGULATORY REQUIREMENTS FOR HHA RECERTIFICATION: REGULATORY REQUIREMENTS • Verification Form: Completed FOR TME RECERTIFICATION: verification form signed by your • Work a minimum of eight (8) supervising nurse verifying continued hours during the prior twenty- • Supervisory registered adequacy of performance. four (24) months as an HHA nurse’s verification of the under the supervision of a TME’s continued adequacy of • In-service: Successful completion of licensed nurse or other licensed performance. twelve (12) hours of board approved health professional. in-service training in pharmacology or • Twelve (12) hours of in-service medication administration. • Twelve (12) hours each year of training in pharmacology or in-service training/continuing medication administration. Please note: Non-compliance with education. (In-service/ continuing these regulatory requirements will result education will not be audited this in a fine and/or discipline against your first renewal period.) certification status. n COMPLIANCE AUDIT: Prior to the renewal period, STEP-BY-STEP ONLINE RENEWAL PROCESS FOR HHAs AND TMEs you may be selected for audit. To renew online: If selected, you will be asked to Step 1: Go to the HRLA website at www.hpla.doh.dc.gov. provide the following information: Step 2: Click on Online License Renewal. Step 3: Scroll down to bottom of page and log in: Enter your Social Security • Verification Form: Completed Number and Last Name (as it appears on your certificate). Step 4: Once you log on, the screen will display your address and other employment verification form personal information [Please update your email address and other signed by your employer, information, if needed]. supervising nurse or licensed Step 5: Establish a User ID and Password. Follow the step-by-step instructions. health professional, verifying Step 6: To pay renewal fee, enter the credit card information for your VISA or that you have worked at least MASTERCARD number. eight (8) hours within the last Step 7: After 24 hours you will be able to verify the renewal of your certification at www.hpla.doh.dc.gov/weblookup. twenty-four (24) months prior to certification renewal under the supervision of a nurse. Please note: Non-compliance with these regulatory requirements will Don’t have access to a computer? Please know that if you have internet access result in a fine and/or discipline on your cell phone you can access this site from your cell phone’s internet against your certification status. connection. e-mail: [email protected] • web: http://doh.dc.gov/bon 17  Re g u l a t i o n DC HOME HEALTH AIDE NOT PREPARED FOR PATIENT EMERGENCY The following is an email sent to the Health Regulation and Licensing Administration regarding a Home Health Aide who was not prepared to deal with a patient emergency: As the Fire Officer with DC Fire and Emergency Medical Services Department, I was called to the address of _____ Street, SE, Washington, DC today for a man with trouble breathing. I was met by a female named _____ who stated she was a Home Health Aide for the patient. When asked for pertinent documents (Care plan, medical history, medication regiment, current diagnosis, DNR, etc.) the caregiver acted lost and kept attempting to hand the phone to me to speak with “a nurse from my agency.” She did search in vain for several minutes handing many pieces of paper that did not relate. I did ask her who she worked for and was told _____ [HHA Agency], located at ____, Washington, DC. Ms. _____ was flustered and kept saying it was her first day as I reminded her that such records should be at the ready for emergencies whether in a facility or in the home care setting. I was able to find a POA [Power of Attorney] for the man’s daughter who advised he was under Hospice care with a DNR [Do Not Resuscitate Order] (Unable to locate contact numbers or paperwork). The daughter further advised that Hospice advised the “Agency” that [the client] should no longer be transported due to his end stage condition. There were several other facts that Ms. ____ was not aware of, but in all this agency and its care giver could not provide basic information for this terminal patient. In a later discussion, I reminded Ms. _____ that when she arrives at a location to give care, she is supposed to review a care plan and written orders to assist any patient with positive outcomes, exercise, meals and medication administration. With a very surprised look from her I asked her to produce her Board of Nursing License. Her License number is HHA[#####] expiring 10/30/17. I feel, although a very nice person, Ms. _____ and her Agency are not providing the adequate standard of care to the gentleman I have referred to. Furthermore, I feel their practices should be investigated as they are receiving government funds for administration of care. Response from Karen Skinner, the executive director of the Board of Nursing: Thank you for this referral. We appreciate your taking the time to make Dr. Nesbitt and me aware of this issue. Copied (on this email) are staff from our Intermediate Care Facilities Division, the division that regulates Home Health Agencies. It is of course of concern that the Home Health Aide was not aware of the patient’s care plan. We will be in touch with the agency as well as the aide. LESSONS LEARNED When a Home Health Aide is assigned, the Home Health Agency must: • Ensure that the aide knows the name and contact information of their Supervising Nurse (The nurse must always be available to the aide for a call.) • Ensure that the HHA knows the patient’s Plan of Care. The Home Health Aide must: • Make sure they have the contact information for their Supervising Nurse. • Know where the patient’s Plan of Care is located; it should include the medical history, medication regiment, current diagnosis, DNR, etc. Knowing this information will alert the aide to changes in behavior which may indicate the need to call the supervising nurse and/or 911. n 18 District of Columbia Nurse: Regulation • Education • Practice NAP NEWS! Nursing Assistive Personnel Q&A source of information to be used by health care facilities in DC. So, my fundamental nurseaides/ and click on “Search the Nurse Aide Registry” to verify their certification question is: Can the Pearson Vue website status. The DC CNA Abuse Registry can be be used as the source of truth for Nurse Aide found at https://doh.dc.gov/node/149282. VERIFICATION OF CNA certification currently? Are there any other CERTIFICATION plans to validate Nurse Aide licenses and CNA RENEWALS certifications through the DOH website? Q : I’m writing to clarify the verification of Nurse Aide certification. Currently, there does not appear to be a direct method A : Pearson Vue is the site for validating District of Columbia Certified Nursing Q : I work at Long-Term Care facility and we know that the date for renewal for CNAs has changed, so what is the renewal to verify these licenses on the District of Assistants (CNA). They certify DC CNAs process for them on-line or still by mail? Columbia Department of Health (DOH) under the authority of the Department of website. The DC website has a link that takes users to a third party (Pearson Vue) website. While it does contain the District Health. Once the CNA regulations pass, CNAs will continue to be certified by Pearson but will be under the authority A : The process has not changed. We are readjusting their expiration date so that they will all expire on the same as our of Columbia Department of Health logo, of the DC Board of Nursing. You can other licensees. Otherwise the process is we want to validate that this is an acceptable go to http://www.pearsonvue.com/dc/ the same. n MEDICAID FRAUD LAWSUIT BROUGHT AGAINST HOME HEALTH AIDE Attorney General Karl A. Racine has filed a False Claims Act lawsuit against Deborah Kale, a personal care aide, for allegedly committing Medicaid fraud. The suit alleges that Kale submitted a phony time sheet to Health Management Incorporated (Health Management), causing the company to bill the District’s Medicaid program for home health aide services that Kale did not perform. The lawsuit was brought under the District’s False Claims Act, which provides for a recovery of triple damages plus civil penalties if the District proves its allegations. In this case, the District lost $783.36 in taxpayer funds to the alleged fraud, and the suit requests damages of $2,350.08 and a civil penalty of up to $11,000. The Attorney General alleges that Kale fabricated a time sheet indicating she provided 94 hours of services to a Medicaid recipient, when, in fact, she was on a cruise in the Bahamas. The District’s Medicaid program reimburses personal care services provided by aides to Medicaid beneficiaries in their homes when the beneficiaries are disabled or have chronic or temporary conditions rendering them homebound. The Medicaid Program Integrity Division within the District’s Department of Health Care Finance (DHCF) provides oversight of the District’s Medicaid program. The principal function of the Program Integrity Division is to reduce and eliminate fraud, waste, and abuse in the Medicaid Program. This includes prevention, investigation, education, audits, recovery of improper payments, and cooperation with the District’s Medicaid Fraud Control Unit and other federal and local law enforcement agencies. Individuals or health care company employees who suspect fraud against the District’s Medicaid program can make an anonymous report online: www.dhcf.dc.gov/page/reporting-fraud-waste-and-abuse-01 or by calling: (877) 632-2873 “We will continue to aggressively pursue caregivers who steal from Medicaid,” said Attorney General Racine. HHA ALERT: Home Health Aides, please be aware that if you submit a timesheet for hours that you did not work, you too can be prosecuted for Medicaid fraud and, as well, you also risk losing your HHA certification. n e-mail: [email protected] • web: http://doh.dc.gov/bon 19  Education NCSBN NEWS RN/LPN SALARY REPORT 2016 Research examines SOP laws for authors, “Telestroke has evolved According to a survey conducted CNMs and their effect on health over the last decade and is now by Medscape, the average full-time outcomes. Researchers used the used extensively to care for acute RN earned $78,000 in 2015, and the variation in SOP laws governing stroke patients” and the statement average LPN earned $43,000. The CNM practice that has occurred “provides a structure against which average salaries for various Advanced over time to evaluate the effect of hospitals can measure the quality of Practice RNs were cited as: $176,000 these laws on the markets for CNMs their telestroke programs so patients for nurse anesthetists, $104,000 for and their services, and on related can be assured of getting the quality nurse midwives, $103,000 for nurse maternal and infant outcomes. they deserve.” practitioners and $95,000 for clinical Researchers focused on SOP laws nurse specialists. About half of RNs that apply to physician oversight The statement sets out standards (47 percent) are salaried employees, requirements and prescribing rules, and recommendations on how according to survey results. and examined the effects of SOP telestroke programs should NCSBN notes the following from laws in medically underserved areas. be measured for quality and the survey: “Average hourly wages Researchers found that restrictive outcomes. Specific standards were identical for full-time and SOP laws to CNM practice do described include: part-time/per diem RNs ($37 per not have a significant impact on hour) and similar for LPNs ($21 per maternal health behaviors or infant • Process measures, such as time hour for full-time and $23 per hour health outcomes. Instead, these to consultation and time to for part-time/per diem). Earnings laws “primarily serve as barriers treatment; increased with level of education. to practice and removing these There was an 11 percent increase in restrictions has the potential to • Information on where patients earnings among RNs going from an improve the efficiency of the health are transferred to and reasons associate degree in nursing (ADN) care system for delivery of infant for that decision; to a Bachelor of Science degree in care.” Additionally, researchers nursing (BSN). For RNs going from found that states that allow • Outcomes such as mortality, a BSN to a Master of Science degree CNMs to practice without SOP- clinical status, hemorrhage rate in nursing (MSN), the average based barriers have lower rates of and patient satisfaction; and salary increases by 9 percent and a induced labor and Cesarean section move from a MSN to a doctorate births. Researchers also found • Quality of communication. is associated with a five percent that regardless of SOP restrictions, increase.” CNMs work collaboratively with The authors stress that time is of (For more, go online at http:// physicians. the essence in treating acute stroke www.medscape.com/features/ patients, and telestroke systems slideshow/nurse-salary-report- TELEMEDICINE QUALITY must ensure that technology does 2016#page=1.) MEASURES AND OUTCOMES IN not introduce time delays that could STROKE reduce the probability of recovery HEALTH OUTCOME OF The American Heart Association/ after acute stroke therapy. CERTIFIED NURSE MIDWIFE American Stroke Association (CNM) SCOPE OF PRACTICE (SOP) recently released a scientific For more, go online at: http:// LAWS statement on quality measures and stroke.ahajournals.org/ A new working paper from outcomes for use of telemedicine in content/early/2016/11/03/ the National Bureau of Economic stroke. According to the statement’s STR.0000000000000114. n 20 District of Columbia Nurse: Regulation • Education • Practice  PROFESSIONAL NURSING SCHOOLS Catholic University School of Nursing Georgetown University School of Nursing & Health Studies Trinity Washington University School of Nursing and Health Dr. Patricia McMullen, Dean Dr. Edilma Yearwood, Chair, Professions Catholic University School of Nursing Department of Professional Nursing Dr. Denise Pope, Associate Dean 620 Michigan Avenue, N.E. Georgetown University 125 Michigan Avenue, N.E. Washington, DC 20017 3700 Reservoir Road N.W. Washington, D.C. 20017 email: [email protected] Washington, DC 20007 email: [email protected] PH: (202) 319-5400 email: [email protected] PH: (202) 884-9682 FAX: (202) 319-6485 PH: (202) 687-0754 FAX: (202) 884-9308 RN, APRN Programs RN, APRN Programs RN Program Only FULL APPROVAL FULL APPROVAL CONDITIONAL - RN PROGRAM George Washington University School of Nursing Howard University Division of Nursing University of the District of Columbia Community College Dr. Pamela Jeffries, Dean Dr. Tammi L. Damas, Associate Dean Ms. Susie Cato, Director The George Washington University School of Nursing 2400 6th St. N.W. Associate Degree Nursing Program 2030 M Street, NW Suite 300 Washington, DC 20059 801 North Capitol Street NE Room 812 Washington, District Of Columbia 20036 email: [email protected] Washington, DC 20002 email: [email protected] PH: (202) 806-7456 email: [email protected] PH: (202) 994-3484 FAX: (202) 806-5958 PH: (202) 274-5914 APRN Program Only RN, APRN Programs FAX: (202) 274-5952 FULL APPROVAL CONDITIONAL – RN PROGRAM RN Program Only FULL APPROVAL – APRN PROGRAM CONDITIONAL – RN PROGRAM PRACTICAL NURSE PROGRAMS St. Michael School of Allied Health Dr. Michael Adedokun, Director 1106 Bladensburg Road, N.E. Washington, DC 20002-2512 email: [email protected] PH: (202) 388-5500 FAX: (202) 388-9588 LPN Program CONDITIONAL – PN PROGRAM NURSING ASSISTANT AND HOME HEALTH AIDE TRAINING PROGRAMS Allied Health & Technology Institute (CNA/HHA) HealthWrite Training Center (CNA/HHA) Nursing Assistant Academy 2010 Rhode Island Avenue, NE 2nd Fl 2303 14th St NW, Suite 100 1418 Pennsylvania Avenue, SE Washington, DC 20018 Washington, DC 20009 Washington, DC 20003 email: [email protected] www.healthwrite.org www.nassistantacademy.com PH: (202) 526-3535 PH: (202) 349-3934 PH: (202) 748-5479 FAX: (202) 526-3939 BRIDGE COURSE - HHA FAX: (202) 748-5593 APPROVAL STATUS PENDING CONDITIONAL - HHA INITIAL APPROVAL - CNA APPROVAL - CNA Bethel Training Institute Opportunities Industrialization Center of 824 Upshur Street, NW Intellect Health Institute Washington DC (OIC DC) (HHA) Washington, DC 20011 3811 Minnesota Ave., NE 3016 Martin Luther King Jr. Avenue S.E email: [email protected] Washington, DC. 20019 Washington, DC 20032 PH: (202) 723-0755 www.intellect-health.com email: [email protected] CONDITIONAL APPROVAL – CNA & HHA PH: (202) 239-2666 PH: (202) 373-0330 Email: [email protected] (202) 373-0336 Captec Med Care APPROVAL STATUS PENDING CONDITIONAL - HHA 3925 Georgia Avenue, NW Washington, DC 20011 Immaculate School of Allied Health University of the District of Columbia-Community email: [email protected] 2512 24th Street NE College (CNA/HHA) PH: (202) 291-7744 Washington, DC 20018 Bertie Backus Campus Certificate Programs APPROVAL – CNA & HHA email: [email protected] 5171 South Dakota Avenue, NE PH: (202) 735-5925 Washington, DC 20017 Carlos Rosario International Public Charter School (CNA) INITIAL APPROVAL - HHA email: [email protected] 514 V Street, NE PH: (202) 274-6950 Washington, DC 20002 Innovative Institute (CNA/HHA) APPROVAL - CNA email: [email protected] 1805 Montana Avenue NE PH: (202) 797-4700 Washington, DC 20002 VMT Education Center (CNA/HHA) FAX: (202) 232-6442 email: [email protected] 901 First Street, NW APPROVAL - CNA PH: (202) 747-3453/ 202 747-3450 Washington, DC 20002 FAX: (202) 747-3481 email: [email protected] APPROVAL STATUS PENDING PH: (202) 282-3143 FAX: (202) 282-0012 BRIDGE COURSE - HHA APPROVAL - CNA CONDITIONAL - HHA e-mail: [email protected] • web: http://doh.dc.gov/bon 21  Nursing Practice New LGBTQ Cultural Competence By Nancy Kofie Dr. Sean Robinson Ken Pettigrew Bianca Palmisano Eric Ackridge REQUIREMENTS FORMS FOR NEW PATIENTS CAN BE A MEANS FOR Once the rules are promulgated, health care practitioners in the LEARNING ABOUT THE PERSON’S LIFE AND IDENTITY: District will be required to obtain three (3) continuing education credits per renewal cycle on the topic of LGBTQ [Lesbian, Gay, Do you think of yourself as: Bisexual, Transgender and Questioning] cultural competence. At __ Straight/Heterosexual an Open House event hosted in the John A. Wilson Building by __ Lesbian the DC Board of Chiropractic, a panel discussion on the basic __ Gay concepts defining the LGBTQ community was led by Dr. Sean __ Bisexual/Pansexual Robinson, Associate Professor, Higher Education & Student __ Queer __ Questioning Affairs at Morgan State University. The other panel participants __ Don’t know___________ were Bianca Palmisano, Ken Pettigrew and Eric Ackridge. __ Other: ________________________________ BASIC TERMINOLOGY What is your relationship status: The challenge to health care providers is to create __ Single a health care system that does not render LGBTQ __ Married patients “invisible”. The first step is grasping the basic __ Partnered/Long-Term Partnership concepts affecting all patients—gender and sex: __ Living Together __ Divorced/Separated Sex – Refers to the presence of specific anatomy. Also __ Widowed may be referred to as ‘Assigned Sex at Birth’. Gender Identity – What your internal sense tells you your gender is. What is your current gender identity? (check ALL that apply) Gender Expression – How you present your gender __ Male to society through clothing, mannerisms, etc. __ Female Sexual Orientation – __ Transgender Male/Trans Man/FTM Whom you are physically and emotionally attracted to. __ Transgender Female/Trans Woman/MTF Whom you have sex with. __ Gender Queer How you identify your sexuality. __ Additional Category (please specify): ______________________________________ Once a health care professional becomes familiar with What sex were you assigned at birth? (Check one) the concepts impacting LGBTQ identity, providers can use __ Male that knowledge to better serve LGBTQ people. Inclusion __ Female can begin with an intake form which recognizes the __ Decline to answer diversity of identities. Do your intake forms assume that your clients are not part of the LGBTQ community? Continued on page 24 22 District of Columbia Nurse: Regulation • Education • Practice Marshall FP ad to come  Nursing Practice Reach Continued from page 22 Recruit During the discussion, panelists noted considerations health care • Your questions about members of the household should be Retain providers should keep in mind inclusive. If you traditionally regarding LGBTQ patients: ask “What is your wife’s/ husband’s name?,” ask for 3 • LGBTQ persons have the name of the “husband, NURSE Volume 9 Number August 2012 COLU MB IA DISTR ICT OF historically been a wife or long-term partner.” d u c at i o n PR a c t i c e marginalized population. R e g u l at i o n e • If you would like to initiate • It is only recently that a discussion about identity SOC IAL MED IA & YOU R LICE NSE : homosexuality and or gender, make room for Are You On Faceboo k, Twi tter? gender identity issues “other” on the form—with have not been labelled space for the patient to explain INSIGHTS FOR ING ASSISTANTS (CNAs) psychological disorders. their situation. An open form CERTIFIED NURS gives the patient permission of the Government District of Columbia (See page 20) S I N g1 Mayor D OF NUR Vincent C. Gray, B IA BOAR h .R g oTv cI.C OF COLUM t hw e l aI. dSoT pD d : fw w bo .h bdlc i. gcv •i Owne oat i a a . dPo u p ll h@ eO -mf afi il c : h • 74% of LGBTQ individuals to talk about themselves Reaching over 37,000 Nurses in were subjected to bullying, and their experiences. Washington DC. harassment, or discrimination during the K-12 years. • One ice breaker question The Washington, D.C. on the intake form could Board of Nursing • LGBTQ persons may be isolated, as they are less be “Do you consider yourself to be a part of the JOURNAL likely to have the support LGBTQ community?” of family and community. to reserve advertising space, contact • If a patient indicates that they Dustin Doddridge at • LGBTQ persons have a higher are “trans,” ask them what [email protected] suicide rate and higher rate that designation means to 1-800-561-4686 ext. 106 of Sexually Transmitted Disease and homelessness. them. Different people may use this term in different ways. Our nursing journals reach over 2 million • Ask new patients about • If you are not sure which nurses, healthcare professionals possible use of alcohol/ pronoun to use, ask the and educators nationwide each quarter. recreational drugs. patient which they prefer. Arizona New Mexico Arkansas North Carolina • Ask if patients have a history • Be affirming—through your The District North Dakota using anti-HIV Pre-Exposure actions, the format of your of Columbia Ohio Prophylaxis (PrEP), hormones intake forms, and through the Florida Oregon Georgia or puberty blockers. pictures on your website. South Carolina Indiana South Dakota Kentucky StuNurse/Nationwide • Use inclusive language • Engage in outreach; obtain Mississippi Tennessee on intake forms. a vendor table at LBGTQ Montana Washington community events. Nebraska West Virginia Nevada Wyoming • If your intake interview is the same for all, consider • LGBTQ issues are human reframing what you are issues. LGBT patients have jobs ThinkNurse.com asking to ensure inclusivity. and families. n 24 District of Columbia Nurse: Regulation • Education • Practice  LGBTQ CULTURAL COMPETENCE CONTINUING EDUCATION REQUIREMENT Once rules are promulgated, health care professionals in the District of Columbia will be required to obtain LGBTQ cultural competency CE credits. The law has passed but the following conditions have to be met prior to implementation: 1. Rules must be promulgated to implement this law. 2. The DOH Director and the Executive Office of the Mayor will not approve rules that would implement the LGBTQ continuing education (CE) requirement in the middle of a CE cycle. The rules will only apply to the next CE cycle after the rules are effective. 3. For most professions, each board needs to recommend for each occupation whether the LGBTQ CE requirement is included in existing CE hour requirements or in addition to existing CE hour requirements. 4. For a health occupation without existing CE requirements, the rules must establish the CE program for at least the LGBTQ CE requirement based on the relevant board’s recommendation. More CEs can be established. 5. Rules need to specify subspecialties considered to be exempt under the statutory provision for a rule waiver as they “do not see patients in a clinical setting.” (For example, radiologists, pathologists, administrative doctors.) See DC Law 21-95, LGBTQ Cultural Competency Continuing Education Amendment Act of 2016 at: http://lims.dccouncil.us/Download/33671/B21-0168-SignedAct.pdf) St Michael 1/2 ad to come e-mail: [email protected] • web: http://doh.dc.gov/bon 25  Nursing Practice KudOs! Black Nurse of the Year: Cynthia E. Edwards, BSN, RN The Black Nurses Association of Cynthia’s professional career Greater Washington, DC Area, Inc., began as a psychiatric nurse at the selected Cynthia Edwards, BSN, RN, Washington Hospital Center. She as the 2017 Black Nurse of the Year. remained at Washington Hospital Ms. Edwards is a Board Certified Center for over 15 years and was Psychiatric Nurse for the District of privileged to have Ada Cain, another Columbia Department of Behavioral charter member of the Black Nurses Health. Association, as her supervisor. After Her nursing education reflects attending a National Black Nurses a continuous climb up the Conference in Miami, Florida, Cynthia E. Edwards, BSN, RN professional ladder. She began Cynthia was inspired to collaborate her nursing education in a two- with Ada and Black nurses at other year nursing program at Guilford DC hospitals to establish a DC Clinic (Spring Road NW). She also Technical Institute in Greensboro, chapter. Cynthia was elected as the worked at the Capitol Hill Hospital NC. There, she was advised to seek founding president of the Black and Riverside Hospital as a nursing further education by transferring Nurses Association of the Greater supervisor. to the nursing program at North Washington DC Area. In 1977, she Cynthia was honored as one of Carolina A&T State University, was elected as the Black Nurses “100 Extraordinary Nurses” by the which was also in Greensboro. Association of Greater Washington Gamma Beta chapter of Sigma Theta While attending A&T, she had the Area’s first member to serve on the Tau at Howard University. She is opportunity to complete a semester Board of Directors of the National a member of the National Black at Columbia University in New Black Nurses Association, and served Nurses Association and the District York. Her credits were accepted at two consecutive terms. of Columbia Nurses Association A&T, and she subsequently earned In addition, Cynthia’s past (DCNA). Currently, she serves on a Bachelor of Science in Nursing. professional experience includes the DCNA legislative committee. In addition, her time in New York a more than 10-year tenure, as a In addition, her membership provided an introduction to a program manager in the District of at the First Baptist Church of chapter of the National Black Nurses Columbia Commission on Mental Glenarden Maryland affords her the Association. Health at the Geriatric Outpatient opportunity to minister with the “Sister for your Journey Ministry.” A native North Carolinian, Congratulations to Lori Yerrell-Garrett, RN, MSN, PMHCNS-BC, who Cynthia is the mother of three has been appointed to serve as a member of the Committee on Impaired adult children. In her spare Nurses (COIN). Ms. Yerrell-Garrett currently serves as Deputy Chief Nurse Executive at Saint Elizabeths Hospital and is a DNP Candidate in time, she enjoys travel, reading the College of Health Professions at Coppin State University College of and spending time with her Graduate Nursing. wonderful grandchildren and great- grandchildren. n 26 District of Columbia Nurse: Regulation • Education • Practice  We are hiring nurses! Join our team! Fast Paced, High Energy, Creative, Passionate and Focused Fast Facts about AmeriHealth Caritas DC · Located in Downtown DC · Office is Metro Accessible · Serve over 100,000 enrollees · Clinical and non-clinical roles available · Opportunities for community-based work Openings in Utilization Management, Integrated Healthcare Management, and Maternal Health · Competitive benefits and salary · Team focused environment We help our members get · Mission driven organization care, stay well and build healthy communities. Learn more about joining our dynamic team at www.amerihealthcaritas.com/careers e-mail: [email protected] • web: http://doh.dc.gov/bon 27  Nursing Practice DOCUMENTATION IMPORTANT ELEMENT OF GOOD DOCUMENTATION IS CLEAR constantly” not “patient was depressed.” NURSING PRACTICE THINKING MADE VISIBLE AND A • If an order is questioned, report that Documentation is an REFLECTION OF INTEGRITY clarification was sought. important element of nursing • Document with accuracy, clarity, legibility • Record each phone call to a physician, practice. The majority of and completeness including time, message and response. licensees called upon to appear • Document objectively • Chart patient’s refusal if they refuse a before the Board of Nursing • Place the patient’s name on the top of treatment. have been contacted by the each page • Never document for anyone else. Board due to documentation • Document what you did and why you did • Learn your institution’s documentation errors, lack of documentation it guidelines. Know your facility’s policies or poor documentation. • Date and sign each note and procedures. Documentation must be • Document what you see, hear and smell • Read your Nurse Practice Act and factual, accurate, legible, • Document in real time Regulations.Keep abreast of changes. and reflect the nursing • Correct mistakes correctly process. It should reflect your • Documentation should be readily COMMON DOCUMENTATION ERRORS assessment, intervention accessible and systematically organized • Not documenting the and patient response— • Documentation should be factual completion of all or part of a assessment, diagnosis, Physician’s Order. planning, implementation, and USE PROPER ABBREVIATIONS AND • Failure to document in evaluation. DATE/TIME the patient’s Medication Good documentation Use proper medical abbreviations and Administration Record. protects you and your facility. not your own [made up] abbreviation. That • Failure to document the Poor documentation can is incorrect! administering and/or wasting have a damaging impact on Accurately date and time-stamp the entry. of medications. your licensure and a financial Fill out all required sections accurately and • Willfully writing false notes impact on your employer. Good completely. Don’t take short cuts. into a patient’s medical file. documentation also will help • Submitting false statements to you remember what occurred. DOS & DON’TS collect fees for which services If you or your facility is sued, • Documentation should be clear enough are not provided. in court you may be asked to so it will be understood ten years from testify about a patient you have now. HEALTH OCCUPATIONS REVISION not seen or thought about in • Document after an action has been ACT VIOLATIONS RELATED TO POOR three years. completed—not before—because you DOCUMENTATION Good documentation also may be interrupted and may not actually • Willfully makes or files a false report helps to ensure continuity complete an intended task. or record in the practice of a health of care for that patient when • Document in ink. Write on every line. occupation. colleagues read what you have Do not leave blank spaces. • Willfully fails to file or record any medical written. • Rewriting? Strike out old text with a single report as required by law, impedes or line; do not completely black out old obstructs the filing or recording of the HEALTH PROFESSIONALS HOLD wording. And if you make an error do not report, or induces another to fail to file or HANDS destroy the note a start another note. record the report. Nursing staff, physicians, and all • Do not erase, do not use liquid correction • Willfully makes a misrepresentation in other staff members who write in a fluid, or cross out entries using more than treatment. patient’s documentation are all linked drawing a single line through error. • Submits false statements to collect fees for together. When you document in a • Be mindful that altering a record is a which services are not provided or submits record, you are holding hands with criminal offense. statements to collect fees for services which everybody else who writes in that • Use universal abbreviations, not your are not medically necessary. record. The documentation must be own made-up abbreviations. • Prescribes, dispenses, or administers drugs consistent. The patient’s progress will • Place patient’s name and identification when not authorized to do so. be monitored based upon changes in number on every page of the chart. • Fails to conform to standards of acceptable symptoms noted in the patient record. • Do not use vague language, such as: conduct and prevailing practice within a “Patient had a good day.” health profession. • Strive to be objective. Do not chart your • Demonstrates a willful or careless opinion. Write “patient tearful and crying disregard for the health, welfare, or safety 28 District of Columbia Nurse: Regulation • Education • Practice  of a patient, regardless of whether the • Documentation can reveal Diversion: BOARD INVESTIGATORS patient sustains actual injury as a result. When a nurse signs-out narcotics, A board investigator’s role is to • Failure to document the patient’s but then there is no documentation determine the truth: What really medication administration record to show that it was ever given to the happen? When did it happen? Why • Failure to document the administering or residents, this is ?????? did it happen? An investigation wasting of medication can substantiate a complaint or NURSING ASSISTIVE PERSONNEL determine that the accusation against DOCUMENTATION AND TIP: As the RN, you are expected a licensee is completely unfounded. CONSEQUENCES: THE CHART TELLS to co-sign documentation written by “Documentation is key in establishing THE STORY nursing assistive personnel (NAP). You that a violation occurred, and proper • Proof of Best Practices: In one are responsible for that documentation. documentation can serve as evidence case, a family was going to sue for If you have concerns about what is that a violation did not occur. Proper malpractice when a young man died written, you can put a disclaimer on the documentation can shield a licensee after going into respiratory distress chart, or you can raise the issue with your from disciplinary action from the Board after what should have been a routine supervisor. You can also ask the NAP to of Nursing. appendectomy. After reviewing the rewrite it. medical record, however the family’s TOOLS AGAINST MALPRACTICE attorney advised the family to drop DRUG DIVERSION • Documentation, the case because the documentation If it is determined that a nurse is Communication and Reporting maintained by the hospital made it of immediate danger to the safety of • Risk Management or Quality perfectly clear that everything that patients — due to the amount of and Assurance could have been done for this patient schedule of drugs diverted — the nurse • Malpractice Insurance to had been done, leaving no basis for a may be issued a Notice of Summary protect yourself claim of negligence or malpractice. Suspension (issued when it ha been • Remember: You are a nurse 24 • Proof that you Communicated: In determined that the nurses’s “conduct hours a day, wherever you go, another case, a nurse assessed positive presents an imminent danger to the but your facility’s Homans Sign and told her supervisor health and safety of the public”. “The • malpractice insurance may not and the physician about the patient’s nurse is Summarily Suspended upon extend beyond the grounds of positive Homan’s—but the nurse never personal service of a Summarily your facility. wrote the words “Positive Homan’s” Suspended order specifying that in the documentation. Later, during they cannot practice at all and have MYTH OR FACT: “INSURANCE a malpractice trial, the supervisor and 72 hours to request a hearing. The CAUSES LAWSUITS.” physician both testified that the nurse employer will be notified too. This Some people believe that having had never mentioned positive Homan’s. individual cannot work.” Then the malpractice coverage attracts lawsuits. • Respond Appropriately: In one matter goes before an administration However, if you have car insurance, case, a resident, age 40, had a fecal law judge to determine whether or not do you believe that causes automobile impaction. He had a gunshot wound the order is withheld. The nurse is also accidents? As long as you do not go and not functional from the waist referred to the Board of Nursing for around telling everyone you meet about down. On his ADL [activities of daily possible discipline and possible referral your coverage, no one will know you living] sheets, under bowl function, to COIN. And because they are part of have it. there were notations of ‘C, C, C, C, the public record, summary actions are C, C’ [Continent]. There was no posted online. THE BASICS further evidence that the resident was (See COIN on page 12) • Put the resident/patient’s name at asked about their bowel functioning. the top of each piece of paper. Consequently, the young man ended HOW DOES THE BOARD LEARN OF • Document the date and time. up with a colostomy. POSSIBLE VIOLATIONS? • Put the proper gender of your • Fully Inform other Practitioners: • The employer contacts the Board resident/patient. There was a resident in long-term care • The patient files a complaint • Be sure you have written all who hit, kick, spit, and threw a chair, • A colleague reports an incident to the words you intend to. Write but because it was not consistently the Board “admitted with right leg fracture” not documented for months, the • DOH health care facility survey “admitted with right leg.” psychiatrist looked at the records and report • Record the date and time of each then reduced the patient’s medication • Boards of Nursing in other entry; a big gap is a big concern to based on the record. jurisdictions. juries: ‘What happened?’ e-mail: [email protected] • web: http://doh.dc.gov/bon 29 DISCIPLINARY ACTION The following is list of licensure actions taken between November 1, 2016 to March 31, 2017 The full citation for disciplinary actions can be found on the DC Department of Health website at https://app.hpla.doh.dc.gov. Each individual nurse and healthcare facilities should report any actual or suspected violations of the Nurse Practice Act. To submit a report, use the online complaint form at https://doh.dc.gov/nod or contact Compliance and Discipline at (202) 724-8691 or mail to D.C Board of Nursing, Department of Health Regulation and Licensing 899 North Capitol St., NE Washington, DC 20002. Date of Licensee Action Violation Action Agwi, 11/2/16 Suspension Unprofessional conduct - by demonstrating a willful or careless Blessing disregard for the health, welfare or safety of a patient. HHA4610 Henry, Anne 11/2/16 Suspension Dishonorable Conduct - Reciprocal Action RN1024474 Intentional falsification of material facts in a material document connected with the practice of nursing. Walters, 11/3/16 Probation Unprofessional conduct – worked prior to Karen obtaining licensure. RN1039415 Igwacho, 11/4/16 Revoked Dishonorable Conduct – Commits fraud or make a false claim in Bernice, connection with the practice of nursing or relating to Medicaid, RN037986 Medicare, or insurance. HHA4973 Kindvall, Carol 11/23/16 Suspension Dishonorable Conduct - Reciprocal Action RN1007764 Violation of Controlled Substance Act - failure to conform to the standards of acceptable and prevailing practice of a profession. Ogbuchi, Peter 12/7/16 Suspension Dishonorable Conduct – Commits fraud or make a false claim in HHA1741 connection with the practice of nursing or relating to Medicaid, Medicare, or insurance. Acquah, 12/20/16 Revocation Unprofessional Conduct – Cecelia convicted of a crime of moral turpitude. HHA3357 Pendarvis, 12/21/16 Application Dishonorable Conduct – Kanie, HHA Denied convicted of a crime of moral turpitude. Atabe, Elvis 2/16/17 Suspension Dishonorable Conduct – Commits fraud or make a false claim in HHA9359 connection with the practice of nursing or relating to Medicaid, Medicare, or insurance. Achoh, Daniel 12/16/16 Suspension Dishonorable Conduct – Commits fraud or make a false claim in HHA10109 connection with the practice of nursing or relating to Medicaid, Medicare, or insurance. Awasum, 12/14/16 Denial of Dishonorable Conduct - Jeannette Reinstatement Intentional falsification of material facts in a material document RN1015095 connected with the practice of nursing. Britt, Paula 2/1/2017 Revocation Violation of Controlled Substance Act RN1028382 Unprofessional Conduct – failure to conform to the standards of acceptable and prevailing practice of a profession. Dishonorable conduct. Kelbore, 3/1/2017 Suspension Unprofessional conduct - committing any act which endangers Bereket, patient safety and welfare CNA807322 30 District of Columbia Nurse: Regulation • Education • Practice e-mail: [email protected] • web: http://doh.dc.gov/bon 31 DC Board of Nursing 899 North Capitol Street NE Presorted Standard First Floor U.S. Postage Paid Little Rock, AR Washington, DC 20002 Permit No. 1884 Congratulations to Washington, D.C.’s first AMSN PRISM Award®-Winning Unit! 2017-2020 Recipient MedStar Georgetown University Hospital is MedStar Georgetown’s Magnet® Nurses have proud to recognize the Nurses of our C6-2 been distinguished by their proven commitment to Neuroscience Medical-Surgical Unit for exceptional nursing practice, leadership, and outcomes. achieving the prestigious AMSN PRISM Award®. Our C6-2 team is now among an elite group of Our 19-bed Neuroscience Medical-Surgical Unit is one only 22 medical-surgical units across the country of MGUH’s three inpatient Neurological/Neurosurgical to have received this award, the first of its kind. Units which are part of our nationally renowned Neurosciences Center of Excellence. For more information on how to join this award-winning team, visit www.medstargeorgetown.jobs/nursing EOE