Missouri Professional Licensing Attorney Discusses Ethical Complaints Against Nurses

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Missouri’s legislature enacted the Nurse Practice Act (“the Act”) designed to govern the practice of nursing in Missouri. The Act entrusts licensing and discipline of nurses to the Missouri State Board of Nursing (“the Board”).  The Missouri Legislature gave the Board rule-making authority, which authorizes the Board to pass regulations for the profession. Consequently, the Board issued regulations establishing the ethical responsibilities and minimum practice requirements for nurses. Additionally, the regulations establish the complaint procedure for alleged ethical violations. The regulations also establish the minimum educational, character, and ethical obligations for both registered nurses and licensed practical nurses. Missouri professional licensing attorney Danielle Sangerng understands that nurses are vital components of our health care system and a responsible for delivering a high standard of care to their patients.

The regulations issued by the Board prescribe the proper procedure for filing a complaint against a nurse for an ethical violation.  The regulations permit only complaints against nurses to be filed if there is evidence to investigate misconduct. Individuals who learn of or witness unethical behavior committed by a nurse are encouraged to notify the nurse and the administration of the medical facility as soon as possible to allow the facility to rectify the situation and immediately correct the nurse’s behavior.  Reporting unethical behavior to the facility also serves as an alternate dispute resolution process which has the potential to informally discipline the nurse while serving to correct the offending behaviors.

The Board received complaints filed against a nurse. The regulations establish a clear and concise procedure to investigate the allegations.  The Board has a gatekeeping obligation to screen out complaints which fail to allege a violation of the Act and also provide sufficient information to commence an investigation.  Anyone may file a complaint with the Board alleging misconduct.  The complaint must be in writing and may be on a form prescribed by the Board. The complaint and any information gathered as a result of the investigation is not a public record. The Board must notify the complainant in writing of receipt of the complaint, and the Board must also notify the complainant if the Board dismisses the complaint or, if not dismissed, the disposition of the complaint.  If the Board finds sufficient information to warrant a disciplinary action, then the Board will file a formal complaint with the Missouri Administrative Hearings Commission.

The regulations impose a duty upon certain health care organizations to report unethical behavior to the Board.  Hospitals, surgical centers, and nurse staffing agencies are mandatory reporters to the Board. Those agencies must report any disciplinary action taken by these agencies against a nurse. The agencies must also report any voluntary resignation by the nurse in the face of discipline or any reports of misconduct pending before the health care facility.  In this context, disciplinary action is any final action taken by the board of the listed agencies to discipline, reprimand, or restrict the practice of the nurse in a meaningful way.  However, disciplinary actions will be considered by the Board only if the actions complained of are also violations of the ethical rules and would warrant disciplinary action by the Board. The complaint in filed by a mandatory reporting agency must be filed within 15 days of the date of the disciplinary action.  Also, the complaint must be in writing and include specific facts which set forth the allegations.   Notwithstanding, if the nurse submits to an employee assistance program in an effort to treat a drug or alcohol addiction, then the agency should not report the nurse. However, the agency must report the nurse if the nurse violates the employee assistance program.

Nurses Need Help Too

Missouri Professional Licensing Attorney Danielle Sanger prides herself on zealously representing nurses, and other professional licensees, who face professional discipline.  Call Attorney Sanger today at 785-979-4353 to schedule your free consultation.

Kansas And Missouri Professional Licensing Attorney Discusses Ethical Teletherapy Practice

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Use of emerging technologies is increasing in many aspects of healthcare. Teletherapy has grown significantly in health care professions such as psychology and other disciplines such as speech therapy.  Teletherapy as a recognized tool for treating patients has become a widely accepted practice. Teletherapy helps deliver treatment to people who have difficulty ambulating, or have to commute long distances like people who reside in rural areas, with greater ease and frequency. Accordingly, ethical obligations such as protecting patient-therapist confidentiality and informed consent are of paramount concern to practitioners utilizing the latest technological advances.  Kansas and Missouri professional licensing attorney Danielle Sanger cautions healthcare professionals who use teletherapy as a component of their practice to maintain the highest levels of data security as well as obtaining the informed consent of the patient to preserve patient-therapist confidentiality and trust.

The American Psychological Association (“APA”) mandates that therapists strictly maintain patient-therapist confidentiality.  Therapists must take every reasonable precaution to guard against disclosure of confidential patient communications. Therapists are obligated not to disclose patient confidences and are further obligated to protect patient data, such as notes, reports, and the like, from disclosure as well. Additionally, the APA imposes an obligation on therapists to discuss the limits of confidentiality. In the context of teletherapy, the therapist must discuss the risks of loss of privacy and limits of confidentiality when using teletherapy as a means to deliver patient services.

Therapists must understand the technology before treating a patient remotely with teletherapy.  HIPPA rules also require therapists to protect confidential client information. The APA mandates that psychologists become knowledgeable about and competent in the technologies used in teletherapy. Treatment providers have to make certain that their patients know about the potential for data or security breach and the potential, if a breach occurs, for loss of confidentiality. Practitioners should consider using all of the security advances available to them such as encryption, use of firewalls, backup systems, password protection of computers and computer files, updated virus protection, as well as reputable third-party vendors who provide data security. Guarding against disclosure also means protecting the records when they are destroyed.  Practitioners must be aware of the proper means to destroy electronic data to prevent unwanted disclosure.

The threat of a data breach is real. Stories are legion about reputable firms, businesses, and government agencies getting hacked. In other words, internet security is illusory, and 100% internet safety cannot be guaranteed. The APA requires therapists to take reasonable steps to ensure confidentiality.  Reasonableness requires the licensee to become competent in the use of the technology and the means employed to secure it.  By way of example, a reasonable means to protect data is to update security software to the latest version and take other precautions that are currently in practice. Also, therapists must inform their patients about any potential data breaches.

Therapists in both Kansas and Missouri use teletherapy are a component of their practice. In theory, therapists can practice out of state because of internet technology. Practitioners must approach this prospect cautiously. Failure to adhere to each state’s out-of-state licensing requirements can result in the practitioner committing a misdemeanor.  Therefore, practitioners must be very careful when delivering services to clients who receive the services in another state.  The better practice for the psychologist and other therapists is to be licensed in the state in which they practice regularly and the state in which the patient receives their services.

For More Information

Kansas and Missouri Professional Licensing Attorney Danielle Sanger has vast experience representing psychologists and other therapeutic professionals facing licensing discipline. Attorney Sanger prides herself on zealously representing professional licensees against disciplinary action. Call Attorney Sanger today at 785-979-4353 to schedule a free consultation.

Kansas And Missouri Professional Licensing Attorney Warns Healthcare Practitioners of Potential Disciplinary Pitfalls

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Many healthcare professionals have formed the opinion that childhood vaccinations are detrimental to children. The debate has raged for some time now. For one California pediatrician who not only ascribes to the belief that children should not be vaccinated but is a vocal advocate for eliminating the practice, the specter of disciplinary action is quite real. The L.A. Times recently reported that Dr. Robert Sears could face disciplinary action from the Medical Board of California for his decision to discontinue vaccinating a school-aged boy.  The Board filed the complaint against Dr. Sears on September 2, 2016.   The case has the potential to set a precedent for other medical licensing authorities across the United States.  Kansas and Missouri professional licensing attorney Danielle Sanger zealously advocates for healthcare providers who face disciplinary action.

According to the L.A. Times article, “Dr. Sears is one of the leading voice in the anti-vaccination world.”  Many parents who do not want their children to be immunized go to Dr. Sears for advice. Dr. Sears faces disciplinary action for writing a medical note on behalf of a two-year-old boy who was entering daycare. The note specifically stated that the boy should not have any additional vaccinations while he is of school age.  Dr. Sears now faces discipline for that decision.

Consequently, the Medical Board of California filed an accusation seeking professional discipline against Dr. Sears. In its accusation, the Medical Board of California alleges that Dr. Sears committed gross negligence, repeated negligent acts, unprofessional conduct, and insufficient record keeping when writing the note for the boy without previously examining the child. The Board alleges that the doctor wrote the note for the child after only receiving an oral history about prior vaccinations and anecdotal information from the child’s mother concerning the child’s reaction to his previous vaccinations.  Additionally, the child’s mother sought treatment for her child regarding head trauma and a cold. Dr. Sears merely indicated in his records that the child had a mark on his head and treated the child’s cold with garlic without further testing.

According to the Medical Board of California, Dr. Sears actions require discipline.  The Medical Board of California seeks suspension or revocation of Dr. Sears’ license or, in the alternative, requests that Dr. Sears’ license be subject to probation. The Medical Board of California also requested that Dr. Sears no longer have authority to supervise subordinate healthcare providers. The Board alleges that Dr. Sears’ failure to fully examine the child before writing the note excusing the boy from further vaccination requirements was grossly negligent. The Board alleges that the standard of care in the profession obligates a physician to examine the child fully for possible adverse reactions to vaccinations. Additionally, the standard of care in the professional demands that a physician obtains a full medical history of the nature of the previous vaccinations as well as a detailed description of the physical reaction the child suffered.  More significantly, the failure to obtain a full medical history prevented Dr. Sears from having all of the critical information necessary to make an informed opinion regarding the decision to order no further vaccinations. The Board argued that the doctor’s failure to adhere to the standard of care in the profession potentially endangered the child and his mother from exposure to preventable communicable diseases.

While many applaud the California Medical Board’s decision to pursue disciplinary action against Dr. Sears, others fear that the pursuit could result in a “witch hunt” for other anti-vaccination doctors in the U.S.  Many criticize the decision as interfering with a physician’s ability to treat their patients properly.

Experienced Advocate For Healthcare Professionals

Missouri Professional Licensing Attorney Danielle Sanger vigorously defends healthcare professionals, as well as other professional licensees, against professional discipline.  Call Attorney Sanger today at 785-979-4353 for a free consultation and learn how Attorney Sanger’s experience will make the difference for you.

Missouri and Kansas Professional Licensing Attorney Discusses Substance Abuse Counselor Ethics In Missouri

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With opiate addiction rates rising across the country, licensed addiction counselors are in high demand.  In Missouri, addiction counselors must obtain their credentials to practice from Missouri’s Credentialing Board (“the Board”).  The Board promulgated a set of ethical rules and responsibilities by which an addiction counselor must abide to remain credentialed.  The Board possesses the authority to investigate and sanction a credentialed counselor. Consequently, addiction counselors must familiarize themselves with the ethical rules and understand that they bear the responsibility for doing so.  Missouri professional licensing attorney Danielle Sanger maintains her law practice by vigorously defending professional licensees facing professional discipline.

The rules by which addiction counselors must conduct themselves are substantially similar to the ethical rules governing other healthcare professions.  Addiction counselors owe a duty to their clients to inform them of the course of counseling as well as the consequences of refusing the course of treatment. Clients, of course, are free to refuse any course of treatment. However, aftercare is vital to the success of initial counseling. Therefore, addiction counselors are ethically obligated to warn of the consequences of refusing aftercare.  Furthermore, addiction counselors must inform their clients of the counselor’s obligation to maintain confidentiality and the boundaries of that duty.

Addiction counselors are responsible for maintaining appropriate professional relationships with their clients. Counselors must take pains to ensure that no harm befalls their clients.  Maintaining a strictly professional relationship with clients, while treating them with dignity and respect, permits counselors to adhere to the lofty standards required of addiction counselors.  Treating clients professionally also means referring clients to other professionals when the situation requires consistent with the needs of the client.  The counselor must avoid dual relationships as well.  The addiction counselor must refer the client to another professional if the possibility of a dual relationship arises. A dual relationship is one in which the counselor is asked to provide counseling to the client, but the client is a family member, friend, financial or other close relationship.  Similarly, the ethical rules prohibit addiction counselors from entering into an intimate relationship with a client within two years after the counselor-client relationship ends.

Addiction counselors must take every precaution against disclosing confidential client information.  A counselor not only must guard against disclosure but also be aware of foreseeable situations which could lead to the disclosure of private client information.  The counselor is vicariously responsible for their subordinates’ actions when protecting clients’ private information.  In conjunction with guarding clients’ privacy right, an addiction counselor must preserve the confidentiality of any records generated by counseling.  A counselor should only release records to competent clients with the caveat that the records should not contain any information detrimental or embarrassing to the client.

Addiction counselors have an affirmative duty to learn about the diversity of their clientele. The addiction counselor has an affirmative duty to learn about their clients’ cultural background as well as learning how the counselor’s cultural background may impact the manner in which the counselor delivers their services.

Addiction counselors have a duty to do no harm to their clients. Doing no harm means refusing to counsel clients when the counselor because of personal incapacity poses a risk of doing harm to clients or others. Addiction counselors need to be role models for their clients and their community. Consequently, addiction counselors have the responsibility to obey all criminal laws and follow all ethical rules.

Who To Call For Help

Kansas Professional Licensing Attorney Danielle Sanger zealously represents all professional -licensees including addiction counselors facing discipline. Count on the experience of Attorney Sanger to vigorously defend your livelihood. Call Attorney Danielle Sanger at 785-979-4353 to schedule a free consultation today.